Can we identify the factors influencing the burden on family members of patients with schizophrenia?

A growing number of studies reflects an increasing growing interest in the burden on the family (BF) of sufferers from schizophrenia. Many of these studies aim at revealing and identifying the variables that determine BF. This review compares and discusses the results of these studies. Although many variables, such as the diagnosis and symptoms of the patient, the duration of the illness, the treatment setting (outpatient/inpatient), the family relationship between the patient and the relative, and the type of family intervention (counselling and psycho-education) are examined in various studies, there is little consensus on which factors determine the extent and/or pattern of BF. In our opinion, this lack of consistency is mainly caused by: (1) the varieties of definitions and operationalizations of BF employed; (2) the fact that most studies examine only one or just a few variables, so that variables other than those examined may have varied between studies; and (3) the difference in the periods of time discussed in the different studies. To gain more insight into the factors that determine BF, a better standardization of the definition and operationalization of BF, as well as of the period of time studied, is needed, as well as exhaustive studies examining the various factors that may determine BF.

Treatment of vas deferens large defects.

Based on the experience of 12 vas deferens reconstructions in 8 patients with iatrogenic (post-herniotomy in infancy) vasa lesions the authors conclude that in the majority of such cases the length of vas defects renders direct vasovasoanastomosis either impossible or too risky, due to tension. To solve the problem the methods of extraanatomical (sub- and suprapubic) vas rerouting were elaborated that allow to shorten the vas length necessary for anastomosing by 9-14 cm. Combined with various crossover techniques, and vasoepididymostomy if necessary, the method proved valuable in most cases of extensive mono- and bilateral vasa deferentia lesions. The experimental data on vas segment transplantation obtained in rats show poor results in the homotransplantation group while autotransplants survive in 70% and provide vas patency restoration in 40%. No experimental proof in favour of endoprosthesing of vas grafts is obtained.

Microsurgery of epididymis: laboratory background for further clinical trial.

Based on the experience of 75 microsurgical reconstructions of the obstructed epididymis, the authors conclude that a simple introduction of microsurgery does not improve the results significantly. This experience, however, has provided a better understanding of the most important problems of epididymal surgery and has shown the ways to solve them. The principal means, they believe, is a well organized clinical study. Experimental data are hardly applicable to human sperm viae pathology. This clinical study should satisfy two requirements: a uniform operative technique and special account for an anastomosis level. End-to-side vasoepididymostomy is suggested to be the method of choice. A training model for epididymal microsurgery is elaborated and used for working out the above-mentioned technique. The reliability of the technique is shown in 20 rabbits, with litters from 17 couples. A special investigation of the microsurgically significant details of epididymal anatomy substantiates several separate zones marking out.