Patients Treatment Resources

Patients Treatment Answers

Open Question: What problems might these symptoms in your staff give you for the Collins computerisaion?

1. Except those suffering from the Schizoid or the Avoidant Personality Disorders, they are insistent and demand preferential and privileged treatment. They complain about numerous symptoms, though they frequently second guess the diagnosis and disobey the physician, his treatment recommendations and instructions. 2. They feel unique, are affected with grandiosity and a diminished capacity for empathy. Consequently, they regard the physician as inferior to them, alienate him and bore him with their self-preoccupation. 3. They are manipulative and exploitative, trust no one and find it difficult to love or share. They are socially maladaptive and emotionally labile. 4. Disturbed cognitive and, mainly, emotional development peaks in adolescence. 5. Personality disorders are stable and all-pervasive – not episodic or transient. They affect all the dimensions of the patient's life: his career, his interpersonal relationships, his social functioning. 6. Though the patient is sometimes depressed and suffers from mood and anxiety disorders - defenses - splitting, projection, projective identification, denial, intellectualization - are so strong, that the patient is unaware of the reasons for his distress. The character problems, behavioral deficits and emotional deficiencies and instability encountered by the patient with personality disorder are, mostly, ego-syntonic. This means that the patient does not, on the whole, find his personality traits or behavior objectionable, unacceptable, disagreeable, or alien to his self. 7. The patient is prone to suffer from other psychiatric disturbances, both personality disorders and Axis I disorders ("co-morbidity"). Substance abuse and reckless behaviors are also common ("dual diagnosis"). 8. Defenses are alloplastic: patients tend to blame the external world for their misfortune and failures. In stressful situations, they try to preempt a (real or imaginary) threat, change the rules of the game, introduce new variables, or otherwise influence the external world to conform to their needs. 9. The personality-disordered are not psychotic. They have no hallucinations, delusions or thought disorders (except those who suffer from a Borderline Personality Disorder and who experience brief psychotic "microepisodes", mostly during treatment). They are also fully oriented, with clear senses (sensorium), good memory and general fund of knowledge. more

Open Question: What goes into a mental health file?

for my major art project , we are supposed to do something meaningful , i was diagnosed with bi polar 11 disorder at the age of 15 , so i decided to focus on mental health , my art project consists of very rare and strange mental disorders that i have researched , but i also want to put them into a file , just as if they were real patients, i have never seen my mental health files from any of the places i have been to for treatment , so i was wondering what goes into them? all i know is that the pych records every thing i say ... LOL more

Open Question: Does Obama's healthcare bill lower the cost of medical treatment?

Medical costs are outrageously expensive. Especially in medical equipment. The reason I ask is I went to the dentist. His X-ray machine is about $75,000. I said why so expensive? He said it's economical and there is really no logical reason. Of course he has to pass the cost on to his patients like me. X-rays were $200 a piece. I'm not pretending I know everything, but it seems this is one area that should be addressed. Does Obama's health care bill address anything like lowering medical costs in such sense?Btw, I have a electrical engineering background and I understand digital circuits along with microchip programming quite well. I personally can't see where this cost comes from? Perhaps its cost is coming from the R&D of the technology or investors but definitely no 75k cost building that machine. X-ray technology isn't new and using gammar rays and digital theory has been around for a while but maybe it's something else. more

Open Question: How to prevent the proliferation of pancreatic cancer metastasis?

The proliferation of pancreatic cancer metastasis mainly through blood metastasis, direct invasion and along the nerves surrounding the transfer. The proliferation of pancreatic cancer generally occurs in the transfer of advanced pancreatic cancer. This is often brought to the treatment of certain degree of difficulty, but also a serious threat to the patient's life, then how to prevent pancreatic cancer spread clinical move? more

Open Question: Would this be a good way to cut hospital costs?

Saw the author of Freakonomics on TV today, he said 30 % of all people don't wash their hands after using the restroom. And that doctors are one of the very worst offenders (according to nurses who notice such things), which helps to create and spread infections that need additional treatment for a patient who is in the hospital for surgery or other procedures. Do you suppose if all doctors always washed their hands the cost of medical care might be reduced? more

Open Question: How would you have answered this Physician Assistant interview question?

I was just recently interviewed for a Physician Assistant program and one of the questions I think I might have failed on was "If a patient came in to see you and your supervising physician was out of the office on vacation and just as you were in the middle of diagnosing the patient, the supervising physician called and wanted to speak with you. He/She asks if everything was ok and you of course tell them that you are actually in the middle of seeing a patient. You give a history and complaint of the patient to your supervising physician and what you as a PA is about to diagnose the patient with as well as treatment options. The physician totally disagrees with you and you tells you to do something totally different. What would you do? If you do decide to not follow his/her decisions, what would you tell him/her when they get back?" My answer was that though he/she is my supervising physician and I value their opinion and input, I feel if I was comfortable enough to diagnose and treat this patient with what I already had in mind, I would stick to it because I am the one directly interacting with the patient. When the physician comes back, I would definately let them know why I chose to do this but also make them aware that I do value their opinion and input. more

Open Question: Breast Cancer patient financial help?

My mom has breast cancer and has been going through treatments and surgeries since October. She has had a full right side mastectomy, and 35 lymph nodes were removed from the axillary region. She was told her cancer was stage 2. and She has went trough chemo treatments every other week for 8 weeks now, and now she has to do another round of a more painful chemo of every other week of 8 weeks and then she has to do radiation 5 days a week for 5 weeks after that....and then some more surgeries, and reconstructive surgery. Through all of this my mom has had to miss so much work because she physically can't work, and she wants to work so bad so she can just make her house payments and utilities. I don't know what to do, she needs help so bad, I am desperate to find my mom some help, please if you know of anything let me know so I can help her, she has no place to go if she can't make her rent. I just don't know what to do. Thank you for your help in advance, this is hard for me to post on here, she just needs help. Thank you thank you! more

Resolved Question: how safe or unsafe is it to give Sandostatin LAR after only 1 subcutaneous 'test dose'?

study protocol orders - for an octreotide naive patient- one subcutaneous dosage of 100mcg, wait an hour, then give an LAR 20. Many here are not comfortable skipping a 2 week SC start, like what is normally done. Has anyone given an LAR on essentially the 1st day of Sandostatin treatment? more

Open Question: Parkinsons and Orthostatic hypo tension problem please help?

