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Biomedical subjects

A Marchand

Publications and source records attributed to A Marchand.

At least 19 recordsLinked to original sources
PubMed2002

Recollections of parent-child relationships in patients with obsessive-compulsive disorder and panic disorder with agoraphobia.

OBJECTIVE: In previous studies, patients with different psychiatric conditions, as compared with matched controls, have reported that their parents were more protective and less caring towards them when they were children. However, studies investigating associations between parental behaviours and anxiety disorders have yielded inconsistent results. The aim of this study was to compare recalled parental behaviours in out-patients with obsessive-compulsive disorder (OCD), in out-patients with panic disorder with agoraphobia (PDA), and in non-anxious controls. METHOD: The sample included 43 out-patients with OCD, 38 with PDA, and 120 controls. Participants completed the Parental Bonding Instrument and the Egna Minnen Beträffande Uppfostran or Own Memories of Parental Rearing Experiences in Childhood. RESULTS: No differences were found between the two anxious groups. However, compared with the control group, anxious patients recalled their parents as more protective. CONCLUSION: Our findings suggest that child rearing practices such as overprotection may be a risk factor in the development of anxiety disorders.

Adult↗
PubMed2001

5-(Trifluoromethyl)-beta-l-2'-deoxyuridine, the L-enantiomer of trifluorothymidine: stereospecific synthesis and antiherpetic evaluations.

As a part of our ongoing work on beta-L-nucleoside analogues as potential antiviral drugs, we have synthesized 5-(trifluoromethyl)-beta-L-2'-deoxyuridine (L-TFT), the hitherto unknown L-enantiomer of trifluorothymidine (CF(3)dUrd, TFT). We have also studied the effect of L-TFT on human and herpes simplex virus (HSV) type 1 and 2 thymidine kinases, and human thymidine phosphorylase, as well as its anti-HSV-1 and anti-HSV-2 activities in cell cultures. L-TFT has been found: (i) to inhibit HSV-1 TK with activity comparable to TFT, with no effect on human TK, (ii) to be phosphorylated by the viral enzyme with similar efficiency to TFT, (iii) to be resistant, in contrast to TFT, to hydrolysis by human thymidine phosphorylase. Unfortunately, when evaluated in cell cultures, L-TFT did not show any anti-HSV-1 and anti-HSV-2 activities.

Antiviral Agents↗
PubMed1998

Panic disorder in coronary artery disease patients with noncardiac chest pain.

In this study we address the following questions: (1) What percentage of coronary artery disease (CAD) patients that present with chest pain, but whose symptoms cannot be fully explained by their cardiac status, suffer from panic disorder (PD)? (2) How do patients with both CAD and PD compare to patients without CAD and to patients without either PD or CAD in terms of psychological distress? Four hundred forty-one consecutive walk-in emergency department patients with chest pain underwent a structured psychiatric interview (ADIS-R) and completed psychological scales. Fifty-seven percent (250 of 441) of these patients were diagnosed as having noncardiac chest pain and constituted this study's sample. A total of 30% (74 of 250) of noncardiac chest pain patients had a documented history of CAD. Thirty-four percent (25 of 74) of CAD patients met criteria for PD. Patients with both PD and CAD displayed significantly more psychological distress than CAD patients without PD and patients with neither CAD nor PD. However, they did not differ from non-CAD patients with PD. PD is highly prevalent in patients with CAD that are discharged with noncardiac diagnoses. The psychological distress in these patients appears to be related to the panic syndrome and not to the presence of the cardiac condition.

Chest Pain↗
PubMed1998

Voltage-gated and Ca2+-activated conductances mediating and controlling graded electrical activity in crayfish muscle.

