肌萎缩侧索硬化症患者的情绪反应

肌萎缩侧索硬化症是一种致命性疾病，可使患者的传入神经处于部分阻滞或完全阻滞状态。在一项探索性研究中，对ALS患者对视觉社会一情绪刺激的反应进行探讨。由12例脊柱发病的慢性进展性中度受累ALS患者和18例年龄相匹配的对照者对国际情绪图片系统（IAPS）的图片进行口头判断，并将之与其精神生理反应进行比较，患者的口头情绪判断较对照者积极。在激发情绪方面，患者对偏激图片加以中和，因为与对照者相比，患者将安静图片评价的更为兴奋，而将兴奋图片评价的更为安静。上述情绪上的变化与抑郁或额叶功能障碍无关，患者和对照者对情绪刺激的生理反应之间无显著性差异。总之，在ALS发病的早期阶段，患者的情绪反应朝积极方面发展，情绪激发朝平衡方面发展。上述结果与以下假说相反，即本病对患者的情绪通常产生消极影响，但本试验结果提示ALS可能会引起代偿性认知或神经可塑性改变。     

Social marketing of pre-packaged treatment for men with urethral discharge (Clear Seven) in Uganda

We implemented social marketing of pre-packaged treatment for men with urethral discharge (Clear Seven) in Uganda, and studied its feasibility, acceptability and effectiveness as a possible means to treat STDs and thereby prevent HIV. Clear Seven was distributed at private health care outlets in three rural districts and two divisions of the capital. Comparisons were made with a pre-intervention period in the same sites plus one additional rural district. There were almost universally positive attitudes to Clear Seven. Cure rate (84% versus 47%), treatment compliance (93% versus 87%), and condom use during treatment (36% versus 18%) were significantly higher among Clear Seven users (n=422) than controls (n=405). Partner referral was similar but fewer Clear Seven partners were symptomatic when seeking treatment. Distribution of socially marketed pre-packaged treatment for male urethritis should be expanded in sub-Saharan Africa. Consideration should be given to developing similar kits for women.     

The clinical pattern of duodenogastric bile reflux in the Kenyan Africans

Forty consecutive African patients found to have duodenogastric bile reflux at endoscopy were studied. Bile reflux was found more commonly among males than females, giving a male/female ratio of 2.3:1, with a peak age at 41-60 years. ABO blood groups had no significant influence on duodenogastric bile reflux. Flatulence and borborygmi were the most consistent symptoms other than the classical dyspeptic pain pattern. Bilious vomiting was a rare finding. Duodenogastric bile reflux was more commonly associated with endoscopic gastritis (67.5%), gastric ulcer (35%) and oesophagitis (30%) than with duodenal ulcer (22.5%), deformed pyloric ring (5%) or distorted duodenal bulb (2.5%). The dysfunction in the pyloric sphincter in people with duodenogastric bile reflux appears to be more of a physiological defect than structural.