Patient with parkinsons has exhibited over last five years Orthostatic hypo tension symptoms but after blood pressure checks patient always in the 140-160/60-70. patient exhibits tiredness and slight dizziness after each dosage of 25/100 meg of LD. what could be other causes of the Orthostatic hypo tension besides low blood pressure and if known what could be treatments or possible remedy of the symptoms? suggested additional reading material to help will be appreciated. more

Resolved Question: What doctors are involved in Hip Replacement Surgery?

I need to know about the doctors involved in the diagnosis, treatment and after care of the hip replacement patient. Thanks for you help I really appreciate it. more

Open Question: Christians, why don't you who have the "gift of healing" to build your own tax-exempt hospital?

Think about it, the hospital could be completely funded by the church, tax free, and have those with the gift of healing to heal patients! It would probably be a cheap place for patients to go to and they wouldn't have to take medicine, receive treatments or go through surgery! Just the healing power which the Holy Spirit gave you! See this would be a miracle: If someone had terminal/inoperable cancer and was healed through only your gift of healing. Nothing else, no treatments, no medicine, just the healing gift from the Holy Spirit. I would think twice if the patient was treated several times, was given medicine and then prayed for and was healed. Was it the prayer/gift of healing that healed them? I wouldn't call that a miracle either. A miracle would be if they had terminal cancer and was healed with no treatments or medicine. Now THAT'S a miracle! more

Resolved Question: i have been diagnosed with BPD- borderline personality disorder. Doc,shrink,websites,books say hard to cure:(?

Im sixteen, my life has been very rough. I have depression and anxiety, but it seemed like something else, and i just felt horrible inside. i went to the doctor, i got told i have BPD, another said the same. So did my psychologist. Its very obvious my BPD is severe, and i have been informed so. After my research and talking to others, i have been informed that the treatment is long term, likely life long. Its a hard disorder to treat, and patient may "eventually" live a happy life. Eventually? I dont know what to do, ive been trying so hard to make things better for me and now this? I cant take having this for the rest of my life! How do i handle this? My family is not around, and i find it very hard to talk about these things, i always feel alot worse coming out from a psychologist or psychiatrist. :(Thankyou so much, they were very informative answers and i feel so much better at the moment . :). Bec- Yes i do severely self harm, and i am always very suicidal and contemplating, and have attempted more than once. I am checking your website right now, thankyou very much xox more

Open Question: Iam worried...pls help me?

hey guyz iam 25 years old....when i was in 16...i had mental illness called 'dipression'..and i got treatment...and i recovered from all the illness....but now iam very shy to think about this..i feel like i was a mental patient..!!!only my parents and some nearest relatives were awared about this..yesterday unexpectedly one of my uncle told about this story infront of my other relatives..i was like 'shocked'...i never expected this from my uncle..my uncle said "he was mad when he was 15"..bcoz iam always likes to hide this truth from evrybody...now iam feeling shy always...becoz im thinking like 'they will think bad about me and will think im like a mad man'..im very nervous now..i dont know how how can i understand them that iam like a normal guy when i was a teenager..i dont know ...pls help me...and they have started to teasing me... more

Open Question: What problems might patients cause if attached to the Collins software projects ?

Patients with personality disorders share certain characteristics: 1. Except those suffering from the Schizoid or the Avoidant Personality Disorders, they are insistent and demand preferential and privileged treatment. They complain about numerous symptoms, though they frequently second guess the diagnosis and disobey the physician, his treatment recommendations and instructions. 2. They feel unique, are affected with grandiosity and a diminished capacity for empathy. Consequently, they regard the physician as inferior to them, alienate him and bore him with their self-preoccupation. 3. They are manipulative and exploitative, trust no one and find it difficult to love or share. They are socially maladaptive and emotionally labile. 4. Disturbed cognitive and, mainly, emotional development peaks in adolescence. 5. Personality disorders are stable and all-pervasive – not episodic or transient. They affect all the dimensions of the patient's life: his career, his interpersonal relationships, his social functioning. 6. Though the patient is sometimes depressed and suffers from mood and anxiety disorders - defenses - splitting, projection, projective identification, denial, intellectualization - are so strong, that the patient is unaware of the reasons for his distress. The character problems, behavioral deficits and emotional deficiencies and instability encountered by the patient with personality disorder are, mostly, ego-syntonic. This means that the patient does not, on the whole, find his personality traits or behavior objectionable, unacceptable, disagreeable, or alien to his self. 7. The patient is prone to suffer from other psychiatric disturbances, both personality disorders and Axis I disorders ("co-morbidity"). Substance abuse and reckless behaviors are also common ("dual diagnosis"). 8. Defenses are alloplastic: patients tend to blame the external world for their misfortune and failures. In stressful situations, they try to preempt a (real or imaginary) threat, change the rules of the game, introduce new variables, or otherwise influence the external world to conform to their needs. 9. The personality-disordered are not psychotic. They have no hallucinations, delusions or thought disorders (except those who suffer from a Borderline Personality Disorder and who experience brief psychotic "microepisodes", mostly during treatment). They are also fully oriented, with clear senses (sensorium), good memory and general fund of knowledge. more

Resolved Question: Why isn't hysterectomy part of the treatment for stage IIB-IV cervical cancer?

Is there a particular reason that this is not the "standard of care" for stage IIB and beyond cervical cancer patients? Once radiation and chemo successfully remove the cancer (or as according to a PET/MRI), why would they not remove the actual original cancer site (cervix) after the lymph nodes and other tissues are no longer cancerous? Are there dangers to having a hysterectomy if you underwent max dose pelvic radiation, but have since completely healed and almost 4 months have passed?zrepmd, actually very clear, thanks. So basically why put someone thru major surgery when radiation is already necessary for the other sites that can't be surgically removed...plus it is likely as good as surgery anyways as far as a cure goes..and surgery first would be a waste of pain for those who won't survive. I get it. Thank you :) And I feel a little better. more

Open Question: How long should a patient have to wait for treatment after being diagnosed with gallbladder malfunction?