Crayfish opener muscle fibers provide a unique preparation to quantitatively evaluate the relationships between the voltage-gated Ca2+ (ICa) and Ca2+-activated K+ (IK(Ca)) currents underlying the graded action potentials (GAPs) that typify these fibers. ICa, IK(Ca), and the voltage-gated K+ current (IK) were studied using two-electrode voltage-clamp applying voltage commands that simulated the GAPs evoked in current-clamp conditions by 60-ms current pulses. This methodology, unlike traditional voltage-clamp step commands, provides a description of the dynamic aspects of the interaction between different conductances participating in the generation of the natural GAP. The initial depolarizing phase of the GAP was due to activation of the ICa on depolarization above approximately -40 mV. The resulting Ca2+ inflow induced the activation of the fast IK(Ca) (<3 ms), which rapidly repolarized the fiber (<6 ms). Because of its relatively slow activation, the contribution of IK to the GAP repolarization was delayed. During the final steady GAP depolarization ICa and IK(Ca) were simultaneously activated with similar magnitudes, whereas IK aided in the control of the delayed sustained response. The larger GAPs evoked by higher intensity stimulations were due to the increase in ICa. The resulting larger Ca2+ inflow increased IK(Ca), which acted as a negative feedback that precisely controlled the fiber's depolarization. Hence IK(Ca) regulated the Ca2+-inflow needed for the contraction and controlled the depolarization that this Ca2+ inflow would otherwise elicit.

Action Potentials↗
PubMed1998

From a unidimensional to a bidimensional concept and measurement of workers' safety behavior.

OBJECTIVES: This study examines the concept and measurement of worker's safety behavior. It shows that the traditional concept of safety behavior centered on workers' carefulness or compliance with safety rules is limited and proposes that an additional dimension, namely, workers' safety initiatives, be taken into account. METHODS: Confirmatory factor analyses were carried out for a random sample of 828 workers drawn from 9 manufacturing facilities located in the province of Quebec (Canada). RESULTS: A 2-correlated congeneric factor model gave parameters in the expected direction, but the overall model was unable to reach a good fit. Separate construct analyses showed that compliance with safety rules is not a consistent dimension. The safety-initiatives dimension achieved a good fit with a high composite reliability (p=0.85). CONCLUSIONS: Workers' compliance with safety rules was not structured as a unitary dimension; therefore a selective process of safety-rules compliance by workers is suggested. Each category of safety rules should be considered as 1 single dimension and measured by several specific indicators. Indicators for safety initiatives provide high reliability, and, since this dimension is an important predictor of effectiveness in accident prevention, the items tested provide a better measurement than those previously published.

Accidents, Occupational↗
PubMed1997

Detecting panic disorder in emergency department chest pain patients: a validated model to improve recognition.

OBJECTIVE: To develop and validate a detection model to improve the probability of recognizing panic disorder in patients consulting the emergency department for chest pain. METHODS: Through logistic regression analysis, demographic, self-report psychological, and pain variables were explored as factors predictive of the presence of panic disorder in 180 consecutive patients consulting an emergency department with a chief complaint of chest pain. The detection model was then prospectively validated on a sample of 212 patients recruited following the same procedure. RESULTS: Panic-agoraphobia (Agoraphobia Cognitions Questionnaire, Mobility Inventory for Agoraphobia), chest pain quality (Short Form McGill Pain Questionnaire), pain loci, and gender variables were the best predictors of the presence of panic disorder. These variables correctly classified 84% of chest pain subjects in panic and non-panic disorder categories. Model properties: sensitivity 59%; specificity 93%; positive predictive power 75%; negative predictive power 87% at a panic disorder sample prevalence of 26%. The model correctly classified 73% of subjects in the validation phase. CONCLUSION: The scales in this model take approximately ten minutes to complete and score. It may improve upon current physician recognition of panic disorder in patients consulting for chest pain.

Adult↗
PubMed1997

Facial growth and the need for orthognathic surgery after cleft palate repair: literature review and report of 28 cases.

PURPOSE: Controversy still exists regarding the optimal timing and surgical technique for primary cleft lip and palate (CLP) repair, and treatment protocols vary considerably. This study reviews the literature on timing and technique for primary repair and reports on the outcome for a consecutive group of patients treated by a single surgical protocol at the Sunnyview Cleft Palate Clinic. PATIENTS AND METHODS: Twenty-eight patients treated by a standardized clinical protocol from infancy through adolescence were evaluated with respect to the need for orthognathic surgery to correct jaw size discrepancy. For each patient, data was collected regarding type of cleft deformity, total number of surgical procedures from infancy, surgeon performing the primary repair, and the need or indication for orthognathic surgery. RESULTS: Twenty-five percent of patients treated by this protocol required orthognathic surgery because of anteroposterior jaw size discrepancy. The number of prior operations was not a significant factor. The need for orthognathic surgery was seen in all types of CLP deformity. Different primary surgeons varied considerably in the percentage of their patients who ultimately required orthognathic surgery. CONCLUSION: The results of this study parallel other larger cohort studies with respect to the percentage of patients requiring orthognathic surgery. The number of prior operations does not significantly affect the later need for orthognathic surgery.

