Impact of outpatient non-myeloablative haematopoietic stem cell transplantation in quality of life vs. conventional therapy

The role of outpatient hematopoietic stem cell transplantation (HSCT) as a therapeutic tool has been strengthened significantly because of the increasing number of patients undergoing this treatment. Due the very nature of this procedure, one of the aspects that should not be overlooked is the quality of life (QOL) of patients undergoing HSCT. Thus, one must consider not only health status after treatment, but also, the psychosocial implications for the patient. This is an observational, longitudinal, and prospective study to assess QOL in patients undergoing outpatient HSCT vs. similar patients receiving medical treatment (MxTx). By applying the COOP/WONKA charts on five occasions (pre-HSCT/initial, post-HSCT/first month, and at 3, 6, and 9 months), thirty-eight patients were analysed, 19 with HSCT and 19 with MxTx with no differences in age, gender or diagnosis. The initial survey found significant differences only in pain perception, which was higher in the HSCT group (p = .08); at the first month, there was a greater tendency for feelings of depression or anxiety in the HSCT group (p = .016), with more limitations in social (p = .003) and daily (p = .044) activities. From 3 months post-HSCT, the results were very similar. The differences persisted only in the area of social activities. Four patients developed graft-versus-host disease with no significant difference in the scores obtained compared to other transplant patients at 3, 6, and 9 months (p = .26) of follow-up.     

Knowledge and Attitudes Towards Genetic Testing: A Two Year Follow-Up Study in Patients with Asthma,Diabetes Mellitus and Cardiovascular Disease

Adequate knowledge and personal attitudes towards DNA-testing are major determinants of optimal utilization of genetic testing. This study aims to (1) assess the genetic knowledge and attitude towards genetic testing of patients with asthma, diabetes mellitus type II and cardiovascular diseases, (2) determine whether their knowledge or attitude changed since 2002, and (3) investigate the predictive role of knowledge on attitude. Data were collected within the Panel of Patients with Chronic Diseases in 2002 and 2004, resulting in 398 data-pairs. Results show that factual knowledge mainly relates to associations between genes and diseases, less is known on associations between genes, chromosomes, cells and body. The perceived knowledge on DNA-testing has not increased since 2002. The attitude towards genetic testing also appeared to be rather consistent. Less perceived medical genetic knowledge and more perceived social genetic knowledge were found predictive for a more reserved attitude towards genetic testing. In conclusion, advanced developments in the field of genetics are not accompanied by increased knowledge of patients with common multi-factorial diseases. The finding that more perceived social genetic knowledge results in more reluctance can be considered an indicator for the necessity of social debates on genetic testing.     

‘Sluts’ or ‘Sleazy Little Animals’?: Young People's Difficulties with Carrying and Using Condoms

Qualitative data from a Western Australian study of sexual behaviour in young people were used to describe difficulties experienced in carrying and using condoms. Both men and women were concerned for their sexual reputation if they carried condoms, although this was more of a problem for the women than the men. However, these fears were not matched by the attitudes of the opposite gender: in general, there was less negativity about condom-carrying than was feared. Many of those who described using condoms had experienced condom failure and other difficulties, and it appeared that they were unfamiliar with the correct way to use condoms. It is suggested that many of these barriers to condom use can be removed with appropriate education and information strategies.     

疾病对社会经济发展的影响

历史上大规模暴发的传染病对社会经济的发展有着非常深刻的影响,它直接打击了社会经济发展的核心与所有生产力要素中最根本的——人类本身;但是,在整个社会经济的发展过程中,公共卫生与医疗保健的作用一直未引起人们的关注,随着人类文明的不断进步,对疾病的控制已经成为世界各国的中心任务,卫生保健服务直接增进了人类健康,促进社会经济健康与持续地发展。     

阿司匹林与其他抗血小板及抗凝药物的合用

动脉粥样硬化性血栓形成是引起心脑血管疾病发生、发展的关键因素。简单而有效的防治方法是合理应用阿司匹林与其他抗血小板及抗凝药物,可以大幅度减少病死率或致残率。阿司匹林既是防治心脑血管疾病的基石,同时也是抗栓治疗的基石,阿司匹林与其他抗血小板或抗凝药物合用,成为抗栓治疗的重要组成部分。抗栓治疗是一柄双刃剑,在临床实际工作中必须合理、有效、正确地应用。有效抗栓治疗同时,尽量避免出血并发症。     

宫腔镜诊治宫腔内疾病的价值

宫腔镜技术在诊断和治疗宫腔内疾病方面已经有着不可替代的地位。对比过去的B超以及诊刮,宫腔镜加诊刮是诊断宫腔内疾病的金指标。宫腔镜电切手术也是宫腔粘连、子宫畸形的最佳手术方式。临床医生应有系统的观点,以循证医学模式为指导,充分尊重患者的意愿,个性化地将这项技术应用于患者。     

解读《恶性肿瘤骨转移及骨相关疾病临床诊疗专家共识》

肿瘤专业工作者不仅要关注患者的抗癌治疗,同时也要关注他们的康复与姑息治疗,骨转移是肿瘤患者的常见转移病灶。《恶性肿瘤骨转移及骨相关疾病临床诊疗专家共识》（2007年版）适时地对恶性肿瘤骨转移及骨相关疾病提出了指导性意见,体现了肿瘤的综合治疗原则,其特点为：（1）多学科合作的结晶;（2）以高级别循证医学证据为基础;（3）突出了实践性和可操作性。和一切“诊断规范”一样,《共识》一方面对指导肿瘤科及其他相关科室医师们的临床实践发挥积极作用,同时又需要在实践中继续得到检验。     

心理应激与DNA损害

心理应激不仅能使人的行为特征发生变化,而且也能使人的生理状况发生改变,因此,被认为是某些身心疾病的诱因。在此过程中,DNA损害是心理应激造成的最终结果之一。有关DNA损害,虽然以往的研究者以人或动物为对象进行了一系列急性应激和慢性应激的实验研究,但是,心理应激是如何造成DNA损害的过程还不清楚,具体的生理心理机制还未阐明。该文利用健康心理学提出的理论模型对此进行了分析,阐述了心理应激与DNA损害之间联系的可能的机制,强调了氧化应激在这一过程中的重要作用。同时,为临床制订预防疾病的干预措施提供了思路     

Psychologie de la santé et éducation thérapeutique : état des lieux et perspectives

The aim of Patient Education (PE) is to make patients with chronic diseases more autonomous by facilitating their adherence to treatments and improving their quality of life. It is a multidisciplinary and expanding device. This article's aim is to propose a state of play of PE and its perspective in relation to psychology, especially health psychology, as a discipline and a practice. First, the development of PE in its historical context is presented as well as its definition. Then, the place and contribution of health psychology and psychologists in PE is presented. The following points deal with the contributions of research to understand the efficacy of PE, the difficulties that the different professionals face and the place of relatives. Finally, a reflexion about the links between the training of psychologists and the training for PE is proposed.     

“疑难杂症”与医学模式

那些长期困扰患者和医生、查不出病因又久治不愈的病症,被称为“疑难杂症”;然而部分“疑难杂症”并非真正的疑难杂症,而是在诊治疾病的过程中所用医学模式出现了问题,医生往往局限于生物医学模式,忽略患者的心理、社会因素。因此,医学模式应该从实际工作中进行转变,而不能仅仅局限于理论上。笔者就临床常见的“怪”现象、医疗对象的复杂性...