Perception of illness and the use of health care givers among cervical cancer patients at Songkla Nagarind Hospital. A study in southern Thailand.

Cervical cancer is one of the leading causes of death among women in Thailand. It also has been observed that women who suffered from the illness seek care from various types of care givers including doctors, herbalists, and spiritual mediums. This article has two major aims. The first aim is to describe the types of healers from whom women seek care. The second aim is to explain women's perception of the illness regarding etiology, time and onset of symptoms, pathophysiology, course of illness, and treatment. One hundred and twenty women who sought treatment at Songkla Nagarind Hospital, a teaching hospital in southern Thailand, were interviewed. An interview schedule that consisted of both open-ended and close-ended questions was designed and used in the in-depth interview. Results showed that most women who suffered from cervical cancer illness at the hospital were from low socioeconomic levels. Approximately 50% of the women received care from both western-trained care givers and other types of care givers such as those who were traditionally trained and themselves. The number of care givers ranged from one to eight persons. The average number of care givers was four per woman. The initial symptom for the women in the study was abnormal vaginal discharge. The cervical cancer caused physical and psychological problems. Seventy percent of the women recognized they would die if the illness was not treated. Most women had a positive attitude about the illness if they were treated. About 80% perceived that they would be cured regardless of the method of treatment used.(ABSTRACT TRUNCATED AT 250 WORDS)

Epidermoid cysts in the central nervous system of mice.

Two epidermoid cysts are described in mice, one intracranial, in the fourth ventricle and the other in the thoracic spinal canal. They were lined by compressed squamous epithelium and contained keratinaceous squamae. These incidental findings suggest that such cysts might be detected more often if more extensive examinations of the CNS were carried out in group studies.

Types of antenatal care and other related factors associated with low birth weight in southern Thailand.

This study investigates the relationship between low birth weight (LBW) and antenatal care (ANC) when provided by different categories of care givers in Thailand. Two types of care providers are distinguished: western trained and traditionally trained. The socioeconomic, biological, and obstetric characteristics of 602 cases and 705 controls were compared based on standardized interviews with postpartum women. The results of the study show that women who receive care from different types of care providers have differing levels of risk of LBW delivery. Women who receive no ANC and those who receive care only from traditionally trained care providers have about twice the level of risk of LBW as women who are attended either by western trained care providers or by a combination of western trained and traditionally trained care providers. Even when major potential confounders, such as maternal age or mother's level of education are controlled, this relationship is still maintained.

Sustainable development and quality of life: expected effects of prospective changes in economic and environmental conditions.

In the context of "sustainable development", we studied which attributes are important to people's quality of life (QoL) and which changes in QoL people would expect from future economic and environmental improvements or deteriorations. About 200 adult subjects evaluated the relative importance of 22 different QoL attributes. They subsequently indicated expected changes in those attributes, under three different scenarios in which economic and environmental conditions would either improve or deteriorate. On average, subjects judged the QoL attributes "healthy", "family", "environmental quality", "nature" and "safety" to be most important, while "recognition", "comfort", "status" and "spiritual life" were found least important. The most important QoL attributes as well as "security" were judged as more important by women than by men. Also observed were income and age effects on relative attribute importance. Our (Dutch) subjects expected significant and varied negative QoL changes from an environmental-deterioration scenario involving either an improved or a deteriorated economy. In contrast, they had mixed positive-negative QoL expectations about environmental improvement combined with economic deterioration. Subjects high in environmental concern assigned greater weight to "environmental" QoL attributes, and they expected environmental improvement versus deterioration to more strongly affect their QoL-attributes "environmental quality", "nature", "health" and "unity with nature", than did subjects low in environmental concern. We conclude that quality of life can be meaningfully conceived as a multi-attribute value concept, useful for assessing the expected effects of future economic and environmental conditions. Suggestions are given for methodological improvement and for further research.

MPP(+)-like neurotoxicity of a pyridinium metabolite derived from haloperidol: in vivo microdialysis and in vitro mitochondrial studies.

Intracerebral (intrastriatal, intranigral and intracortical) microdialysis studies were conducted in conscious rats to investigate the comparative dopaminergic and serotonergic neurotoxic potential of the pyridinium metabolite 4-(4-chlorophenyl)-1-[4-(4-fluorophenyl)-4-oxobutyl]pyridinium (HPP+), derived from the extensively used neuroleptic agent haloperidol and 1-methyl-4-phenylpyridinium (MPP+), the pyridinium metabolite derived from the parkinsonian inducing agent 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Although HPP+ was less potent than MPP+ on the dopaminergic system, the two compounds displayed comparable toxic effects on the serotonergic system. HPP+ also proved to be a weaker inhibitor of mitochondrial respiration than MPP+ in vivo as measured by increases in extracellular lactate levels. On the other hand, HPP+ was a more potent inhibitor of mitochondrial respiration in vitro than MPP+, with IC50 values of 12 microM (HPP+) and 160 microM (MPP+). Quantitative estimations established that the concentrations of the more hydrophobic HPP+ in the brain tissues surrounding the microdialysis probe were less than those of MPP+ after comparable perfusions. Consequently, the inherent toxicity of HPP+ relative to MPP+ may be greater than suggested by the results observed in the microdialysis experiments. These data support previous speculations that HPP+ may contribute to some of the persistent extrapyramidal side effects associated with chronic haloperidol treatment.