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Biomedical subjects

F Mahieux

Publications and source records attributed to F Mahieux.

33 records · Page 2Linked to original sources
PubMed1991

[Münchhausen syndrome. A study of 8 cases of neurologic manifestations].

Eight cases of Münchhausen syndrome were registered within two years in two hospital neurological departments. Summaries of their clinical history were obtained following an enquiry in 58 hospitals of Paris and suburbs. All patients met Asher's description for the emergency presentation, the truculence-evasiveness manner, the luxuriance of tales, the eclecticism of the alleged symptoms, the vehement request of dangerous or painful procedures and the apparent senselessness. The paucity of scars and modesty of peregrinations recorded are discussed, as well as the lack of self-inflicted injury. Ethical implications and traps set by these tricky patients against consistent medical strategies are developed.

Adult↗
PubMed1989

Rilmenidine and vigilance. Review of clinical studies.

In this study, the possible effects of rilmenidine on vigilance are evaluated. Sedation is the most disturbing side effect of alpha 2-agonists, especially during the first weeks of treatment. The level of vigilance was first determined by assessing drowsiness using visual analogue scales and/or by several psychometric tests in four pharmacoclinical studies in healthy subjects or in hypertensive patients: three studies with single administration of rilmenidine (0.5 to 3.0 mg) and one study with repeated administration for three days. These studies were double-blind, Latin-square designed, and controlled versus placebo (in all studies) and versus clonidine (in three studies). Analysis of these results illustrated that after short-term and repeated administration: (1) the effects on vigilance observed with rilmenidine 1 mg did not differ statistically from data observed with placebo; and (2) sedative effects observed with clonidine were significantly greater than with rilmenidine, at equihypotensive doses. Daytime drowsiness was systematically assessed and graded by inciting questioning at each visit in five clinical studies. Ambulatory hypertensive patients were treated with rilmenidine (1 mg per day or 1 mg twice a day). These studies were controlled versus placebo (one study for two weeks, 120 patients; and one study for one month, 126 patients), hydrochlorothiazide (six weeks, 56 patients), clonidine (six weeks, 333 patients), and methyldopa (three months, 157 patients). The results showed that: (1) drowsiness observed with rilmenidine did not differ statistically from that observed with placebo or diuretic; and (2) drowsiness occurred less frequently with rilmenidine than with reference alpha 2-agonists at equihypotensive doses. In conclusion, these results confirm in current clinical use the dissociation already observed in laboratory animals between the antihypertensive effects and the sedative effects and may distinguish rilmenidine among alpha 2-agonists.

Adrenergic alpha-Agonists↗
PubMed1989

Acute myeloradiculitis due to cytomegalovirus as the initial manifestation of AIDS.

A 26 year old male intravenous drug abuser presented with rapidly progressive paraplegia and total incontinence. CSF examination showed elevated protein level and pleocytosis. HIV testing was positive. Anti CMV titres were mildly elevated in serum and CSF. Death occurred 26 days after the onset of neurological signs. Necrotic and inflammatory lesions with numerous inclusion bodies characteristic of CMV were found in the roots of the cauda equina, conus terminalis and lumbar segments of the spinal cord. CMV subependymal encephalitis and HIV encephalitis were also present.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Efficacy and safety of rilmenidine for arterial hypertension.

To assess the long-term acceptability and efficacy of rilmenidine (S 3341), patients with placebo-resistant hypertension (diastolic blood pressure [BP] greater than or equal to 95 mm Hg and less than 115 mm Hg) were included in an open 1-year treatment study. Eight examinations allowed treatment adaptation if diastolic BP remained greater than or equal to 90 mm Hg (monotherapy with rilmenidine, 1 or 2 mg/day, followed by the addition of a diuretic, then tritherapy). Three hundred seventeen patients, aged 58.0 +/- 0.7 years, were included. Two hundred sixty-nine were followed for 1 year and 48 withdrew from the trial without any symptom suggesting a withdrawal syndrome: 4 because of adverse effects; 6, lack of efficacy despite triple therapy; 9, intercurrent diseases; 10, noncompliance independent of adverse effects; 18, personal reasons not associated with treatment; and 1, lost to follow-up. On the 12th month, the decrease in supine systolic and diastolic BP reached 25 and 17 mm Hg with monotherapy (n = 150), 26 and 17 mm Hg with double therapy (n = 90) and 20 and 15 mm Hg with triple therapy (n = 29). BP was normalized (diastolic BP less than or equal to 90 mm Hg) on months 6 and 12 in 80 and 84% of the patients, respectively. Monotherapy was maintained in 66 and 60% of these patients, respectively, two-thirds being treated with 1 mg once daily. Adverse effects with monotherapy were mainly observed at the beginning of treatment in 3 to 8%: dry mouth, asthenia, gastralgia, palpitations, drowsiness, insomnia; other adverse effects were rare (1 to 2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Agonists↗
PubMed1988

[Spinal dural arteriovenous fistulae: exacerbation after myelography with metrizamide].

