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Seventy patients presenting symptoms of hysteria (49 women and 21 men) were selected among patients observed at the Institute Minkowska during the year. This work is part of a research work on socio-cultural and environmental factors which can change mental status of immigrants. These are all portugese workers presenting for the first time atypical mental troubles called by the author: "bastard hysterical syndrome of the immigrant" and characterized partly or totally by the following symptoms: fatigue, anxiety, sense of suffocation, dyspnea, coughing, unilateral chills or generalized chil, abdominal or gastric pains, headaches and "diffused pains", paresthesia, aching back, tears and sorrow, fear of dying or having a cancer, asthenia, leg paresthesia and contractions, vomiting, diarrhea, cardiac pains, palpitations, dizziness and collapsing. These troubles appear sometimes without apparent motives but they are almost always due to a precipitating cause expressed by the patient: a delivery, a familial death, a homosexual proposition, a trauma without importance, a working conflict etc... But the most frequent cause invoked is "the french climate" without knowing precisely what the word "climate" means: atmospheric conditions, athmosphere or reception milieu? This latest interpretation seems more likely after months of psychotherapy. Most patients are not french speaking and cannot write; their origin is rural (familial villages well structured regarding their food and sexual economy), and people well "armed" by a system of defense mechanisms and well adopted conditioned reflexes. In this work, hysteria of the portugese immigrant is compared to childhood hysteria. As the hysterical burst of the child is aimed at calling attention, love of the mother, at finding a solution to a familial or social conflict, the hysterical burst of the immigrant is aimed at the absent family or at its substitutes, the bos, social security, the doctor. Furthermore, the attitude of the hosting Country--wanting and rejecting--is very ambivalent; "tenderness" at the time of reception, followed by indifference. Early attentions are followed by constant interdictions (threat of unemployment, false statements on sexual dangers of the immigrant etc;..). The immigrant, like the hysterical child, is periodically controlled (work and visit cards), supervised (supervisors), The narcistic satisfactions of being called a good worker can be followed by threats of firing in economic crisis. The society of the hosting country requires the immigrant to be identical to this society: language, physical appearance, food. The real paradoxical situation to which the immigrant is confronted and the real or hypothetical fears constitute conditions of experimental neurosis, to which portugese immigrants react very often by a bastard symptomatology of hysterical type, characteristic of displaced man. These preliminary studies are the frame for a future epidemiological survey in this specific population.
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PMID:[Hysteria and psychosomatic disorders in Portuguese immigrants]. 102 Jun 87

Whatever the specific details of their practices, SNPs have shown themselves able to function effectively in their expanded roles because they have assumed more responsibility, initiative, interdependence, and independence in caring for children. Specifically, they have learned to be confident of their decision-making abilities, to adapt themselves to an expanded framework of nursing, and to regard themselves as highly qualified professionals. What this means to the individual nurse practitioner, the parent and--most important--the child is well summed up in these remarks from Larea Younkman, SNP in the Denver Public Schools: "Previously," she writes, "my recommendations to the parents as to what to do and when, such as seeking medical attention, were frequently too general and consequently not heeded by the parent. Now when I talk to a parent, I am not only confident of my findings but I'm also much more convinced that what I suggest is necessary. As a result, parents are looking at SNPs differently, trusting our judgment, and, I think, following through on the advice we offer to a greater extent than previously." Thus the SNP could well be the vital bridge between this country's traditional system of health care delivery and those children who are deprived of the care they need through reluctance, ignorance, parental apathy, or lack of available health care facilities.
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PMID:The school nurse practitioner. 104 Jan 57

