Brazilian consensus on public policies on alcohol

This is the summary of a meeting where a group of experts, representing several health organizations and academic departments from different parts of Brazil, created a consensus about the main alcohol policies which should be implemented by different levels of the Brazilian government. The World Health Organization has been suggesting for 30 years the actions that should be implemented for the public good. Two important conclusions were reached: 1) The research establishes beyond doubt that public health measures of proven effectiveness are available to serve the public good by reducing the widespread costs and pain related to alcohol use; 2) To that end, it is appropriate to deploy responses that influence both the total amount of alcohol consumed by a population and the high-risk contexts and drinking behaviours that are so often associated with alcohol-related problems. To conceive of these intrinsically complementary approaches as contractory alternatives would be a mistake. The objectives of the consensus are: 1) To make the scientific evidences more available to the Brazilian policy makers; 2) To facilitate the evaluation of the available strategies according their effectivity, scientific support, cost and cultural adaptability; 3) To make the Brazilian health professionals familiar with the priorities of alcohol policies.     

应重视脑卒中的综合预防

脑卒中高居人口死亡原因的第 2位 ,每年新发患者 >15 0万例 ,现有幸存者 >6 0 0万例 ,其中 75 %丧失劳动力 ,4 0 %中度致残 ,是老年人致残和认知障碍的主要原因 ,年直接或间接经济损失高达数百亿元。高血压、心脏病、房颤、糖尿病、高脂血症、无症状颈动脉狭窄以及不良生活方式 ,包括吸烟、酗酒等均为脑卒中的危险因素 ,应针对危险因素予以控制 ,并长期有效坚持 ,大部分脑卒中是可以预防的。1.高血压 :我国高血压超过 1亿人口 ,是脑卒中最常见的可控危险因素。 14项随机对照研究结果表明 ,舒张压降低 5～ 6ｍｍＨｇ可以减少脑卒中发生率的 4…     

Clinical and experimental studies on the action of ethamsylate on haemostasis and on platelet functions

In a series of tests,the action of ethamsylate on haemostasis and on platelet functions was examined. After oral administration of the drug,a highly significant diminution of the bleeding time and of the blood loss from a standard wound was observed. This effect was demonstrated in healthy individuals and in patients suffering from platelet dysfunctions,and there was a distinct dose relation. There was also an increase of platelet adhesion,of PF 3 availability and of PF 4 release. The action of prostacyclin on the epinephrine induced platelet aggregation could be inhibited by ethamsylate. This offers a possible explanation for some of the effects on hemostasis. In addition,an action of ethamsylate on the platelet membrane was assumed since an in vitro increase of functions of the platelet membrane like PF 3 availability would not be explainable by a possible inhibition of prostacyclin.     

Remarks on an educational training course on headache

In the last years several studies have been performed on migraine; however, only few topics have changed the clinical practice. Among these, there are physiopathological insights (e.g., allodynia and gastric stasis) or therapeutical evidences (e.g., topiramate) that become very important in the management of migraine and could clarify the different response to the therapies. The aim of a training school on headache should be to link research to practice without transferring contradictory data. To teach is not only to support notions with simple data: we think that knowledge has to be used according to the condition of the patient and the situation in which the migraineurs live.

     

不同病房模式对精神分裂症病情影响的研究

目的探讨不同病房模式对首发精神分裂症患者病情的影响及康复情况。方法开放式病房的患者为研究组68例,同时选择住封闭式病房患者为对照组130例,对两组患者的临床资料进行比较分析。结果对照组患者入院时焦虑抑郁及敌对猜疑出现明显变化（P＜0.05）;研究组患者在第1周时焦虑抑郁已经开始改善,第2周时病情、阳性症状、一般精神病理、敌对猜疑、激活性也出现明显变化（P＜0.05）;第4周时研究组病情及各因子、认知功能及自知力显著改善,与对照组比较存在统计学差异（P＜0.05）。结论开放式病房模式可以减少患者的负性影响,更快改善患者的认知功能,有利于患者自知力的恢复,使患者的病情达到更全面的康复。     

Ethopharmacological studies on the effects of antihormones on rodent agonistic behavior with especial emphasis on progesterone

The effects of a range of antiandrogens and antiestrogens on conflict behaviors in laboratory rats and mice are reassessed in the light of recent studies applying ethophamacological analyses (recording the full spectrum of behaviors) to such investigations. It is argued that any antihostility properties of the antiandrogen cyproterone acetate are largely a consequence of indirect actions on odor communication, whereas antiestrogens (e.g., tamoxifen and CI 680) seem to have more fundamental motivational effects in addition to communicatory actions. A detailed example of the approach is provided in which progesterone (which can be antiandrogenic) is given to rats paired in different ways. The type of pairing has a very substantial effect on the actions seen after treatment, and the ethopharmacological approach generates a better picture of antihormone effect than traditional psychopharmacological tests.     

