不同重复经颅磁刺激模式对慢性精神分裂症阴性症状的疗效及安全性

目的：比较不同重复经颅磁刺激（ rTMS）模式对慢性精神分裂症阴性症状的疗效及安全性研究。方法：将90例慢性精神分裂症患者随机分为5Hz组、10Hz组、伪刺激组,每组30例。3组在维持原有抗精神病药物种类及剂量不变的基础上,刺激部位均选择左侧前额叶背外侧皮质区（ DLPFC）,刺激强度为80％运动阈值,每天1次,每周5次,共2周。治疗前后采用阳性与阴性症状量表（ PANSS）和阴性症状量表（ SANS）量表评定疗效。结果：3组治疗后比较,PANSS总分、阴性因子分、SANS评分差异有统计学意义（F＝22．99,39．73,31．90;P均＜0．05）,10Hz组较伪刺激组PANSS总分、阴性因子分、SANS评分低,差异有统计学意义（ q＝－5．60,－5．70,－7．67;P均＜0．05）;10Hz组较5Hz组PANSS总分、阴性因子分、SANS评分低,差异有统计学意义（ q＝－4．97,－5．80,－7．40;P均＜0．05）。与治疗前比较,10Hz组PANSS总分、阴性因子分、SANS评分降低,差异有统计学意义（ t＝－5．45,－7．03,－7．23;P均＜0．05）;5Hz组和伪刺激组PANSS总分及各因子分、SANS评分差异无统计学意义（P均＞0．05）。结论：10Hz rTMS模式能改善慢性精神分裂症患者阴性症状,有较好的安全性。     

齐拉西酮联合小剂量氯氮平对男性难治性精神分裂症患者认知功能的影响

目的：观察齐拉西酮联合小剂量氯氮平对男性难治性精神分裂症患者认知功能的影响及临床疗效、安全性研究。方法：将100例男性难治性精神分裂症患者随机分为两组各50例,治疗组给予齐拉西酮联合小剂量氯氮平治疗,对照组给予氯氮平治疗。两组均于治疗前后采用阳性与阴性症状量表（ PANSS ）、韦氏成人智力量表（ WAIS－RC）、个人与社会功能量表（ PSP）及不良反应发生量表评定认知功能影响及临床疗效与安全性。结果：两组患者在治疗12周后PANSS总分及各因子分均明显下降,且差异具有统计学意义（t＝16．98,P＜0．05）;治疗后,治疗组WAIS－RC评分及PSP评分均显著提高,且两组差异具有统计学意义（t＝4．76,2．54;P＜0．05）;治疗12周后,两组间临床疗效相当,且治疗期间,治疗组不良反应的发生率明显低于对照组,两组差异具有统计学意义（χ2＝4．24,P＜0．05）。结论：齐拉西酮联合小剂量氯氮平治疗男性难治性精神分裂症与单用氯氮平治疗临床疗效相当,但安全性高,且能更好地改善患者的认知功能。     

生活质量和社会功能量表评分在强迫症和伴强迫症状的精神分裂症患者临床鉴别诊断

目的：探讨生活质量和社会功能量表评分在强迫症和伴强迫症状的精神分裂症患者临床鉴别诊断中的意义。方法：选取2013年2月－2014年8月在我院就诊的强迫症（ n＝125）和伴强迫症状的精神分裂症患者（ n＝112）,同时从体检中心选取90名健康者作为对照,利用生活质量综合评定问卷－74评估3组研究对象生活质量,利用WHO残疾评定量表评价3组研究对象社会功能,利用临床疗效总评量表中的疾病严重程度分量表评估3组研究对象临床症状严重程度。结果：3组研究对象在躯体功能、社会功能、心理功能、物质生活和总分差异均具有统计学意义（F＝568．314,936．032,1819．747,204．339,811．339;P＜0．05）,经LSD－t两两比较,强迫症组和伴强迫症状的精神分裂症组患者躯体功能、社会功能、心理功能、物质生活和总分均低于健康对照组,差异均具有统计学意义（P＜0．05）,伴强迫症状的精神分裂症组患者社会功能评分（26．7±4．8）低于强迫症组（35．9±3．3）,差异具有统计学意义（P＜0．05）;3组研究对象社会功能和临床症状严重程度评分差异均具有统计学意义（F＝1434．813,363．305;P＜0．05）,经LSD－t两两比较,强迫症组和伴强迫症状的精神分裂症组患者社会功能和临床症状严重程度评分均高于健康对照组,伴强迫症状的精神分裂症组患者社会功能（114．5±10．6）和临床症状严重程度评分（4．47±1．14）均高于强迫症组,差异均具有统计学意义（P＜0．05）;经Pearson相关分析显示,所有患者临床症状严重程度评分与社会功能评分呈正相关（r＝0．317,P＜0．05）,伴强迫症状的精神分裂症组患者临床症状严重程度评分与社会功能评分呈正相关（r＝0．251,P＜0．05）。结论：强迫症和伴强迫症状的精神分裂症患者均表现出生活质量和社会功能受损,且伴强迫症状的精神分裂症组患者社会功能损害程度,以及临床症状严重程度均高于强迫症组。     