I was diagnosed with a malfunctioning gallbladder three days ago. I have been in severe pain with nausea, vomiting, diarrhea, and constipation for four weeks. I have been in the ER at the same hospital 3 times in the last two weeks and each time I go its a 6 to 9 hour wait and the doctors just give me 20 pain pills and send me home, saying if the pain worsens or symptoms change to come back. The pain has steadily increased and I have lost over 30 lbs within this time span until 20 5/500 vicodin last only about 3 days (I take two every four hours just to lessen the pain to the point of being able to move). I set up a surgical consultation today, the 8th of march, and was told the earliest appointment for just the consultation was March 29th, three weeks away. I have no insurance, but have received a discount through the hospital, but this leaves me with no primary care physician and the earliest date to meet with a potential primary is in late april, way past the point where it will do me any good for this. I am sick, unable to sleep or eat, and in constant, debilitating pain and am not sure how I am going to make it another three weeks this way. Is it normal to have to wait this long between diagnosis and treatment for gallbladder problems? What can I do to speed up the process besides calling every day in hopes of a cancellation? more

Open Question: Parents send you to shrinks to cover up their sin?

Did you know many times parents send kids with so called out of control behavior to cover up their sin? There are zero blood test for mental disorders. Verbal abuse is not to help you. Dont' get labled with a mental illness to cover up your parents sin. Stand up to shriks. There is zero medical scholarship is psychiatry. Its only an opinion no science at all. Psychiatrists claim that a person needs a drug to combat their chemical imbalance in the brain which is causing a persons mental disorder. However, the concept that a brain-based, chemical imbalance underlies mental illness is false. While popularized by heavy public marketing, it is simply psychiatric wishful thinking. As with all of psychiatric disease models, it has been thoroughly discredited by researchers. Diabetes is a biochemical imbalance. However, as Harvard psychiatrist Joseph Glenmullen states, the definitive test and biochemical imbalance is a high blood sugar balance level. Treatment in severe cases is insulin injections, which restore sugar balance. The symptoms clear and retest shows the blood sugar is normal. Psychiatrists do not draw blood to determine the presence of a biochemical imbalance in patients. more

Open Question: please help calc question?

A patient receives 2 milligrams of a certain drug each day. Each day the body eliminates 20% of the amount of drug present in the system. Estimate the total amount of the drug present after extended treatment, immediately after a dose is given. ________________mg more

Open Question: Cause of vomiting and constipation?

We have a patient female age 20 She has constipation for 9 months and vomiting for 7 month. When she eats food fluid or other things after 15 minutes she vomits All of tests are normal like endoscopy brain MRI, Abdominal CT Scan, Ultrasound, Abdominal X-ray with barium, blood culture. Also she got psychologist treatment too. But still she is not getting better I want answer of it. more

Resolved Question: Should the US provide health care to its working poor instead to foreign aristocrats?

In most countries the wealthy elite are required to wait their turn behind patients with greater medical need. However, the wealthy elite from those countries can come to the US and get priority treatment even though many US citizens die because they can't get the same treatments. Shouldn't the US prioritize the health of its own citizens ahead of the health of foreign aristocrats?i've heard a number of Republican law makers tell stories about wealthy foreignors who have come here for treatments that are denied Americans, often because the health insurance company retroactively cancelled someone's policy.The US only has a limited supply of medical workers and faciliteis which are paid for in part by the taxes of working people and those resources are used to heal the wealthy elite from all over the world while Americans die. more

Open Question: insect problem in stomach?

i have a insect in my stomach thats why whatever i eat food is all eaten by insect and thats why i am not able to improve my health. can any body tell me good treatment? many times i face these problem. can any tell possible reasons? i m constipation patient and my digestion is not good. is that the reason for insect problem again and again? pls post yours thoughts! pls tell treatment with no trouble! more

Resolved Question: Is it really fair to deny legal residents care to give treatment to illegal residents?

TALLAHASSEE — Mentally ill patients are being placed on waiting lists for treatment because Florida's mental health institutions are crowded with illegal immigrants. The crisis puts Florida at the forefront of a national debate over whether illegal immigrants should enjoy the same rights to public health care as legal residents. Florida's mental health facilities spent $19.6 million to care for at least 86 undocumented immigrants counted during an informal November survey, and more unidentified illegal immigrants could be in custody, state officials said. The growing population has put a strain on the state's mental health resources, contributing to a waiting list of 60 beds. http://www.tampabay.com/news/politics/stateroundup/mentally-ill-wait-for-services-behind-illegal-immigrants/1078159 more

Open Question: Can you give me any ideas about this writing, please? Is it fine?

Health care is a very major issue that deals with the future of the U.S and its citizens. President Obama wants to make the insurance more available to all people and change the American’s health care system so that it is cheaper. He also wants the change so that the insurance companies find it harder to get out of paying for treatment. There are many pros of enforcing health care such as it will come to the aid of people who do not have Medicare or Medicaid. Many people have went to hospitals for serious conditions and have either been sent back out of the hospital or tended to last because they cannot afford to pay the bill. If this is enforced, the costs of the health bills will be reduced and more affordable. People will not have to pay a large amount of money just because of natural causes. On the other hand, patients receiving medical coverage also receive additional help in the event of a serious injury or illness. It would also assist people who have a very low income but yet work hard acquire the help they require. For instance, perhaps right now they are stress out about not being able to afford prescription drugs or frustrated that they cannot afford to pay a dentist or to operate on their teeth. It would provide relief to families fighting to make ends meet. People would also be protected in the event of an accident. Additional pro is that there will be increased competition in the insurance market. It might be from a public option. It might also be from some kind of non-profit, state-specific, co-operative. This might push the health care companies to lower costs and provide better services. Health care enforcement not only has pros but it also has some cons. There will be fewer doctors in medicine because of a drastic pay cut. Patients may be subjected to wait extremely long for treatment. If health care does happen to get enforced, hospitals will be packed with patients that need to be treated. Another con of health care enforcement is that people will be controlled more by the government. If health care does get enforced then it is more than likely that the government is going to take charge and make huge changes. He may pass additional restrictions to keep us away from certain things or increase taxes on things such as smoking, fast-food, etc. Doing these things could actually stop many Americans from having the freedom that they already have. All of our health records and personal information will be in the hands of the government and all of that information will no longer be confidential. Moreover, government-controlled health care could lead to a decrease in patient flexibility. The doctors cannot get to all of the patients at one time and they have to figure out which people will have to be treated first. These decisions could lead to people with serious problems waiting for many months just to get treatment at the hospitals. Should Congress pass a health care reform bill? I think it is important that they do everything within their power to get the middle class back to full employment before they try to overhaul the health care system. No matter what reforms are made, it is going to add a huge burden to government budgets. The U.S cannot maintain the current rate of spending, much less increase it, without a solid middle class tax base because we can be certain that the rich and business are not going to pay for it. more

