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Despite a wide spectrum of efficient chemotherapies, tuberculosis patients even today are often given inpatient treatment. This fact is shown by the MSV, the Medical Statistics of VESKA (Association of Swiss Hospitals), which is coded according to the ICD key and numbers tuberculosis forms from 010 to 018. The MSV figures for the year 1990 in its associated clinics are: total diagnoses 685,204, principal diagnoses 346,671, number of nursing days 4,613,737 and average stay 13.3 days. At the same time, the following data were registered: total of 1009 hospitalizations with a tuberculosis diagnosis, including 555 patients with a principal diagnosis of tuberculosis. Hospitalizations due to tuberculosis as the principal diagnosis account for 13,995 nursing days, which corresponds to 0.3% of the total. The average hospital stay lasts 25.2 days. In both diagnosis groups, first place is occupied by pulmonary tuberculosis (011) with 67.0% and 70.5% respectively, and among the extrathoracic forms 013-018, urogenital tuberculosis (016) with 6.3% principal diagnosis. The cases with the principal diagnosis of tuberculosis generate (partly calculated, partly estimated) hospital costs of approximately Sfr. 4.9 million and a paid wage total of some Sfr. 1.5 million. In the case of secondary tuberculoses of the 2nd and 3rd position in the statistics, analogous sums of an estimated total of Sfr. 2.4 million are added. It is therefore safe to say that tuberculosis is still not without financial significance in Switzerland.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hospitalization of tuberculosis patients in Swiss hospitals in 1990]. 146 48

The medical statistics of VESKA (Association of Swiss Hospitals), MSV, comprise and include the spectrum of all diseases in patients admitted to Swiss hospitals which are members of the association. Documentation is carried out in accordance with the WHO ICD code. Tuberculosis is registered under the main figures 010 to 018. The MSV makes an essential contribution in a special area to the recording of tuberculosis in Switzerland. The ICD code classes the disease either in positions 1 to 3 as the category of "all (TB) diagnoses' or as "principal diagnosis' in the first place. The numerical values are either recorded individually for the years 1990 to 1993 or as mean values of these four years. Tuberculosis occupies a small space within the overall statistics. Of a total of 722 868 and 369 840 coded diagnoses (1990 to 1993, averages), 1100 and 627, respectively, fall under tuberculosis in the two categories. This corresponds to a proportion of 0.15% and 0.17%, respectively. Tuberculosis becomes more important because the general average hospital stay of 12.7 days is almost doubled with an average of 24.7 days for tuberculosis patients. If the costs per case generally stand at Sfr. 7353.-, then, for tuberculosis patients, they rise to Sfr. 14 301.-. The overall costs for tuberculosis patients per calendar year total Sfr. 15 731 430.- and Sfr. 8 966 915.-, respectively, in the two categories. Tuberculosis is, therefore, a disease which is still of economic significance even in Switzerland. In the category of types of tuberculosis, pulmonary tuberculosis (011) still today occupies first position compared to previous analyses with current figures of 65.1% and 67.7% respectively. In the case of the extra-pulmonary types, uro-genital tuberculosis (016) stands in second place with 5.7% and 3.5% in the two categories, after the group of tuberculosis of other organs (017) with 5.9% and 6.1%, respectively. There was a constant preponderance of male over female patients (64.3% vs. 35.6%). If decades ago tuberculosis shifted to and was spread over more advanced age groups in Switzerland, the proportion of foreigners now within the whole population has brought about a change. Almost twice as many tuberculosis cases occur within the 20-year to 40-year age group than in the other age groups, in which a certain degree of levelling off is apparent. From comparisons of notifications to authorities in Switzerland and from hospitalization rates, it can be deduced that there is no increased need for hospitalization for any particular age group.
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PMID:[Prevalence of tuberculosis in Swiss hospitals in the years 1990 to 1993]. 870 Nov 68

What was known in the past as "obsessive psychoneurosis" was considered to be rare, chronic and difficult to treat. New definitions proposed by APA diagnostic systems (DSM III, DSM III-R, DSM IV) and the WHO (ICD-10) have opened up the possibility of epidemiologic studies in the population as a whole and among patients consulting psychiatrists and general practitioners. All these studies reveal a much higher prevalence, the incidence increasing from 0.05% (former estimate) to about 2.5% of the general population (American ECA survey). This implies new clinical and etiopathogenic concepts of this pathology. Experience of so-called antidepressant drugs, with an essentially serotoninergic action, bringing about a notable improvement in obsessive disorders, has greatly contributed to these changes. COD and COS are very often interlinked with other psychiatric symptomatology, this frequent co-morbidity raising the question of the autonomy of certain syndromes, as well as that of the borders between the normal and pathological. The TOC of clinicians are not the same as the TOC of epidemiologists. Another problem is that of the role played by these obsessive disorders in what has been referred to as "general neurotic syndrome". What is the relationship between mood disorders and anxious pathology as a whole, insofar as the same drugs are indicated in these various disease patterns. We report here the results of the DRT survey involving patients presenting for the first time to psychiatrists in office practice and concerning 731 COD and COS, i.e. 17 % of 4 364 adult out-patients (6.5 % definite COD, 2.7 % probable COD and 7.5 % COS).
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PMID:[Obsessive disorders and syndromes and affective disorders. Apropos of a French epidemiologic obsessive compulsive disorders and obsessive compulsive syndromes DRT survey]. 876 24

