ICD 10. CLASS XVIII. SYMPTOMS, SIGNS AND DEVIATIONS FROM THE NORM, IDENTIFIED DURING CLINICAL AND LABORATORY STUDIES, NOT CLASSIFIED OTHERWISE (R20-R49)
SYMPTOMS AND SIGNS RELATING TO THE SKIN AND SUBcutaneous Tissue (R20-R23)
R20 Skin sensitivity disorder
Excluded: dissociative anesthesia and sensory loss
perception ( F44.6)
psychogenic disorders ( F45.8)
R20.0 Skin anesthesia
R20.1 Skin hypoesthesia
R20.2 Skin paresthesia. "Crawling" sensation. "pins and needles" sensation
Excludes: acroparesthesia ( I73.8)
R20.3 Hyperesthesia
R20.8 Other and unspecified violations skin sensitivity
R21 Rash and other nonspecific skin eruptions
R22 Localized bulging, induration or swelling of the skin and subcutaneous tissue
Includes: subcutaneous nodules (localized) (superficial)
Excluded: deviations from the norm detected upon receipt
diagnostic image ( R90-R93)
enlarged The lymph nodes (R59. -)
localized fat deposition ( E65)
hardness or swelling:
mammary gland ( N63)
intra-abdominal or pelvic ( R19.0)
swelling ( R60. -)
intra-abdominal or pelvic bulge ( R19.0)
swelling of the joints ( M25.4)
R22.0 Localized bulging, induration, or swelling in the scalp
R22.1 Localized bulging, induration, or swelling in the neck area
R22.2 Localized bulging, induration, or swelling in the torso area
R22.3 Localized bulging, induration, or swelling of the upper limb
R22.4 Localized bulging, induration, or swelling in the lower extremity
R22.7 Localized bulging, hardening, or swelling of multiple areas of the body
R22.9 Localized bulging, induration, or swelling, unspecified
R23 Other skin changes
R23.0 Cyanosis
Excluded: acrocyanosis ( I73.8)
attack of cyanosis in a newborn ( P28.2)
R23.1 Pallor. Cold, damp skin
R23.2 Hyperemia. Excessive redness
Excludes: associated with menopause and menopause in women ( N95.1)
R23.3 Spontaneous ecchymoses. Petechiae
Excluded: ecchymosis in the fetus and newborn ( P54.5)
purpura ( D69. -)
R23.4 Changes in skin structure
Peeling)
Seal ) skin
Scaly)
Excludes: epidermal thickening NOS ( L85.9)
R23.8 Other and unspecified skin changes
SYMPTOMS AND SIGNS RELATING TO THE NERVOUS AND MUSCULOSCAL SYSTEMS (R25-R29)
R25 Abnormal involuntary movements
Excluded: specific movement disorders (G20-G26)
stereotypical movement disorders ( F98.4)
tics ( F95. -)
R25.0 Abnormal head movements
R25.1 Tremor, unspecified
Excludes: chorea NOS ( G25.5)
tremor:
essential ( G25.0)
dissociative ( F44.4)
intentional ( G25.2)
R25.2 Cramp and spasm
Excluded: carpopedal spasm ( R29.0)
baby spasms ( G40.4)
R25.3 Fasciculation. Jerking NOS
R25.8 Other and unspecified abnormal involuntary movements
R26 Gait and mobility disorders
Excluded: ataxia:
NOS ( R27.0)
hereditary ( G11. -)
motor (syphilitic) ( A52.1)
immobility syndrome (paraplegic) ( M62.3)
R26.0 Ataxic gait. Unsteady gait
R26.1 Paralytic gait. Spastic gait
R26.2 Difficulty in walking, not elsewhere classified
R26.8 Other and unspecified gait and mobility disorders. Unsteadiness when walking NOS
R27 Other coordination disorder
Excluded: ataxic gait ( R26.0)
hereditary ataxia (G11. -)
dizziness NOS ( R42)
R27.0 Ataxia unspecified
R27.8 Other and unspecified coordination disorder
R29 Other symptoms and signs relating to the nervous and musculoskeletal systems
R29.0 Tetany. Carpopedal spasm
Excluded: tetany:
dissociative ( F44.5)
newborn ( P71.3)
parathyroid ( E20.9)
after removal thyroid gland (E89.2)
R29.1 Meningism
R29.2 Abnormal reflex
Excludes: abnormal pupillary reflex ( H57.0)
elevated vomiting reflex (J39.2)
vasovagal reaction, or fainting ( R55)
R29.3 Abnormal body position
R29.4 Snapping hip
Excludes: congenital hip deformity ( Q65. -)
R29.8 Other and unspecified symptoms and signs related to the nervous and musculoskeletal systems
SYMPTOMS AND SIGNS RELATED TO THE URINARY SYSTEM (R30-R39)
R30 Pain associated with urination
Excludes: psychogenic pain ( F45.3)
R30.0 Dysuria. Difficulty urinating [strangury]
R30.1 Tenesmus Bladder