Open Question: blood pressure during hemodialysis?

does the pump speed on the hemodialysis machine affect the blood pressure of a patient receiving dialysis treatment. I continually have this debate with non nephrology doctors. I would grateful for a answer with evidence based data. more

Resolved Question: Doctors ask for "informed consent." Should religions also inform converts of possible harmful side-effects?

Physicians & medical practitioners are instructed first to "do no harm" to their patients. Then, if they provide treatment, they have to inform patients of possible problematic side effects of their medications & procedures. (Thus, we hear a cascade of warnings following pharmaceutical ads.) Religions, in contrast, have traditionally never even tried to inform potential converts about the possible negative side of participation or membership. Should they supply such warnings? If you were to inform a potential member of your own religious group of the possible negative side-effects that could arise from joining, what would you include in your list? more

Open Question: pl. suggest best Ayurvedic treatment for VITILIGO>?

Please advise best Ayurvedic medicine for the disease VITILIGO. Is there necessary that patient has to be admiitted/ Which Ayurvedic Hospital in Kerala/india specialised to treat this disease? more

Resolved Question: in 'Shutter Island' what was with all the naked guys in the cell?

the head doctors made a big stink about how this was a hospital for the patients to have peace and find treatment and they were going on about making sure they were treated well, yet they had like five guys naked in a dark, dank call together... what was that about? more

Resolved Question: Is it normal for prostate cancer patients to frequently urinate?

Since the result of my biopsy and treatment, I have been going to the bathroom frequently. I was prescribed a pill called 'harlan' which has moderated the frequency but it is still painful and more frequent than I want. Can anyone help?. I don't want to keep calling my doctor with what may appear to be minor issues. more

Open Question: What is bio-magnetic therapy?

Is this a legitimate treatment option. Does it help cancer patients? Does it have side affects? more

Open Question: What are the treatments available for patients with sulcus vocali?

Hi, I am male, 22 yrs old. I have been having speaking problem all my lifetime. I was recently diagnosed with sulcus vocali by an ENT doctor. He suggested a vocal injection to treat my problem. I am scheduled to get the injection in 3 weeks. But I would like to know a little bit more about the treatments available today before I get the injection. Also, are there any side effects if I opted for the injection? Thank you. more

Open Question: Does Collins project start to make sense, when you read this : ?