Adolescent↗
PubMed1997

Suicidal ideation in emergency department chest pain patients: panic disorder a risk factor.

Most patients who present to the emergency department (ED) for chest pain do not have a cardiac disorder. Approximately 30% of noncardiac chest pain patients suffer from panic disorder (PD), a disabling, treatable, yet rarely detected psychiatric condition. Although still controversial, PD may be a risk factor for suicidal ideation and attempts. The prevalence of recent suicidal ideation (ie, past week) was studied in 441 consecutive ED chest pain patients who underwent a structured psychiatric interview. To examine the controversial link between panic and suicidal behavior, logistic regression analyses were conducted in which current psychiatric diagnoses (Axis I) as well as pertinent medical and demographic information were assessed as risk factors for suicidal ideation. Participants were interviewed with the Anxiety Disorders Interview Schedule-Revised to establish psychiatric diagnoses. Recent suicidal ideation (ie, past week) was assessed with question 9 of the Beck Depression Inventory. Ten percent of patients had recent suicidal ideation. Sixty percent of patients with suicidal thoughts met criteria for PD. In the patients with PD, suicidal ideation could not be explained by the presence of comorbid psychiatric or medical conditions or medication. In the total sample, only diagnoses of PD (odds ratio [OR] = 4.3; 95%, confidence interval [CI], 2.09-8.82; P = .0001) and dysthymia (OR = 9.98; 95% CI, 4.00-24.8; P = .00001) were significant and independent risk factors for suicidal ideation. PD, the most common psychiatric condition in ED chest pain patients, may be an independent risk factor for suicidal ideation, further supporting the need for recognition and treatment of these patients.

Adult↗
PubMed1997

Cardiac troponin I does not increase after cardioversion.

BACKGROUND: Serum total creatine kinase (total CK) level increases in the patients following electrical cardioversion. The same has been observed with CK-MB, an isoenzyme of the total CK with some cardiospecificity. Cardiac troponin I (cTnI), a new specific cardiac biological marker, is highly effective to discriminate myocardial and muscular injuries after noncardiac surgery. METHODS: To assess cardiac damage after cardioversion, we measured serum cTnI, myoglobin, total CK, CK-MB mass, 1, 2, 3, 4, 8, 12, and 24 h after elective cardioversion of supraventricular tachycardia in 28 patients (eight women, 20 men; mean age, 64 +/- 10 years). Cumulative energy was below 370 J in 17 patients, between 370 and 900 J in eight patients, and 1,020 J in three patients. Serum cTnI was measured using a sandwich immunoenzymologic assay. The detection limit of the assay was 0.35 microgram/L and normal values range from 0.35 to 1.3 micrograms/L. RESULTS: In all but three patients, cTnI remained below 0.35 microgram/L. In these three patients, cTnI ranged between 0.35 and 0.9 microgram/L. There was no correlation between cTnI and the number or the energy of cardioversion. Myoglobin and total CK increased to abnormal concentrations in 11 patients (myoglobin, 630 +/- 190 micrograms/L, and total CK, 2,584 +/- 780 U/L) and reached myocardial infarction-like values in five patients. Modest increases of CK-MB were then also observed. A strong correlation was observed between the total energy of direct current cardioversion and the increase of either myoglobin (r = 0.87; p < 001) or total CK (r = 0.81; p < 001). CONCLUSION: Cardioversion in a clinical setting does not induce elevation of cTnI. Increase in total CK, CK-MB, and myoglobin may be due solely to muscular lesions and is closely related to the cumulative energy delivered.

