No abstract available.
Humans ; Siblings* ; Thrombasthenia*

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) has often been cited as the basis for the abolition of involuntary hospitalization for persons with mental illness. Although the UNCRPD itself does not refer explicitly to the abolition of involuntary hospitalization, the General Comment prohibited all compulsory admission without adequate explanation. While the disability status alone may not justify the denial of legal capacity, the existence of impaired decision-making ability can raise issues regarding whether involuntary admission can be justified in the best interest of persons with mental illness. The General Comment, however, argues that involuntary admission does not comply with the CRPD which prohibits discrimination on the basis of disabilities. This statement defies logic since the issue is whether the existence of impaired decision-making ability may be an exceptional case. It is also against the principles of beneficence to withhold treatment for persons with mental illness just for self-determination when poor outcomes are anticipated if left untreated. The concept of supported decision making suggested by the General Comment is also ambiguous, and not clearly distinguishable from substitute decision making. Another reason for the prohibition of involuntary admission relates to doubt concerning the accuracy of assessment of mental capacity, which implies adequate assessment may justify involuntary admission. In practice, it is not always complicated to assess mental capacity in order to make treatment-related decisions. The third reason concerns the argument that psychiatric treatments lack empirical evidence concerning effectiveness. Scientific evidence supporting the effectiveness of psychiatric treatment is abundant. The rights of persons with mental illness are important ethical issues. However, it is doubtful whether the blanket prohibition of compulsory admission is appropriate and ethical. Critical review of the UNCRPD and the General Comment is urgent for timely treatment and for the well-being of persons with mental illness.
Beneficence ; Decision Making ; Denial (Psychology) ; Disabled Persons* ; Discrimination (Psychology) ; Ethics ; Evaluation Studies as Topic* ; Hospitalization ; Humans ; Logic ; United Nations*

Recurrent peritonitis is the major complication of continuous ambulatory peritoneal dialysis (CAPD) and a common reason for discontinuation of this form of therapy. Polymicrobial peritonitis by gram- negative organisms suggests intraabdominal pathology not directly associated with CAPD, necessitating early removal of catheter and/or abdominal exploration. The source of infection may still be gastrointestinal, especially in light of the polymicrobial gram-negative peritonitis and rarely be gastrointestinal malignancy. We recently experienced a case of 64-year-old woman with recurrent CAPD peritonitis by polymicrobial gram-negative organisms, originated from colon cancer. Colon cancer was confirmed by barium enema, abdominal CT and colonoscopic biopsy. She underwent right hemicolectomy and removal of catheter simultaneously. The biopsy revealed a moderately to poorly differentiated adenocarcinoma with abundant mucin production.
Adenocarcinoma ; Barium ; Biopsy ; Catheters ; Colon* ; Colonic Neoplasms* ; Enema ; Female ; Humans ; Middle Aged ; Mucins ; Pathology ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Tomography, X-Ray Computed

OBJECTIVES: This study was carried out to suggest preventive methods for hypertension in cold-exposed workers. METHODS: In 11 refrigeration industries, 68 workers working in refrigerated areas more than one time per day were selected as the exposed group, and 68 workers not exposed to cold were selected as the control group. We interviewed the subjects with a questionnaire covering occupational history, and conducted clinical and laboratory tests including measurements of blood pressure and core temperature. RESULTS: The systolic blood pressure in the exposed group(130.0+/-13.3 mmHg) was significantly higher than that recorded in the control group(118.3+/-12.1 mmHg), as was the diastolic blood pressure in the exposed group(82.7+/-8.5 mmHg) versus the control group(77.4 +/-8.7 mmHg). The core temperature in the exposed group(36.1+/-0 . 7degrees C) was significantly lower than that experienced in the control group(36.4+/-0 . 5degrees C). In logistic regression analysis, age, cold exposure severity and milk intake were significant variables, with odds ratios of 5.204(95 % CI 1.440~18.812), 2.674(95 % CI 1.080~6.618), and 0.364(95 % CI 0.141~0.942), respectively. CONCLUSIONS: Our study suggests that cold-exposed workers have higher a higher risk of hypertension, and that their core temperature is lower. Risk factors affecting hypertension of cold-exposed workers include age, cold exposure severity and milk intake. For the prevention of hypertension, cold-exposed workers should minimize cold-exposure time as much as possible.
Blood Pressure ; Hypertension* ; Logistic Models ; Milk ; Odds Ratio ; Questionnaires ; Refrigeration ; Risk Factors

Pulmonary hypertension is a frequent complication of chronic obstructive pulmonary disease (COPD) and associated with a worse survival and increased risk of hospitalization for exacerbation of COPD. However, little information exists regarding the potential role of systemic inflammation in pulmonary hypertension of COPD. The purpose of the present study was to investigate the degree of C-reactive protein (CRP) and endothelin-1 (ET-1) levels in COPD patient with and without pulmonary hypertension. The levels of CRP and ET-1 were investigated in 58 COPD patient with pulmonary hypertension and 50 patients without pulmonary hypertension. Pulmonary hypertension was defined as a systolic pulmonary artery pressure (Ppa) > or =35 mmHg assessed by Doppler echocardiography. Plasma CRP and ET-1 levels were significantly higher in patients with pulmonary hypertension than in patients without hypertension. There were significant positive correlations between the plasma ET-1 level and CRP level in the whole study groups. For COPD patients, systolic Ppa correlated significantly with plasma CRP levels and plasma ET-1 levels. These findings support a possibility that CRP and ET-1 correlate to pulmonary hypertension in COPD patients.
Aged ; Blood Pressure ; C-Reactive Protein/*analysis ; Echocardiography, Doppler ; Endothelin-1/*blood ; Female ; Humans ; Hypertension, Pulmonary/*blood/complications ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive/*blood/complications