Definition of Personality The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision [Washington DC, American Psychiatric Association, 2000] defines "personality" as: "…enduring patterns of perceiving, relating to, and thinking about the environment and oneself … exhibited in a wide range of important social and personal contexts." Characteristics common to all personality disorders Patients with personality disorders share certain characteristics: 1. Except those suffering from the Schizoid or the Avoidant Personality Disorders, they are insistent and demand preferential and privileged treatment. They complain about numerous symptoms, though they frequently second guess the diagnosis and disobey the physician, his treatment recommendations and instructions. 2. They feel unique, are affected with grandiosity and a diminished capacity for empathy. Consequently, they regard the physician as inferior to them, alienate him and bore him with their self-preoccupation. 3. They are manipulative and exploitative, trust no one and find it difficult to love or share. They are socially maladaptive and emotionally labile. 4. Disturbed cognitive and, mainly, emotional development peaks in adolescence. 5. Personality disorders are stable and all-pervasive – not episodic or transient. They affect all the dimensions of the patient's life: his career, his interpersonal relationships, his social functioning. 6. Though the patient is sometimes depressed and suffers from mood and anxiety disorders - defenses - splitting, projection, projective identification, denial, intellectualization - are so strong, that the patient is unaware of the reasons for his distress. The character problems, behavioral deficits and emotional deficiencies and instability encountered by the patient with personality disorder are, mostly, ego-syntonic. This means that the patient does not, on the whole, find his personality traits or behavior objectionable, unacceptable, disagreeable, or alien to his self. 7. The patient is prone to suffer from other psychiatric disturbances, both personality disorders and Axis I disorders ("co-morbidity"). Substance abuse and reckless behaviors are also common ("dual diagnosis"). 8. Defenses are alloplastic: patients tend to blame the external world for their misfortune and failures. In stressful situations, they try to preempt a (real or imaginary) threat, change the rules of the game, introduce new variables, or otherwise influence the external world to conform to their needs. 9. The personality-disordered are not psychotic. They have no hallucinations, delusions or thought disorders (except those who suffer from a Borderline Personality Disorder and who experience brief psychotic "microepisodes", mostly during treatment). They are also fully oriented, with clear senses (sensorium), good memory and general fund of knowledge. Differential Diagnoses The classification of Axis II personality disorders - deeply ingrained, maladaptive, lifelong behavior patterns - in the Diagnostic and Statistical Manual, fourth edition, text revision [American Psychiatric Association. DSM-IV-TR, Washington, 2000] - or the DSM-IV-TR for short - has come under sustained and serious criticism from its inception in 1952. The DSM IV-TR adopts a categorical approach, postulating that personality disorders are "qualitatively distinct clinical syndromes" (p. 689). This is widely doubted. Even the distinction made between "normal" and "disordered" personalities is increasingly being rejected. The "diagnostic thresholds" between normal and abnormal are either absent or weakly supported. The polythetic form of the DSM's Diagnostic Criteria - only a subset of the criteria is adequate grounds for a diagnosis - generates unacceptable diagnostic heterogeneity. In other words, people diagnosed with the same personality disorder may share only one criterion or none. The DSM fails to clarify the exact relationship between Axis II and Axis I disorders and the way chronic childhood and developmental problems interact with personality disorders; The differential diagnoses are vague and the personality disorders are insufficiently demarcated. The result is excessive co-morbidity (multiple Axis II diagnoses); The DSM contains little discussion of what distinguishes normal character (personality), personality traits, or personality style (Millon) - from personality disorders; A dearth of documented clinical experience regarding both the disorders themselves and the utility of various treatment modalities; Numerous personality disorders are "not otherwise specified" - a catchall, basket "category"; Cultural bias is evident in certain disorders (such as the Antisocial and the Schizotypal); The emergence of dimensional alternatives to the categorical approach is acknowledged in the DSM-IV-TR itself: “An alternative to the categoricalThe emergence of dimensional alternatives to the categorical approach is acknowledged in the DSM-IV-TR itself: “An alternative to the categorical approach is the dimensional perspective that Personality Disorders represent maladaptive variants of personality traits that merge imperceptibly into normality and into one another” (p.689) The following issues - long neglected in the DSM - are likely to be tackled in future editions as well as in current research: The longitudinal course of the disorder(s) and their temporal stability from early childhood onwards The genetic and biological underpinnings of personality disorder(s) The development of personality psychopathology during childhood and its emergence in adolescence The interactions between physical health and disease and personality disorders The effectiveness of various treatments - talk therapies as well as psychopharmacology.Psychological Testing for Personality Disorders A qualified mental health diagnostician administers lengthy tests and personal interviews to determine the existence and virulence of a personality disorder. The predictive power of these tests - often based on literature and scales of traits constructed by scholars - is hotly disputed. Still, they are far preferable to subjective impressions of the diagnostician which are often amenable to manipulation. The Minnesota Multiphasic Personality Inventory. Diagnostic test composed of 567 true-or-false questions arranged in three validity scales and ten dimensional clinical scales. The latter measure hypochondriasis, depression, hysteria, psychopathic deviation, masculinity-femininity, paranoia, psychasthenia, schizophrenia, hypomania, and social introversion. There are also scales for alcoholism, post-traumatic stress disorder, and personality disorders. The interpretation of the MMPI-II is now fully computerized. The computThe interpretation of the MMPI-II is now fully computerized. The computer is fed with the patients' age, sex, educational level, and marital status and does the rest. The Millon Clinical Multiaxial Inventory-III (MCMI-III) tests for personality disorders and attendant anxiety and depression. The third edition was formulated in 1996 by Theodore Millon and Roger Davis. Millon Clinical Multiaxial Inventory. Diagnostic test composed of 157 true-or-false items. The MCMI-III consists of 24 clinical scales and 3 modifier scales. The modifier scales serve to identify Disclosure (a tendency to hide a pathology or to exaggerate it), Desirability (a bias towards socially desirable responses), and Debasement (endorsing only responses that are highly suggestive of pathology). Next, the Clinical Personality Patterns (scales) which represent mild to moderate pathologies of personality, are: Schizoid, Avoidant, Depressive, Dependent, Histrionic, Narcissistic, Antisocial,Aggressive (Sadistic), Compulsive, Negativistic, and Masochistic. Millon considers only the Schizotypal, Borderline, and Paranoid to be severe personality pathologies and dedicates the next three scales to them. The last ten scales are dedicated to Axis I and other clinical syndromes: Anxiety Disorder, Somatoform Disorder, Bipolar Manic Disorder, Dysthymic Disorder, Alcohol Dependence, Drug Dependence, Posttraumatic Stress, Thought Disorder, Major Depression, and Delusional Disorder. Scoring is easy and runs from 0 to 115 per each scale, with 85 and above signifying a pathology. The configuration of the results of all 24 scales provides serious and reliable insights into the tested subject. The Narcissistic Personality Inventory (NPI) is used to spot narcissistic traits. The Borderline Personality Organization Scale (BPO) was designed in 1985. It sorts the responses of respondents into 30 relevant scales. It indicates the existence of identity diffusion, primitivedefenses, and deficient reality testing. To these one may add the Personality Diagnostic Questionnaire-IV, the Coolidge Axis II Inventory, the Personality Assessment Inventory (1992), the excellent, literature-based, Dimensional assessment of Personality Pathology, and the comprehensive Schedule of Nonadaptive and Adaptive Personality and Wisconsin Personality Disorders Inventory. The next diagnostic aim is to understand the way the patient or client functions in relationships, copes with intimacy, and responds to triggers. The Relationship Styles Questionnaire (RSQ) (1994) contains 30 self-reported items and identifies distinct attachment styles (secure, fearful, preoccupied, and dismissing). The Conflict Tactics Scale (CTS) (1979) is a standardized scale of the frequency and intensity of conflict resolution tactics - especially abusive stratagems - used by members of a dyad (couple). The Multidimensional Anger Inventory (MAI) (1986) assesses the frequency of angryresponses, their duration, magnitude, mode of expression, hostile outlook, and anger-provoking triggers. The Rorschach Inkblot Test is a diagnostic test comprised of 10 ambiguous inkblots printed on 18X24 cm. cards, in both black and white and color. The cards and the diagnostician's questions provoke free associations in the test subject. These are recorded verbatim together with the inkblot's spatial position and orientation. The patient can then add details and comment on his choices. Scoring is based on the parts of the cards referred to in the subject's responses (location), the correspondence between the blot and the answers provided (determinant), the content of the responses, how unique or common they are (popularity), how coherent are the patient's narratives (organizational activity), and how well does the patient's percept fit the card (form quality). The interpretation of the test relies on both the scores obtained and on what we know about mental healthdisorders. The test teaches the skilled diagnostician how the subject processes information and what is the structure and content of his internal world. These provide meaningful insights into the patient's defenses, reality test, intelligence, fantasy life, and psychosexual make-up. The Thematic Appreciation Test (TAT) is a diagnostic test comprised of 31 cards. One card is blank and the other thirty include blurred but emotionally powerful (or even disturbing) photographs and drawings. Subjects are asked to tell a story based on the content of the cards. The TAT was developed in 1935 by Morgan and Murray. The patient's reactions (in the form of brief narratives) are recorded by the tester verbatim. Some examiners prompt the patient to describe the aftermath or outcomes of the stories, but this is a controversial practice. The TAT is scored and interpreted simultaneously. Murray suggested to identify the hero of each narrative (the figure representing the patient); the innerstates and needs of the patient, derived from his or her choices of activities or gratifications; what Murray calls the "press", the hero's environment which imposes constraints on the hero's needs and operations; and the thema, or the motivations developed by the hero in response to all of the above. The Structured Clinical Interview (SCID-II) was formulated in 1997 by First, Gibbon, Spitzer, Williams, and Benjamin. It is based on the language of criteria for personality disorders in the the DSM-IV. Its 12 groups of questions correspond to the 12 personality disorders. The scoring is simple: either the trait is absent, subthreshold, true, or there is "inadequate information to code". The SCID-II can be administered to third parties (a spouse, an informant, a colleague) or self-administered (in a reduced format with 119 questions). The Structured Interview for Disorders of Personality (SIDP-IV) was composed by Pfohl, Blum and Zimmerman in 1997. It also covers theself-defeating personality disorder from the DSM-III. It is conversational and the questions are grouped into 10 topics such as Emotions or Interests and Activities. There is a version of the SIDP-IV in which the questions are grouped by personality disorder. The scoring classifies items as present, subthreshold, present, or strongly present. Yet, even a complete battery of tests, administered by experienced professionals sometimes fails to identify personality disorders. Such patients are uncanny in their ability to deceive their evaluators.http://open-site.org/Health/Conditions_and_Diseases/Psychiatric_Disorders/Personality/ more

