Der Nervenarzt
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The effects of expulsion from German territories following World War Two have not been studied systematically, and little is known about long-term effects of this potentially traumatic experience. Via mail, 600 refugees from former German territories due to World War Two were asked to complete questionnaires about biographic data, somatic and psychic health (SCL-90-R questionnaire), and specific aspects related to traumatic experiences (post-traumatic stress disorder questionnaire). Of those contacted, 25% participated in the investigation. ⋯ Analysis of the SCL-90-R questionnaire showed higher scores for former refugees in somatic and psychic complaints than the control group. We show that expulsion following war may lead to symptoms of post-traumatic stress disorder and somatic and psychic complaints after more than 50 years. Our investigation supports the necessity of adequate care for subjects expelled from their home countries and the psychologically traumatised.
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Progress in neuroscience leads not only to novel therapeutic opportunities but also raises several ethical problems. These problems are often subsumed under the term "neuroethics," of which the definition and purpose often remain unclear. ⋯ Due to distinct categories and frames of reference, these philosophical-ethical terms cannot be limited only to the brain; the development of systematic relations is suggested. This accounts for the "special ethical position of the brain." It is concluded that only this sense can neuroethics account for the ethical complexity in neuropsychiatric disorders.
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Review Case Reports
[Management and causes of pneumocephalus. Case report and review of the literature].
Pneumocephalus is commonly seen after head and facial trauma, tumors of the skull base, after neurosurgery or otorhinolaryngology, and rarely spontaneously. Venous air embolism can result from right-to-left shunting or pneumocephalus. ⋯ Treatment was either revision of the skull base with craniotomy or conservative therapy of the brain edema. Based on these case reports and the medical literature on pneumocephalus, we review the causes and treatment of this rare condition.
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Case Reports
[Interventional endovascular therapy (stenting) for residual stenosis after lysis of the basilar artery].
Despite the introduction of local thrombolytic therapy, there is still a very high mortality rate in basilar thrombosis. We report three cases of successful intra-arterial thrombolysis of acute basilar artery occlusion and consecutive interventional endovascular therapy. ⋯ The clinical outcomes were excellent. We discuss early consecutive stenting as a possible therapeutic option in cases of residual stenosis after successful intra-arterial lysis of basilar artery occlusion.
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Psychiatry and penology are responsible together for adequate therapy of mentally ill and disordered criminals. The increased security demands of current criminal policy on the penal and forensic hospital treatment have to be moderately counteracted. The considerable increase in deculpation according to Section 21 of the German Penal Code (StGB) during the past 30 years should be balanced by more limited application, especially regarding antisocial personality disorder, borderline personality disorder, and sexual identity disorder (paraphilia).