Articles: patients.
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Introduction Spinal epidural abscess is a rare cause of neurological disability, which is frequently, preceded by local spinal pain. There are only a few case series in the literature and the prognosis for this disease has not improved significantly over the past 50 years. Patients and methods Seven patients were treated neurosurgically with laminectomy and abscess drainage for spinal epidural abscesses from 1991 to 1994. ⋯ Elevated blood sedimentation rates in conjunction with local pain of the vertebral column should direct attention to the possibility of an epidural abscess. Magnetic resonance imaging is the radiological technique of choice for establishment of the diagnosis. Conventional X-rays are of no value for early diagnosis because neurological signs and symptoms precede bony changes of the vertebrae.
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Pain therapy with epidural or intrathecal catheters is an invasive method. These techniques have specific indications in both acute and chronic pain therapy. However, complications can occur. ⋯ Monitoring: During treatment with spinal catheters, adequate monitoring increases safety for the patients. Efficacy of the injections, puncture site and the neurological status should be documented daily. Neurological deficits must be diagnosed without losing time and adequate therapy must be initiated.
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The shadow of the father plays an important role in a son's ability to live a creatively meaningful life. The mythological basis for the father's shadow is found in the myth of Cronos and his son Zeus. ⋯ The conclusions reached regarding the importance of the father's shadow are based on research conducted with an ongoing men's group. An early underground phallus dream of Jung is examined, along with the creative work of a patient, both offering evidence of the importance of the body-bond with the father for a son's creative development.
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To describe how medical residents discuss do-not-resuscitate (DNR) orders with patients. ⋯ Medical ethicists, professional societies, and the public recommend more frequent discussions about DNR orders. Even when housestaff discuss resuscitation with patients, they may not be accomplishing the goal of increasing patient autonomy. Research and education must focus on improving the quality, as well as the quantity, of these discussions.
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Chronic pain requires chronic treatment. Dihydrocodeine retard (DHC) complies with the requirements for treatment of chronic pain: its sustained release formula provides pain relief for up to 12 h. Thus, taking two tablets of this preparation daily is sufficient to ensure continuous pain relief. ⋯ The most frequent side effects were gastrointestinal (n=106), followed by symptoms related to the central nervous system such as dizziness, sedation, etc. (n=50), and non-specific symptoms such as indisposition (n=29). Other specific symptoms were rare and distributed over many different organ systems. Insummary, the findings of this post marketing surveillance study suggest that sustained-release dihydrocodeine is an effective and safe analgesic drug for the treatment of chronic pain of various causes.