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The practice of group psychotherapy has its roots in Freudian dynamics and concepts, and varies from play group psychotherapy to analytic group psychotherapy, using the dynamics of transference, catharsis, interpretation, insight, ego building, reality, and sublimation.This presentation is based on the experience of the author with about 40 women patients formed in groups at a sanatorium. The majority were neurotic, psychoneurotic or manic-depressive. Several were psychotic. Some of the patients were treated in groups that included their husbands, after discharge from the sanatorium. Analytic group psychotherapy is a concept of an attenuated mobile and uncensored societal setting, where persons who have failed in the larger and harsher social reality may again attempt resocialization in a permissive, friendly, and protected environment. It is not to be considered the poor man's makeshift for individual psychoanalysis. Group dynamics facilitate the regression and catharsis necessary to produce insight and ego strength, leading to more rapid recovery. Husband and wife participation in the same group led to a more tolerant acceptance by the husband of the concept of mental ailment, and empathy for the spouse. The role of the psychiatrist in group psychotherapy is very similar to that in individual psychoanalysis. He represents the reality to the patient and the group. He is objective but permissive, and not passive. Therapeutic goals are the same as in individual therapy, and may focus on the resolution of pre-oedipal conflicts or on situational maladjustments.  相似文献   

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Eating disorders in early childhood are the same frequency in boys and girls. During adolescence eating disorders are ten (10) times more frequent in girls than in boys. Worrying is the fact that eating disorders are the third chronic illness among adolescents after obesity and asthma. Depicting this adolescent we tried to show difficulty of treatment of this disorder, where in the beginning is important to stabilize body weight and prevent somatic damages such as: heart damage, amenorrhoea, changes in EKG (electrocardiogram) and electrolyte dysbalance that could endanger the life of patient. Simultaneously it is important to recognize and treat comorbid psychological disturbances such as in this case: depression, delusions with occasional psychotic reactions combined with unrealistic thinking about the layout of her own body. There is still no cure for the treatment of eating disorders which are in growing number of reports among male adolescents.  相似文献   

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Gilbar R  Gilbar O 《Bioethics》2009,23(3):183-192
Objectives:  The objectives of the study were (1) to assess similarities and differences between breast cancer patients and their husbands in terms of doctor-patient/spouse relationships and shared decision making; and (2) to investigate the association between breast cancer patients and husbands in terms of preference of type of doctor, doctor-patient relationship, and shared decision making regarding medical treatment.
Method:  Fifty-seven women with breast cancer, and their husbands, completed questionnaires measuring doctor-patient/spouse relationships (paternalism, autonomy), and decision making regarding medical treatment.
Results:  Patients believe they have a key role in the medical decision-making process (93%) and that the participation of their husbands, and their agreement with the decision, is important (84% and 89%, respectively). Both breast cancer patients and their husbands prefer a shared decision-making process to paternalistic or autonomy-based approaches.
Conclusion:  In contrast to legal and bioethical approaches, which focus on the patient as the primary decision maker, this study reflects a practical recognition of the role of the breast cancer patient's husband in the decision-making process. It also reflects a relational rather than an individualistic perception of patient autonomy.  相似文献   

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An efficient synthesis of an auxiliary group, the 2-mercapto-4,5-dimethoxybenzyl (Dmmb) moiety, to form a Gly-building block is presented. The building block was incorporated into peptides to study the reaction with thiobenzyl-activated derivatives. The target peptides have been obtained by standard chemical ligation reaction, followed by TMSBr-assisted cleavage to remove the auxiliary group. Prior to Dmmb removal, under acidic conditions an unexpected rearrangement was observed and evidence for a mechanism is provided.  相似文献   

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A large representative sample of psychotic women of reproductive age was selected from patients admitted to a London mental hospital during 1955–63 and followed up during the years of developing community care. Before first admission the probability of marriage of schizophrenics was three-quarters of that of corresponding normal women, and after admission it was just over one-third of normal. Fertility of schizophrenics was slightly reduced both before and after illness, and much of this reduction remains due to their being in hospital. The probability of marriage and fertility of women suffering from severe affective disorders was very similar to that found in the corresponding general population. Despite a lessening of differentials between patients and normal women since the impact of community care the probability of marriage of schizophrenics with abnormal personalities is still significantly reduced.  相似文献   

