科技创新 建功立业

在新春来临、万象更新之际,我谨代表国家人口计生委向全国广大计划生育科技工作者致以最诚挚的新年祝福!2007年,我国人口和计划生育科技工作进入了新的发展时期。一年来全国各地认真学习、深入贯彻落实党的十七大和中央《决定》精神,按照全国人口和计划生育科技大会的工作部署,紧紧围绕中心,服务大局,锐意进取,开拓创新,科技事业蓬勃发展,科技工作取得了可喜的成就,为新时期人口和计划生育工作稳定健康发展奠定了坚实基础。2008年是充满希望、大有作为的一年,也是落实中央《决定》和《全国人口和计划生育科学技术“十一五”发展规划》的关键…     

Children and adolescents with cancer: experiences with chemotherapy

This study aimed to comprehend chemotherapy from the perspective of children and adolescents with cancer. Ten children and adolescents between eight and 18 years of age, in different phases of chemotherapy, participated in this exploratory, qualitative study. Data collection was carried out through semi-structured interviews and analysis of the patients' medical records. Analysis of the empirical material followed the content analysis technique. The study allowed the comprehension that, for the children and adolescents, chemotherapy is mainly remembered for its collateral effects and suffering. After the initial impact, mainly due to physical changes, preoccupations are related to disease recovery, i.e. a cure. Over time, they also mentioned that the disease was seen as something to be overcome and, due to the chemotherapy, likely to be the outcome.     

Osteoporosis with vertebral fractures associated with pregnancy and lactation

Three cases of young women who developed severe vertebral osteoporosis after pregnancy and during lactation are described. These patients shared several features: a low-calcium diet during most of their lives, very-low body weight in two patients, and a positive family history of osteoporosis in two patients. Initial studies disclosed vertebral fractures, severely diminished bone mineral density of the spine (Z score = -3.3 to -4.1), and a less severely affected bone mineral density of the hip (Z score = -1.6 to -2.3). During the prolonged follow-up of these patients, treated with oral biphosphonates, vitamin D, and calcium, an improved clinical response with a marked recovery of spine bone mineral density was observed. Poor general nutrition, low calcium intake, and a positive family history of osteoporosis appear to be strong risk factors for pregnancy- and lactation-associated osteoporosis. Although the mechanism of action is uncertain, calcium, vitamin D, and antiresorptive agents may have been beneficial in the treatment of this severe disorder.     

Interstitial nephritis attributed to treatment with piperacillin-tazobactam and with ciprofloxacin

A 26-year-old man was treated with piperacillin-tazobactam because of suspected cholangitis and a 77-year-old man was given ciprofloxacin because of an infected knee-prosthesis. They both developed symptoms of an interstitial nephritis: malaise and laboratory deviations. The symptoms disappeared after the antibiotics were withdrawn. No other explanation for the renal function disorders could be found in either patient. Piperacillin-tazobactam and ciprofloxacin are considered to be relatively safe and serious adverse effects are rare. Acute interstitial nephritis may, however, occur and its clinical presentation may not be very informative. Withdrawal of the culprit usually leads to recovery.     

Adolescents with sickle-cell anemia deal with life and death.

Confusion associated with the developmental problems of adolescence is intensified and prolonged for those suffering from sickle-cell anemia. Feelings of isolation and dependence due to a life-threatening disease can impede the transition to responsible, self-actualizing maturity. Weekly group meetings with nine young women suffering form sickle-cell anemia helped them move toward maturation and a sense of their own competence. The experience of closeness with other adolescents who shared the same vulnerabilities was mutually facilitating. These young women had been caught by a sense that it was impossible to progress to independent maturity, and so became resigned and passive. Yet an inner sense of vitality and their emerging sexuality occasionally sparked rebellion against this helplessness. Sexual senations and potential for family life were available counter-balances against recurrent association with pain and death. Through group support these linkages with hope were strengthened.     

