[Suggestions for dealing with drug-dependent adolescents in practice (author's transl)]. / Hinweise für den Umgang mit drogenabhängigen Jugendlichen in der Praxis

The three areas are outlined which the doctor must handle with drug-dependent adolescents in the pre-clinical stage. Besides diagnosis and treatment there is also the danger of becoming a supplier of drugs of addiction. Direct questioning revealed that drug-dependent adolescents are frequently prescribed medicaments uncritically as substitute drugs and consequently an insight into the need for therapy is prevented. Specific modes of behavior of these patients in acquiring drugs is described and concrete suggestions for the doctor are deduced from them.

Systematic desensitization of erectile impotence: a controlled study.

Results of a study conducted to assess the therapeutic effectiveness of systematic desensitization of erectile impotence are described. Three groups of eight patients each were formed. They were treated with systematic desensitization or conventional medication and general advice, or put on a waiting list. Therapeutic effects were investigated on the behavioral, subjective, and physiological levels. There were no significant differences among the three groups except on the subjective level. On this level, after therapy the systematic desensitization group rated feelings in sexually arousing situations as associated with significantly less anxiety than the other two groups. Systematic desensitization used alone as a treatment for erectile impotence shows only limited therapeutic effect. The unimproved patients were later treated using a modification of the Masters and Johnson technique. Early results suggest that this technique may be superior to systematic desensitization alone.

Heroin addiction: beta-endorphin immunoreactivity in plasma increases during withdrawal.

Seven patients with heroin addiction were hospitalized and immediately withdrawn from opiates. Abstinence symptomatology was evaluated quantitatively by use of the Himmelsbach Score. Maximal intensity of withdrawal symptomatology was reached within 2 days. beta-Endorphin immunoreactivity in plasma was measured by use of a very sensitive radioimmunoassay with a low cross-reactivity (28%) against beta-LPH. A statistically significant increase of mean plasma beta-endorphin-like immunoreactivity during withdrawal could be demonstrated.

[Assessment of the risk of occipitocervical dislocation in inflammatory rheumatic diseases]. / Zur Risikobeurteilung occipito-cervicaler Dislokationen bei entzündlich-rheumatischen Krankheiten.

In this mainly retrospective study we examined by means of tomographic and computer tomographic findings various manifestations and courses of cranio-cervical subluxations in chronic inflammatory rheumatic diseases and the resulting neurological complications. Even in marked cranio-cervical subluxations neurological complications are rarely observed. More serious anterior atlanto-axial subluxation represents the highest risk for spinal cord injury as a result of the mobility of the atlas. A subsequent vertical (upward) atlanto-axial subluxation occurring particularly in serious courses of illness reduces this risk since it is generally to be found together with a fixation of the atlas. This also applies to a possible pseudobasilar invagination. As a result of our studies we found ways of using CT to achieve further information. We could also derive guidelines for the indication of operative treatment. In view of the further development of surgical methods and variations in operative risk dependent on the preoperative situation, these recommendations can only be provisional.