R30.9 Painful urination, unspecified. Painful urination NOS
R31 Nonspecific hematuria
Excludes: recurrent or persistent hematuria ( N02. -)
R32 Urinary incontinence, unspecified
Enuresis NOS
Excluded: enuresis of inorganic nature ( F98.0)
stress-induced urinary incontinence and others
specified urinary incontinence ( N39.3-N39.4)
R33 Urinary retention
R34 Anuria and oliguria
Excluded: cases complicating:
abortion, ectopic or molar pregnancy ( O00
-O07
, O08.4
)
pregnancy, childbirth and postpartum period (O26.8, O90.4)
R35 Polyuria
Frequent urination
Nocturnal polyuria [nocturia]
Excludes: psychogenic polyuria ( F45.3)
R36 Discharge from the urethra
Discharge from the male penis
R39 Other symptoms and signs related to the urinary system
R39.0 Extravasation of urine
R39.1 Other difficulties related to urination. Intermittent urination. Weak stream of urine
Split stream of urine
R39.2 Extrarenal uremia. Prerenal uremia
R39.8 Other and unspecified symptoms and signs related to the urinary system
SYMPTOMS AND SIGNS RELATED TO COGNITIVE ABILITY
PERCEPTION, EMOTIONAL STATE AND BEHAVIOR (R40-R46)
Excluded: symptoms and signs that are part of the clinical picture mental disorder (F00-F99)
R40 Doubt, stupor and coma
Excluded: coma:
diabetic ( E10-E14 with a common fourth character.0)
hepatic ( K72. -)
hypoglycemic (non-diabetic) ( E15)
newborn ( P91.5)
uremic ( N19)
R40.0 Doubtfulness [hypersomnia]. Drowsiness
R40.1 Stupor. Prekoma
Excluded: stupor:
catatonic ( F20.2)
depressive ( F31-F33)
dissociative ( F44.2)
manic ( F30.2)
R40.2 Coma unspecified. Unconscious state NOS
R41 Other symptoms and signs related to cognition and awareness
Excludes: dissociative [conversion] disorders ( F44. -)
R41.0 Disorientation, unspecified. Blackout NOS
Excluded: psychogenic disorientation ( F44.8)
R41.1 Anterograde amnesia
R41.2 Retrograde amnesia
R41.3 Other amnesias. Amnesia NOS
Excluded: amnesic syndrome:
caused by the consumption of psychoactive substances
funds ( F10-F19 with a common fourth character.6)
organic ( F04)
transient complete amnesia ( G45.4)
R41.8 Other and unspecified symptoms and signs related to cognition and awareness
R42 Dizziness and loss of stability
"Lightness" of the head
Dizziness NOS
Excluded: syndromes related to dizziness ( H81. -)
R43 Impaired sense of smell and taste
R43.0 Anosmia
R43.1 Parosmia
R43.2 Parageusia
R43.8 Other and unspecified disorders of smell and taste. Combined impairment of smell and taste
R44 Other symptoms and signs relating to general sensations and perceptions
Excluded: disorders of skin sensitivity ( R20. -)
R44.0 Auditory hallucinations
R44.1 Visual hallucinations
R44.2 Other hallucinations
R44.3 Hallucinations, unspecified
R44.8 Other and unspecified symptoms and signs related to general sensations and perceptions
R45 Symptoms and signs related to emotional state
R45.0 Nervousness. Nervous tension
R45.1 Anxiety and agitation
R45.2 A state of anxiety due to failures and misfortunes. Anxious state NOS
R45.3 Demoralization and apathy
R45.4 Irritability and anger
R45.5 Hostility
R45.6 Physical aggressiveness
R45.7 State of emotional shock and stress, unspecified
R45.8 Other symptoms and signs related to emotional state
R46 Symptoms and signs relating to appearance and behavior
R46.0 Very low level personal hygiene
R46.1 Fancy appearance
R46.2 Strange and inexplicable behavior
R46.3 Excessive activity
R46.4 Lethargy and slow reaction
Excluded: stupor ( R40.1)
R46.5 Suspiciousness and obvious evasiveness
R46.6 Excessive interest and increased attention to stressful events
R46.7 Verbosity and unnecessary details that make unclear reason contact
R46.8 Other symptoms and signs related to appearance and behavior
SYMPTOMS AND SIGNS RELATED TO SPEECH AND VOICE (R47-R49)
R47 Speech disorders not elsewhere classified
Excluded: autism ( F84.0-F84.1)
speech excitedly ( F98.6)
specific developmental disorders of speech and language ( F80. -)
stammering [stammering] ( F98.5)
R47.0 Dysphasia and aphasia
