[Development of our understanding of and our insight into mental patients during the past few decades, especially from the clinician's viewpoint (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Bach.
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5.2% healings by second intention must be added to the 91.4% healings by first intention. The proportion of patients (1.1%) who could not be followed up for various reasons is but small. In view of the findings of this epidemiologically founded study, it seems justified to conclude that the long-term prognosis of acute type A virus hepatitis may be considered to be favourable since healing occurred in 96.6%.
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The morbidity by viral hepatitis within the municipal and rural district of Eisenhüttenstadt with 66 211 inhabitants from 1960 t0 1970 amounts to 19.45 +/- 1.06%. The transition into chronic hepatitis appears in 5.5 per cent in 1 283 controlled cases of illness. Contrary to the acute viral hepatitis the numbers of illness by chronic hepatitis are increasing with proceeding age (0.3 per cent up to 14 per cent). The prognosis of viral hepatitis is altogether favorable. 84.1 per cent are healing completely primarily without any subsequences and 4.4 per cent are followed by defective states. The chronic persisting hepatitis heals in more than the half of the cases, mostly after a duration of two till five years of illness. The tendency to heal is significantly stronger in children and adolescents than in adults. The chronic aggressive hepatitis has an unfavorable prognosis. In the development of the cirrhosis of the liver (0.5 per cent) additional noxes are playing a role. The alcohol shows an unfavorable influence on the course of the illness (0.7 per cent). A hyperbilirubinemia does not appear essentially more frequently than in the normal population. The prospective character of the study in not selected patients imparts to these findings a real epidemiological sentential power.
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An unselected sample of a population aged between 15 and 45 years shows an average level of serum bilirubin of 0,624 plus or minus 0.251 mg p. c. in 1862 test persons. The distribution graphes are slightly inclined to the left and their peaks are for both sexes and in all age groups between 0.50 and 0.69 mg p. c. The results are independent of the age (between 15 and 45 years). Male persons on an average show a significant higher level of serum bilirubin than female persons (0.677 : 0.566 mg p. c.). In 93.5 p. c. of all men and in 97.1 p. c. of all women the level of serum bilirubin is under 1.1 mg p. c. In the sample 6.0 p. c. of the test persons show a level of serum bilirubin above 1.09 mg p. c. Serum bilirubin levels of 1.1 mg p. c. and higher are defined as hyperbilirubinemia. These patients have to be controlled carefully, because in the fifth part of them it is found an organic cause and in the major part of the rest there is indication for a functional distrubance in bilirubin metabolism.
The possibilities and limitations in the education of the mentally handicapped can today be defined in both medical and pedagogical terms. We think that the physician can create essential preconditions for optimal education of a mentally handicapped child by diagnostic retience, avoidance of negative suggestions, by observation of the possibilities which remain open, by concern for education as early as possible, by informing of special educational facilities and by emotional stabilization of the parents. This is the only way of attaining a successful upbringing with respect to a sufficient integration.
The maximum diameter of the third ventricle was ultrasonically determined on 769 children aged 3 to 10, of whom 401 were boys and 368, girls. The empirical range included values between 2.1 and 5.5 mm, the average value being 3.8 mm and the standard deviation, 0.57 mm. Limiting ranges bordering on pathological values are, for the time being, considered to be as follows: 4.5 mm in the third year of life; 5.0 mm in the fourth to fifth years of life; 5.5 mm in the sixth to seventh years of life; and 6.0 mm in the eighth to tenth years of life.
The author, after giving an outline of various theories of the genesis of sexual malpractices in general and so-called fetishistic practices in particular, tries to show, by reference to the behavior shown by several normally intelligent and socially fully integrated young persons, that juvenile fetishism cannot be considered a perversion in the proper sense of the word. Also, the results of observations made on these young persons show that biological factors play a minor role in the genesis of sexual malpractices. Disturbed social learning processes in the realm of interhuman relations are considered to be essential to the development of abnormal practices.
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