A boy with Churg-Strauss syndrome and thrombosis associated with eosinophilia

A 13-year-old boy, recently diagnosed as having Churg-Strauss syndrome, presented with a thrombus at the level of the aortic bifurcation. Echocardiography revealed a left-ventricular thrombus as well. He was treated by means of surgical thrombectomy, corticosteroids, heparinisation and a coumarine derivative. Eosinophilia (an increase in the number of eosinophilic granulocytes in the circulation or tissues) occurs in various diseases, such as allergic diseases, parasitic infestations, haematologic diseases and autoimmune diseases like the rare Churg-Strauss syndrome. It appears likely that eosinophilia played an important role in the development of both thrombi in the described patient. Eosinophils produce cationic proteins that may inhibit the effect of natural anticoagulants. Infiltration of eosinophils may also cause endocardial damage with the subsequent formation of intracardial thrombi.     

Experiments on monkeys with cholera toxin partially purified and detoxified with formol and glycine

Cholera toxoid partially purified and detoxified with formol and glycine and inoculated in monkeys proved safe. Histological examination revealed no changes in the skin of the animals treated. Blood samples taken from monkeys immunized with 2 doses of toxoid 12 days after the second inoculation revealed appreciable levels of antitoxin in the animals that had received two 100-μg doses of toxoid. The monkeys vaccinated with toxoid, when inoculated with challenge doses of cholera toxin, had the capacity to neutralize the toxin. Detoxification with formol and glycine may be the first step towards the preparation of a highly purified, innocuous, and antigenic cholera toxoid.     

Implicit and Explicit Associations with Erotic Stimuli in Women with and Without Sexual Problems

Conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning. The present study aimed to investigate implicit and explicit cognition in sexual functioning in women. Gynecological patients with (N = 38) and without self-reported sexual problems (N = 41) were compared. Participants performed two Single-Target Implicit Association Tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence and motivation. Participants also rated the erotic pictures that were shown in the ST-IATs on the dimensions of valence, attractiveness, and sexual excitement, to assess their explicit associations with these erotic stimuli. Participants completed the Female Sexual Functioning Index and the Female Sexual Distress Scale for continuous measures of sexual functioning, and the Hospital Anxiety and Depression Scale to assess depressive symptoms. Compared to nonsymptomatic women, women with sexual problems were found to show more negative implicit associations of erotic stimuli with wanting (implicit sexual motivation). Across both groups, stronger implicit associations of erotic stimuli with wanting predicted higher level of sexual functioning. More positive explicit ratings of erotic stimuli predicted lower level of sexual distress across both groups.     

Understanding medical students' attitudes towards and experiences with persons with disabilities and disability education

BackgroundIn the United States, approximately one quarter of individuals are living with disabilities and receiving healthcare services. The undergraduate medical school curriculum provides an opportunity to improve the attitudes and skills of physicians working with persons with disabilities (PWD).Objective/hypothesisThe purpose of this study was to gain an understanding about fourth-year medical students’ self-reported attitudes towards and experiences with PWD and disability education. We hypothesized that medical students would recall having education about disabilities, would be able to identify a pivotal disability education experience, and would report being less comfortable working with PWD than persons without disabilities.MethodsThis mixed methods observational study was conducted via an online survey distributed to medical students during Winter 2020/2021. It contained an adapted instrument and a few short answer questions.ResultsOur survey had 44 respondents, a 28% response rate. Though 98% of students reported receiving disability education during one or more courses, 80% felt their disability education during medical school has been inadequate. Additionally, 64% reported having an influential learning experience involving PWD. Despite their attitudes, education, and experiences, respondents reported feeling less comfortable obtaining a history, performing a physical exam, and establishing a differential diagnosis when working with PWD.ConclusionsThis study highlights the need for continued development of disability curricula, which likely extends beyond the studied institution. Additional educational elements could be added to humanities sessions, as well as other courses and clerkships.