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[Decentralization of psychiatric health service].

The article discusses two stages of de-centralization of psychiatric hospitals: the first consists in further division into sub-districts, the second one includes successive establishment of psychiatric wards in general hospitals. With the growth of their number these wards are to take over more and more general psychiatric tasks from the specialized psychiatric hospitals. These wards will not substitute psychiatric hospitals completely. The hospitals, though decreasing in size and number, will be a necessary element of the de-centralized and versatile psychiatric care for a long time to come.

Health Services Accessibility↗
PubMed1997

[Hodgkin disease treated at the Tromsø regional hospital 1985-93. Diagnosis, treatment, prognosis, quality of life and costs of a decentralized treatment].

Between 1985-93, 55 patients were treated for Hodgkin's disease at the University Hospital of Tromsø. The median diagnostic delay was four months and a significant prolonged delay was connected with the lymphocyte predominance subgroup. The ChlVPP regimen was shown to be a risk factor for herpes zoster virus infection. The 5-year overall survival was 90%. The survivors experienced a low frequency of symptoms and a high level of functioning. The females reported a significant superior global quality of life and had a lower psychological distress and fatigue score than the males. The cost of one quality-adjusted life year (QALY) (production gains included and using a 10% discount rate) was estimated to be 1,651 pounds. This makes Hodgkin's disease one of the most cost-effective malignancies to treat.

Adolescent↗
PubMed1997

Decentralization monoamine super-sensitivity of migraine and opiate abstinence: common features and different target mechanisms?

The similarity between opiate withdrawal and migraine (M) has been confirmed regarding increased monoamine sensitivity at the neuromuscular junction of the hand's dorsal vein as well as at the neuraxis where dopamine (DA) supersensitivity was observed. Similarities also included an increase in cAMP levels as a precocious sign in both M and opiate withdrawal. Particular attention has been devoted to the time-course of monoamine supersensitivity in M and in abstinence. It has been found that the maximum level of super-sensitivity occurs in M at the end of the M attack, whereas the maximum super-sensitivity is present at the very beginning of opiate abstinence. The inverse time-course of this phenomenon suggests that it could play some pathophysiological role in inducing the end of the M attack. Conversely, it can represent the expected transient result of a pharmacological denervation which ought to result in a supersensitivity of opioid-dependent neuron during withdrawal. In M, the super-sensitivity is wider, indeed, it involves more receptor types. This could be an indirect proof of the involvement of inhibitory pathways other than the opioidergic one.

Adult↗