Psychiatry today

A COMMON SITUATION: Primary care physicians often provide care for schizophrenic patients. The main approaches include drug regimens, psychotherapy and psychosocial support. DRUG THERAPY: Neuroleptics should be given in single drug regimens in a continuous protocol for long periods. Side effects, particularly neurological effects, can be countered with antiparkinson medication. The aim is to reach the best possible balance between the therapeutic effect and side effects. PSYCHOTHERAPY: The general practitioner does not necessarily use sophisticated psychotherapeutic protocols but rather relies on a certain number of attitudes aimed at helping the patient accept the medications and control the main pathological mechanisms the schizophrenic state as expressed in the relationship with the health care provider. PSYCHOSOCIAL SUPPORT: A series of assistance measures (allocations for handicapped adults, adapted housing, protection of property) often involve a team of workers who should all take part in the therapeutic strategy.     

Vaccination today and tomorrow

The vaccines against infectious diseases in use today are, with few exceptions, prepared from the causal agents themselves, either by inactivating them with a chemical such as formaldehyde or by attenuating them so that they grow and thus evoke an immune response in the natural host but cause no disease. These empirical approaches have produced many highly successful vaccines. Increasing knowledge at the molecular level of the agents and of the immune response to protein antigent is now providing us with the opportunity to design vaccines that will elicit protective responses without the need to use the agents themselves. The critical issue is to identify the immune responses that correlate with protection.     

Viruses of mycoplasmas and spiroplasmas

Acholeplasmas, mycoplasmas and spiroplasmas of the class Mollicutes have been shown to carry DNA viruses. Morphologically they occur as rods, polyhedrons with short or long tails and as enveloped spheres. These latter resemble enveloped nonlytic animal viruses and are now placed in the new family of bacterial viruses the Plasmaviridae. Viruses of mycoplasmas and spiroplasmas present a suitable experimental model for studies of the virus-cell interactions.     

Information resources yesterday and today

The author discusses the most important sources of information from the historical aspect as well as with regard to the present time. She characterizes briefly the best known information centres, primary and secondary sources of information and their different types. In the conclusion of the article the author mentions modern sources of information which benefit from modern technology (multimedial means, Internet) and she outlines also the future development in the 21st century.     

Clinical andrology today

Of a group of 860 men who attended a private infertility clinic in Western Australia, 80 (9.3%) presented with vasectomy-related infertility. Of these men, 73 (91%) requested treatment due to re-marriage. The median age of the men was 42.5 years and their present partners were approximately 10 years younger. The median vasectomy interval in the men in this study was 9 years. Treatment of vasectomy-related infertility included vasectomy reversal procedures, donor insemination and both in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). It is suggested that care must be taken in counselling such patients prior to a vasectomy. The cryopreservation of semen prior to vasectomy would also make much of this type of infertility treatment unnecessary.     

Assessing bioethics today

Our society clearly needs to set limits on health care. The United States health care delivery system is the fourth largest economy in the world, yet its inflation continues to grow at twice the normal rate of other products and services. The inefficiencies are built in in such a way that while intensive care beds are plentiful, and very expensive, 37 million Americans cannot gain access to health care because they are either uninsured or underinsured. It is estimated that this figure will approach 39 million by the end of the decade. Since many of these individuals are young, the problem, it is said, has no real practical consequences because the young are relatively healthy. Yet evidence exists that the uninsured and underinsured receive poorer care than covered individuals. This and other inequities in the system have led many thinkers like Leonard Fleck to ask how just we must be in society. The answer to this question would presumably help us determine the lengths we must go in correcting the inequities. Even if the peace-dividend emerges from the new political events around the world, and we are able to spend more of our money on health care, our resources are not a bottomless pit. If need alone drives the system, just performing open-heart surgery on everyone who needs it would cost more than the annual budget itself. Virtually everyone agrees, then, that escalating health care costs are a moral problem because justice is involved, a political problem because public interest is involved, and that limits must be set that are moral and public.     

Reinforcement today.

