Language difficulties in an Outpatient Clinic in Switzerland

This small-scale study attempts to examine the languages spoken in medical consultations during a one-month period in an outpatient clinic in Geneva and the ways health professionals use to communicate with their allophone patients, in particular by using interpreters. Patients of foreign origin accounted for 58% of all the consultations during the survey. Of these, 37% were Non-French-speakers (NFS). The four major language groups of NFS were Albanian, Somali, Tamil and Serbo-croat. Qualified interpreters were used in 24% of the consultations, relatives acting as interpreters in 17%, and in the other consultations without anyone interpreting (59%), a common language had to be negotiated: French, English, Italian, Spanish or German. In only 14% of the consultations without interpreters, both patient's and doctors ability to speak a common language was rated as good. Our data suggest that there has been an increasing awareness of the possible language barriers in the medical outpatient clinic. Even if proxy solutions (informal interpreters or the use of a common language) still play an important role, access to an interpreter service has been widely used. This calls for systematic and regular interpreter use, planning the interpreting needs in a timely manner. In the future, training in working with interpreters should become an integral part to the introductory sessions for the junior physicians assigned to the outpatient clinic.     

Taking a male sexual history

Despite a wave of public awareness of erectile dysfunction as a result of Viagra and its successor oral therapies, most men are not discussing issues related to sexuality with health care professionals. Epidemiologic surveys indicate that male sexual dysfunction (MSD) occupies an epidemiologically compelling position. Few doubt that sexual function is an important priority for men throughout their lifespan. The "therapeutic gap" between the frequency with which clinicians currently engage patients in discussions about sexual health and the optimal frequency of such discussions is substantial. Fortunately, readily applicable interviewing tools can allow health care professionals to obtain necessary fundamental information about sexual health and close this therapeutic gap.     

Variability in the stereotaxic position of cerebral points in the albino rat

An analysis of variability in the stereotaxic position of five cerebral points in rats revealed:

1. (1) that variability was less from the bregma skull point than from ear-bar-zero or the lambda skull point,

2. (2) that high correlations exist between the position of skull points and cerebral structures, and

3. (3) that the use of two external landmarks for predicting the position of cerebral targets produces a greater than 40% reduction in errors over that resulting from the use of single (ear-bar-zero or skull landmark) predictors.

Performance Optimization of a High-Repetition-Rate KrF Laser Plasma X-Ray Source for Microlithography

In order to develop a high-intensity laser plasma x-ray source appropriate for industrial application of x-ray lithography, experiments have been carried out using a high-repetition-rate (up to 40 Hz) excimer laser (249 nm, 300 mJ) with a power density of 2 × 1013 W/ cm2 in the laser focus. In this study emphasis is given to remedying specific problems inherent in operating the laser plasma x-ray source at high repetition rates and in its prolonged operation. Two different methods of minimizing the production of target debris are investigated. First, the use of helium as a quenching gas results in a reduction of the amount of atomic debris particles by more than two orders of magnitude with negligible x-ray absorption. Second, a tape target as opposed to a solid target reduces the production of larger debris particles by a further factor of 100. Remaining debris is stopped by an aluminized plastic or beryllium filter used to avoid exposure of the resist by plasma ultraviolet radiation. The x-ray source has been used to image x-ray transmission mask structures down to 0.3 μm onto general purpose x-ray photo-resist. Results have been analyzed with SEM. The x-ray emission spectrum of the repetitive laser plasmas created from an iron target has been recorded and the conversion efficiency of the laser light into x-rays that contribute to exposure of the resist was measured to be 0.3% over 2π sr.     

Penfluridol: An open phase III study in acute newly admitted hospitalized schizophrenic patients

An open study was carried out in 17 acutely ill, newly admitted, floridly psychotic schizophrenic patients to a city hospital in New York. Penfluridol was given on a daily basis up to doses of 120 mg and patients were rated objectively by means of different psychometric evaluations; vital signs were monitored daily as were side effects.The drug was found to be a rapid acting, well-tolerated, and highly effective antipsychotic agent within the population of patients explored and within the dose range used. It was particularly effective in acutely agitated floridly paranoid schizophrenics; a statistically significant impact was achieved by 7 days and usually within 72 h after initiating treatment. The drug appears unique in that (1) its effects are realized without the untoward and usually trouble-some effects of nonspecific sedation attendant upon the use of many other neuroleptic medications, and (2) even within the relatively high doses used it produces no hypotensive effects. It is concluded that this appears to be a unique antipsychotic agent and a potentially important addition to the treatment armamentarium of both acute and chronic schizophrenic individuals.Dr. Klein was a research fellow who has since returned to the University of Munich, West Germany. Dr. Selzer was also a research fellow who is now in private practice     

Changes in brain norepinephrine associated with sensitization to d-amphetamine

Pretreatment of B6AF₁/J mice with d-amphetamine HCl 10 mg/kg, twice daily for 5 days, produced a 4-fold increase in the running response to a test dose of 5 mg/kg amphetamine. Amphetamine pretreatment decreased whole-brain norepinephrine levels to 50% of control values and whole-brain dopamine to 85%. The test dose of 5 mg/kg amphetamine lowered whole brain norepinephrine levels of control mice from 0.50 g/g to 0.28 g/g in 2 h. In amphetamine-pretreated mice, this injection caused an increase in whole-brain norepinephrine levels from 0.22 g/g to 0.55 g/g at 30 min, followed by a decrease to 0.22 g/g at 60 min. No change in whole brain dopamine levels was observed in either group. Amphetamine sensitization and norepinephrine depletion were still evident 25 days after pretreatment. No cross sensitization to morphine or cocaine was observed. Reserpine pretreatment resulted in a 3-fold increase in locomotor activity following injection of d-amphetamine, 5 mg/kg. No sensitization or changes in catecholamine levels were observed in amphetamine-treated A/J mice. These results suggest that the sensitization produced by amphetamine pretreatment may be related to the depletion of brain norepinephrine.     

Altered NMDA glutamate receptor antagonist response in recovering ethanol-dependent patients.

Ethanol is an antagonist of the N-methyl-D-aspartate (NMDA) glutamate receptor. Ethanol dependence upregulates NMDA receptors and contributes to crosstolerance with selective NMDA receptor antagonists in animals. This study evaluated whether recovering ethanol-dependent patients show evidence of a reduced level of response to the effects of the NMDA receptor antagonist, ketamine. In this double-blind study, 34 recently detoxified alcohol-dependent patients and 26 healthy comparison subjects completed 3 test days involving a 40-min infusion of saline, ketamine 0.1 mg/kg, or ketamine 0.5 mg/kg in a randomized order. Recovering ethanol-dependent patients showed reduced perceptual alterations, dysphoric mood, and impairments in executive cognitive functions during ketamine infusion relative to the healthy comparison group. No attenuation of ketamine-induced amnestic effects, euphoria, or activation was observed. The alterations in NMDA receptor function observed in recovering ethanol-dependent patients may have important implications for ethanol tolerance, ethanol dependence, and the treatment of alcoholism.