Excludes: progressive isolated aphasia ( G31.0)
R47.1 Dysarthria and anarthria
R47.8 Other and unspecified speech disorders
R48 Dyslexia and other disorders of recognition and understanding of symbols and signs, not classified elsewhere
Excluded: specific developmental disorders of learning skills ( F81. -)
R48.0 Dyslexia and Alexia
R48.1 Agnosia
R48.2 Apraxia
R48.8 Other and unspecified impairments in the recognition and understanding of symbols and signs. Acalculia. Agraphia
R49 Voice disorders
R49.0 Dysphonia. Hoarseness
R49.1 Aphonia. Loss of voice
R49.2 Open twang and closed twang
R49.8 Other and unspecified voice disorders. Voice change NOS
Hibernation, lethargy, numbness Dictionary of Russian synonyms. stupor noun, number of synonyms: 3 lethargy (39) ... Synonym dictionary
SOPOR- SOPOR, pat. sleep state observed in a number of diseases of the central nervous system and in case of severe general suffering (infection, intoxication). According to the patient's condition, S. occupies a middle place between drowsiness and coma. Under drowsiness usually... Big medical encyclopedia
- (from the Latin sopor, numbness, lethargy), deep depression of consciousness with loss of voluntary and preservation of reflex activity (with severe intoxications, traumatic brain injury, etc.). Further depression of consciousness leads to coma... Modern encyclopedia
- (from the Latin sopor, torpor, lethargy), deep depression of consciousness with loss of voluntary and preservation of reflex activity. Further depression of consciousness leads to coma... Big encyclopedic Dictionary
- (lat. sopor numbness, sleep) one of the forms of deep disorder of consciousness, in which the patient has no reaction to the environment, reflex activity, reaction to strong stimuli and the ability to mental activity; more often … Dictionary of foreign words of the Russian language
- (from the Latin sopor, numbness, lethargy), deep depression of consciousness with loss of voluntary and preservation of reflex activity. Further depression of consciousness leads to coma. * * * SUPOR SUPOR (from lat. sopor numbness, lethargy), deep... ... encyclopedic Dictionary
Sopor- (Latin sopor - unconsciousness) - a violation of consciousness, occupying an intermediate place between stunned consciousness and coma. Characterized by disconnection from reality, loss of self-perception, interruption of contacts with others, cessation of all types... ... Encyclopedic Dictionary of Psychology and Pedagogy
- (sopor; lat. unconsciousness; syn.: soporous state, subcoma) deep stage stunning, in which there are no reactions to verbal treatment and only reactions to painful stimulation are preserved... Big medical dictionary
- (from Lat. sopor numbness, lethargy) deep depression of consciousness while maintaining Reflexes. The patient in S. is passive, indifferent, although he is able to respond to some strong external stimuli by calling out, persistent repeated orders, etc... Great Soviet Encyclopedia
I Sopor (lag. sopor unconsciousness) see Stunning. II Stupor (sopor; lat. “unconsciousness”; synonym: stuporous state, subcoma) is a deep stage of stupor, in which there are no reactions to verbal treatment and only reactions to pain are preserved... ... Medical encyclopedia
Developmental brain dysfunction due to traumatic brain injury can be caused by:
- damage to the skull and secondary compression of the brain by bone fragments. The most serious is a fracture of the base of the skull, accompanied by bleeding and cerebrospinal fluid leakage from the nose, pharynx, and ears;
- brain contusion, i.e. contusional damage to the brain substance at the site of impact and in the area of counter-impact. During an impact (concussion), the brain is displaced in the cranial cavity in the direction of the impact. In addition to the cerebral hemispheres, the brain stem is damaged; often it is the brain stem symptoms that become leading in clinical picture cerebral coma.
