Southern medical journal
-
Southern medical journal · Apr 1985
Case ReportsPatient-physician communication and interaction: a unifying approach to the difficult patient.
Many difficult patients encountered by the primary care physician may be understood in terms of severe unmet dependency needs. These patients often evoke negative feelings on the part of physicians. A mutual participation approach to the patient-physician relationship is a means of providing effective care for these patients, at the same time preventing frustration and burnout in the physician by preserving his energies.
-
Southern medical journal · Apr 1985
Intracranial complications of ear disease in a pediatric population with special emphasis on subdural effusion and empyema.
Between the years 1963 to 1982, 84 consecutive cases of intracranial complications of ear disease in pediatric patients were diagnosed and treated at the North Carolina Baptist Hospital. This group consisted of 65 patients with otitic meningitis, four with otitic brain abscess, four with otitic hydrocephalus, three with lateral sinus thrombosis, three with otitic subdural empyemas, and five with an otitic subdural effusion of fluid. The advent of antibiotics has drastically altered the natural history of middle ear infections. We present these 84 cases to review diagnostic problems and therapeutic options, and to offer a plea for continued awareness of the middle ear as a potential source of central nervous system complications.