[Diagnostics and treatment of alcohol-related disorders: results of a representative study in psychiatric and psychotherapeutic practices]. / Diagnostik und behandlung alkoholbezogener störungen - ergebnisse einer repräsentativen umfrage in psychiatrischen und psychotherapeutischen praxen.

BACKGROUND: Alcohol use disorders (AUD) are of high prevalence in the community. The aim of the present study is to examine the diagnostic and therapeutic strategies of psychiatrists and psychotherapists in patients with AUDs. METHODS: A standardized questionnaire was sent to all psychiatrists and psychologists in the South Badenia region (n = 745). It consisted of general questions and those regarding diagnostic and therapeutic procedures in the last patient seen with an AUD. A total of 224 questionnaires sent back by 160 psychotherapists [PT] and 64 psychiatrists [P] could be included in the analysis. RESULTS: The mean stated prevalence of AUDs was 5 %. The mean age of the reported patient was 44 +/- 10 years, 60 % were men. The initial reason for consultation in psychotherapy was in 61.9 % depression in comparison to 40.7 % psychiatry (p < or = 0,01). The majority of patients seen by psychiatrists (44.1 %) were referred by their general practitioners. Standardised screening instruments were rarely used. The concordance of the diagnostic judgement and formal ICD 10-criteria was 74.5 % [P] vs. 45.5 % [PT] (p

[Soft-tissue cervicofacial emphysema and pneumomediastinum caused by self injury]. / Zervikofaziales Weichteilemphysem und Pneumomediastinum durch Selbstverletzung.

A prison inmate was referred to us for diagnostic procedures and therapy due to a combination of pneumomediastinum with emphysema of neck and face. External injuries were absent and pathogenesis remained uncertain until thorough examination of the patient revealed two intraoral wounds, presumably from a needle, reaching into the maxillary sinus. This large subcutaneous emphysema of the face, neck and mediastinum was the result of an exaggerated Valsalva maneuver. With this self-inflicted injury, unknown to us, the prisoner achieved the desired immediate admission to hospital.

Therapist's and client's perceptions in behaviour therapy: the development and cross-cultural analysis of an assessment instrument.

This paper describes the use of a scale to assess the therapist's perception of the client and the client's perception of the therapist within behaviour therapy. A factor analysis revealed specific therapist and client factors which describe aspects of each participant's activity within sessions. The results suggest that the therapist's interpersonal manner is important in treatment and that attention should be given to this in training behaviour therapists.

[The "unreadable" knee arthrogram. The problem and proposal of a new method: air- and magnification-technic]. / Das "unleserliche" Kniearthrogramm. Problematik und Vorschlag einer neuen Methode: Luft- und Vergrösserungstechnik.

The problem of the difficulty experienced by non-radiologists in reading a convention knee arthrogram is discussed. A new method is proposed, consisting of air as contrast medium in combination with direct radiological magnification. Operative control of the first 100 patients showed correct arthrographic diagnosis in 91%. The advantage of the new method is a better presentation of meniscus pathology to the operating surgeon and the possibility of video documentation.

[Is it possible to diagnose idiopathic chondropathia patellae using radiologic methods?]. / Ist die idiopathische Chondropathia patellae mit radiologischen Methoden diagnostizierbar?

In a retrospective study of 47 cases of chondromalacia proved by operation, a correct diagnosis had been made by arthrography in three cases. In 44 patients a false negative finding had been obtained. A prospective study was carried out comparing single and double contrast arthrography as well as double contrast arthrotomography and scintigraphy in ten patients with typical chondropathia. It was confirmed by arthroscopy in nine cases. Only two patients with severe chondromalacia showed abnormal findings by arthrography or scintigraphy. Our investigation has led to the conclusion that arthrography is not a suitable method for demonstrating idiopathic chondropathia of the patella.

[Discrepancy between arthrography and arthrotomy with posterior lesions of the medial meniscus (author's transl)]. / Wie zuverlässig ist die intraoperative Untersuchung des medialen Meniskushinterhorns? Diskrepanz zwischen Arthrographie und Arthrotomie.

In 102 cases with arthrographic proven lesion of the medial meniscus clinical, radiological and operative results were correlated. In 10% the lesion could not be found by arthrotomy. These were all cases with lesions in the posterior part of the meniscus, mostly at the basis. It must be assumed, that the posterior portion of the medial meniscus cannot be judged completely by arthrotomy, especially if a ventral approach is used.

[Magnification radiography in orthopedics (author's transl)]. / Direkte radiologische Vergrösserungstechnik in der Orthopdie.

A simplified method of 1,5 to 2,0 x radiographic magnification is presented with a focal spot of 0,15 mm. The examination of 358 patients shows a gain in clinical information in 74%, which was decisive in 24%. The place of magnification radiography in orthopedic diagnostic procedures is defined.

Amputee stump radiology.

In patients with stump problems, radiological examination of the stump is desirable. To get a maximum of information, the X-ray technique has to be adapted to the qualities of the stump which are different from the corresponding part of a normal limb. Special techniques permit further diagnosis.

Evaluation of magnification radiography in bone tumors.

The additional information obtained by direct radiographic magnification is examined in comparison to standard exposures of 50 bone tumors. A diagnostically significant increase in information is obtained in 84% of these cases. This is distributed at an irregular rate over the various decisive phases of the tumor diagnosis. In 24% of the cases the magnification exposure was helpful excluding other diseases, in 40% it permitted a differentiation between benign and malignant lesions and in 20% it permitted a classification of the type. The clinical importance of the magnification technique is relevant.

[Radiological diagnosis of the narrow lumbar spinal canal syndrome (author's transl)]. / Radiologische Diagnose des engen lumbalen Spinalkanals

31 myelograms of patients with the syndrome of lumbar spinal canal constriction were analysed. Two forms can be distinguished - a primary form with hypoplasia of the lumbar section of the spinal canal, and a secondary form with circumscribed constriction through olisthy or spondylosis deformans. The characteristics symptoms of the primary form (n = 21) are: difficult lumbar puncture, the ascent of the contrast medium in the thoracic section of the vertebral canal, multiple protrusions of the intervertebral discs, reduced sagittal diameter of the dural area which is marked by additional signs of spondylosis. In this connection, the alterations were so characteristic that it was possible to diagnose the condition even before the operation. The myelogram with water-soluble contrast-medium is considered to be markedly superior to other methods of radiological examination.

[Clinical signs of the narrow lumbar spinal canal (author's transl)]. / Klinische Zeichen des engen lumbalen Spinalkanals

The syndrom of the narrow spinal canal is today to be separated from other lumbar diseases by its nosological entity. It starts slowly and becomes manifest in middle and advanced age. Claudicatio intermittens is the characteristic symptom of this disease the aetiology of which is multifactory. Most patients show in the myelogram konstitutionell alterations combined with localized or generalized degenerative narrowing of the spinal canal. The clinical findings correspond to the lumbar segments affected. With localized narrowing the differential diagnosis of disc herniation is generally possible by myelography. This is of therapeutic consequence because in this cases a removal of the disc is unnecessary.