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Stigma is linked to negative prejudices without examining whether there is any justification for such behaviour. Over time, various efforts have been made to reduce prejudice toward people with mental illness. Yet, the World Health Organization (WHO) World Health Report still describes stigma as one of the greatest obstacles to the treatment of mental illness. While schizophrenia, among other mental illnesses, is the most stigmatized even to the point that some want the name of the illness to be hidden or changed, patients with bipolar illness may also be exposed to stigma. The degree of stigmatization has been found to be positively associated with the severity of the mental disorder, and stigma is carried out not only by patients but also by their families in correlation with the severity. Tragically, people with mental illness themselves are as negative in their opinions about mental illness as is the general public, and concerns about stigma adversely affect self-esteem and adaptive social functioning. There are many programmes worldwide for the fight against stigmatization, and there is clear recognition of the fact that stigma can only be successfully eliminated if the programme becomes a normal part of health service rather than of campaigns of limited duration.  相似文献   

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目的探讨沈阳地区孕晚期妊娠妇女B族链球菌(group B Streptococcus,GBS)的定植率及其耐药性,评估GBS感染妊娠妇女分娩期给予产时抗生素预防(intrapartum antibiotic prophylaxis,IAP)的临床效果。方法选择2017年9月至2017年12月在沈阳市妇婴医院行GBS筛查的691例怀孕35~37周的妊娠妇女为研究对象,将GBS筛查阳性妊娠妇女中采用顺产方式分娩的38例妊娠妇女作为研究组,638例GBS筛查阴性妊娠妇女作为对照组。研究组妊娠妇女给予IAP,对照组妊娠妇女不作处理。分析两组妊娠妇女GBS定植情况、GBS菌株耐药情况及给予IAP后新生儿不良事件发生率。结果 691例妊娠妇女中有53例GBS培养阳性,GBS定植率为7.67%。全部GBS菌株对青霉素、头孢唑林及万古霉素的敏感率均为100.00%;对红霉素、克林霉素耐药率分别为81.48%和73.95%。研究组中新生儿黄疸发生率为7.89%,新生儿窒息发生率为2.63%,脑膜炎、肺炎、败血症的发生率均为0.00%。对照组中新生儿黄疸发生率为3.13%,新生儿窒息发生率为0.63%,肺炎发生率为0.16%,新生儿脑膜炎及败血症发生率均为0.00%。两组新生儿在新生儿黄疸、新生儿窒息、脑膜炎、肺炎和败血症发生率方面比较差异无统计学意义(均P0.05)。结论沈阳地区妊娠妇女GBS带菌率较高,青霉素可作为治疗的首选药物。预防性使用抗生素治疗可以改善新生儿结局。  相似文献   

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通过比较健康女性和宫颈癌患者的尿蛋白质组,发现并分析差异表达蛋白,从中筛选潜在的宫颈癌的标志物。研究对象由43名宫颈癌患者(CC)和47名健康女性(HW)组成。用超速离心法沉淀尿蛋白,再用一维凝胶电泳(SDS-PAGE)与液相色谱-质谱联用技术(LC-MS/MS)鉴定尿液中的蛋白质,蛋白质定量采用无标定量。比较患者尿蛋白质组、健康对照的尿蛋白质组和宫颈癌组织蛋白质组,有1910个蛋白质是患者和健康对照共有的尿蛋白,这其中有746个蛋白质也存在于宫颈癌组织蛋白质组。在这746个蛋白质中找到84个上调蛋白和82下调蛋白。通过生物信息学分析发现牛皮癣素(S100A7)和癌胚抗原相关细胞黏附分子8(CEACAM8)是宫颈癌尿液样本独有蛋白质。在验证组的70例样本中,双盲法测试S100A7、CEACAM8以及两者联合诊断宫颈癌的敏感性能达到73%、87%、93%。结果提示,宫颈癌患者的尿蛋白质组与健康女性的尿蛋白质组不同,并且S100A7和CEACAM8可以作为宫颈癌潜在的肿瘤标志物。  相似文献   