Metrizamide dorsal myelography was performed in two patients with minor to moderate sensorimotor paraparesis. Direct and indirect myelographic signs of spinal arteriovenous aneurysm were seen and spinal cord angiography showed thoracic dural arteriovenous fistulae (AVF) in both cases. Within 24 hours following myelography, clear neurological worsening occurred, associated with cephalalgia, nausea and transient diplopia in one case, leading to paraplegia in a few days. Paraplegia was complete six months after surgery in one case, and had resolved after embolization of fistula in the other patient. The mechanism of neurological worsening may include: substraction of cerebrospinal fluid, sitting position during and after myelography and local increase of metrizamide concentration secondary to impaired resorption caused by the fistula. Water-soluble myelography is of invaluable aid in the diagnosis of dural AVF and must be followed by early angiography, thus allowing prompt therapeutic embolization.

Adult↗
PubMed1987

[Recurrent acute dyskinesia as the sole manifestation of phenytoin poisoning].

A 20 year-old epileptic female patient was admitted because of recurrent dyskinesias of 3 months duration. She was receiving phenobarbital, phenytoin (PHT) and clonazepam. PHT dosage had been increased 4 months earlier. Clinical examination and CT scan gave normal results. PHT plasmatic levels were 42 micrograms/ml on admission and there were no other symptoms of PHT toxicity. PHT-induced dyskinesias usually occur together with severe encephalopathy and/or clinical or paraclinical evidence of basal ganglia damage and/or other evidence of PHT toxicity, none of which were present here.

Adult↗
PubMed1987

[Cerebral cysticercosis: 4 cases].

Four cases of cerebral cysticercosis are reported, occurring in an immigrant population. Two patients presented with periodic epileptic fits and cerebral calcifications. One patient presented with an acute hemiparesis associated with lymphocytic meningitis and cerebral calcifications; the fourth patient had chronic meningitis with epileptic fits. Three patients were treated with praziquantel: an acute reaction occurred during treatment in two cases with an increase in the titres of the immunological reaction of hydatid cyst disease in one case. The authors suggest classifying this condition in three types: acute (parenchymatous or subarachnoid), chronic (chronic meningitis, hydrocephalus, progressive dementia), and sequelae (epilepsy with or without headaches). This classification seems the most appropriate way of summarizing the variable clinical presentation of this condition which is rarely observed in France. The most valuable diagnostic investigation is CT brain scanning. Immunological reaction to hydatid cyst (CSF and blood) are sometimes negative. Treatment with praziquantel often causes an acute reaction with a rise in antibody titres; this is a clinically benign reaction, and it could be used as a diagnostic test.

Adolescent↗
PubMedDate not supplied

[Memory clinics: value and limitations].

CONCEPT: Memory clinics have developed since the early 1980s. Their main objective is the diagnosis of dementia for early multiple disciplinary management. INTEREST: Memory clinics serve an expert center, allowing early diagnosis in the predementia phase and a precise diagnosis of the cause. Memory clinics have revealed the frequency of psychiatric disorders, particularly depression and anxiety, leading to memory complaints. They provide a significant contribution for follow-up of dementia patients, announcement of the diagnosis, initiation of new treatments, prevention of "emergency hospitalizations" as well as postponement or preparation of institutionalization. They also have an educative role, promoting better use of psychotropics and a better understanding of management approaches and incidents observed during the disease course. Clinical research, which is not always sufficiently supported, is one of their important responsibilities. LIMITATIONS: The basic limitation for memory centers is the problem of the availability of qualified personnel. The lack of sufficient interest in truly early screening for Alzheimer's disease remains a problem to be solved.

Activities of Daily Living↗
PubMedDate not supplied

[Memory clinics: long-term follow-up].

Follow-up of patients in memory units raises problems of structure, team, diseases, evaluation and organization. Structures could be within the hospital, for early diagnosis, or outside hospital for prevention. The medical team is organized around the neurologist, must integrate different medical specialists (neurologist, psychiatrist, geriatrician) and be composed minimally of a clinician and a psychologist. Diseases range from memory complaint to very serious diseases such as Alzheimer's, vascular or post-traumatic dementia. Therapy includes cognitive stimulation and drug clinical trials. Evaluation requires medico-psycho-social analysis of the patient and his/her family. Memory consulting units could be integrated in a caring network organised in a modular fashion or like a geriatric hospital.

Follow-Up Studies↗