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EN
The article concerns the circumstances of the creation of neurology and psychiatry faculties at the Stefan Batory University in Vilnius, established in 1919. It presents the difficult working conditions of the teaching faculties created after the Partitions period - the strive for the correct equipment, localization and staff. It examines the changes in those two faculties in the period of 15 years, until they were merged into one administrative structure in 1934. It also shows the scientific and didactic efforts of those faculties, underlining the independence of the teaching from the usual European approaches to neurology and psychiatry. The article is based on the analysis if the sources taken from the Vilnius archives.
2
Content available remote Technika wstrząsów magnetycznych
PL
Od ponad 10 lat trwają badania nad nową techniką magnetowstrząsów. Przesłankami dla nich były: wysoka efektywność terapii elektrowstrząsowej EW, niezbyt duża skuteczność terapeutyczna przezczaszkowej stymulacji magnetycznej TMS, pewien potencjał drgawko rodny stymulacji TMS. Skonstruowane zostały wystarczająco silne stymulatory magnetyczne, które były w stanie w sposób powtarzalny wyzwalać w mózgu naczelnych i człowieka czynność napadową. Dotychczasowe badania skoncentrowały się jednak głównie na ocenie bezpieczeństwa, a nie realnej skuteczności klinicznej nowej metody. Praca prezentuje kilka uwag krytycznych w stosunku do techniki MST/MCT.
EN
More than 10 years have passed since investigations on a new technique of magnetic seizures (MST = magnetic seizure therapy; MCT = magnetoconvulsive therapy) have begun. The circumstances for them were: a high efficiency of the electroconvulsive therapy ECT, low therapeutic efficacy of transcranial magnetic stimulation TMS, and a certain proconvulsive potential of TMS. Sufficiently strong magnetic stimulators were constructed, with which it is been able to evoke in repetitive way the paroxysmal activity in brain of hominids and humans. Hitherto existing studiem concentrated however mainly on the safety of MST/MCT, and not its real clinical effectiveness. The work presents several critical considerations In the relation to the technique MST/MCT.
3
Content available remote Historia zastosowania stymulacji elektrycznej w psychiatrii
PL
Od czasów prehistorycznych trwają próby wykorzystania terapeutycznego stymulacji elektrycznej - również w przypadku zaburzeń natury psychiatrycznej. Wykorzystywane były zarówno naturalne źródła (bursztyn, ryby elektryczne), jak i sztuczne źródła „elektryczności” (maszyny elektrostatyczne, stosy Wolty, butelki lejdejskie, inne generatory prądu elektrycznego). Realną skuteczność dawnych metod stymulacyjnych - niedrgawkowych - ocenić można za niewielką lub żadną. Nowoczesną epokę stosowania stymulacji elektrycznej w psychiatrii rozpoczyna wprowadzenie elektrowstrząsów EW.
EN
The efforts of therapeutic utilization of the electric stimulation (also in the case of the psychiatric disorders) last from prehistoric times. They were used both natural sources (amber, electric fish), and artificial sources „electricity” (electrostatic machines, Volt's stocks, Leyden bottles, the different generators of the electric current). The real effectiveness of former (non-convulsive) stimulation methods can be estimated as low or non. The modern epoch of applying electric stimulation in psychiatry begins by introduction of electroconvulsive therapy ECT.
4
Content available remote Problemy z placebo i ślepą próbą magnetycznej stosowanych w psychiatrii
EN
Except pharmacotherapy in treatment of various psychiatric disorders are used different physical techniques based on the electrical or magnetic stimulation of the head/brain. Confirmation of the effectiveness of the given method requires clinical investigations conducted in the blinded conditions and in the control to placebo. The paper presents difficulties connected with the assurance of these conditions in the case of chosen physical methods.
PL
Oprócz farmakoterapii w leczeniu rozmaitych zaburzeń psychiatrycznych wykorzystuje się różne techniki fizykalne polegające np. na stymulacji elektrycznej lub magnetycznej głowy/mózgu. Potwierdzenie skuteczności danej metody wymaga badań klinicznych przeprowadzonych w warunkach zaślepienia oraz w kontroli do placebo. Praca prezentuje trudności związane z zapewnieniem tych warunków właśnie w przypadku wybranych metod fizykalnych.
EN
Recent technological developments concerning Web 2.0 have enabled the use of three-dimensional virtual platforms for educational purposes. In this paper, focus is placed on the modification of an OpenSimulator based 3D environment for its reuse in a different field of medical education; developments are presented alongside the associated effort to reconstruct and repurpose this environment so as to fit medical specialties of different clinical skills. The aim of this study was to present repurposing aspects of a learning environment modification and adaption to the needs of various medical specialties, in an attempt to reuse- and therefore share- learning content between different medical areas. Initially, a 3-Dimensional environment was created using the OpenSim platform for use in cardiology. Then, the virtual environment was modified so as to be oriented to the needs of psychiatry. The reconstruction of the educational environment and context and the reformation of the educational clinical scenario offer the possibility of reusability of this content which can be tailored to the needs of each medical field.
6
Content available remote Psychiatria XX wieku w Europie Zachodniej i USA - próba retrospekcji
EN
The article analyzes various areas of twentieth-century psychiatry: (1) a number of ideas whose roots date to the second half of the 19th century, including the ideas of biological psychiatry, constitutional psychiatry and behavioural therapy; (2) the emergence of a modem paradigm of mental disease and the contribution made to that field by Kraepaelin and Bleuler; (3) attempts to find new effective solutions, especially with regard ot biological therapy; (4) an overview of the problems and dilemmas of contemporary psychiatry. Special emphasis has been put in the article on the stages and dimensions of the socalled ’’psychopharmacological revolution” and the history of the development of various groups of psychiatric drugs (chlorpromazine and the first psychiatric drugs, soporifics and sedatives, antidepressants). The author makes an attempt to point out the fundamental dilemmas of contemporary psychiatry, especially the dangers it faces from other branches of medicine and non-medical disciplines, as well as from mass culture and commercialization.
7
EN
Due to the specific political and economic conditions under which Poland found itself in the 19th century, including above all the lack of independent statehood, any attempt to identify the directions of change in psychiatric care observed in the lands of Poland in that period can be undertaken mainly through an analysis of those scientifc and general-purpose medical writings of the period which point to the formation and transformation in the physicians' awareness, rather than by an assessment of the particular practical achievements the transformations in health care as such. In her search for traces of the first mentions of new ideas in psychiatric care, the author analyzes the general-purpose writings of August Ferdinande Wolff and Józef Frank, as well as the first specialist writings in the field, by Józef Jakubowski and Józef Korzeniowski, which appeared in the 1830 and 1840s. She indicates the sources of inspiration and describes the emergence of the so-called psychomoral approach in treatment. At the same time she gives a background for the new ideas, by describing the realities of the psychiatric institutions of the time, where mechanicalsurgical and somatic treatment predominated. She shows the effort made by such pioneers as, e.g., Klemens Maliszewski and Damian Reykowski of Vilnius, who brought about a change in the views on the etiology and prognosis of mental illnesses, and contributed to the gradual introduction of psychologically based treatments and to the inclusion of the care of patients in their treatment, especially since the 1870s, when new forms of psychiatric care had begun to appear, including psychiatric care outside hospitals.
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