The relationship between psychopathy and mental disorders was investigated in 61 male subjects during a forensic psychiatric examination. The Psychopathy Checklist Revised (PCL-R) and the Structured Clinical Interview for DSM-III-R (SCID) were used for the assessments. Although psychotic subjects were excluded, the overall psychiatric morbidity in the study population was high. Comorbidity was common, irrespective of the degree of psychopathy. Psychopathy was strongly positively correlated with substance abuse/dependence but negatively correlated with depression. Almost all of the subjects with high PCL-R scores had DSM-III-R antisocial and/or borderline personality disorders. However, some subjects with antisocial personality disorders had medium or low PCL-R scores. When the subjects were reassessed with diagnoses of DSM-IV and ICD-10 personality disorders, the difference between psychopathy and antisocial personality disorder was reduced.
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PMID:Psychopathy and Axis I and Axis II psychiatric disorders in a forensic psychiatric population in Sweden. 891 55

INTROD: Clinical samples gives a piece of information mediated by singular characteristics of the area (general practitioners, health services organization, needs of care feld by family or patient), but they are an important way in the study of psychosocial variables and their influence in pathways and morbidity of psychiatric disorders. MET: We obtained by SISMA survey (Information System for Mental Health in Andalucia) clinical and sociodemographic variables of a 2,016 Mental Health Center sample consulting during 40 months (attendance people = 90,368, rural area). We realized a descriptive and association study, with special attention to gender as modulating another factors related with health services use, diagnostic and clinical features. RES: ICD-10 Diagnostic groups of our sample was Affective disorders (F.3x) (36.5%, OR 1.99 for female), Neurotic disorders (F.4x) (29.75%, OR 2.01 for female) and Schizophrenia and related disorders (F.2x) (9.83%, OR 0.31 for female). The female-male ratio of our clinical sample was 1.70, incremented to 2.31 in geriatrics. Woman significantly consulted by themselves and men by their family. Married marital status was a help factor of psychopathology in women, as single status in men. Work activity and high or medium educative level was protective factors of psychopathology. CONCLUS: Clinical and sociodemographic variables we have seen, give us similar results to another spanish samples, too similar to actually accepted in Psychiatric Epidemiology. Female gender and class-linked vulnerability have an important influence as help-factors for specialized psychiatric treatment in our community.
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PMID:[Psychiatric disorders in a rural area: descriptive study of 2106 cases]. 913 54

Many newly defined tumour antigens are 'self' proteins. Immunizing cancer patients against these antigens may be difficult due to tolerance. The HER-2/neu oncogenic protein is such a 'self' tumour antigen. Rat neu is homologous with human HER-2/neu and provides a model system for studying vaccination strategies. Rats are tolerant to rat neu. Vaccination with this 'self' protein elicits no detectable immune response. The current studies evaluated whether tolerance to rat neu can be circumvented by immunizing with the highly homologous foreign human HER-2/neu protein. Rats were immunized with human HER-2/neu intracellular domain (hICD) protein that is 92% homologous to rat neu ICD. Animals immunized with hICD developed significant antibody and T-cell responses that were specific for both human HER-2/neu and rat neu. Neu-specific antibodies were present in titres of greater than 1:200,000. Analysis of the specificity of the antibody response using synthetic peptides demonstrated substantial reactivity to an epitope with 100% homology between rat and human protein. Significant T-cell responses (stimulation index > 10) to hICD and rat neu protein (stimulation index > 4) were detected. The T cells also responded to both human and rat ICD. The results imply that immunization with foreign proteins, which are highly homologous to 'self' tumour antigens, may be an effective vaccine strategy for 'self' tumour antigens.
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PMID:Human HER-2/neu protein immunization circumvents tolerance to rat neu: a vaccine strategy for 'self' tumour antigens. 961 68

