General practitioners attitudes towards depression: a study in primary care setting in Brazil.

A self-report instrument comprising twenty visual analogue scale statements about attitudes towards depression was sent to all 110 general practitioners working in primary health care centres in the city of Campinas, Brazil. The statements of the Depression Attitude Questionnaire (DAQ) cover three main areas: nature of depression, treatment preferences and professional reactions regarding depressed patients. Seventy-eight (71%) doctors returned the questionnaire. Forty-two percent of the doctors believe "it is difficult to differentiate whether patients are presenting with unhappiness or a clinical depressive disorder that needs treatment". Sixty-three percent believe that "antidepressants usually produce a satisfactory result in the treatment of depressed patients in general practice". However, most doctors would refer patients in need of anti-depressants (66%) or psychotherapy (60%) to a specialist. They also view the treatment of depression as "heavy going" (46%) and "unrewarding" (57%). These findings suggest a need for further education of general practitioners on the nature, diagnosis and management of depressive disorders.

Alteracoes arteriograficas no figado esquistossomotico apos esplenectomia. / Arteriographic changes in the schistosomatic liver after splenectomy

Foram estudados 36 pacientes portadores da forma hepato-esplenica da esquistossomose mansonica, divididos em dois grupos.O grupo I constou de 32 pacientes nos quais, apos esplenectomias, realizamos arteriografias hepaticas por intermedio de cateter introduzido atraves o coto da arteria esplenica. No grupo II, constante de quatro pacientes nao operados, foram realizados cateterismos seletivos simultaneos das arterias hepatica e esplenica Obtivemos arteriografia hepatica e, imediatamente apos, insuflamos o balao do cateter colocado na arteria esplenica, obliterando-a, e repetimos a arteriografia hepatica. No grupo I e no II apos a insuflacao do balao, observamos enriquecimento da rede arterial hepatica. Realizamos medidas dos diametros vasculares nas diversas situacoes

[Treatment of duodenal ulcer with delayed-action cimetidine]. / Tratamento da úlcera duodenal pela cimetidina de ação retardada.

Twenty patients with duodenal ulcer, clinically diagnosed, were treated. Radiologic and endoscopic controls were carried out. Following a random scheme, a group of ten patients was treated with conventional cimetidine and a group of ten with cimetidine of sustained release. The authors consider that cimetidine of sustained release offers the advantage of minor doses and major facility of administration. Similar results were therapeutically obtained.

Tratamento da ulcera duodenal pela cimetidina de acao retardada. / Treatment of duodenal ulcer with cimetidine of delayed action

Vinte pacientes que tiveram sua ulcera duodenal diagnosticada clinica, radiologica e endoscopicamente, foram tratados com cimetidina, obedecendo uma tabela randomizada, sendo que dez pacientes receberam a forma convencional e outros dez a forma retardada.Oito dos dez pacientes que fizeram uso de cimetidina de acao retardada, tiveram sua ulcera cicatrizada ao final de 4 semanas, o mesmo ocorrendo com 7 dos 10 pacientes que usaram a forma convencional da cimetidina. A necessidade do uso adicional de antiacido foi pequena nos dois grupos tratados, bem como os episodios de dor noturna e diurna, que ocorreram em numero reduzido, nao ultrapassando a 1a.semana de tratamento. Isto demonstra a boa eficacia terapeutica, com percentual de cura semelhante e bastante significativo nos dois grupos estudados. Foi considerado como vantagem para a cimetidina de acao retardada o uso de doses menores e melhor comodidade posologica na obtencao do mesmo efeito terapeutico conseguido com a cimetidina convencional

Chagas' disease of the colon.

One hundred cases of chagasic megacolon operated upon in Bahia, Brazil, have been analysed. The principal theories of the pathological physiology of the disease are discussed. The pre- and postoperative radiographic features of the colon are presented, and the surgical treatment as well as the incidence of complications and late results are reported.