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Biomedical subjects

J Wertheimer

Publications and source records attributed to J Wertheimer.

59 records · Page 4Linked to original sources
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Psychogeriatric organization in the medico-social network: the experience of the canton of Vaud, Switzerland.

In Switzerland (7 million inhabitants), the organization of health care is in the hand of the cantons and not of the Confederation. The canton of Vaud (600,000 inhabitants), in the south-west part of the country, counts 4 psychiatric sectors, each with a psychogeriatric service. Otherwise the canton has 146 long-stay facilities with a total of 6,000 beds, of which 600 are for psychogeriatric cases. Home care is in charge of a network of 38 medico-social centres with multidisciplinary teams including psychiatric nurses. Several nursing homes, some specialized in psychogeriatrics, are equipped, besides long-stay beds, by units for temporary care, for medico-social emergencies and for medico-social observations. Moreover, in Lausanne (250,000 inhabitants) an 'Orientation Office of Medico-Social Emergencies', with psychiatric nurses, assumes emergencies at home and by-passes hospitalizations of medico-social cases in the General Hospital, by the resource of medico-social emergency beds in the nursing homes. The medico-social network thus designed in this way is profoundly permeated with the reality of psychogeriatrics.

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[Interruption of the aortic arch: a neonatal emergency. Report of 50 cases ].

Interruption of the aortic arch, associated with curable cardiovascular anomalies (8 times out of 10) was observed over a period of 8 years in 50 children aged less than 10 days in 80% of cases. They presented with congestive heart failure, with variable degree of shock in most cases, suggesting the diagnoses of left ventricular hypoplasia or coarctation syndrome. Diagnosis was established with ultrasound and angiocardiography. Evolution was lethal in 21 children who were not operated on. 20 children were operated on: before treatment with prostaglandin E1, 9 attempts ended up in 78% immediate mortality and 89% global mortality; after treatment with prostaglandin. E1, these figures were respectively reduced to 45% and 55% (20 cases). This malformation should therefore be recognized as an emergency and then treated with prostaglandin up to surgery.

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[Psychotherapy of neurotic disorders in older adults: a new doorway to life].

The general concept of neurosis in old age includes the classical forms as well as the ones specific to this particular community and, also, the reactions to social circumstances. This point of view practically covers the greatest part of the behavior that the ones we call "elders" usually show and almost drives us to give a psychological definition of this state. Etiology of these disorders is plural. It involves the role of the emotional past, of the medicosocial implications of ageing, especially regarding affectivity. Psychotherapeutic intervention needs a great pliancy allowing to interfere both on the pragmatic and the interpretative levels. The freudian prejudice build up on the impediment of psycho-affective rigidity hides the unconscious fears of the therapist towards his own old age as well as the fear of being questioned about his efficiency. A restriction in the means as well as in the therapeutic ambition is not underrating but rather valorizing his action in which he must show self-control and suppleness. This psychotherapy must catalyze the energy that the elderly displays in his quest of unity. It trends to give back the individual an unlimited opening on life.

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