Lege Artis Medicinae

[Cochlear implantation: results and perspectives in the therapy of profound deafness in Hungary]

KÜSTEL Marianna, RIBÁRI Ottó, RÉPÁSSY Gábor

APRIL 20, 2002

Lege Artis Medicinae - 2002;12(04)

[Cochlear implantation is a relatively new method that revolutionised the therapy of bilateral deafness and profound hearing loss of inner ear origin which could not be treated with surgery before. The function of the inner ear that is irreversibly damaged either because of congenital causes, trauma, infection or unknown origin is substituted by cochlear implant. In implanted patients the device fixed in the middle ear transmits the previously transformed electrical stimuli directly to the cochlear nerve via the electrodes inserted in the inner ear. Prior to implantation there is a detailed selection process and also a lengthy, followed by a several-year-long rehabilitation period, resulting in nearly perfect speech discrimination without lipreading in most cases. Cochlear implantation is indicated in the first place in case of prelingual deafs under 5 and postlingual deaf patients of any age. In the article authors discuss the theoretical basis, technical background and indications of cochlear implantation, while also providing an overview of the whole procedure from the preoperative examinations to postoperative rehabilitation.]

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[BACKGROUND - Several studies have shown that a substantial part of patients with mood and anxiety disorders seeks help at their primary care physician. It is well known that recognition of these disorders cause difficulties for general practitioners. In our study starting in 1998, we attempted to map the psychiatric disorders present in primary care patients. This paper investigates the factors that may contribute to the difficulties in recognition and diagnosis of mental disorders. METHOD - 1815 primary care patients in 12 general practice offices has been evaluated for mood and/or anxiety disorders with DIS interview. The DIS diagnosis was compared with complaints and symptoms of patients and diagnosis given by their GPs. RESULTS - Diagnosis given by GPs and DIS evaluation showed low concordance. The main factor in this proved to be the presence of somatic disorders, whereas socio-demographic factors played little role. The highest concordance of diagnosis was found when acute or chronic somatic disorders were not present.]

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