In the cases listed above, epi-, subdural, subarachnoid, intraventricular, and parenchymal bleeding are possible. Subarachnoid bleeding and subdural hematomas are more often observed, contributing to brain dislocation and compression, and the development of cerebral coma.
Circulatory disorders, hypercoagulation, hypoxia, lactic acidosis and irritation of the meninges with blood and detritus are the main causes of impaired consciousness and features clinical symptoms cerebral coma.
Morphologically, hemorrhages and necrosis of brain tissue are detected, mainly at the site of direct injury. With increasing edema-swelling of the brain, these phenomena can become diffuse until complete aseptic or septic (in case of open injury) melting.
Often cranial cerebral coma develops gradually (after a light interval of several hours), which is associated with the growth of intracranial hematoma. Wherein complete loss Consciousness is preceded by somnolence, stupor, and stupor. The most important clinical signs promotion intracranial pressure are headache and the symptom of vomiting, which is part of the cerebral syndrome.
General cerebral phenomena in cerebral coma are always accompanied by meningeal and focal symptoms. In TBI they are affected cranial nerves, severe paresis and paralysis develop to varying degrees. Disturbances in the rhythm of breathing and pulse may be a sign of damage to the trunk. Brain dislocation is accompanied by anisocoria, hyperthermia, and bradycardia.
Diagnosis of TBI is based on medical history, M-echography of the skull (deviation of the echo signal by more than 2 mm from the axis), computed tomography or nuclear magnetic tomography. Diagnostic lumbar puncture must be performed with great care. EEG and angiography complement the main examination methods.
Principles of treatment of cerebral coma in TBI:
- ensuring vital functions, starting from the moment of transportation, the patient is transferred to a lying position on his side or on his back, be sure to turn his head to the side (in order to prevent aspiration of vomit or blood and cerebrospinal fluid in case of a fracture of the base of the skull);
- oxygen therapy while maintaining spontaneous ventilation or during mechanical ventilation;
- restoration of bcc and microcirculation in blood vessels using plasma substitutes (albumin, rheopolyglucin);
- neurovegetative blockade;
- antibiotics wide range actions (in some cases, dexazone is used as a means to prevent swelling);
- neurosurgical intervention is performed urgently when verifying a hematoma, depressed or comminuted fractures skull bones.
Brain coma due to inflammation
Primary inflammation of the brain in children can be in the form of meningitis (inflammation soft shell), encephalitis (parenchymal inflammation), meningoencephalitis, as well as meningoencephalomyelitis.
The causes of cerebral coma of an inflammatory nature are very diverse. Their causative agents can be bacteria, viruses, fungi, and rickettsia. Among the bacterial group, meningococcal, pneumococcal, staphylo- and streptococcal are most often observed in children, as well as tuberculous meningitis or meningoencephalitis, meningitis caused by Haemophilus influenzae. Enteroviral and mumps etiology serous meningitis dominates Lately among viral meningitis.
The causative agents of meningitis penetrate into brain tissue mainly hematogenously, but lymphogenous and perineural penetration is also possible. Usually, inflammatory process is developing rapidly, clinical manifestations meningitis often become maximum by the 3-4th day (except for tuberculosis).
The main pathogenetic factors causing the symptoms of cerebral coma are brain edema, hypoxia, and toxic-hypoxic cell damage. Dystrophic and necrotic changes are observed at the site of inflammation. General cerebral and meningeal symptoms occur against the background of a febrile reaction, external manifestations specific infectious disease. With encephalitis (meningoencephalitis) there are also pronounced violation consciousness and emergence focal symptoms. Cranial nerves are most often affected.
When diagnosing cerebral coma accompanied by brain damage, the entire range of conventional studies is used, including mandatory spinal tap with microscopy, biochemical examination and culture of cerebrospinal fluid.