齐拉西酮对首发精神分裂症患者疗效及认知功能的影响

目的：探讨齐拉西酮对首发精神分裂症患者疗效及认知功能的影响。方法：将80例首发精神分裂症患者随机分为研究组与对照组各40例。研究组采用齐拉西酮治疗,对照组采用氯氮平治疗,均治疗12周。于治疗前、后用威斯康星卡片分类测验（ WCST）,韦氏记忆量表（ WMS）评定认识功能,阳性与阴性症状量表（ PANSS）评定临床疗效。结果：治疗12周后研究组,对照组PANSS、WCST、WMS均较治疗前显著性下降（ t＝2．872～5．648,P＜0．01）。两组间完成分类数,错误应答数,再生,联想,理解,背数比较差异均有显著性（t ＝2．175～2．683,P＜0．05）,不良反应比较有显著性差异（t＝2．071～2．534,P＜0．05）。结论：齐拉西酮与氯氮平对首发精神分裂症患者疗效相当,但齐拉西酮对认知功能的改善优于氯氮平。     

氨磺必利与奥氮平治疗首发男性精神分裂症的疗效及对糖脂代谢的影响

目的：对比氨磺必利、奥氮平对首发男性精神分裂症患者的疗效特点和对糖脂代谢的影响。方法：将64例首发男性精神分裂症患者采用随机分组方法,分为氨磺必利治疗组和奥氮平治疗组,于治疗前,治疗第2、4、6、8周末,使用PANSS量表对精神症状评定,同时采空腹血测定空腹血糖（FBS）,总胆固醇（TC）,高密度脂蛋白（ HDL）,三酰甘油（ TG）,低密度脂蛋白（ LDL）。结果：8周末实际完成61例,第2周末奥氮平组PANSS阳性因子分低于氨磺必利组（t＝2．216,P＝0．031）。第4、6、8周末时氨磺必利组PANSS阴性因子分低于奥氮平组（P＜0．05或0．01）。至研究结束两组间精神病理分和总分无明显差异（P＞0．05）。奥氮平组在第2周末时TG高于氨磺必利组（P＜0．05）,第4周末至研究结束FBS、TC、TG均高于氨磺必利组（P＜0．05或0．01）。奥氮平组与治疗前FBS、TC、TG相比较升高存在统计学差异（P＜0．05）,氨磺必利组与治疗前相比较差异无统计学意义。结论：两药疗效基本相当,奥氮平对急性阳性症状疗效稍好。氨磺必利对阴性症状较好,且对糖脂代谢影响相对较小。     

小学教师主观幸福感及其影响因素

目的：研究与小学教师主观幸福感相关的因素，寻找提高教师幸福感的有效途径。方法：用总体幸福感量表和压力来源量表对合肥市经济开发区小学139名教师进行测查。结果：小学教师主观幸福感平均分高于理论平均分；男教师主观幸福感显著高于女教师（t＝2．734，P＜0．01），同时在忧郁与愉快心境（t＝2．236，P＜0．05）对情感行为控制（t＝2．613，P＝0．01）上差异显著；未婚教师在紧张因子上得分显著高于已婚教师（t＝2．147，P＜0．05）；收入高的教师主观幸福感显著高于收入低者（F＝2．905，P＜0．05），忧郁愉快心境差异显著（F＝5．660，P＜0．01）；教师年龄与主观幸福感（r＝0．209，P＜0．05）和忧郁与愉快心境（r＝0．234，P＜0．01）低相关；年龄与主观幸福感（r＝0．415，P＝0．014）及忧郁愉快心境（r＝0．108，P＝0．006）显著线性相关。工作量压力与精力大小（r＝－0．225，P＝0．008）、家庭情感压力与紧张松弛（r＝－0．207，P＝0．015）、人际关系压力与情感行为控制（r＝－0．184，P＝0．030）显著负相关。结论：性别，年龄，收入及压力来源对小学教师主观幸福感有显著影响。     

