[Deep vein thrombosis: new developments and recommendations for the primary care physician].

The management of deep vein thrombosis is becoming more specific in terms of diagnostic methods and drug treatments. The use of the dichotomous Wells' score is now established. The indications for direct oral anticoagulants have expanded.

Fluvoxamine as effective as clomipramine against symptoms of severe depression: results from a multicentre, double-blind study.

Background: Although selective serotonin reuptake inhibitors (SSRIs) are better tolerated than tricyclic antidepressants, their efficacy in severe depression remains to be further elucidated.

Method: A double-blind, multicentre study was conducted in 86 severely depressed inpatients (>or= 25 on the 17-item Hamilton depression rating scale [HAMD] total score) to compare the efficacy and safety of fluvoxamine with that of clomipramine. Following placebo run-in, 86 patients were randomised to receive fluvoxamine or clomipramine (100-250 mg/day) for 8 weeks.

Supportive and palliative care at the University Hospital Lausanne.

The development of supportive and palliative care services within the Canton of Vaud in Switzerland is traced, and the current situation and future plans are outlined.

[Schizophrenia and language disorders].

The speech of schizophrenics is idiosyncratic, possibly unrelated to thought disorders. Review of relevant literature indicates that schizophrenic speech disorders include: errors in the use of pronouns, articles, verbs and verb tenses, which are neither pointed out or corrected; absence of redundancy, skewering of the meaning of words, faulty establishment of common references with others. Sentences appear disjointed due to improvised vocabulary and the scant use of conjunctions and other linking words or phrases.

Alopecia and mood stabilizers: two case reports.

Two cases of alopecia observed during treatment with lithium and valproate are described, and the recent literature on this subject is reviewed. Our clinical observations confirm earlier reports. These toxic alopecias are characterized by a diffuse but rarely total hair loss.

[Palliative care: therapeutic possibilities for patients at the end of life].

Palliation seeks to provide alleviation of pain and all other physical complaints, together with psychologic and spiritual support. The commonly used symptomatic therapies are undoubtedly fit to significantly improve the patient's quality of life. Subjects of palliative medicine should be included in postgraduate nursing education, covering above all the basic notions listed by the WHO, such as the principles of efficient communication, the pathophysiology of symptoms in advanced cancer, the evaluation and importance of pain, the basic physiologic and spiritual needs of the seriously ill or the dying.

[Multicenter study comparing efficacy and tolerance of moclobemide and fluvoxamine in hospitalized and ambulatory patients with severe depressive episodes].

In a double blind study performed in psychiatric clinics the efficacy and tolerability of the new antidepressant Moclobemide was compared. Moclobemide belongs to a new class of substances called RIMA (Reversible Inhibitor of the monoamine oxidase type A). 61 patients with major depression (according to DSM-III) were either treated with Moclobemide or Fluvoxamine, a selective reuptake-inhibitor of 5-HT.

Expressed emotion and first-admission schizophrenia. Nine-month follow-up in a French cultural environment.

A study of 36 French-speaking families in Geneva identified 66% of high-EE household. At nine-month follow-up, the relapse rate for the high-EE group (33%) was significantly higher than for the low-EE group (0%). These results seem to confirm the relevance of EE as predictor of relapse.

Preferential clonogenic deficit of CD8-positive T-lymphocytes infiltrating human solid tumors.

The vast majority of tumor infiltrating lymphocytes (TIL) are either CD4+ or CD8+ T-lymphocytes. In order to examine directly the functional capabilities of the individual CD4+ and CD8+ TIL subsets we performed cell sorting of double immunofluorescence-labeled TIL recovered from 15 biopsies by enzyme digestion. These CD4+ and CD8+ TIL subsets were compared with similar subsets of T-lymphocytes from peripheral blood of normal subjects.

Proliferative and cytolytic potentials of purified human tumor-infiltrating T lymphocytes. Impaired response to mitogen-driven stimulation despite T-cell receptor expression.

Using limiting dilution analysis (LDA) we have previously shown that in most instances, the frequency (F) of proliferative T lymphocyte precursors (PTL-P) was strikingly reduced in tumor-infiltrating lymphocytes (TIL). In this study involving 19 cases, we show that the impaired clonogenic potential of CD2+ TILs is primarily caused by an intrinsic defect rather than to suppressor T cells or to a direct effect of the tumor cells usually present in the culture system. This was demonstrated by experiments in which the F of PTL-Ps was quantitated both in highly purified CD2+ TILs (using a cell-sorter) and in non-purified TIL suspensions (still containing tumor cells), which originated from the same biopsy specimen.

Family expressed emotion and outcome of schizophrenics: a study in a French cultural environment.

This is the first attempt in a french cultural environment to relate family characteristics and expressed emotion to clinical course of schizophrenics. patients were studied during a two year period after their first or second hospital stay. Critical comments on subcategory of classical expressed emotion is associated with relapse, rehospitalization and work capacity but not with a broad measure of social activity.

Combination of mitomycin, vindesine, and cisplatin in the treatment of head and neck squamous cell carcinoma.

Thirty patients with squamous cell carcinoma of the head and neck were treated with a combination of mitomycin (10 mg/m2, Day 1), vindesine (3 mg/m2, Days 1 and 8), and cisplatin (60 mg/m2, Day 1), repeated every 28 days. Seven patients were previously treated by surgery, radiotherapy, or chemotherapy, and 23 had untreated advanced tumors. Objective responses were seen in 17 of 27 evaluable patients (63%), with three (11%) complete remissions.

[Costs of psychiatric treatment: a comparative approach to 3 categories of patients].

Based on methodology similar to that used in international studies, the calculation of costs was carried out for three cohorts of patients: schizophrenics, other psychotics and non-psychotics, taking into account the parameters of sex, age, professional employment/unemployment. Attention is paid particularly to: the preponderance of indirect costs over direct costs, the much higher level of costs for psychotic patients and amongst these above all of schizophrenics, and significant differences in this last group with regard to sex and age. As far as direct costs are concerned, no substitution of hospital costs by outpatient costs is noted; on the contrary, the cumulative effect of these two constituent parts is marked among the three cohorts no matter what parameters of analysis of data are used.