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Psychiatric needs in local jails: emergency issues.

There is an urgent need for psychiatric services for mentally ill inmates in local jails. The authors recommend that a psychiatric team be established inside the jail to provide short-term crisis evaluation, disposition, and treatment; that special training be provided for jail booking personnel in the recognition of psychiatric problems during the initial jail screening and classification process; that special modules be developed for mentally ill inmates; and that inmates in need of hospitalization have easy access to hospital beds. They describe a psychiatric ward actually located within a county jail to treat mentally ill inmates who are considered security risks.

Adult

[The origins of the Brno School of Pharmacy and the development of pharmaceutical chemistry as an important discipline].

After the foundation of the course of pharmaceutical studies at Masaryk University in Brno in 1945, its Institute of Pharmaceutical Chemistry has been founded. In pharmaceutical chemistry, which was divided into the theoretical, synthetic and control-analytical parts, a system of classification was worked out based on classification of drugs according to the kind of effect for which it serves. This conception was incorporated into three editions of the book Chemická léciva (Chemical Drugs). The research programme of the Institute solved the development of novel local anaesthetic and antituberculous agents. After the disestablishment of the Faculty of Pharmacy in Brno, the development of pharmaceutical chemistry, continued at the Department of Pharmaceutical Chemistry, Comenius University, Bratislava, and beginning with 1969 at Charles University Faculty of Pharmacy in Hradec Králové.

Czechoslovakia

Validation of the pellet coating process used for a new sustained-release theophylline formulation.

Within the scope of the validation process described in this report, the influence of the process parameters on the factors determining the quality of Euphylong pellets during the spraying process is examined. The process is challenged within the meaning of the validation guidelines. Investigations within the scope of product-independent validation of the automated fluid bed coating apparatus (Wurster setup) used here provide the basis for installation qualification and operational qualification as defined by the PIC convention and the GMP guidelines. Within the scope of a classification of risks, potential operating and system errors are examined, giving consideration to the worst case conditions, and the relevance of the "blue book" to the process is discussed. Three critical process parameters (spraying temperature, air velocity and relative humidity) are investigated with respect to their influence on the goal parameter "in-vitro release of the active ingredient after 1 h". Product-related validation of the process is accomplished by means of statistical experimental design (factorial design). Statistical analysis is done using the methods described by Box-Wilson and Yates and by response surface research and grid-search methods via contour plots and isometric graphs. This yields the acceptable range of process parameters with respect to product quality. Finally the differences between validation and optimization are discussed.

Analysis of Variance

New directions in standard terminology and classifications for primary care.

Three documents that considerably facilitate primary care research have been produced in recent years. They are an international glossary of primary care health terms, an international classification of primary care health problems, and a primary care process classification. To describe the full spectrum of primary health care, however, additional classifications are needed that detail the reasons for encounters and indicate health status. Work on these several classifications is in progress and a set of primary care classifications has been proposed as a basis for the 10th revision of the International Classification of Diseases.

Diagnosis

History of epilepsy in Chinese traditional medicine.

The first known document on epilepsy in China appeared in The Yellow Emperor's Classic of Internal Medicine, Huang Di Nei Ching, written by a group of physicians around 770-221 B.C. The description of epilepsy in this book and in many others later published was confined to generalized convulsive seizures. No documentation of absence or simple partial seizures was provided. The first classification of epilepsy, probably by Cao Yuan Fang in A.D. 610, listed five types of epilepsy: "Yang Dian," "Yin Dian," "Feng (Wind) Dian," "Shih (Wet) Dian," and "Lao (Labor) Dian." Later, other classifications named seizures after the cry of animals whose cry the "epileptic cry" resembled, or after "visceral organs" believed to be responsible for the seizures. The concept of partial versus generalized seizures, however, was not observed in any of these classifications. The treatment of epilepsy, based on principles of "Yin Yang Wu Xing," consisted of herbs, acupuncture, and massage.

China

Medications of elderly institutionalized incontinent females.