Cerebral coma of this etiology is treated as follows:
- targeted antibacterial and antiviral therapy, the choice of which is determined by the diagnosis of the disease. Typically, intramuscular and intravenous methods of drug administration are used. The dose of antibiotics is determined by their ability to penetrate the blood-brain barrier under pathological conditions. In this regard, penicillins, for example, are administered in high doses;
- fight against cerebral edema (diuretics, plasma expanders, corticosteroids) and its hypoxia (oxygen therapy, mechanical ventilation);
- detoxification (fluid infusion in a volume of 20-50 ml/kg per day);
- symptomatic therapy (anticonvulsants in the presence of seizures, neurovegetative blockade during agitation, antipyretic therapy, etc.).
Coma- unconsciousness caused by dysfunction of the brain stem.
Code by international classification diseases ICD-10:
- R40.2
Causes
Etiology: cranial - brain injury, stroke, infection, status epilepticus, brain tumors, exogenous intoxications, systemic metabolic disorders ( diabetes, hypoglycemia, uremia, eclampsia, thyrotoxicosis), etc. A decisive role in the development of coma is played by damage to the ascending activating systems brain stem and interstitial brain.
Symptoms, course. Depending on the severity of the disorder vital functions whom are divided into several degrees. At mild degree comatose patients react to painful stimuli; reflexes from the nasal mucosa, corneal and pupillary, are preserved; sometimes tendon reflexes persist and Babinski's sign is caused. Severe degree of coma: reaction only to intense painful stimuli, swallowing is impaired, but if food gets into the Airways a reflex cough occurs; stertorous breathing, often of the Cheyne-Stokes type. Deep coma: areflexia, atony, mydriasis, gross violations breathing and blood circulation. Transcendental (terminal) coma: the patient’s vital activity is maintained only due to artificial ventilation lungs and heart stimulation.
Treatment
Treatment. When establishing the nature of the coma - pathogenetic therapy. At all stages of coma - resuscitation measures.
Forecast depends on the cause of the coma and the severity of the brainstem damage. In deep coma, the prognosis is often unfavorable; absolutely unfavorable prognosis for extreme coma.
Diagnosis code according to ICD-10. R40.2
Nervous regulation of the heart is carried out by sympathetic and parasympathetic impulses. The former increase the frequency, strength of contractions, and blood pressure, while the latter have the opposite effect. Age-related changes in the tone of the autonomic nervous system are taken into account when prescribing treatment.
The sympathetic nervous system is designed to activate all body functions when stressful situation. It provides a fight-or-flight response. Under the influence of irritation of the nerve fibers that enter it, the following changes occur:
- mild bronchospasm;
- narrowing of arteries, arterioles, especially those located in the skin, intestines and kidneys;
- contraction of the uterus, bladder sphincters, spleen capsule;
- spasm of the iris muscle, dilation of the pupil;
- demotion motor activity and tone of the intestinal wall;
- accelerated
Strengthening all cardiac functions - excitability, conductivity, contractility, automaticity, breakdown of adipose tissue and the release of renin by the kidneys (increases blood pressure) are associated with irritation of beta-1 adrenergic receptors. And stimulation of type 2 beta leads to:
- dilatation of the bronchi;
- relaxation of the muscular wall of arterioles in the liver and muscles;
- breakdown of glycogen;
- release of insulin to carry glucose into cells;
- energy generation;
- decreased uterine tone.
The sympathetic system does not always have a unidirectional effect on organs, which is due to the presence of several types of adrenergic receptors in them. Ultimately, the body's tolerance to physical and mental stress increases, the work of the heart and skeletal muscles increases, and blood circulation is redistributed to nourish vital organs.
What is the difference between the parasympathetic system
This part of the autonomic nervous system is designed to relax the body, recover from exercise, ensure digestion and store energy. When the vagus nerve is activated:
- blood flow to the stomach and intestines increases;
- the release of digestive enzymes and bile production increases;
- the bronchi narrow (at rest, much oxygen is not required);
- the rhythm of contractions slows down, their strength decreases;
- arterial tone decreases and
The influence of two systems on the heart
Despite the fact that on cardiovascular system Sympathetic and parasympathetic stimulation have opposite effects, this is not always so clearly manifested. And the mechanisms of their mutual influence do not have a mathematical pattern; not all of them have been sufficiently studied, but it has been established:
- the more it rises sympathetic tone, the stronger the suppressive effect of the parasympathetic department will be - accentuated opposition;
- when the desired result is achieved (for example, acceleration of the rhythm during exercise), the sympathetic and parasympathetic influence is inhibited - functional synergism (unidirectional action);
- the higher First level activation, the less the possibility of its increase during irritation - the law of the initial level.