The attitudes and practices of a selected sample of American obstetricians and pediatricians was studied in an effort to gain insight into why more mothers do not choose to breast feed their babies and why many mothers, who really want to breast feed, are unsuccessful in their attempts. Emphasis was on studying physicians' attitudes toward the general value of breast feeding and to the practical advice and help they give to mothers who want to breast feed their children. The names and addresses of a total of 205 physicians were obtained from the 1974-1975 Directory of the Los Angeles County Medical Association. The final sample included 105 obstetricians and 73 pediatricians. A 5-page self-administered questionnaire was mailed to all physicians in both samples. 46 usable obstetrician questionnaires and 52 usable pediatrician questionnaires were returned. 58% of the pediatricians as compared to 38% of the obsteticians said that breast feeding was "very important." None of the pediatricians said that breast feeding was "not very important" and only 4% reported neutral feelings about it. 33% of the obstricians gave these answers. It was not possible to determine the specific reasons why the physicians felt that breast feeding was or was not important. Only 30% of the physicians indicated that they routinely try to persuade their patients to breast feed. 52% said they would try to persuade a mother to breast feed only if she expressed an interest in it. 42% replied that they would encourage an undecided mother to breast feed. Many questions regarding the type of advice given by the physicians were concerned with the lactation management practices which are considered to make a crucial difference between success and difficulty. 73% of the total sample indicated that they discuss nursing techniques but only a minority reported that they give their patients either a prenatal or postnatal talk about the anatomy of the breast and the "let-down reflex." 42% of the pediatricians as compared to 7% of the obstetricians correctly instructed mothers to wash their nipples with water only. Books and other individuals (65% and 64%, respectively) were physicians' sources of breast feeding information. The study findings indicate that the attitude of American physicians towards breast feeding is generally 1 of indifference with pediatricians appearing more interested in and knowledgeable about breast feeding than obstetricians.
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PMID:Attitudes and practices of physicians concerning breast-feeding and its management. 105 37

I have tried to summarize the different points of view in regard to clinical diagnosis of child psychosis. The main purpose is to reach a more universal agreement to base a diagnosis that allows us not only to facilitate an early diagnosis but also its treatment and above all better bases for research. Infantile psychosis varies at different levels of growth, according to age, however it is considered that psychosis in children is basically a disturbance in ego-functions. This is clearly evident in the thinking process, in affect, perception, motility, language, individualization, disturbance of object relations, and lost of contact with reality. The basic points for the diagnosis of child psychosis proposed by the "Group for the Advancement of Psychiatry" and initially studied by the English working party headed by Goldberg and col. are discussed: disturbances of their interpersonal relationships, indifference or preoccupation with inanimate objects, lack or failure in speech development, alteration in sensorial perception, bizarre or stereotyped behavior, resistance to change routines or change of environment, poor personal identification, crises of anger or panic which are not predictable and finally an uneven intellectual development.
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PMID:[Clinical diagnosis of childhood psychoses]. 105 2

Diagnosis is often overlooked because symptoms develop slowly and insidiously and many patients don't complain about them. Then too, the giddiness, apathy, confusion, clumsiness, and similar problems may be considered simply signs of "old age." Iron deficiency anemia is the most common type in old people. It's usually due to gastrointestinal bleeding, but there may be a second, less obvious cause. The classic picture of low serum iron, high total iron-binding capacity, and low iron-binding saturation is sometimes distorted. Usually, many studies are needed to confirm the suspicion of a vitamin B12 or folic acid deficiency. A raised mean corpuscular volume in itself signals the need for further investigation. In patients with macrocytosis, the bone marrow must be examined. Tests for intestinal malabsorption must be considered too. Repeated blood tests are essential in patients being treated for any type of anemia. Iron deficiency may hide evidence of folate or B12 deficiency. And iron therapy may lessen bleeding from colonic cancer, delaying diagnosis until it's too late to operate.
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PMID:Anemia--a common but never a normal concomitant of aging. 108 61

A double-blind cross-over study is reported which compares the antipsychotic properties and the side effects of depot flupenthixol with fluphenazine decanoate in chronic schizophrenic inpatients. Special emphasis was laid on examining changes in the target symptoms of apathy/anergia and depression in which flupenthixol has been claimed to be particulary effective. No significant differences were found between treatments on schizophrenic symptoms, or as regards the extrapyramidal side effects produced by equipotent doses of the two drugs. Reasons for the essentially negative results are discussed against a background review of earlier optimistic studies of flupenthixol.
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PMID:A comparative trail of fluphenazine decanoate and flupenthixol decanoate. 109 Nov 24

