Breast Cancer in Men: Emasculation by Association?

The occurrence of breast cancer in men is rare in comparison to women. Public knowledge that men can get breast cancer and of male breast self-examination are lacking. Research in the course and treatment of breast cancer in men is needed. Men generally present in more advanced stages of breast cancer than women, and have a poorer prognosis. In this article, the epidemiology, common symptoms, diagnostic methods, and current treatment of breast cancer in men are described. Gender differences in presentation and course of illness are discussed. Additionally, the psychological implications of breast cancer for male gender roles and masculine identity are explored. Directions for further investigation are given. Treatment providers are encouraged to educate themselves and their male patients on breast cancer in men and male breast examination techniques so that this disease may be identified earlier in its course and survival rates improved.     

Contextual fear conditioning predicts subsequent avoidance behaviour in a virtual reality environment

Avoidance behaviour is a crucial component of fear and is importantly involved in the maintenance of anxiety disorders. Presumably, fear conditioning leads to avoidance of the feared object or context. A virtual reality contextual fear conditioning paradigm was used to investigate the association between explicit conditioning effects and subsequent avoidance behaviour. Mild electric shocks were administered in one context (anxiety context), but never in a second context (safety context). Subsequent avoidance behaviour was assessed by asking participants to choose two out of three contexts (a neutral context was added) to visit again. Participants avoided the anxiety context, but did not prefer the safety over the neutral context. Participants with substantial conditioning effects, as reflected in differential valence, arousal and anxiety ratings, avoided the anxiety context but not the safety context. In sum, we demonstrated an association between context conditioning effects on an explicit level and later avoidance behaviour.     

Learning Words Via Reading: Contextual Diversity,Spacing, and Retrieval Effects in Adults

We examined whether variations in contextual diversity, spacing, and retrieval practice influenced how well adults learned new words from reading experience. Eye movements were recorded as adults read novel words embedded in sentences. In the learning phase, unfamiliar words were presented either in the same sentence repeated four times (same context) or in four different sentences (diverse context). Spacing was manipulated by presenting the sentences under distributed or non‐distributed practice. After learning, half of the participants were asked to retrieve the new words, and half had an extra exposure to the new words. Although words experienced in diverse contexts were acquired more slowly during learning, they enjoyed a greater benefit of learning at immediate posttest. Distributed practice also slowed learning, but no benefit was observed at posttest. Although participants who had an extra exposure showed the greatest learning benefit overall, learning also benefited from retrieval opportunity, when words were experienced in diverse contexts. These findings demonstrate that variation in the content and structure of the learning environment impacts on word learning via reading.     

On the use of fluency training in the behavioral treatment of autism: a commentary

The substantial demand for behavior-analytic treatment of early childhood autism has been associated with rapid dissemination of treatment procedures to practitioners and caregivers. This level of demand could plausibly induce premature dissemination of treatments that do not yet have sufficient empirical support. We argue that this might have happened with the use of fluency training for learners with autism and identify four areas of research that are necessary to ensure that dissemination efforts are better matched to the available empirical support for this instructional strategy.     

重症免疫性血小板减少性紫癜紧急救治方案的探讨

为了探讨重症免疫性血小板减少性紫癜(ITP)的治疗方案,回顾性分析118例接受激素(92例)或丙种球蛋白(16例)或rhTPO(10例)治疗患者的临床资料,分析疗效及不良反应。结果显示:(1)激素组、丙种球蛋白组和rhTPO组总有效率分别为76.1%、81.3%和70%,组间差异无统计学意义。复发组有效率(67.3%)明显低于初治组(83.3%,P0.05),PAIgG伴PAIgM升高组有效率明显低于不伴PAIgM升高组(P0.05);(2)血小板达峰时间:激素组为(5.70±3.68)d,丙种球蛋白组为(4.31±0.75)d,rhTPO组为(5.00±1.63)d,激素组与丙种球蛋白组间差异有统计学意义(P0.05);(3)不良反应:激素组均出现类库欣综合征表现,丙种球蛋白组未见不良反应,1例(10%)rhTPO组患者出现轻度转氨酶增高。总之,丙种球蛋白和rhTPO治疗成人重症ITP疗效好,不良反应轻微。     

血液病治疗中的人文关怀

新医学模式指出人文关怀在医疗服务中有重要意义。目前我们在血液病治疗中对人文关怀重视不够。由于大部分血液系统疾病起病隐匿,发病机制不清,病程长,并发症多,所以预后差,再加上治疗费用高,社会角色转变困难,很容易使患者产生焦虑、抵触、恐惧、多疑、抑郁等心理问题,并影响和谐医患关系的建立。人文关怀有助于缓解患者的心理问题,促进良好医患关系的建立,加速疾病的恢复,提高患者的生存质量。     

老年高血压治疗决策的个体化和系统化

高血压是严重危害老年人健康的常见病,老年人高血压临床症状及特点与中青年高血压有显著不同,在诊断治疗中应注重老年人血压升高的病理生理特点及机制,在老年高血压的治疗决策中运用个体化和系统论的原则,选择个体最优化综合治疗决策,启思和引导老年高血压研究水平的纵深发展,积极有效地改善老年人的生活质量。     

老年人行结肠镜检查相关问题探讨

结肠镜检查是一项广泛用于临床的直观有效的诊断结肠疾病的方法。对于整体机能减退的老年人来说,我们可从结肠镜前准备工作中的三个方面:肠道准备用药的比较选择、基础合并症的处理以及医患交流和心理护理提高老年患者对结肠镜的耐受性。     

重型颅脑损伤围术期亚低温治疗路径——循证医学指导下的治疗抉择

早期动物实验研究表明亚低温能减轻脑损伤后的继发性损害,促进神经功能恢复,然而对其临床疗效不同研究结果不完全一致。本文应用循证医学思想,检索和评价国内外文献,为重型颅脑损伤患者制定了围术期亚低温实施方案。随访结果表明,亚低温可改善患者预后。