Open Question: What do you think about this Red Cross is latest victim of Mexican drug war?

MEXICO CITY (AP) - Red Cross clinics in some parts of Mexico are refusing to treat people wounded by gunshots after finding themselves caught in the drug war, with cartel hit men intercepting ambulances to seize patients and even killing a Red Cross worker this week. Miguel Angel Valdez, director of operations for the Red Cross in the Gulf coast city of Tampico, said he implemented the policy after gunmen this week forced an ambulance over at gunpoint just two blocks from a Red Cross clinic and dragged off a man wounded in a gun battle. "We have made the decision at the (local) Red Cross not to accept patients from prisons or wounded in armed clashes, because that puts the safety of our personnel at risk," he said. In drug-plagued Sinaloa state on the Pacific coast, police started escorting ambulances and guarding Red Cross clinics after a Red Cross dispatcher was killed Sunday in crossfire by assailants who followed a wounded man to a clinic to finish him off. Maria Genoveva Rogers is believed to be the first Red Cross worker killed since President Felipe Calderon launched his drug war in 2006. Hundreds of emergency personnel, medical technicians and ambulance crews took to the streets in the Sinaloa capital of Culiacan, some holding a banner that read "Service Suspended ... We Demand Safety" as ambulances accompanying the march blared their sirens. "We are just calling on everyone to respect the symbol of the Red Cross, but there has been a loss of values," said the state's Red Cross director, Arnoldo Montano. "It is like people have forgotten what the Red Cross is." Culiacan's Red Cross clinics closed for two days following Rogers' death. And in the violent city of Ciudad Juarez, across the border from El Paso, Texas, doctors and other personnel at two government-run clinics stayed off the job Tuesday to protest gunmen barging into emergency rooms to either rescue wounded comrades or execute rivals. Gangs have also targeted doctors for extortion. "We are one of the sectors that has been most affected by the situation of violence," said Dr. Leticia Chavarria Villa, president of the Medical-Civic Committee, a nonprofit group founded in the wake of the wave of violence that has swept the city. Some doctors now refuse to admit patients at private clinics after 6 p.m., or they see only people who have been referred to them by their other patients, she said. Amid the drug violence that has killed more than 17,900 people in Mexico in a little more than three years, even the criminals seemed to respect the Red Cross, an organization known for treating everyone - regardless of gang allegiance, criminal or social status, said Valdez, the Red Cross director in Tampico. "But suddenly, these rules are being broken," he added. http://www.ktvz.com/Global/story.asp?S=12091466 Isn't this what the illegals here are claiming is everyone has a basic human right to be given medical care regardless of who it is or how they came to need treatment ? more

Voting Question: Where can i get patient's case report on Alzheimer’s disease.?

I need a complete case report on Alzheimer’s disease, that is at what age the signs and symptoms are appeared, what test he undergone to diagnose Alzheimer’s disease and what treatment he is undergoing now. A complete case. Please help me, since i need to present a case report on Alzheimer’s disease. Thank you more

Open Question: What happens when a patient tells their counselor they did something illegal, like having used illicit drugs?

Do counselors or other mental health professionals have to keep EVERYTHING you say confidential? Are their exceptions to this? Assuming the patient is an adult and the focus of their mental health treatment is not drug related. Could their counselor/Psychiatrist/etc report them to the police? Testify in court? Would this be recorded in their medical record? If they are currently being prescribed potentially addictive medications and admitted to occasional use of street drugs would they be forced to stop taking these medications? Thanks!Do counselors or other mental health professionals have to keep EVERYTHING you say confidential? Are their exceptions to this? Assuming the patient is an adult and the focus of their mental health treatment is not drug related. Could their counselor report them to the police? Testify in court? Would this be recorded in their medical record? If they are currently being prescribed potentially addictive medications and admitted to occasional use of street drugs would they be forced to stop taking these medications? Thanks! **update* * I understand the legal part better but is this bad to have on my medical records. If everything is supposed to be kept confidential, but when seeing a new Dr. they make me sign that release to see prior treatment information from other drs. I understand concerns about coordination of care and interactions, etc. My new Dr. refused to fill 2 of my (potentially addictive) meds. She quoted my medical record, my ex told (incorrect) info to a previous Dr. Help! more

Voting Question: Please can someone help? I'm have to write a Case Study for a fictional Physiotherapy patient attending rehab.?

