Cultural and historical aspects of eating disorders

A review of cultural and historical accounts of anorexia nervosa indicates that this disorder is found primarily in Westernized societies during periods of relative affluence and greater social opportunities for women. Some hypotheses regarding the vulnerability to eating disorders are proposed to the basis of these data.     

Culturally sanctioned secrets? Latino men's nondisclosure of HIV infection to family, friends, and lovers.

Spanish-speaking Latino men (n?=?107) were more likely than English-speaking Latinos (n?=?85) and Whites (n?=?206) to withhold their HIV-positive serostatus and their gay or bisexual orientation from significant others, especially family members. Similar effects were observed when Latinos were divided by birthplace and when analyses controlled for sociodemographic and medical factors. Reasons for revealing or concealing an HIV diagnosis varied across targets. Although both Latinos and Whites were more likely to withhold their diagnosis from their parents to prevent worrying them than to avoid personal rejection, this tendency was somewhat stronger among Latinos. Our findings suggest that some traditional values may deter Latinos from seeking HIV-related social support in times of need. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient education by the surgeon. Judicial aspects, ethical aspects, deontologic aspects

AIM OF THE STUDY: The surgeon must inform his patient about eventual risks before any investigation with diagnosis purpose and before any therapeutic intervention. According to the decree of the first Civil chamber of the "Court of Cassation", the surgeon must be able to prove that this information has been given as required by the article 1315 of the civil code. This decree has created in France an important change in the relationship between surgeon and patient. The French Academy of Surgery has organized a special session to study this problem in terms of legal, ethical and deontological aspects. CONCLUSIONS OF THE ACADEMY: The Academy confirms the necessity to give information to the patients and suggests that the modalities of the information be prepared by the medical societies, the "Conseil National de l'Ordre des Médecins", eventually by ethical committees and legal organizations concerned with medical questions, in view of a common use in all French juridictions. According to the Academy, it is necessary to determine the limits of the information to be given to the patient concerning the most common risks and those with the most serious consequences, in order not to disturb him psychologically. The Academy wishes that necessary and sufficient means be indicated in order for the surgeon to be able to prove that the information has really been given.     

Ethical aspects of resuscitation

OBJECTIVE: To evaluate whether basal levels of circulating cytokines and selectins exhibit a distinct profile in attack-free, non-colchicine taking familial Mediterranean fever (FMF) patients compared to normal healthy controls, and to determine the effect of colchicine treatment on these parameters. METHODS: Serum levels of interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-alpha, and soluble P-, E-, and L-selectin in attack-free, asymptomatic, non-colchicine using FMF patients (n = 11) and in normal controls (n = 10) were studied. Following 2 months of colchicine treatment the same parameters were evaluated again in the FMF patients. RESULTS: Before colchicine treatment the serum levels of all parameters except soluble P-selectin were significantly higher in FMF patients than in controls. After two months of treatment statistically significant decreases were observed in these parameters (p < 0.05). CONCLUSION: A distinct profile of IL-6, IL-8, TNF-alpha, and soluble E- and L-selectin levels was observed in FMF patients, which could reflect the presence of sustained inflammation in attack-free FMF patients. The effect of colchicine on these parameters suggests its therapeutic potential.     

SociaL aspects of pulmonology

A group of new-onset pulmonary tuberculosis patients has been studied and its social characterization is provided in the paper. Comparison of the 1991-1992 findings with those obtained in 1970-1980 has indicated that social aspects are topical as before and have some specific features in recent years. The most important issues are now living conditions, financial status of the patients, their social lifestyle, refugees and rational employment of tuberculosis patients and disabled persons.     

Genetic aspects of parkinsonism

The genetic basis of many monogenic neurological diseases with parkinsonian features has been elucidated over the past few years. The clinical and genetic features are discussed for the diseases with prominent parkinsonian signs. There is also accumulating evidence for a role of genetic factors in the aetiology of idiopathic Parkinson's disease (PD); however, the approach to polygenic diseases is quite different from that to the simpler single-gene disorders. The role of epidemiology in not only establishing genetic susceptibility, but its impact on estimating the size of the problem, is also discussed. A number of candidate genes have been studied in PD but, to date, there is no conclusive proof for any of these. It therefore seems likely that a random genome search is required, and the technical and statistical methods are now available. It is hoped that knowledge of the genes involved will lead to better therapy for this incurable and common disorder.     

