L'union medicale du Canada最新文献

Non-functioning pituitary adenoma is a lesion usually large enough to produce loss of vision and often loss of libido. Transsphenoidal microsurgery is the treatment of choice of these patients. Postoperative radiation therapy should be performed in patients with significant residual pituitary adenoma. Some studies have recently reported that somatostatin analogue may be useful as adjuvant medical therapy, at least in order to improve visual field defects.

Prolactinoma is the most common type of secretory pituitary tumor. The clinical presentation varies with age and sex, and the size of the adenoma. The differential diagnosis with nonfunctioning adenoma and hyperprolactinemia is particularly important in selecting an appropriate therapy. The choice of therapy depends on a number of factors including the patient's preference. In cases of radiologically undetectable microprolactinomas, we prefer observation only. However, hypogonadic patients are treated with bromocriptine. Generally, it is our recommendation that almost all of the patients with micro--and macroprolactinomas undergo a primary medical therapy, provided they are willing to continue such therapy on a long term basis. We recommend transsphenoidal surgery for patients who refuse long term medical therapy and in rare cases of prolactinomas which are unresponsive to medical therapy. We also consider surgery as a valuable alternative to medical therapy in patients with microprolactinomas and prolactin below 200 micrograms/L.

The objective of this study was to determine pregnant women's knowledge level concerning premature birth. During July of 1990, 465 pregnant women completed a questionnaire evaluating their knowledge of the following dimensions of premature birth: risk factors, symptoms, epidemiology, prevention and self-assessment of risk. The subjects were all francophones, at 16 weeks of less of pregnancy, with characteristics comparable to all pregnant women in Quebec. The study participants considered premature birth to be a serious health problem, and over-estimated the premature birth rate. Fifty-seven percent thought that the rate was 17% or greater. Eighty percent associated premature birth with some morbidity and mortality risks. On the other hand, the risk factors concerning premature birth were poorly known; approximately 50% of the women did not recognize twin pregnancy and a past history of premature delivery as risk factors. Moreover, a third of the women did not recognize the signs and symptoms of premature rupture of membranes and of premature labor. In conclusion, a high proportion of pregnant women in Quebec do not have even minimally adequate knowledge levels concerning the prevention or risks of premature birth.

A transverse survey was conducted with 772 Quebecers in September 1992. Its purpose was to evaluate the level of awareness of the general public about mental illness, the general knowledge of these illnesses and their treatments and the attitudes towards mentally ill patients. Results show that half of the interviewed subjects still feel that they are not informed enough about mental illness and even well informed people have a poor general knowledge of mental illnesses and their treatments. Finally, more than 65% of the surveyed population show positive attitudes towards psychiatric patients, which seems to be an improvement in comparison with the past years. The author believes that physicians should give more information on mental illness and particularly on the role of drugs in the treatment of mentally ill patients. It seems also important to put more emphasis on information to low and middle class people.