The instructions say, "Your individual note entries - often just a line in length and very rarely exceeding a 10 line paragraph - but must give a comprehensive overview of the client's treatment process. Are 'individual note entries' the same as case notes? I thought case notes were more than one liners. more

Voting Question: If cystinine crystals are present in a patient's urine sample,what is the diagnosis and treatment?

Between these two answers,which 1 is the correct answer.. Cystinuria or Urinary Tract Infection more

Voting Question: Mathematical Modelling?

Description When viral particles of a certain virus enter the human body, they replicate rapidly. In about four hours, the number of viral particles has doubled. The immune system does not respond until there are about 1 million viral particles in the body. The first response of the immune system is fever. The rise in temperature lowers the rate at which the viral particles replicate to 160 % every four hours, but the immune system can only eliminate these particular viral particles at the rate of about 50 000 viral particles per hour. Often people do not seek medical attention immediately as they think they have a common cold. If the number of viral particles, however, reaches 1012, the person dies. Modelling infection 1. Model the initial phase of the illness for a person infected with 10 000 viral particles to determine how long it will take for the body’s immune response to begin. 2. Using a spreadsheet, or otherwise, develop a model for the next phase of the illness, when the immune response has begun but no medications have yet been administered. Use the model to determine how long it will be before the patient dies if the infection is left untreated. Modelling recovery An antiviral medication can be administered as soon as a person seeks medical attention. The medication does not affect the growth rate of the viruses but together with the immune response can eliminate 1.2 million viral particles per hour. 3. If the person is to make a full recovery, explain why effective medication must be administered before the number of viral particles reaches 9 to 10 million. The antiviral medication is difficult for the body to adapt to, so it must initially be carefully introduced to the body over a four-hour time period of continuous intravenous dosing. This means the same amount of medication is entering the body at any given time during the first 4 hours. At the same time, however, the kidneys eliminate about 2.5 % of this medication per hour. The doctor has calculated that the patient needs at least 90 micrograms of medication to begin and maintain the rate of elimination of 1.2 million viral particles. 4. Create a mathematical model for this four-hour period so that by the end of the four hour period the patient has 90 micrograms of medication in their body. Find the solution to your model analytically, or estimate its solution with the help of technology. Once the level of medication has reached 90 micrograms the patient is taken off the intravenous phase and given injections every four hours. The kidneys will still be working to eliminate the medication, so the doctor must calculate the additional dosage, D accordingly. Dosage D should allow for maintenance of a minimum of 90 micrograms within the patient’s bloodstream throughout the treatment regimen. 5. What dosage, D, administered every four hours from the end of the first continual intravenous phase, would allow for the patient to maintain at least 90 micrograms of the medication in his system? Make sure you take into account the kidneys’ rate of elimination. Explain carefully how you came to this number. 6. Determine the last possible time from the onset of infection to start the regimen of medication. How long it will take to clear the viral particles from the patient’s system? Show on a graph the entire treatment regimen from the time treatment begins until the viral particles are eliminated. 7. Explain how your models could be modified for use if the patient were not an adult, but a young child.mistake in second par. "If the number of viral particles, however, reaches 10^12, the person dies. more

Open Question: What is in a name? And in asking this question,I will then ask you for help in choosing?

a name for a new project I am engaged in.It is a drug treatment concept where as the focus is on the "implementation" of accepted existing treatment practices coupled with the patients individual need.I believe the approach and implementation are key.I also believe there is no such thing as a lost cause,when you are talking about a persons life. Please,serious answers only. I don't think there's a better community I could have come to with this.A little help out there.Only one to choose from ? Come on. However I do appreciate the fact the trollers have given it the respect it deserves.Thank You. more

Resolved Question: Do people actually believe that Cuba has better health care then us here in the US?

Before you answer you should know that Cuba has the poorest form of health care and that actual footage of how patients are treated there have been leaked out that shows inhuman methods of treatment towards patients. It should also be known that medication is very hard to come by and that Michael Moores movie is false in saying the human life span is greater then ours since its the communist government that gives the numbers they want to show. more

Resolved Question: So wazzup with hospitals and illegals?

Source: http://www.diggersrealm.com/mt/archives/000612.html Illegal Aliens Threaten New Jersey Hospitals By Bookmark and Share I have reported in the past about California Emergency Rooms closing due to illegal aliens, now New Jersey hospitals are facing the same fate. New Jersey Times New Jersey's escalating population of illegal immigrants is placing an ever-growing burden on the state's hospitals, which expect to lose $200 million this year on care to the underground community. Doctors and administrators around the state are complaining that the cost of treating illegal immigrants has forced them to delay the purchase of life-saving technology or the addition of valuable staff. And according to the New Jersey Hospital Association (NJHA) in West Windsor, the burden will only increase unless state or federal agencies step in and pay the bills. How about we enforce our immigration laws and get rid of the illegal aliens rather than banter about who should pay the bill? New laws need to be put in place like Arizona's Proposition 200 requiring staff and government agencies to ask for immigration status or face criminal prosecution and jail time for not doing so. I have no problem with treating injured people, but upon finding they are here illegally they should be deported and not just let go to once again burden our systems in the future when they once again get sick or get injured. In California, which has far more illegal aliens than New Jersey, the state medical association reports the cost of caring for illegal immigrants has helped force 60 emergency rooms to close during the past decade. Those closures, in turn, have led to crowding at many of the others. In big cities from Sacramento to San Diego, patients with minor injuries often must wait hours for care. The situation will likely get worse in the next few years. The rate of closures is on the rise, according to reports from the California Medical Association, and considering that some 80 percent of the state's emergency rooms report that they now lose money, largely because of the care they give away to illegal immigrants, hundreds more emergency rooms may be at risk. Now ask yourself where the high cost of healthcare is coming from. For every illegal alien who is receiving treatment at these emergency rooms -- even for minor care like a cold -- they are taking from millions of citizens and those here legally. more

Voting Question: Is it OK from the health perspective if a dentist in Maryland starts and finishes 4 RCT's on one patient in th?