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In biotechnological processes, fundamental performances of microorganisms are used. The economy of these processes is essentially determined by the efficiency, velocity (productivity) and quality of the products. Therefore it is a permanent task and challenge for basic and biotechnological research to seek out measures for improving the actually attained parameters. The auxiliary substrate concept supplics an approach. It is based on the fact that chemo-organo-heterotrophic substrates differ in the carbon: energy ratio, thus, growth yield is limited in energy and/or reducing power. It says that, by simultaneous utilization of physiologically similar substrates (mixed substrates), the growth yield increases. The substrates are to combine in such a way that with their simultaneous utilization a minimum of carbon is dissimilated merely for the purpose of the generation of biologically useful energy and/or reducing power. Since all chemo-organo-heterotrophic substrates are more or less energy-deficient, an increase in growth efficiency can be expected if the individual substrates of the mixture are assimilated more efficiently than the respective substrates alone. This may result, for instance, from an immediate assimilation of a substrate (according to the “manner of finished part construction”). An increased growth rate is rather the rule than the exception in mixed substrate utilization. In product syntheses the substrates are, depending on the concrete product and metabolic pathway, either energy-excess or energy-excess or energy-deficient. or, in other words, the processes are energy-generating or energy-consuming, respectively. If this is responsible for discrepancies between the possible yields determined by the carbon metabolism and the experimentally obtained yields, the discrepancies should be able to be decreased and the yields increased by mixing substrates. The substrates are to choose and combine so that, due to simultaneous utilization, the product formation process becomes energy neutral. As a rule, the enhanced efficiency is accompanied by an increased velocity. This does not only apply to syntheses, but also to degradation (and detoxification) reactions. Even supposedly inert compounds or persistent substances can be activated by simultaneous (co-)metabolization of another (an auxiliary substrate, victim substrate or co-substrate) and converted at a considerable rate. It is of interest for syntheses of products but in particular for degradation and decontamination of harmful and waste products in the environment that the residual concentrations of the substrates are smaller than those achieved if the compounds of a mixture are metabolized separately. The auxiliary substrate concept has proven to be fruitful, both for theoretical and practical questions. It was practically already being used before it was formulated (mixed substrate utilization, cometabolism). However, an abundance of regulatory and energetic aspects are waiting to be investigated in more detail.  相似文献   

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The function of auxiliary operators   总被引:5,自引:2,他引:3  
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As high-conductance calcium- and voltage-dependent potassium channels, BK channels consist of pore-forming, voltage-, and Ca2+-sensing α and auxiliary subunits. The leucine-rich repeat (LRR) domain–containing auxiliary γ subunits potently modulate the voltage dependence of BK channel activation. Despite their dominant size in whole protein masses, the function of the LRR domain in BK channel γ subunits is unknown. We here investigated the function of these LRR domains in BK channel modulation by the auxiliary γ1–3 (LRRC26, LRRC52, and LRRC55) subunits. Using cell surface protein immunoprecipitation, we validated the predicted extracellular localization of the LRR domains. We then refined the structural models of mature proteins on the membrane via molecular dynamic simulations. By replacement of the LRR domain with extracellular regions or domains of non-LRR proteins, we found that the LRR domain is nonessential for the maximal channel-gating modulatory effect but is necessary for the all-or-none phenomenon of BK channel modulation by the γ1 subunit. Mutational and enzymatic blockade of N-glycosylation in the γ1–3 subunits resulted in a reduction or loss of BK channel modulation by γ subunits. Finally, by analyzing their expression in whole cells and on the plasma membrane, we found that blockade of N-glycosylation drastically reduced total expression of the γ2 subunit and the cell surface expression of the γ1 and γ3 subunits. We conclude that the LRR domains play key roles in the regulation of the expression, cell surface trafficking, and channel-modulation functions of the BK channel γ subunits.  相似文献   

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