Watch the video about the effect of the sympathetic and parasympathetic systems on the heart:
The influence of age on autonomic tone
In newborns, the influence of the sympathetic department predominates against the background of general immaturity nervous regulation. Therefore, they have significantly accelerated. Then both parts autonomic system develop very quickly, reaching a maximum by adolescence. At this time it is celebrated highest concentration nerve plexuses in the myocardium, which explains the rapid change in pressure and contraction speed under external influences.
Up to 40 years of age predominates parasympathetic tone, which affects the slowing of the heart rate at rest and its rapid return to normal after exercise. And then they begin age-related changes– the number of adrenergic receptors is reduced while the parasympathetic ganglia are preserved. This leads to the following processes:
- excitability worsens muscle fibers;
- the processes of impulse formation are disrupted;
- the sensitivity of the vascular wall and myocardium to the action of stress hormones increases.
Under the influence of ischemia, cells become even more responsive to sympathetic impulses and respond to even the slightest signals by spasming the arteries and accelerating the pulse. At the same time, the electrical instability of the myocardium increases, which explains the frequent occurrence with, and especially with.
It has been proven that disturbances in sympathetic innervation are many times greater than the zone of destruction during acute disorder coronary circulation.
What happens when you get excited
The heart contains mainly beta 1 adrenergic receptors, some beta 2 and alpha type. Moreover, they are located on the surface of cardiomyocytes, which increases their accessibility to the main transmitter (conductor) of sympathetic impulses - norepinephrine. Under the influence of receptor activation, the following changes occur:
- cell excitability increases sinus node, conduction system, muscle fibers, they react even to subthreshold signals;
- conduction of the electrical impulse is accelerated;
- the amplitude of contractions increases;
- the number of pulse beats per minute increases.
Parasympathetic cholinergic receptors of type M are also found on the outer membrane of heart cells. Their excitation inhibits the activity of the sinus node, but at the same time increases the excitability of the atrial muscle fibers. This can explain the development of supraventricular extrasystole at night, when the tone of the vagus nerve is high.
The second depressive effect is depression parasympathetic system conduction in the atrioventricular node, which delays the propagation of signals to the ventricles.
Thus, the parasympathetic nervous system:
- reduces ventricular excitability and increases it in the atria;
- slows down heart rate;
- inhibits the formation and conduction of impulses;
- suppresses the contractility of muscle fibers;
- reduces myocardial oxygen demand;
- prevents spasm of arterial walls and.
Sympathicotonia and vagotonia
Depending on the predominance of the tone of one of the sections of the autonomic nervous system, patients may have an initial increase in sympathetic influences on the heart - sympathicotonia and vagotonia with excessive parasympathetic activity. This is important when prescribing treatment for diseases, since the reaction to medications can be different.
For example, with initial sympathicotonia in patients it is possible to identify:
- the skin is dry and pale, the extremities are cold;
- the pulse is accelerated, an increase in systolic and pulse pressure predominates;
- sleep is disturbed;
- psychologically stable, active, but there is high anxiety.
For such patients, it is necessary to use sedatives and adrenergic blockers as the basis of drug therapy. With vagotonia, the skin is moist, there is a tendency to faint with a sudden change in body position, movements are slow, load tolerance is low, the difference between systolic and diastolic pressure is reduced.
For therapy, it is advisable to use calcium antagonists.
Sympathetic nerve fibers and the transmitter norepinephrine ensure the body’s activity under the influence of stress factors. When adrenergic receptors are stimulated, blood pressure increases, the pulse accelerates, and the excitability and conductivity of the myocardium increases.
Pair sympathetic division and acetylcholine have the opposite direction of influence on the heart; they are responsible for relaxation and accumulation of energy. Normally, these processes successively replace each other, and when nervous regulation is disturbed (sympathicotonia or vagotonia), blood circulation indicators change.
Read also
VSD itself is unpleasant, and panic attacks along with it can bring a lot of unpleasant moments. Symptoms include fainting, fear, panic and other manifestations. How to get rid of this? What treatment is there, and what is the connection with nutrition?
Loading...