The purpose of the study was to explore drug use of elderly incontinent female nursing home residents, to identify potential drug--drug interactions, and to identify the number and categories of drugs taken having the potential to cause urinary incontinence. The medication administration records of 84 female residents were examined. The drugs were categorized by therapeutic classification as designated by the American Hospital Formulary Service. Potential drug--drug interactions were identified using The Hansten Drug Interaction Knowledge Base Program, a microcomputer version of Hansten's (1985) book Drug Interactions. Data were computer-coded and analysed using the Statistical Analysis System (SAS). A total of 454 drugs was taken by the 84 subjects, with an overall average of 5.40 drugs per person. The most frequently taken drugs were gastrointestinal drugs, central nervous system agents, electrolytic, caloric, and water balance drugs, and cardiovascular drugs. Fifty per cent (n = 42) of the subjects were identified as having 119 potential drug-drug interactions. Seventy per cent (n = 59) of the subjects were taking a drug having the potential to cause urinary incontinence. Suggestions for future research are presented.

Aged

The history of pediatric surgery in France.

In 1741, Nicolas Andry, counsellor of King Louis XV, published a book about "orthopedics," inventing this word. The book is interesting as the author refers to beliefs and habits of the time. In 1864, Guersant published Notes About Pediatric Surgery, a real textbook which was translated into English and German and dealt with the importance of children's psychological training, anesthesia, and water or mother's milk after the operation, and also described tracheotomy, draining of cervical adenitis, and lithotrity. The classification of bone affections was still very confused. Tuberculosis and syphilis have an important place; hypospadias is not treated by surgery. In 1905, Froehlich published Pediatric Surgery Studies dealing exclusively with visceral surgery and demonstrating progress compared to Guersant's study. In 1906, Kirmisson published Pediatric Surgical Textbook, containing the first discussion of radiology and the description of the pathology of the omphalomesenteric duct and of other congenital malformations. Osteomyelitis was given its proper name, and cervical fistulas were explained. In 1914, A. Broca achieved further progress describing treatments of megacolon, intussusception, and the operation of Fredet Ramstedt. The book by Ombredanne, already out of date at the time of its publication, showed that he was not aware of the wartime, progress achieved by Ladd and Gross in the USA. French publications have diminished since then, and French pediatric surgery is still trying to find a precise identity.

France

Occupational risks for meningiomas of the CNS in Sweden.

Using the Cancer-Environment Registry of Sweden, which links cancer incidence (1961 to 1979) with census information (1960) for all employed individuals in Sweden, a systematic, population-based assessment was made of the occurrence of meningiomas of the CNS according to industrial and occupational classifications. Statistically significant standardized incidence ratios (SIR) between 5 and 6 for meningioma were observed among glass, porcelain, or ceramic workers of both sexes. SIRs of similar magnitude were also found for men employed in the headwear fabrication and book publishing industries. Significantly elevated two- to three-fold risks were observed for men employed in health care, railroad and trolley construction, sheet and plate metal fabrication, and as moving equipment operators. Some of the findings of this descriptive survey may have arisen as a result of multiple comparisons, but several are consistent with earlier observations for brain cancer from other countries and deserve further study.

Central Nervous System Diseases

Hot and cold in women's ethnotherapeutics: the American-Mexican West.

The purpose of this paper is to report the current status of hot/cold principles in the ethnotherapeutics of women of southwestern U.S.A., northwestern Mexico. The paper presents a secondary data analysis from three studies, including a data bank of Women's Ethnotherapeutic Agents derived from literature searches, interviews of women in research of Mexican American Grandmothers as Health Care Advisors, and research in the historical roots of the ethnotherapeutic agents used in contemporary domestic medicine. This report presents women's home remedies, what these remedies are believed to do, and the sources of this domestic therapy knowledge. It concentrates on persistence and change in one aspect of the theoretical base of these remedies, their humoral complexional classification. In the analysis of data from these studies, continuation of aspects of the hot/cold theory is demonstrated. It is suggested that the persistence is tacit, with the lack of articulated knowledge of humoral theory today stemming from the content of contemporary remedy books. Instead of arguing either diffusion or independent invention, commonly held ethnophysiological concepts are offered as a possible explanation for the persistence of hot and cold therapy practices.

Cold Temperature

[Classification of hearing loss in industrial workers for the purpose of expert testimony].

