This paper presents a series of stratagems designed to minimize the potential psychological problems of children who require dermatological surgery. After discussing the "normal" critical periods of childhood, the selective approaches to children at different ages are presented. General and specific suggestions are made for pre- and postoperative management for both office and hospital surgical procedures.
This paper presents another causative or additive factor in the production of post-cardiotomy delirium. Comparison of two matched groups of patients from the National Heart Institute reveals a marked difference in the incidence of psychosis between the group that is from the United States and speaks English and the group that is foreign and has no ability to communicate in English. The United States group had two patients with psychosis (3.9 percent), while the foreign group had fifteen (29.4 percent) (p<0.001). A higher incidence of delirium occurred in men than women, and there was suggestive evidence that the group with psychoses had more medical complications, with resulting delays in discharge. The importance of language and culture in the determination of this delirium are considered and methods of mitigating this reaction are presented.
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