Conflict play and its modification in the course of treating children

The authors report their experience with a special form of psychodrama for the treatment in small groups of neurotic children aged five to fifteen. The acting out of ambivalent, partly unconscious and restrained tendencies and inclinations by playing, i.e., by taking roles in spontaneous performances, is followed by alternation of identification in the group and, possibly, careful indirect verbalization by the therapeutist and/or group, of which the purpose is to arrive at a reorientation of the attitudes of patients and a consolidation of the newly won attitude.     

Aortic isthmus stenosis from a neurological viewpoint

The etiology, pathogenesis, and clinical treatment of stenoses of the isthmus aortae are outlined. Following this, the particular case of a 41-year-old patient with typical stenosis of the isthmus of the aorta is reported. The course of disease required the need for a surgical operation, which had not initially been taken into consideration, to be reexamined. The patient, after performance on him of vascular restoration, is now on a part-time job. Using age as the sole circumstance indicating the inadvisability of performing a surgical operation in the case of stenosis of the isthmus aortae cannot any longer be considered justifiable.     

Cardiac autonomic reactivity and recovery in predicting carotid atherosclerosis: the cardiovascular risk in young Finns study.

The present study examined the association of cardiac autonomic task-induced reactivity and recovery to preclinical atherosclerosis. Thirty-three men and 33 women aged 24-39 years participated in the ongoing epidemiological Cardiovascular Risk in Young Finns study. The authors measured heart rate (HR), respiratory sinus arrhythmia (RSA), and preejection period (PEP) during the mental arithmetic and speech tasks in 1999. Carotid atherosclerosis was assessed by measuring the thickness of the common carotid artery intima-media complex (IMT) with ultrasound in 2001. Higher HR, RSA, and PEP reactivity were associated with lower IMT values even after adjusting for cardiovascular risk factors (lipid levels, obesity, and blood pressure). In addition, better HR recovery after the mental arithmetic task was associated with lower IMT values, and this association persisted after all adjustments. Thus, higher task-induced cardiac autonomic reactivity and better HR recovery were related to less preclinical atherosclerosis. The authors concluded that cardiac pattern of reactivity and quick recovery may be associated with better cardiovascular health, and therefore all reactivity occurring in challenging situations should not automatically be considered as potentially pathological.