ABSTRACT
BACKGROUND: Subjective explanations of illness concepts and disease can differ from culture to culture. We examined explanatory models of West African patients with schizophrenia in a community-centred department of psychiatry in Mali, West Africa. METHODS: Patients and experts volunteered to be interviewed in the Department of Psychiatry of the University Hospital, Pont G, in Bamako, the capital of Mali. We used semi-structured interviews to explore key psychotic symptoms and explanatory models of psychosis in five experts and fifteen patients with schizophrenia. All interviews were analysed using computer assisted content-analysis with the program Atlas.ti. RESULTS: African patients displayed key symptoms of schizophrenia such as commenting and imperative voices, inserted thoughts and other phenomena of alien control, which were often subjectively explained as obsession by witches or jinns. Explanatory models differed depending on occidental migration experience and age. The involvement of family members in the treatment-setting facilitates inclusion and recovery. Experts emphasized the need to integrate traditional and ethno-pharmacological approaches and modern medicine to treat their patients in a culture sensitive manner. DISCUSSION: Our data suggests a strong influence of illness concepts on the experience of psychotic symptoms, treatment expectations and health-related behaviour.
Subject(s)
Culture , Health Knowledge, Attitudes, Practice , Psychotic Disorders/diagnosis , Schizophrenia/diagnosis , Adult , Emigration and Immigration , Humans , Mali , Psychotic Disorders/psychologyABSTRACT
Fast changes in spring water quality in karst areas are a major concern for production of drinking water and require detailed knowledge of the complex interaction between karst aquifer, transport behavior of microorganisms and water treatment. We have conducted artificial and natural particle transport experiments at a karst spring with bacteria, bacteriophages, microspheres, and pathogens. Transport of the investigated microorganisms, turbid matter and chemical pullutants as well as increase in discharge are strongly related to precipitation and the heterogeneity of the aquifer. The indicator bacteria E. coli revealed a significant correlation to verotoxin-producing E coli and Cryptosporidium spp. We conclude that artificial particle tracers can help identify 'hot spots' for microbial recharge and that system parameters in spring water such as turbidity, UV-extinction and increase in discharge can be key parameters for efficient raw water management.
Subject(s)
Soil Microbiology , Water Microbiology , Water Supply , Bacteria/isolation & purification , Bacteriophages/isolation & purification , Environmental Monitoring/methods , Microspheres , Particle Size , Water Movements , Water Pollutants/analysisABSTRACT
A 47 year old male patient with Miller-Fisher-syndrome did not respond to treatment with plasmapheresis and intravenous high dose 7 S immune globulins. Only cerebrospinal fluid pheresis, administered as final alternative, lead to definite improvement and cure.
Subject(s)
Immunoglobulin G/cerebrospinal fluid , Miller Fisher Syndrome/therapy , Ultrafiltration , Female , Humans , Male , Middle Aged , Miller Fisher Syndrome/cerebrospinal fluid , Miller Fisher Syndrome/immunology , Neurologic Examination , Plasmapheresis , Treatment FailureABSTRACT
We report a case of multiple cerebral and spinal abscesses due to Nocardia asteroides in a non-immunocompromised patient. The initial central nervous system manifestation was a sterile meningitis, with secondary development of multiple cerebral and spinal abscesses. Since the location of the abscesses did not allow neurosurgical exploration and the cultures remained negative, the diagnosis was finally established by raised antibody titres to Nocardia asteroides. After specific antibiotic therapy, resolution of the spinal and cerebral abscesses was documented on the basis of serial magnetic resonance tomography and computed tomography controls.