宁养义工服务对癌末患者生活质量影响

目的：了解癌末患者生活现状,分析影响生活质量的基本因素及评价宁养义工服务的作用。方法：通过宁养志愿者对癌末患者生活进行干预研究,应用生命支持量表和生命质量量表进行现状调查,并运用统计学软件进行结果分析。结果：癌末患者的生命支持量表：经过t检验可以看出在性别（t＝－0．492,P＝0．002）、年龄（t＝－2．69,P＝0．012）方面差异具有统计学意义;经过方差分析可以看出,癌末患者在家庭人均收入（ F＝5．369,P＝0．011）和身体状况（F＝4．14,P＝0．027）方面差异具有统计学意义;癌末患者的生命质量量表：经过t检验可以看出在性别（t＝－3．345,P＝0．002）、年龄（t＝－2．804,P＝0．009）方面差异具有统计学意义;经过方差分析可以看出,癌末患者在家庭人均收入（F＝5．914,P＝0．007）、是否有宗教信仰（F＝5．744,P＜0．001）、身体状况（F＝13．861,P＜0．001）以及对病情的了解程度（F＝5．875,P＝0．008）方面差异具有统计学意义。经过4个月的宁养义工服务后,有超过90％的癌末患者希望社工能够为其持续的服务。通过宁养义工服务前后的对比,能够发现癌末患者的支持量表前后测量的差值有统计学意义（t＝2．841,P＜0．05）。结论：宁养义工服务能够对癌末患者生活产生积极地影响作用。     

三种抗精神病药物对精神分裂症患者孕酮的影响

目的：探讨利培酮、阿立哌唑和齐拉西酮3种抗精神病药物对精神分裂症患者血清孕酮水平的影响。方法：随机选择门诊和住院的女性精神分裂症患者180例分为利培酮组、阿立哌唑组和齐拉西酮组,每组60例;分别于治疗前和治疗1、3和6个月行PANSS评分和TESS评分,并测定血清孕酮（ Prog）水平、比较治疗前后各测量值的变化,并与健康对照组比较。结果：3组治疗1、3和6月PANSS评分均明显下降,组间差异无统计学意义;在治疗3个月和6个月时阿立哌唑组和齐拉西酮组TESS 评分明显低于利培酮组,差异有统计学意义（ F＝3．120,3．167;P＜0．05）;3组孕酮治疗前均明显低于健康对照组（F＝3．645,P＜0．05）;利培酮组在治疗1月、3月和6月孕酮水平逐渐下降,低于健康对照组（P均＜0．001）,组间差异亦有显著性（P均＜0．001）;阿立哌唑组和齐拉西酮组在治疗1月、3月和6月孕酮水平逐渐升高,差异有显著性（P均＜0．001）,并逐渐接近健康对照组。结论：利培酮、阿立哌唑和齐拉西酮治疗女性精神分裂症患者疗效相当,但阿立哌唑和齐拉西酮副反应明显小于利培酮;精神分裂症患者可能存在自身孕酮水平低下;经阿立哌唑和齐拉西酮治疗后孕酮水平明显升高并接近正常,而利培酮则降低孕酮水平。     

盐酸文拉法辛缓释片对42例Ⅱ型精神分裂症患者听觉P300的影响

目的：应用事件相关电位（ERP）听觉P300（即P3）评估盐酸文拉法辛缓释片对Ⅱ型精神分裂症患者认知功能的影响。方法：选取疗效已达显著进步以上的Ⅱ型精神分裂症患者42例,随机分为研究组（22例）和对照组（20例）。研究组给予盐酸文拉法辛缓释片治疗,在治疗前后对两组患者分别进行听觉ERP检查及阳性症状与阴性症状量表（PANss）评定。结果：在治疗后,研究组靶刺激P300潜伏期缩短（P〈0．05）和波幅升高（P〈0．05）,PANSS评定提示阴性因子分、反应缺乏因子分及抑郁因子分下降和激活因子分升高（P〈0．05）,与对照组比较,差异有统计学意义（P〈0．05）。对照组在治疗前后P300各项目和PANSS评分比较差异无统计学意义（P〉0．05）。结论：从ERP的P300可反映出盐酸文拉法辛缓释片能改善U型精神分裂症患者的认知功能。     

精神分裂症患者一级亲属心理调查

目的：探讨精神分裂症患者一级亲属心理状态及个性特征。方法：采用SCL－90症状自评量表及艾森克个性量表对研究组230例精神分裂症患者一级亲属进行心理测试,并将调查结果与常模对照分析研究。结果：在SCL－90评定中,研究组与对照总分、躯体化、抑郁、焦虑、恐怖、偏执、精神病等因子分高于常模（t＝8．86,16．11,6．19,9．22,15．78,17．07,16．43;P＜0．05）。 EPQ评定中研究组与对照组比较,E分男女均低于常模（ t＝6．57,6．55;P＜0．05）;N分男女均高于常模（t＝7．29,4．85;P＜0．05）。结论：精神分裂症亲属存在明显心理问题,具有不良的性格特征,应对其进行必要的心理干预。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.