Somatization in general practice

Patients with unexplained physical symptoms are very common in primary care. Some patients attribute these symptoms to physical disease (somatizing patients). Somatization can be a symptom of psychiatric disorder, which is found in 1/4 to 1/3 of the patients in a primary care setting. This form of somatization makes diagnosing difficult and is the main reason why psychiatric disorders are underdiagnosed. Simple techniques for diagnosing and treating somatizing patients are available to general practitioners. However, to improve diagnostic sensitivity and treatment, further teaching and development in primary care settings are necessary.     

Adolescent sexuality: Part 4. The practitioner''s role

As no systematic study has been done to get an accurate estimate of the incidence of return to oestrus after first insemination in sows in the Netherlands, the objectives of this investigation were: 1) to obtain an estimate of the incidence of return to oestrus after insemination at the herd level; 2) to investigate the association between incidence of return to oestrus after first insemination and reproduction characteristics in order to get an impression of the economic importance of reproductive failure. These objectives were investigated by using the reproduction results of 240 swine breeding herds in the Southern Netherlands in 1987. This information was obtained from CBK plus computerized herd management records. The average incidence rate of return to oestrus after first insemination at a herd level was 16.9 per 100 first inseminations. The occurrence of return to oestrus after first insemination was distinctly higher in the insemination months July and August compared to the rest of the year. An increased incidence, with 10 returns per 100 first inseminations corrected for confounders in a multiple linear regression model, was associated with a decrease of approximately 0.3 live born piglets/sow/year. A prospective longitudinal study was started in 1988 and 1989 in 37 sow herds. Individual sows were monitored from weaning to first insemination, to the occurrence of return to oestrus, or not, after first insemination, and to farrowing. The investigation focused in particular on the relationship between return to oestrus after first insemination and seroconversion against porcine parvovirus (PPV) and Leptospira interrogans serovar bratislava (L. bratislava).(ABSTRACT TRUNCATED AT 250 WORDS)     

The immunologic identification of abnormal hemoglobins

Guinea pig antisera against human hemoglobin contain antibodies to multiple antigenic determinants. Hemoglobin variants having single amino acid substitutions affecting these determinants are recognized as antigenically deficient in a radioimmunoassay system. The multivalent antisera may be made more selective by appropriate absorption with hemoglobin variants. Three such antisera containing antibodies specific, respectively, for the beta-chain of Hb A, Hb S, and Hb C are described. They can differentiate among the hemoglobins of individuals who possess these variants alone or in any paired combination. Their discriminating ability is not hindered by the presence of 1,000-fold concentrations of Hb F and may therefore be extended to the early prenatal diagnosis of sickling disorders. The antisera described also detect several other variants of Hb A. The approximate location of the substitution in variants so detected can be determined by a complementation test. This is based on the finding that two antigenically deficient hemoglobins will complement each other in mixture provided their amino acid substitutions involve different determinants.