1例妊娠合并急性白血病患者带来的分析与思考

通过对1例妊娠合并急性白血病患者的病例资料进行回顾分析,从孕期化疗的特点来探讨其终止妊娠及进一步化疗治疗的时机与方式,以及从该患者治疗和妊娠之间的矛盾来讨论医生在母体和婴儿生存权益的重要性,总结出医护人员的人性化与职责,深入伦理学思考临床医生对类似患者的最佳治疗应该作出的判定与决策,从而有利于构建和谐社会。     

如何才能保持拉米夫定的疗效及降低耐药——临床优化治疗策略

探讨拉米夫定的临床优化治疗策略,包括选择适用人群,用药最佳时机,预防和应对耐药的方法。旨在提高和保持拉米夫定在慢性乙型肝炎抗病毒治疗的效果。     

子宫内膜癌患者治疗方式的选择

子宫内膜癌是女性生殖道常见的恶性肿瘤之一,其主要的治疗手段是手术,传统的治疗术式将双侧卵巢一并切除。随着医学模式的转变,现代医学提出了新的观点一保留卵巢功能,但是卵巢保留有其风险性和安全性,这就要求选择保留卵巢时要慎重。     

Neuropsychological Functioning and Antiretroviral Treatment in HIV/AIDS: A Review

This article presents a review of studies that have investigated the neuropsychological effects of antiretroviral treatment (ART) for HIV-1 infection. It provides a brief overview of the era of monotherapy, dual-therapy, and an extended overview of the current era of combination antiretroviral therapy (CART). This review highlights that while CART has had a dramatic effect on the incidence and the severity of HIV-associated neurocognitive disorders (HAND), HAND, in its mild form, still remains prevalent. New causes of this sustained prevalence are poor CNS penetration of some antiretroviral agents, drug resistance, poor adherence, potential neurotoxicity, co-morbidities such as the long-term CART side effects in relation to cardio-vascular disease, and chronic HIV brain infection that may facilitate the expression of new forms of neurodegenerative processes. The review emphasizes the need to address methodological limitations of published studies and the need for large and representative cross-disciplinary longitudinal investigations across the HIV illness span.     

The Role of Parental Stress, Mother’s Childhood Abuse and Perceived Consequences of Violence in Predicting Attitudes and Attribution in Favor of Corporal Punishment

We investigate maternal attitudes toward corporal punishment and the attribution of blame to the child on the basis of data gathered from a population survey of a representative sample of mothers and mother figures. A total of 3,148 women living at least half of the time with a child participated in a telephone survey. The independent variables included in the multivariate model predicting maternal attitudes and attributions include the child’s, the mother’s and the family’s characteristics and social support. Results of the multiple regression analysis demonstrate the unique contribution of variables according to the mother’s characteristics (mother’s sensitivity to the consequences of violence, mother’s experience of childhood violence and parental stress related to child’s temperament). These results partially support the importance of prevention programs that would reduce stress and increase the level of parental empathy through the means of parental training.     

Development of a Substance Abuse Consultation and Referral Service in an Academic Medical Center: Challenges, Achievements and Dissemination

Approximately 25% of US hospital beds are occupied by individuals with active substance use disorders (SUD). Acute medical hospitalization provides an opportunity to address SUDs and provide patient-centered intervention and referral for treatment. Nationally, some hospitals have developed substance abuse consultation departments to improve the care of hospitalized substance users. In this paper we describe the Addiction Psychiatry Service (APS) in a large urban hospital which provides bed-side SUD consultation, screening, intervention and referral to treatment. APS utilizes the multiple disciplines of psychology, social work and medicine to integrate substance abuse services throughout the hospital and educate future generations of medical and psychology trainees. We conclude with how the APS service is informing the development of similar programs in other academic departments within our hospital and best practice recommendations to further disseminate this service model.     

Long-term outcome of Internet-delivered cognitive-behavioural therapy for social phobia: A 30-month follow-up

Internet-delivered guided cognitive behaviour therapy for social anxiety disorder has been found to generate promising short-term results, up to one year posttreatment. No study has however documented longer follow-up periods. In this 30-month follow-up we contacted 57 participants from the original study of which 77.2% (44/57) responded to the Internet-administered outcome measures and 66.7% (38/57) completed a telephone interview. Results showed large pretreatment to follow-up within-group effect sizes for the primary outcome measures (Cohen's d 1.10-1.71), and a majority (68.4%; 26/38) reported improvements in the interview. The findings suggest that the long-term effects seen in previous live treatment CBT trials can occur in Internet-delivered treatment as well.     

Traumatic stress and psychological adjustment in treatment-seeking women sexually abused in childhood: A follow-up

The objective of this study was to assess post-traumatic stress disorder (PTSD), psychological distress, and risk factors among women sexually abused in childhood (CSA) after six months in therapy. Thirty in-treatment CSA survivors reported their abuse history and filled out several questionnaires. Comparisons were made to a non-CSA in-treatment sample. Although, 50% of the CSA women still had PTSD, there was a remarkable decrease in PTSD symptoms (Cohen's d = 1.06). A considerable change in self-worth and in attachment styles was found. It was concluded that CSA survivors benefit much from 6 months of weekly treatment. However, it is recommended that treatment should continue for a still longer period.     

Recent advances in research on school-based extracurricular activities and adolescent development

Updating a previous systematic review of the literature, this review summarizes the literature over the last 5 years on the relationship between school-based extracurricular activity participation and academic achievement, substance use, sexual activity, psychological adjustment, and delinquency. The review also considers mediators and moderators of these relationships. This review also discusses recent advances in activity research including participation measurement (intensity, breadth, and duration), person-centered approaches, and an exploration of the overscheduling hypothesis. The review reveals a mixed picture of the relationship between activity participation and these adolescent developmental outcomes. A call for continued exploration into measurement issues, analysis approaches, outcome measures, and causal models of activities and adolescent functioning is made.