Clinical aspects of glomerulonephritis

With the help of 260 bioptically ascertained cases of glomerulonephritis clinical characteristics for individual forms of glomerulonephritis are explained. Specific laboratory findings and functional tests are correlated to the bioptic findings and their valency for the individual groups of diagnosis discussed. As a result of the investigation 99% of all cases of disease may be recognized only by the examination of the urine, taking into consideration the interference of the individual symptoms.     

Social aspects of pathology

Pathology is a basis science not only for theoretical and practical medicine but also for health service. Autopsies of the persons dying in the hospitals and outpatient departments would be the most valuable and objective indices of treatment quality during the period of transition to insurance medicine. The most efficient social functioning of pathology will be possible only if the pathology service is centralized. Under such conditions it is necessary to create the consulting centers for all pathology departments.     

Microstructural aspects of superplasticity

This short review summarizes the contribution of microstructural studies to the present understanding of the deformation mechanisms operating during superplastic deformation. A background summary is included that describes the major features of superplasticity, the relevant deformation theories, and the requirements for successful microstructural studies. However, most of the paper is concentrated on a discussion of the microstructural evidence in the literature on two types of material. The first is a representative group of modern commercial nickel, aluminum, and magnesium alloys. The second is the Zn-Al eutectoid, a member of the well characterized “classical” group of superplastic materials based upon eutectic or eutectoid compositions. The importance of dislocation motion at maximumm is emphasized, both as an accommodation mechanism for grain boundary sliding and directly in response to the applied stress. However, it is shown that, in IN100 and Supral 150, other processes occur simultaneously, including recrystallization and diffusion. This paper is based on a presentation made at the symposium “On the Mechanical, Microstructural and Fracture Processes in Superplasticity” held at the annual meeting of the AIME in Pittsburgh, PA on October 7, 1980 under the sponsorship of the Flow and Fracture Activity of the Materials Science Division of ASM.     

Epidemiological aspects of ageing

A major societal challenge is to improve quality of life and prevent or reduce disability and dependency in an ageing population. Increasing age is associated with increasing risk of disability and loss of independence, due to functional impairments such as loss of mobility, hearing and vision; a major issue must be how far disability can be prevented. Ageing is associated with loss of bone tissue, reduction in muscle mass, reduced respiratory function, decline in cognitive function, rise in blood pressure and macular degeneration which predispose to disabling conditions such as osteoporosis, heart disease, dementia and blindness. However, there are considerable variations in different communities in terms of the rate of age-related decline. Large geographic and secular variations in the age-adjusted incidence of major chronic diseases such as stroke, hip fracture, coronary heart disease, cancer, visual loss from cataract, glaucoma and macular degeneration suggest strong environmental determinants in diet, physical activity and smoking habit. The evidence suggests that a substantial proportion of chronic disabling conditions associated with ageing are preventable, or at least postponable and not an inevitable accompaniment of growing old. Postponement or prevention of these conditions may not only increase longevity, but, more importantly, reduce the period of illnesses such that the majority of older persons may live high-quality lives, free of disability, until very shortly before death. We need to understand better the factors influencing the onset of age-related disability in the population, so that we have appropriate strategies to maintain optimal health in an ageing population.     

Some aspects of impotence

The fine structure of human nasal sero-mucinous glands was studied in 15 chronic allergic patient. There was total absence of the mucous glands, and proliferation of seroud elements, with hugely dilated lumina containing large numbers of intact zymogen granules, and absence of microvilli. The relation between the goblet cells and the nasal glands was discussed. An interchange between the serous and mucous elements was deduced.     

Psychosomatic aspects of sarcoidosis

Sarcoidosis is a multisystemic granulomatous disorder of unknown etiology. Several times pneumonologists described a remarkable personality of patients suffering from sarcoidosis. 44 patients with sarcoidosis were examined physically and psychosomatically. There are subgroups of patients, an important risk group shows long-lasting depressive features.