Certain predictions on the effectiveness of l-DOPA on parkinsonism

Summary Sixty nine patients with Parkinson's disease were treated with L-DOPA for more than a year. L-DOPA produced remarkable improvement in akinetic patients, moderate improvement in rigidity and slight improvement in tremor. The degree of improvement in akinesia, rigidity and tremor tended to be reversely related to the severity of the disease. Rigidity and akinesia improved better in young patients, but there was no correlation between age and the response of tremor to the treatment. Except for rigidity there was no correlation between the improvement and the duration of the disease.

---

Zusammenfassung 69 Parkinsonpatienten wurden während mehr als 1 Jahr mit L-DOPA behandelt. Es wurde dadurch bei akinetischen Patienten eine beachtliche, bei Patienten mit Rigor eine mäßige und bei Patienten mit Tremor eine geringfügige Besserung erreicht. Das Ausmaß der Besserung war in allen drei Formen um so geringer, je ausgeprägter die Symptome bei Behandlungsbeginn waren. Rigor und Akinesie sprachen bei jungen Patienten besser auf die Therapie an, aber es bestand keine Korrelation zwischen dem Alter der Patienten und der Beeinflußbarkeit des Tremors durch die L-DOPA-Therapie. Außer für den Rigor bestand keine Korrelation zwischen dem Ausmaß der Besserung und der Dauer der Erkrankung vor Behandlungsbeginn.

     

持续颅内压监测在小脑出血手术中的应用

目的探讨持续颅内压监测在小脑出血手术中的临床意义。方法回顾性分析16例小脑出血手术患者的临床资料,均采用脑室内颅内压监测,根据ICP值调节脱水剂的用量。结果全组死亡5例,其中3例为有严重合并症的老年患者,1例为脑干功能衰竭,1例为再出血,家属放弃治疗。颅内压监测5~14d,平均7.8d,无探头植入引起的颅内大出血,2例发生颅内感染,对症治疗后好转。经过3个月~1年的随访,平均8个月,根据GOS评分:良好7例,中残3例,重残1例。结论小脑出血患者手术后应用持续颅内压监测,可指导降颅压药物的实施,能及早、安全拔除脑室引流,对减少颅内感染的发生有着积极的临床意义,操作简单,值得推广。     

Norman Geschwind: Influence on his career and comments on his course on the neurology of behavior

Norman Geschwind (1926–1984) was a critical force in the emergence of behavioral neurology and neuropsychology as important disciplines in the 1960s and 1970s. Factors that influenced his early career are described, with extensive quotes from a document that Geschwind wrote in 1982, supplemented by interviews with his childhood friends, colleagues from his early career, and his daughter. He entered Harvard College as a math major, but became interested in psychology when he served in the Army infantry in World War II and observed soldiers who acted irrationally in combat. Returning to undergraduate studies, he was taught that knowledge of the brain would shed little light on behavior. His interest in behavioral neurology began with his medical student courses in physiology and neuroanatomy, where he first learned about epilepsy and aphasia. He then trained for 2 years at Queen Square, where his research focused on periodic paralysis, but was greatly influenced by the writings of Hughlings Jackson and Charles Bastian and the teachings of Sir Charles Symonds. Returning to Boston, Geschwind became Dr. Denny-Brown’s Chief Resident at the Neurologic Unit of Boston City Hospital. Another unrecognized source of Norman Geschwind’s intellectual legacy is the unpublished course he taught on The Neurology of Behavior at Harvard Medical School in the 1970s and 1980s. These lectures were an opportunity for Geschwind to formulate, share, and refine his ideas on behavioral neurology to an eclectic mixture of Boston academics, from linguists, philosophers, and anthropologists to physiologists and psychiatrists. From tape recordings of the Spring 1974 course, 10 lectures were transcribed. One of these slightly edited lectures, “Personality Changes in Temporal Lobe Epilepsy,” is reproduced in this issue of Epilepsy & Behavior.     

Efficacy of milnacipran on poststroke depression on inpatient rehabilitation

Post-stroke depression (PSD) has a negative impact on rehabilitation following stroke. No satisfactory antidepressant treatment for PSD has yet been developed. The present study examined the effect of milnacipran, a serotonin and norepinephrine reuptake inhibitor, on PSD patients. Eleven PSD patients taking milnacipran in a rehabilitation hospital were compared to age-matched, sex-matched, and severity of depression at admission-matched PSD patients hospitalized during 2001 who did not take any antidepressant as historical control. Severity of depression was measured using self-rating depression scale for depression (SDS) assessed at admission and discharge after 3 months inpatient rehabilitation. Activities of daily living (ADL) and quality of life (QOL) were measured, respectively, by the functional independence measure (FIM) and a self-completed questionnaire for QOL (QUIK) as outcomes of rehabilitation. For the SDS score, the group taking milnacipran showed significant improvement compared to the control group in our study. FIM was improved in both groups. In the end QUIK did not change significantly in either group. We found no major side-effects of milnacipran among the patients. These results suggest that milnacipran is a safe and effective treatment for PSD for inpatients undergoing rehabilitation.