4 Root canals therapies performed on one patient in the same day. The starting and the finishing treatment on 2 bicuspits and 2 enterior teeth. How does OSHA and dental insurances view the quality/ethics/law of that kind of treatment? What about the patient's rights? more

Voting Question: Is there any scientifical proof that Psychiatric Service Dogs can help patients with OCD?

I would like to know if anyone have any scientifical information about Psychiatric Service Dogs if it helps patients with Obsesive Compulsive Disorder. What breed of dog is most suitable to help in treatment of anxiety disorder, we are looking at any other treatment against medicine advise. thanks more

Resolved Question: In desperate need of help...cervical cancer recurrance now in uterus?

I am in desperate need of answers for my friend. She had stage 2B squamous cell cervical cancer (spread into lymph nodes) and underwent 7 weeks of Cisplatin Chemo concurrent with 7 weeks of external radiation and a few sessions (inpatient) of internal radiation. She was done with treatment and received a clear PET scan in September, putting her into remission. She went for a follow up pap in December and it was good. Then in January she was scheduled for one more follow up PET scan but her insurance had been cut off (it was Medicaid) due to her clear pap and scan and she could not afford to pay out of pocket the $5,000 the PET scan would cost. She has been having severe abdominal pains and the doctor kept telling her that it was just a side effect of the radiation. As a CC patient myself I told her that I was not experiencing this type of pain and I didn't think it was normal. Sure enough, after a CT scan, ultrasound and exam, her oncologist now thinks her cancer is back. They said her uterus is 2 times the size it's supposed to be and it's filled with air. Her uterus is so swollen that it's pushing on a lot of her organs and that is what's causing her pain. She is on morphine and vicodin right now, until the weekend when they are going to figure out exactly what is going on and do treatment. This weekend they will be doing a biopsy to find out if it's cancer for sure, but the doctor already said he's pretty sure that it is. I do understand from my personal experience that it only takes 1 microscopic cell to be left behind after chemo and radiation for it to show up again. I guess that one cell could have gone to the uterus and caused cancer there. Would it be likely for a stage 1 uterine cancer to behave in this way, to cause these extreme symptoms and enlargement? What are the chances that this recurrance isn't in her lymph nodes? And basically I guess I am just wondering if it has spread into other tissues other than the uterus, is there any hope of survival? If it's just in the uterus, would a hysterctomy likely take care of it? I am not very clear on how cervical cancers spread. I am a cervical cancer patient and survivor myself and I have learned quite a bit leading up to the point of surviving it, but I don't know much about recurrance because I haven't wanted to scare myself about that aspect of it. Now I am scared and I would like to know for my friends sake what is likely going on?If someone on here tells me it's likely that my friend is going to die, I am not going to discourage her by telling her! If the opinion is positive I would probably tell her if the opinion came from a reliable source. I've been googling and reading all I can with no good answer for this situation. I need a cancer expert's opinion and I know there are some very knowledgable people here. more

Voting Question: before dental treatment can begin,a patient who has had a hip or knee replacement must?

 more

Resolved Question: what is a good treatment for diabetes patient?

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Voting Question: why the southern railway authority did not allow full concession to cancer patientss?

india govt in its recent budget it was mentioned that full railway concession will be given to cancer patients who are getting treatment from recognized hospitals. Why this is not implemented in southern railway? more

Voting Question: How can I legaly get assistants with federal cannabis treatment in Georgia USA?

I have been run over by a lawn mower and have been in and out of mental hospitals I am also obviously in severe pain and have been on every type of medicine there is with no great results. I live in georgia so we cannot have marijuana here and i do not want to leave home nor do i have enough money. Can anyone help me? I have herd that the government has a federal program that will supply marijuana to some patients. Can anyone please help me? more

Voting Question: Can you check my answers please: Math probability and distribution?

A psychologist has devised a stress test for dental patients sitting in the waiting rooms. According to this test, the stress scores for patients waiting for root canal treatments are found to be approximately normally distributed with a mean of 7.59 and a standard deviation of .50. 1. What percentage of such patients has a stress score lower than 6.0? *I got .07%, I really get the feeling this one might not be right. 2. What is the probability that a randomly selected root canal patient sitting in the waiting room has a stress score between 7.0 and 8.0? *For this one I got 67.49% more

Resolved Question: Is mental illness a disease?

A "real" disease is defined as what society believes to be a legitimate disease. A "real" disease is degenerative and/or fatal. Cancer, heart disease, tuberculosis, etc. can all result in death. The medicine/ treatment provided for such diseases is meant to prevent the breakdown of the body and restore the patient to physical health. Mental illness itself is not directly fatal or damaging (dementia falls into the category of "real" diseases for this reason). It is an ongoing state of perception/ emotion, and the purpose of treatment is to alter such state so as to improve the experience of the patient. I would classify psychiatric drugs as painkillers rather than medicine or medication. Thoughts? more

Voting Question: Radiation sickness therapy?

Hey Was reading about radiation poisoning and it stated that if the exposure is over 10 Sv (1,000 REM) mortality is 100% and currently death is inevitable the only treatment that can be offered is pain management. These patients die from hemorrhagic shock (bleed to death,) septic shock and nonhemorrhagic hypovolemic shock due top the loss of large amount of fluid from the damaged GI mucosa. In the final stages the delirium and coma results from the circulatory collapse and electrolyte imbalances. (http://en.wikipedia.org/wiki/Radiation_poisoning) Why is death inevitable, 1. Simply prevent this guy from bleeding to death with FFP and platelets 2. Treat the septic shock with IV fluids, albumin and antibiotics 3. Correct the electrolyte imbalances with IV fluids and keep giving IV fluids until the massive fluid loss stops in the GI tract Why is death inevitable? Just maintain circulation!! more

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