Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa

Although it was previously believed that systemic lupus erythematosus was uncommon among Africans, it has become increasingly apparent that the incidence is higher, and socioeconomic challenges such as physician shortages, poor medical facility access, and poor health literacy may worsen prognosis. This retrospective study examines characteristics and outcomes of hospitalized systemic lupus erythematosus patients over a two-year period and serves as a baseline for comparison for future studies to examine the outcomes with the provision of more dedicated care. There were 51 patient admissions over a two-year period, with a mean duration from start of illness to admission of approximately two years. Duration of admission ranged from one to 140 days with a mean period of 26.12 days (SD ± 26.6). There were 22 deaths (43.1% of admissions), which were mainly due to infections and renal complications. Factors associated with risk of death in regression analysis were: infections, fever, disease flare, musculoskeletal involvement, amenorrhea, depression, a clinical finding of hepatomegaly, and chest infection. Understanding the effect and outcome of systemic lupus erythematosus across different countries can elucidate the role of genetic, environmental, and other causative factors in the progression of the disease.

A controlled study of psychological and social change after surgical gender reassignment in selected male transsexuals

Of two groups of 20 patients accepted for gender reassignment surgery, one was offered early operation and therefore had had surgery by follow-up two years later, while the second was still awaiting operation at two-year follow-up. Although the groups were similar initially, significant differences between them emerged at follow-up in terms of neuroticism and social and sexual activity, with benefits being enjoyed by the operated group.

Aspects of psychiatric symptoms at different stages in the treatment of transsexualism

Three groups of male transsexuals at different stages of the treatment process were examined and shown to match retrospectively in actuarial and psychiatric data. Transsexuals who were on a waiting list for surgery showed lower neurotic scores on the Crown-Crisp Experiential Index than those at the assessment stage of clinic attendance, while post-operative transsexuals obtained scores lower than either of the other groups. Transsexuals during the assessment stage of treatment obtained the lowest scores on items in the Bem Sex Role Inventory that define stereotypical masculine characteristics and the highest scores on items that define stereotypical feminine characteristics, in relation to the other two groups.

Psychiatric aspects of sex reassignment surgery

Sex reassignment surgery is perhaps the most controversial issue in psychiatry today. Clinicians involved in the treatment of transsexualism have been accused of "playing God" or colluding with the patient's psychopathology. This paper reviews the literature and argues for a systematic approach to the treatment of transsexualism.

The disconnection in anomic aphasia between semantic and phonological lexicons

PB, a right handed woman aged 26, has developed anomic language disturbances following right frontal and left temporal brain damage due to a road traffic accident. Her anomia shows exceptional features: it occurs in naming tasks in test conditions but not in continuous speech; it involves comprehension deficits but very few semantic errors in expression; it improves with phonemic, but not with semantic cues. These features, it is argued, indicate the disconnection between two intact lexicons: the semantic and the phonological.