Problems in the treatment of religious patients

Members of religious groups are bound together by doctrine, ritual, and social organization. These factors also separate religious people from members of other groups or cultures. This division is apparent during interactions with other groups, and critical when members of religious groups are referred for help for psychiatric problems. In this paper we discuss four problems that therapists may encounter with strictly religious patients. Religious patients are often suspicious of secular therapists and therapy, and therapists too, may be influenced by their personal attitudes toward religion. Differentiating religious beliefs and rituals from delusions and compulsions is difficult for therapists ignorant of the basic tenets of that religion. Clinical examples of the four problems are presented from our work with patients from the ultra-orthodox Jewish community of North Jerusalem and we provide guidelines for their resolution. Therapists need a basic knowledge of the religion's doctrines and rituals, should assess patients using its terminology, and approach the patients through the social organization of their religious group. We consider that attention to these issues is vital for effective communication and assessment of strictly religious patients.     

Procarbazine chemotherapy in the treatment of recurrent malignant astrocytomas after radiation and nitrosourea failure

The Brain Tumor Study Group has shown procarbazine (PCB) to be as effective an adjuvant treatment as 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU). We treated 35 patients with recurrent malignant astrocytomas after radiation and nitrosourea failure with successive courses of PCB 150 mg/m2/d for 28 days every 8 weeks. After 2 courses, 2 patients had complete responses, 7 had partial responses, 11 had stable disease, and 15 had progression. Significantly more patients receiving PCB had complete or partial responses or stable disease than a similar group of patients in a previous trial who received intra-arterial (IA) cisplatin (DDP). There is a significant advantage in time to disease progression for those receiving PCB compared with those receiving IA diaziquone (AZQ). Our results suggest that PCB is a more effective 2nd agent than IA DDP or AZQ following radiation and nitrosourea failure.     

毛细管气相色谱法测定人血清中二十二碳六烯酸的浓度

毛细管气相色谱法测定人血清中二十二碳六烯酸的浓度李青翠张驰彭会明夏桂珠（北京医科大学药学院，北京１０００８３；山西省药品检验所，太原０３０００１）二十二碳六烯酸（ｃｉｓ４，７，１０，１３，１６，１９ｄｏｃｏｓａｈｅｘｅｎｏｉｃａｃｉｄ，Ｄ...     

Complicated acute type B dissection and endovascular repair: indications and pitfalls

In light of the morbidity and mortality associated with open repair of complicated acute type B dissection, endoluminal approaches provide an attractive option; however, the challenges of accurate placement within an angulated arch, size of the delivery system, and uncertainty regarding long-term durability have been cited as reasons for caution. This review examines the current literature regarding acute type B dissection and details the methods and potential pitfalls in endovascular management of these complex pathologies.     

The need for leadership in global health

Globalisation has brought with it many advances in health, but also a new range of challenges. There is a need to move from "nation-focused" (international) public health to global public health--and the terminology we use here matters. Global public health leadership requires that respect be shown to evidence, especially that about the changing nature of disease worldwide. The Australian medical and research communities have a significant opportunity to provide global public health leadership.