In an in-patient population in Sri Lanka, only those receiving a diagnosis of schizophrenia had Schneider's First Rank Symptoms. Amond 65 males and 104 females, the prevalence of FRS was 25.4 per cent. Those patients with FRS in the first episode are likely to develop more during subsequent episodes. An attempt is made to explain the findings on a cultural basis.
OBJECTIVES:Nonsteroidal anti-inflammatory drugs (NSAIDs) contribute to the esophageal mucosal injury through its direct topical impact on the luminal aspect of the surface epithelium. Its indirect, systemic impact, however, on salivary component of the esophageal pre-epithelial barrier remains to be explored. Therefore, salivary mucin secretion and viscosity at baseline and during naproxen-placebo, as well as naproxen-rabeprazole, administration were investigated.METHODS:Twenty-one asymptomatic volunteers were included in this double-blind, placebo-controlled, crossover designed study. Salivary samples were obtained in basal and pentagastrin-stimulated conditions (6 mg/kg s.c.) mimicking the food-stimulated conditions. Patients received 7 days of naproxen-placebo or naproxen-rabeprazole with a 2-week washout period in between. Salivary mucin content and viscosity were measured before and after treatment using periodic acid/Schiff's methodology and Cone/Plate Digital Viscometer, respectively.RESULTS:The rate of salivary mucin secretion in basal condition declined by 32% during administration of naproxen-placebo (11.3±1.7 vs. 16.8±3.3 mg/h). Salivary mucin secretion in pentagastrin-stimulated condition declined significantly (by 34%) during the administration of naproxen-placebo (13.6±1.5 vs. 20.7±3.0 mg/h; P<0.05). Viscosity significantly decreased after naproxen-placebo administration in basal (by 60%) and stimulated conditions (by 56%) (P<0.001). Coadministration of rabeprazole at least partly restored the naproxen-induced decline of salivary mucin in basal condition (by 8%), and pentagastrin-stimulated conditions (by 30%).CONCLUSIONS:A significant decline of salivary mucin and viscosity during administration of naproxen may at least partly explain a propensity of patients on chronic therapy with NSAIDs to the development of esophageal mucosal injury and complications. In addition the trend to restorative capacity of rabeprazole on the quantitative impairment of salivary mucin during administration of naproxen may potentially translate into its tangible clinical benefit but it requires further investigation.
Este trabajo tiene por objeto el análisis de las relaciones entre el Derecho internacional del medio ambiente y el desarrollo sostenible. En la actualidad, tales relaciones no son ya una opción entre otras posibles, son una necesidad ineludible. No se puede concebir el Derecho internacional del medio ambiente al margen del desarrollo sostenible. Y, viceversa, no puede haber desarrollo sostenible sin incorporar las preocupaciones e intereses medioambientales. Las ideas fundamentales que se defienden son que tales relaciones no son casuales, aleatorias o fortuitas sino que son interacciones sistémicas porque se realizan en el marco del sistema jurídico internacional que les da cobertura jurídica y explica su sentido y consecuencias jurídicas. Estas relaciones sistémicas son ambivalentes ya que tienen algunas ventajas pero también algunos inconvenientes. Una de las principales cuestiones que plantean es si el desarrollo sostenible contribuye a diluir la normatividad del Derecho internacional del medio ambiente o bien si ha ayudado a su reformulación en el nuevo contexto internacional. Es decir, la duda interpretativa es si el desarrollo sostenible tan sólo ha contribuido a su softness y/o también ha supuesto su transformación.
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