Fibromyalgia patients hardly suffer from major psychiatric illnesses. Most often, persistent somatoform pain disorder (ICD-10) and dysthymia are identified by psychiatric assessment. Features of "pain proneness" can also be found regularly, which can explain the elevated levels of stress observed in FMS. Repeated traumatic experiences during childhood and as adults can be discovered in many cases, which helps to understand some of the difficulties met in psychotherapy with FMS patients. Modified psychotherapy techniques are recommended using pain-centered behavioral methods initially, and progressing only later to an insight orientated approach.
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PMID:Psychological and psychiatric aspects of fibromyalgia syndrome (FMS). 1002 94

We cloned and expressed the SH2 domain of human GRB2 as glutathione S-transferase and maltose binding protein fusion proteins. We screened three phagemid-based fd pVIII-protein phage display libraries against SH2 domain fusion proteins. Sequence analysis of the peptide extensions yielded a variety of related peptides. By examining the ability of the phage clones to bind other SH2 domains, we demonstrated that the phage were specific for the SH2 domain of GRB2. Based on the sequence motif identified in the "random" library screening experiment, we also built and screened a phage display library based on a Tyr-X-Asn motif (X5-Tyr-X-Asn-X8). To examine the affinity of the phage derived peptides for GRB2, we set up a radioligand competition binding assay based on immobilized GRB2 and radiolabelled autophosphorylated EGFR ICD as the radioligand. Results obtained with peptide competitors derived from the phage sequences demonstrated that nonphosphotyrosine-containing peptides identified with the phage display technology had an affinity for the receptor similar to tyrosine-phosphorylated peptides derived from the EGFR natural substrate. Interestingly, when the phage display peptides were then phosphorylated on tyrosine, their affinity for GRB2 increased dramatically. We also demonstrated the ability of the peptides to block the binding of the GRB2 SH2 domain to EGFR in a mammalian cell-based binding assay.
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PMID:Potent inhibitory ligands of the GRB2 SH2 domain from recombinant peptide libraries. 1040 Mar 18

Eighty six in-patients suffering from puerperal psychosis within six weeks after childbirth were prospectively investigated in Muhimbili National Hospital during two years. Formal psychiatric history, mental status evaluation, research and diagnostic criteria including ICD 10 and clinical progression were employed for diagnosis. Using a structured questionnaire, the socio-demographic characteristics, concomitant physical disorders, major obstetric events, period of onset of puerperal psychosis following delivery and social support given were established. Mean age was found to be 23.6 years; the majority was primiparous women with parity of between one and three children. Main physical co-morbidities included anaemia in 51.4% of cases, infections in 44.2% and EPH-gestosis in 17.4%. Most mothers received social support from their extended families. Organic psychosis was found in four fifths of the mothers and schizophrenia in 8.1%. A high rate of early onset puerperal psychosis (3.2/1000 (births), predominantly in young primiparous women, was found.
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PMID:The nature of puerperal psychosis at Muhimbili National Hospital: its physical co-morbidity, associated main obstetric and social factors. 1247 28

We reviewed 25 patients ascertained through the finding of trigonocephaly/metopic synostosis as a prominent manifestation. In 16 patients, trigonocephaly/metopic synostosis was the only significant finding (64%); 2 patients had metopic/sagittal synostosis (8%) and in 7 patients the trigonocephaly was part of a syndrome (28%). Among the nonsyndromic cases, 12 were males and 6 were females and the sex ratio was 2 M:1 F. Only one patient with isolated trigonocephaly had an affected parent (5.6%). All nonsyndromic patients had normal psychomotor development. In 2 patients with isolated metopic/sagittal synostosis, FGFR2 and FGFR3 mutations were studied and none were detected. Among the syndromic cases, two had Jacobsen syndrome associated with deletion of chromosome 11q 23 (28.5%). Of the remaining five syndromic cases, different conditions were found including Say-Meyer syndrome, multiple congenital anomalies and bilateral retinoblastoma with no detectable deletion in chromosome 13q14.2 by G-banding chromosomal analysis and FISH, I-cell disease, a new acrocraniofacial dysostosis syndrome, and Opitz C trigonocephaly syndrome. The last two patients were studied for cryptic chromosomal rearrangements, with SKY and subtelomeric FISH probes. Also FGFR2 and FGFR3 mutations were studied in two syndromic cases, but none were found. This study demonstrates that the majority of cases with nonsyndromic trigonocephaly are sporadic and benign, apart from the associated cosmetic implications. Syndromic trigonocephaly cases are causally heterogeneous and associated with chromosomal as well as single gene disorders. An investigation to delineate the underlying cause of trigonocephaly is indicated because of its important implications on medical management for the patient and the reproductive plans for the family.
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PMID:Clinical and genetic aspects of trigonocephaly: a study of 25 cases. 1256 9


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