Aged↗
PubMed1996

Panic disorder in emergency department chest pain patients: prevalence, comorbidity, suicidal ideation, and physician recognition.

PURPOSE: To establish the prevalence of panic disorder in emergency department (ED) chest pain patients; compare psychological distress and recent suicidal ideation in panic and non-panic disorder patients; assess psychiatric and cardiac comorbidity; and examine physician recognition of this disorder. DESIGN: Cross-sectional survey (for psychiatric data). Prospective evaluation of patient discharge diagnoses and physician recognition of panic disorder. SETTING: The ambulatory ED of a major teaching hospital specializing in cardiac care located in Montreal, Canada. SUBJECTS: Four hundred and forty-one consenting, consecutive patients consulting the ED with a chief complaint of chest pain. PRIMARY OUTCOME MEASURE: Psychiatric diagnoses (AXIS I). Psychological and pain test scores, discharge diagnoses, and cardiac history. RESULTS: Approximately 25% (108/441) of chest pain patients met DSM-III-R criteria for panic disorder. Panic disorder patients displayed significantly higher panic-agoraphobia, anxiety, depression, and pain scores than non-panic disorder patients (P < 0.01). Twenty-five percent of panic disorder patients had thoughts of killing themselves in the week preceding their ED visit compared with 5% of the patients without this disorder (P = 0.0001) even when controlling for co-existing major depression. Fifty-seven percent (62/108) panic disorder patients also met criteria for one or more current AXIS I disorder. Although 44% (47/108) of the panic disorder patients had a prior documented history of coronary artery disease (CAD), 80% had atypical or nonanginal chest pain and 75% were discharged with a "noncardiac pain" diagnosis. Ninety-eight percent of the panic patients were not recognized by attending ED cardiologists. CONCLUSIONS: Panic disorder is a significantly distressful condition highly prevalent in ED chest pain patients that is rarely recognized by physicians. Nonrecognition may lead to mismanagement of a significant group of distressed patients with or without coronary artery disease.

Chest Pain↗
PubMed1996

[Behavioral and cognitive models of post-traumatic stress disorder].

The necessity of developing efficient treatment for the numerous victims of violence and catastrophes render essential the understanding of the mechanisms of development, maintainance and resorption of the Posttraumatic Stress Disorder (PTSD). Consequently, this article presents the most influential behavior and cognitive models followed by a brief critical analysis. The etiological models chosen are those of Mowrer (1960), Foa and al. (1989), Jones and Barlow (1990), Chemtob and al. (1988) and Janoff-Bulman (1985). Finally these models are compared and discussed.

Behavior Therapy↗
PubMed1995

Large scale survey of bovine babesiosis due to Babesia divergens in France.

Data on the epidemiology of bovine babesiosis in France were collected from two sources: a questionnaire sent to large animal veterinary surgeons and blood samples collected from cattle treated for clinical babesiosis. Babesia divergens was common and widespread. B major was found in only one sample. The disease was particularly widespread in north west, south west and central France. The mean clinical incidence was 0.4 per cent. The bimodal seasonality of the clinical cases was correlated with that of the tick vector (Ixodes ricinus). Of the affected animals 72.6 per cent were more than three years old.

Age Distribution↗
PubMed1994

Panic disorder, chest pain and coronary artery disease: literature review.

OBJECTIVE: To examine the association among panic disorder, atypical chest pain and coronary artery disease (CAD). This article's purpose is to inform cardiologists of the prevalence of psychiatric disorders, primarily panic disorder, among patients consulting for chest pain. Panic disorder is described. Treatment modalities are summarized, and social, financial and medical consequences of nondetection are underlined. DATA SOURCES: PSYCHLIT and MEDLINE searches under panic disorder and chest pain-related headings were conducted. DATA EXTRACTION: The search covered January 1973 to June 1993. Thirty-eight articles were studied. DATA SYNTHESIS: Panic disorder is present in 30% or more of chest pain patients with no or minimal CAD and may coexist with CAD. Panic disorder may often be unrecognized by physicians. Left untreated, risk for disease progression may be augmented, and social vocational disability as well as medical costs may increase. CONCLUSION: Physicians should attend to the panic symptomatology and, when in doubt, refer possible panic patients with or without CAD to a mental health professional for assessment and treatment. Future panic prevalence studies in cardiology patients should be prospective, attempt to increase sample size and use randomized protocols where experimenters are blind to chest pain and medical diagnoses. Studies should also focus on CAD patients with atypical chest pain refractory to optimal cardiac therapy.