The discovery of facts and practices concerning reinforcement in the past 25 years "have increased our power to predict and control behavior and in so doing have left no doubt of their reality and importance." In the acquisition of a bowling response in pigeons 3 points are relevant: (a) The temporal relationships between behavior and reinforcement are very important. (b) Behavior was set up through successive approximations. (c) Behavior gradual "shapes up" by "reinforcing crude approximations of the final topography instead of waiting for the complete response." The maintenance of behavior through various schedules of reinforcement is discussed. "The world in which man lives may be regarded as an extraordinarily complex set of positive and negative reinforcing contingencies… . In any social situation we must discover who is reinforcing whom with what and to what effect." The modern study of reinforcement is: (a) difficult and relatively expensive; (b) usually single-organism research, in which a statistical program is "unnecessary" and "wrong"; (c) not theoretical. "The new principles and methods of analysis which are emerging from the study of reinforcement may prove to be among the most productive social instruments of the twentieth century." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Care of wounds today

Fifty three (45 males, 8 females) patients with primary meylodysplastic syndrome were seen between January 1990 and June, 1996. Fifteen (28%) patients had refractory anaemia (RA), 9 (17%) refractory anaemia with ring sideroblast (RARS), 21 (40%) refractory anaemia with excess blasts (RAEB), 5 (9%) refractory anaemia with excess blasts in transformation (REABt) and 3 (6%) had chronic myelomonocytic leukemia (CMML). The mean age for the whole cohort was 59 years. Patients with RAEB and RAEBt were significantly younger than other FAB types with a mean age of 53.5 and 45 years respectively. Among the FAB types RAEB appeared to be over represented. Symptomatic anaemia (66% cases) was the major cause to seek medical attention. The commonest laboratory findings was anaemia; Hb < 8 g/dl in 31 (59%) patients. Only two patients had Hb > 12 g/dl at presentation. Twenty four (45%) patients had normocytic anaemia, mainly in RAEB group (61%). Macrocytosis was a dominant finding in patients with RA (53%) and RARS (53%). Bicytopenia (72%) was a more common finding than pancytopenia (8%). Bone marrow was normocellular in 32 (60%) patients and hypoplastic in 11 (21%). Dyserythropoiesis predominantly affected RA (80%), RARS (55%) and RAEB (43%) groups. Bilineage dysplasia (21%) was commoner than trilineage dysplasia (19%). Increased bone marrow fibrosis was seen in about half of the available trephines, mainly in RAEB patients. Median survival of patients was ten months with a follow up duration of 2-55 months. Four patients transformed to acute leukemia (M1 or M2) and died subsequently. However, infection was major complication and cause of death (10 cases). The preponderance of younger people to acquire the disease (especially the RAEB and RAEBt variants), the emergence of RAEB as the major group of MDS and increased prevalence of hypoplastic MDS point towards non-therapeutic genotoxin (s) in the causation of disease. Shortened survival and low rate of acute transformation points that patients did not withstand cytopenias and died earlier.     

计算机网络病毒的危害与防治

介绍了计算机网络病毒的发展和主要特性,分析了其传播途径,并根据工作实践提出了防治措施。     

Molecular basis for the generation in pigs of influenza A viruses with pandemic potential

Genetic and biologic observations suggest that pigs may serve as "mixing vessels" for the generation of human-avian influenza A virus reassortants, similar to those responsible for the 1957 and 1968 pandemics. Here we demonstrate a structural basis for this hypothesis. Cell surface receptors for both human and avian influenza viruses were identified in the pig trachea, providing a milieu conducive to viral replication and genetic reassortment. Surprisingly, with continued replication, some avian-like swine viruses acquired the ability to recognize human virus receptors, raising the possibility of their direct transmission to human populations. These findings help to explain the emergence of pandemic influenza viruses and support the need for continued surveillance of swine for viruses carrying avian virus genes.     

Transplantectomy today: indications and complications

Analysis of the indications for transplantectomy and its complications over a 12-year period. Over a total of 159 failure grafts, we performed 53 transplantectomies (33.3%). The percentage of complications was 16.9%. Three patients died (5.6%) during the more or less immediate post-operative period. In our experience, consistent and prolonged maintenance of immunosuppression should avoid the need for transplantectomy in a high percentage of grafts. Only 15 transplantectomies were made on 104 failure grafts after 6 months (14.4%). Our short but successful experience with embolization of 2 rejected grafts confirms the validity of this conservative alternative versus conventional surgical transplantectomy in selected cases.     

计算机病毒及其防范策略

对计算机病毒作了整体概述，介绍了计算机病毒的基本知识，并着重强调了计算机病毒的危害；同时对计算机病毒的防范策略进行了进一步的阐述。