A paranoid strain is manifest in Stoic utterances generally, especially in the Stoic conception of autarky, where the Sage regards himself as distinctly "other" in the midst of society, and indifferent to its values, except as he dissembles his indifference. Now, influential theories of paranoia stress a projective process: for Freudians, the projection of repressed homosexual libido in altered form, for Ovesey, a "pseudohomosexual" anxiety arising out of a maladaptation in the male to the culturally assigned competitive male role, a failure perceived as effeminate. But Stoicism took root in the culture (Classical Greece) where homosexuality, far from being universally regarded as degenerate, was widely extolled as the norm for superior men and the most advantageous frame work for the tutelage of aristocratic boys. It would seem unlikely that paranoia in this context would reflect uneasiness over unconscious homoerotic (or distorted pseudo-erotic) strivings. What light is shed on the purported projection of either homosexual or pseudo-homosexual anxiety by paranoid elements in Stoicism?
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PMID:Stoicism and paranoia. 109 1

A combined antibiotic therapy is only useful in a few precisely defined clinical pictures where testing of the chemotherapeutics administered is required to determine their characteristics of action (antagonism, indifference, synergism) on the isolated organism. For the initial therapy of critical acute infections, simultaneous administration of cephalothin and gentamicin proved to be valuable. In the present study, the efficiency of these chemotherapeutics alone and in combination was investigated in a quantitative serial dilution test and with the membrane-filtration method. Thirty strains of Proteus mirabilis and enterococci showed only low sensitivity to the antibiotic alone. In combination, whereby gentamicin was at a constant level comparable to in vivo serum levels, an increase of bacteriostatic and bactericidal action could be demonstrated, especially for Proteus mirabilis. The antibacterial spectrum, the molecular-biological mode of action, clinical experience and possible side-effects of the cephalotin-gentamicin combination are discussed.
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PMID:[Studies on the in vitro effects of cephalothin and gentamicin, alone and in combination, on proteus mirabilis and enterococci (author's transl)]. 110 55

(1) Chronic glaucoma accounts for a high proportion of blindness which is preventable and calls for energetic action because existing knowledge is not applied as it should be because of the indifference of the Department of Health and Social Security to the glaucoma problem. (2) The condition is frequently insidious and advanced before being identified, and requires life-long supervision. (3) When diagnosed, the management of glaucoma is frequently inadequate and intermittent for a variety of reasons. (4) AtKing's College Hospital, a Glaucoma Centre has been initiated to supervise accurately and regularly a large number of glaucoma patients, assisted by numerical recording and computer analysis. While we are fortunate in having a computer in the hospital, it is important to emphasize that the system can be operated without this facility, either by employing manual methods, or by batch processing. It would be both possible and desirable to organize recording a nd analysis on a regional basis in collaboration with hospitals wishing to participiate. (5) Attempts are being made to improve the early diagnosis ofglaucoma by better communication between the hospital ophthalmologists, and other members of the medical, optical, and ancillary professions by lectures, demonstrations, and publications. (6) Research is always hampered by the absence of factual knowledge. It is planned to use fully the opportunity for research into glaucoma made possible by this basic organization. At present however, we consider it more important to carry out investigations into the problems of organizing the investigation, treatment, and follow-up of glaucoma patients than t o embark on a few individual projects of research. We are serously hampered in our work by shortage of funds for staff and facilities, but we look forward confidently to the time when, with the essential support of the Department of Health, these methods will give us access to the facts of glaucoma, which besides enabling us to give a high standard of treatment to our patients, will give us an unprecedented opportunity of wide ranging research into all aspects of this important disorder.
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PMID:Prevention of blindness from glaucoma using the King's College Hospital computerized problem orientated medical record. 113 49

Many factors already contribute to limit the amount of bank blood available for therapeutic use; a possible reduction in the amount of available blood could stem from the relative indifference of young people towards the gift of blood and the increase in the size of the pool of positive carriers of Australian antigen. Moreover, new operations appear (coronary by-pass) which increase the demand for blood. It is imperative that we adopt attitudes and practice techniques that will contribute to the conservation of blood. This paper discusses the advantages of an active blood bank committee which, alone, can reduce the consumption of blood by 20 percent. Moreover, actual techniques for conservation of blood are reviewed: controlled hypotension, haemodilution and intraoperative blood salvage.
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PMID:[Conservation of the blood]. 113 83


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