Search

Presents a letter to the editor in response to the article of Milson et al., which suggest that 13-cis-retinoid does not cause marked changes in tear secretion and tearfilm break-up time, although the authors recognize that these tests are crude and difficult to reproduce.

In this article, we review a number of studies on sexual functioning after sexual assault. Among the studies discussed, three different approaches can be distinguished: the descriptive analyses of sexual functioning and sexual problems, the exploration of factors which predict sexual problems, and the study of relationships between sexual problems and other psychological problems. Although the studies vary considerably in methodology, they point to the conclusion that frequency of sexual contact decreases after sexual assault. Satisfaction and pleasure in sexual activities seem to diminish for a considerable group of victims for at least 1 year postassault. In several studies it was revealed that victims develop sexual problems that can persist for years after the assault. These include response inhibiting problems, such as fear and arousal and desire dysfunctions. Most researchers have found that factors such as a young age, a known offender, and penetration during the assault are related to sexual problems. With respect to physical violence used during the assault, the results are inconclusive. Furthermore, emotions felt during and immediately after the assault, such as anger towards self, shame, and guilt, may predict sexual problems. Avoidance of sexual contact also appears to be related to sexual problems. A loving and understanding partner seems to be a protective factor. Finally it can be concluded that sexual problems are related to other psychological problems, including posttraumatic stress symptoms and depression.

In pain clinics, thorough documentation of patient-related data is essential for analysis of patient history, long-term evaluation of diagnostic and therapeutic procedures, and research on the etiology and epidemiology of chronic pain syndromes. With these requirements in mind, we realized a microcomputer documentation system based on a commercial data-base software concept (dBASE). Each patient's data are stored in three different sections: data for identification, basic data (mainly diagnostic findings), and treatment related follow-up data. The program was initially developed to run on a single IBM/XT- or AT-compatible computer (at least 640 kB RAM, 1 hard-disk-drive) with MS-DOS but has now been improved to work on a local area network (LAN) with the NOVELL-Netware operating system. Important features of our new system are: multi-user capability, flexible data management via menu-driven user dialogue, rapid data access, and high compatibility allowing data exchange with other standard software packages. The microcomputer documentation system offers listings for administration as well as effective patient scheduling thanks to a recall system by date of last contact, selected therapeutic procedures and any other item in the medical record. A mail-merge service can be applied, which is particularly useful for follow-up-studies. The documentation system means routine work can be standardized and performed in an economical manner, with the ultimate aim of enhancing the quality of pain therapy.