De la psiquiatría de la pérdida a la psiquiatría positiva / From psychiatry of loss to positive psychiatry

El objetivo del presente trabajo es el de efectuar una aproximación a los fundamentos básicos de la perspectiva de la psiquiatría y psicología positivas. Este enfoque tiene una vieja tradición de énfasis en los aspectos constructivos de la adversidad y su superación. Los problemas y las pérdidas afectivas en el proceso de vivir son inevitables. Los individuos deben aprender a extraer beneficios de ellos. La vida no puede orientarse ni al fracaso, ni única y exclusivamente a tratar o curar traumas. Desde la perspectiva positiva se realza la integridad personal, la inteligencia personal, social o práctica, el coraje, la perseverancia y, generalmente, un cierto grado de espiritualidad. Todo esto se enmarca dentro de una perspectiva orientada al crecimiento personal, y a construirse la vida dentro de un proceso de vivir con significado. Se habla de sujetos invulnerables y resistentes a la adversidad. A ello se debe orientar la evaluación, y el tratamiento de las personas que han sufrido un quebranto vital grave. También las pérdidas traumáticas pueden transformase en un recurso para el realzamiento de crecimiento personal (AU)

Calpain inhibitor I retards seizure offset in the hippocampus of freely moving rats.

The implications of increased calpain-mediated proteolysis during epileptic seizures are still unclear, and in this study we investigate the effect of the continuous perfusion of calpain inhibitor I on picrotoxin-induced seizures in chronic freely moving rats. Continuous intrahippocampal microperfusion of 500 microM calpain inhibitor I had no effect on basal EEG, but doubled (P < 0.05) average seizure duration, and increased more than five-fold (P < 0.01) the total seizure time and three-fold (P < 0.01) the seizure offset time compared to picrotoxin alone, in each individual rat. However, seizure type and onset time were not modified by calpain inhibitor I. These results indicate that a calpain-mediated mechanism may be responsible for seizure offset, probably through AMPA glutamate receptors internalization and further degradation.

General surgery with a special interest in vascular surgery: changing patterns of workload.

Prospective surveys of workload were carried out during 1989, 1990 and 1995. Analysis of outpatient referrals, inpatients and operations performed over periods of 3 months was undertaken and the changing patterns of general surgical and vascular surgical workload noted. The number of outpatient referrals rose throughout the study period because of a significant increase in the number of patients with both varicose veins and other vascular problems. There was an increase in the number of emergency admissions for vascular disease. The number of patients having general surgical operations fell; there was a corresponding increase in the number for arterial and venous disease. The general surgical component of a general surgical unit with a vascular interest is gradually declining, as increased numbers of patients with vascular problems are being referred and managed.

The diagnosis of male infertility--prospective time-specific study of conception rates related to seminal analysis and post-coital sperm-mucus penetration and survival in otherwise unexplained infertility.

Infertile women without any inherent female infertility factors and able to secrete normal cervical mucus were studied prospectively in relation to post-coital sperm-mucus penetration (PCT) and their partner's seminal analysis, excluding men with azoospermia. Time-specific cumulative conception rates calculated as for life-table analysis were related to each measured seminal variable on routine analysis of 2-3 samples (volume, density, proportion with progressive motility, and proportion with normal morphology); to various derivatives from combinations of these variables; to seminal findings after vital staining; and to the PCT results. The best seminal predictor of fertility was the motile normal sperm density (MNSD), the 18 month conception rates being 57.4% +/- 4.6 (SE) and 30.2% +/- 5.9 (ratio 1.9, P less than 0.001) above and below a derived threshold value of 4 x 10(6)/ml. The PCT led to rates of 55.6% +/- 4.3 and 14.9% +/- 5.1 (ratio 3.73, P less than 0.001) for positive and negative results, respectively. The PCT also gave rise to a significantly distinct intermediate poor-positive sub-group (conception rate 30.6% +/- 9.0). Seminal analysis (the MNSD) did not affect the conception rate associated with a positive PCT but helped to discriminate further with a negative PCT (conception rates 22.5% +/- 8.7 with an MNSD above 4 x 10(6)/ml versus 5.6% +/- 4.8 below, P less than 0.05). The PCT was the single best predictor of fertility but seminal analysis (the MNSD) was of additional value after a negative PCT.