Does long term use of piracetam improve speech disturbances due to ischemic cerebrovascular diseases?

Aphasia causes significant disability and handicap among stroke survivors. Language therapy is recommended for aphasic patients, but not always available. Piracetam, an old drug with novel properties, has been shown to have mild beneficial effects on post-stroke aphasia. In the current study, we investigated the effects of 6 months treatment with piracetam on aphasia following stroke. Thirty patients with first-ever ischemic strokes and related aphasia were enrolled in the study. The scores for the National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), and Gülhane Aphasia Test were recorded. The patients were scheduled randomly to receive either 4.8 g piracetam daily or placebo treatment for 6 months. At the end of 24 weeks, clinical assessments and aphasia tests were repeated. The level of improvement in the clinical parameters and aphasia scores was compared between the two groups. All patients had large lesions and severe aphasia. No significant difference was observed between the piracetam and placebo groups regarding the improvements in the NIHSS, BI and mRS scores at the end of the treatment. The improvements observed in spontaneous speech, reading fluency, auditory comprehension, reading comprehension, repetition, and naming were not significantly different in the piracetam and placebo groups, the difference reached significance only for auditory comprehension in favor of piracetam at the end of the treatment. Piracetam is well-tolerated in patients with post-stroke aphasia. Piracetam taken orally in a daily dose of 4.8 g for 6 months has no clear beneficial effect on post-stroke language disorders.     

The prevalence of suicidal ideation and suicide attempt in patients with rheumatic diseases: a systematic review and meta-analysis

A number of studies have reported the suicidal ideation (SI) or suicide attempts (SA) of patients with rheumatic diseases. However, the estimated prevalence of those disorders varies substantially between studies. This systematic review aimed to describe the prevalence of SI and SA in rheumatic diseases. Literature search was done using Web of Science, Embase, the Cochrane database library, PubMed and CNKI database through June 2017. Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated. The data was analyzed using STATA version 12.0. A random-effect meta-analysis was conducted on all eligible data. A total of 17 identified studies matched the inclusion criteria, involving 5174 participants with systemic lupus erythematosus (SLE), osteoarthritis (OA), rheumatoid arthritis (RA) and fibromyalgia (FM). Meta-analysis showed that rheumatic diseases patients have high prevalence of SI (26%, 95% CI: 19%-32%, I²=96.2%) and SA (12%, 95% CI: 3%-21%, I²=96.6%). We also found the prevalence of SI and SA in females may be higher than in males. All of these indicated that rheumatologists should screen for SI and SA in their patients. Early appropriate intervention is therefore essential to promote the patients’ good mental health.     

Psychologie sociale de la santé et compétences psychosociales en éducation thérapeutique : des enjeux pour la recherche et pour la pratique

The article presents the theoretical-methodological contributions of Social Health Psychology on the evaluation and reinforcement of psychosocial skills in the context of therapeutic patient education. This is illustrated by a synthesis of the results of several empirical researches in the field of pediatric diabetes. This synthesis shows that psychosocial skills are part of a system of actions and interpretations shaped by therapeutic and relational issues as well as social symbolism. Several practical implications emerge from these results for more effective work on the psychosocial skills of patients. The article concludes with the interest of a “psychosocial clinic” which draws on the viewpoint of Social Health Psychology to evaluate, analyze and intervene on the psychosocial determinants of health behaviours.     

Psychological consequences of rheumatic diseases in children and adolescents: A first exploratory study

The objective of our study was to make a first exploratory study about the psychological status of children and adolescents with rheumatic diseases exploring, also, the significant differences between girls and boys. A total of 123 children (81 girls and 42 boys) with rheumatic diseases, between the ages of 1 and 19 years old were assessed using different measures for evaluating behavioral and emotional problems. The results showed a picture of a mild or moderate degree of psychological problems in the different measures of anxiety, depression, general distress and behavioral problems. Girls, compared to boys, scored higher in most of the measures used, showing more internalizing than externalizing kinds of symptoms. The results suggest the importance of making a more detailed study of these children, comparing them with matched controls and making prospective, longitudinal studies in order to detect psychological problems, and to explore the influence of predictive variables.     

行为生命周期假设在慢性病防治中的应用

目前,慢性病已成为妨害人民健康的主要疾病,是我国重要的公共卫生问题,但人们并没有对此给予重视。本文运用行为经济学的理论与方法,对此进行分析解释,认为行为生命周期假说能够有效解释此种现象,并可以通过开展群体活动、完善机制和设立名义账户等措施来改变居民的行为方式,从而有效地防治慢性病。     

自身抗体检测新技术及其临床应用

自身抗体的检测在自身免疫性疾病（A ID ）的诊断,判断疾病的严重程度及评价疗效方面拥有十分重要的临床意义。随着免疫检测技术的进步,新的自身抗体特异性靶抗原被发现,自身抗体的检测技术也越来越多,出现如何评估自身抗体检测方法及诊断价值的新问题。本文介绍自身抗体检测的新技术及自身抗体检测技术的发展趋势,评估自身抗体检测方法应用现状,分析了临床自身抗体检测技术的优缺点,让临床实验室更加合理有效选择自身抗体检测技术。     

盆腔炎性疾病的预防

盆腔炎性疾病（pelvic inflammatory disease,PID）是影响妇女健康的常见病,针对其发病的诱因,预防PID可以从以下几个方面进行：（1）加强性教育,减少性传播疾病;（2）积极做好妇女的卫生保健指导工作;（3）重视筛查、早期诊断及一次性根治下生殖道感染;（4）提高医务人员的理论水平和技术,避免医源性感染;（5）持续正确选择避孕措施;（6）避免阴道冲洗。此外,长期放置宫内节育器不会增加PID的风险;口服避孕药对PID无明显预防作用,而仅仅与减轻其严重症状有关。     

HMGB1在心血管疾病中的研究进展

高迁移率族蛋白B1(high mobility group protein box1protein,HMGB1)是一组高度保守的非组织核蛋白,存在于多种真核细胞的细胞核中。其可通过活化细胞的主动分泌和坏死细胞的被动释放进入胞外,并与配体结合引发信号转导,诱导炎症介质的产生,扩大炎症反应。大量研究表明,HMGB1在心血管疾病的发生发展及转归中起着重要作用,并受到人们越来越多的关注。