Chest Pain↗
PubMed1993

[Effect of personality disorders on response to cognitive behavioral therapy of panic disorder with agoraphobia].

This study measures the effect of personality disorders on the efficacy of treatment of agoraphobia. Forty-one patients suffering from panic disorder with agoraphobia are evaluated for the presence of a personality disorder (according to DSM-III-R criteria) before the onset of treatment. The treatment consists in 14 sessions of behavioural cognitive therapy. Various measures of agoraphobic avoidance are obtained before (pre-test) and after the end of treatment (post-test, three month follow-up). Effect of treatment reaches statistical and clinical significance for all patients. Grouping of patients according to presence or absence of personality disorder shows no significant difference between the groups before or after treatment on scores of agoraphobia. A subgroup of patients with dependent personality disorder does not differ on measures of agoraphobic avoidance from patients without personality disorders or with other personality disorders. The discussion points out methodological limitations, differences in our study from other studies regarding the effect of personality on the treatment outcome of panic disorder with agoraphobia, as well as possibilities for future studies.

Adult↗
PubMed1992

[Azygo-portal disconnection for hemorrhagic cirrhosis. Results and value of abdominal and thoracic approach apropos of 20 cases].

The authors report about the results of 20 azygoportal deconnections for the treatment of hemorrhagic cirrhosis caused by the rupture of esophageal or cardiotuberosal varices. All patients had an ethylic cirrhosis of Child-Pugh classes A (1), B (15) or C (4). All had a contraindication to calibrated laterolateral portocaval shunting. Azygoportal deconnection was performed with a thoracic approach in 7 cases, using a Bérard eso-clip in 6 cases and a Prioton button in 1. In 13 cases the approach was abdominal, using EEA circular mechanical clamps. In this cases, trunk vagotomy was performed in 12 cases, in association with pyloroplasty in 10 cases and gastroenteroanastomosis in 2 cases. Splenectomy was performed in 3 patients and the ligation of the splenic artery in a 4th patient. Mortality at 2 months is of 30%, the 6 deaths being caused by hepatic insufficiency in 3 cases, heart and esophageal fistula after an eso-clip was laid in 1 case. The two patients with chronic ascites died of hepatic insufficiency. Mortality at 2 months is of 23% for patients operated in an elective period, and 43% for semiergent operations. Twenty-six percent of the Child B patients and 50% of the Child C patients died. The percentage of residual varices is 57% in the surviving patients. Every second patient had complementary sclerosis. All had had azygoportal deconnection with mechanical clamps. Bleeding recurred in 2 patients (16.6%). Survival is 50% at 1 year and 39% at 3 years.

Abdominal Muscles↗
PubMed1992

[Oxygenated free radicals and vascular pathology].

Oxygen free radicals are used as a weapon by neutrophil morphopolynuclear cells, monocytes and macrophages against bacterial attacks. They do interact with arachidonic acid cascade catabolism that means they stimulate too, platelet cells and endothelial cells activity (EDRF is indeed "NO"). They prime all along inflammatory process and thrombosis which are main items of the pathology of vessels.

Free Radicals↗
PubMed1991

Cytological and immunological responses to Babesia divergens in different hosts: ox, gerbil, man.

A continuous in vitro culture system for Babesia divergens was initiated from a human isolate. It was maintained through 305 subcultures for 3 years using a low concentration of serum and a low haematocrit, with no decrease in the initial virulence. This in vitro system enabled the routine culture of all human and bovine B. divergens isolates thus far tested, with a mean parasitaemia level of 30%-40%. Different cytological aspects observed in the same isolate by optical and electron microscopy were described in parasitized ox, gerbil and human erythrocytes. The sequence of B. divergens antibody responses was determined in man and ox, enabling the precise identification of major B. divergens antigens as candidates for vaccines.

Animals↗