Diagnose and treat testis torsion immediately (always suspect torsion in children and young adults who are not yet sexually active). Treat epididymitis with antimicrobials. In adolescents, remember the possibility of a chlamydia infection. Diagnose varicocele as a cause of prolonged testis pain. In association with acute abdominal pain, remember to examine the testes.
In association with depression, the patient often has other mental disorders as well, most commonly anxiety disorders (10–50 %), substance abuse disorders (10–30 %) and personality disorders (10–50 %).The associated disorders have significance on the prognosis and functional ability so that concomitant occurrence of the disorders renders the treatment more challenging and increases the risk of a reduction in the functional ability.
Pain management, prevention of venous thrombosis and reduction of swelling in the stump are the principal goals in the acute phase. Physiotherapy should be introduced as soon as tolerated in order to restore optimal functional capacity and mobility. Plans must be made as regards suitable rehabilitation, equipment and adaptations to the patient’s home.
Always remember the possibility of cervical spine injury in an unconscious trauma patient (cervical spine x-rays are more important than a skull x-ray; in clear suspicion of a fracture, a CT scan is the primary investigation). Injuries to the spine are most often associated with falling from a height or falling over. Note particularly the risk groups that may suffer a fracture of the spine even after a low-energy trauma: elderly persons, especially if an accidental fall is associated with head injury or if the person falls to a sitting position patients with ankylosing spondylitis or osteoporotic changes in the spine. The patient must be moved in supine position, and if a cervical spine injury is suspected the patient's neck has to be supported with a collar. If the patient is conscious, a muscle spasm will provide some protection to the injured site. Moving an unconscious patient requires particular care.
Determine the level of the disorder: is there a damage to the peripheral nerve system (e.g. disorder of a nerve plexus) only one affected nerve, i.e., mononeuropathy systematic peripheral nerve damage, i.e., polyneuropathy. The symptoms can be motor, sensory, autonomic or all these together. Many neuropathies are caused by a systemic disease, the most common causes being diabetes and excessive consumption of alcohol.
The term dual diagnosis denotes a condition where substance dependence, or other excessive substance use, co-occurs with at least one mental health disorder that is not a direct effect of the substance use (intoxication and withdrawal symptoms).Substance abuse (alcohol, legal and illegal drugs and solvents) may affect a patient’s mental illness in different ways. It may precipitate mental illness worsen mental illness alleviate mental illness have no effect on mental illness. The relationship between the patient’s different mental health disorders and substance abuse is not necessarily always the same. In dual diagnosis, mental illness will persist even when substance use has ceased for a prolonged length of time.