Periodical examinations of 472 industrial workers exposed to noise promoted classification of those workers' hearing into four categories: A. Normal hearing, B. Non-noise-induced impairments, C. Multi-causal impairments, not excluding noise, D. Chronic acoustic trauma. To the particular categories, appropriate qualifying, preventive or therapeutic procedure have been ascribed. Appropriate hearing category (A, B, C or D) entered into the worker's health record book would spare repeating the medical examinations at a new workplace, simplify administrative, certificatory (selection of the workplace, prevention or treatment) and claiming procedures.

Disability Evaluation

TNM classification of genitourinary tumours 1987--position of the EORTC Genitourinary Group.

This report analyses the changes in the classification of the genitourinary tumours introduced by the 1987 edition of the TNM system. Criticism and suggestions for improvement are given. These are based on the extensive experience of the EORTC GU Group with clinical trial work particularly the identification of prognostic factors, on their success in reaching international consensus on tumour classification, and on information from the literature. Many of the changes introduced in the 1987 system are not considered to be strictly necessary. These include the introduction of the new additional descriptors, including "C" and "R", the changes in the T classification of prostatic and renal cancer, and the introduction of uniform N categories for all tumours and other features. We regret the omission of minimal requirements, the omission of the V classification for macroscopic or microscopic vascular invasion, the changes in the T categories of carcinoma of the bladder and the introduction of stage groupings for all urological tumours. Some of these changes are considered unacceptable. The attitude of the EORTC GU Group toward the use of the new TNM classification is indicated in detail.

Female

George Gaylord Simpson as mentor and apologist for paleoanthropology.

The influence of George Gaylord Simpson (1902-1984) on paleoanthropology provides a well-documented, historical example of how one scientific discipline can impact upon another, bringing the latter quickly "up to speed" without having to retrace ground covered by the former. Paleoanthropologists were bystanders during the formulation of the evolutionary synthesis (1936-1947). After World War II, the younger paleoanthropologists looked to George Gaylord Simpson as one of several mentors regarding the implications of the synthesis for their own discipline. But why Simpson? Having earlier defined the superfamily Hominoidea (1931) as holding the Pongidae and Hominidae and monographed lower primate fossils (e.g., "Studies on the earliest primates," 1940), Simpson's "Principles of classification and a classification of mammals" (1945) further solidified his reputation as a mammalian systematist. Simpson's Meaning of Evolution (1949) was widely read as an introduction to the synthesis, and his Tempo an Mode in Evolution (1944) made accessible the more complex aspects. Consequently, in the 1950s and 1960s paleoanthropologists invited Simpson to participate in their symposia (e.g., "Some principles of historical biology bearing on human origins," 1951; "The meaning of taxonomic statements," 1964), used his books as classroom texts, and cited his publications to support claims for their own work. Later in the 1960s, Simpson moved from mentor to apologist, as the paleoanthropologists were by then familiar with the synthesis and incorporated its theoretical concepts in their interpretations of the many newly discovered hominoid fossils. Simpson now took special care to celebrate these results in his more general, less technical writings, acting as a forceful apologist for the materialistic view of human origins (e.g., "The biological nature of man," 1966; "The evolutionary concept of man," 1972). During the 1970s, Simpson's influence waned, and he became just another practitioner at the margin of the discipline. However, anthropologists acknowledged Simpson's earlier impact, for example, when he was invited, yet again, to address them at the 50th anniversary celebration of the American Association of Physical Anthropologists in 1981.

Anthropology

[Open disponibility before self - on Medard Boss' Basis of Medicine and Psychology].

In this book, written in collaboration with Heidegger, Medard Boss endeavours for the first time to use Heidegger's late philosophical oeuvre as a basis for medicine and psychology. Boss attempts to uncover behind the understanding of man as existence, which prevail in "Sein und Zeit" and which has been so influential for Binswanger's existential analysis, a more original understanding of man as eksistence, as "open disponibility" (Offenständigkeit). The interest of this view resides in the resulting general principle of classification and interpretation of all forms of disease, giving rise to an "existenialistic pathology". The problematic aspect consists in the failure to integrate the "being-onself" in the understanding of human existence as open disponibility, which leads to a one-sided interpretation of disease processes.

Ego