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Biomedical subjects

M Abbar

Publications and source records attributed to M Abbar.

53 records · Page 3Linked to original sources
PubMed1994

[Treatment of depression: methods and stages].

According to recent epidemiological studies, the lifetime prevalence of major depression ranges between 10 and 20%. However, informations concerning the course of depressive illness remain limited. It appears that only about one-quarter, or even less, of all depressives are affected once in their lifetime. Today, it could be assumed that 75-80% of depressive cases are recurrent. Many antidepressive treatments are available today, including first generation and second-generation antidepressants, psychotherapies, and sismotherapies. While antidepressants are similar in terms of drug or efficacy, onset of action, and latency to treatment response, their potential side effect and toxicity profiles are quite different. These factors must be weighed before treatment of depression is begun in an effort to prescribe the compound that is most beneficial i.e., clinically effective while exhibiting the fewest negative aspects. Determination of patients with an "at-risk" profile for drug side effects is best done by a careful analysis of their medical history, comorbidity with other axis I and axis II disorders and concomitant drug therapies. In fact, it appears that depressive patients with coexisting anxiety are often prone to side effects either with tricyclic compounds and SSRI's. In these patients these medications should therefore be introduced at a low dose and slowly increased. Otherwise, because of the frequent comorbidity of depression and alcoholic disorders, the clinician should make very effort to obtain a detailed history of the patient's substance use. If the patient is found to have a substance use disorder, a program to secure abstinence should be regarded as a priority in the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Antidepressive Agents↗
PubMed1994

[The contribution of endoscopy in the diagnosis of unilateral hematuria of renal origin and pseudotumors of the upper urinary tract].

From 1985 to 1992, 9 patients (6 males, 3 females) with a mean age of 47 years, presenting with a clinical picture suggestive of a tumour of the upper urinary tract (haematuria and/or pelvic or caliceal radiolucent filling defect), underwent retrograde (6 cases) and/or percutaneous (9 cases) endoscopic exploration of the upper urinary tract. The percutaneous examination allowed a precise diagnosis and appropriate treatment adapted to the lesion detected (papillary necrosis: 2 cases; ectopic papilla: 2 cases; hypertrophy of Brunn's nests: 1 case; papillary angioma: 1 case; haemorrhagic papillitis: 3 cases) in every case. Endoscopic exploration of radiolucent lesions of the upper tract and unexplained renal haematuria is therefore justified whenever the diagnosis of upper tract tumour is uncertain on the basis of the radiological and cytological assessment.

Adult↗
PubMed1993

[A quiet revolution: the Wallstent urethral prosthesis (Urolume AMS)].

14 patients (mean age: 57 years) with posterior urethral stricture were treated by internal urethrotomy and implantation of one or several Wallsten prostheses. The stent had to be removed in 2 patients (15%), while 12 patients (85%) obtained satisfactory urethral patency (mean follow-up: 17.5 months). Complications were observed in 50% of cases. They were able to be treated endoscopically with a satisfactory result in 5 out of 6 cases (intraprosthetic calculi or stenosis of the ends of the stent; 2 patients who became incontinent after insertion of the stent regained normal continence after insertion of an artificial sphincter above the stent. The Wallsten endoprosthesis therefore appears to be a very satisfactory treatment for recurrent complex strictures of the posterior urethra.

Adult↗
PubMed1993

[Psychosocial stress factors and suicidal acts].

Suicidal behaviour is actually understood as being multidetermined and the result of an interaction between state and trait related effects. Several types of risk factors have been extensively studied: psychiatric and personality disorders, genetic variables, biological factors and psychosocial stressors, the latter being the purpose of this review. Social and familial factors, negative life events and medical illness may interact with the factors mentioned above in three main ways to produce suicidal acts: as predisposing factors increasing vulnerability, as precipitating or as contributing factors. A summary of social and clinical studies will be presented and implications for medical care and prevention will be discussed.

Depressive Disorder↗
PubMed1993

[Fragmentation of urinary calculi using the Lithoclast EMS. Technique and results].

The Lithoclast is an endoscopic lithotriptor which uses the ballistic energy produced by a small hand-held apparatus, by the movement of a small metal part (the projectile) driven by a jet of compressed air. The energy is transmitted to a metal rod whose diameter is selected according to the application: 0.8 or 1 mm in the ureter; 2 mm in the bladder and kidney. We have used this apparatus to treat 40 stones in 39 patients (25 ureteric stones, 11 renal stones, 4 bladder stones). Satisfactory fragmentation was obtained for 39 of the 40 stones (97.5%). The apparatus is very easy to use in the kidney and bladder (the risk of urinary tract perforation is very low at this level). The risk of perforation of the ureteric wall by 0.8 mm or 1 mm rods is considerable (12% of cases), but these punctate lesions heal rapidly over a double J stent. Special techniques should be used in the ureter to limit the risk of pushing the stone towards the renal pelvis.

Adult↗
PubMed1992

Evidence for a pseudoautosomal locus for schizophrenia. II: Replication of a non-random segregation of alleles at the DXYS14 locus.

Because of an association between sexual aneuploidies and schizophrenia, and because schizophrenic siblings have been found to be more often of the same than of the opposite sex, the susceptibility locus for schizophrenia is thought to lie within the pseudoautosomal region of the sex chromosomes. We analysed 33 sibships comprising 18 pairs, 13 trios, and 2 quartets of affected siblings, and found support for non-random segregation of of alleles at the DXYS14 locus in affected siblings. These findings are consistent with the pseudoautosomal hypothesis for schizophrenia and favour a genetic linkage between DXYS14 and the disease.

Alleles↗
PubMed1992

[Clinical study of 5 families with bipolar disorder].

Five pedigrees of bipolar patients with at least two bipolar subjects on two generations have been identified in psychiatric departments of Nantes, Montpellier and Challans for linkage studies. In each pedigree, it was found one or more patients suffering from other conditions, like Borderline personality, Anorexia-bulimia, Mental retardation with dysmorphia, and Panic disorders. Mood disorders spectrum and therapeutic implications are discussed.

Adult↗
PubMed1991

[What is the role of endoscopy in the diagnosis and treatment of tumors of the upper urinary tract?].

17 patients with upper urinary tract tumours were investigated by endoscopy. 3 patients (Group I) with fibrous or fibroepithelial polyps were treated via a retrograde approach and did not develop any recurrences. 2 patients (Group II) developed unexplained haematuria: the diagnosis of high-grade carcinoma was confirmed by endoscopy and they were treated by nephroureterectomy. 12 patients (Group III) with low grade non-invasive urothelial carcinoma, in whom radical surgical was not indicated, were treated conservatively via the percutaneous (13 tumours) or retrograde (1 tumour) endoscopic approach. The local recurrence rate was 33% (4 out of 12 tumours) for a mean follow-up of 22 months. The recurrences were treated by repeated endoscopy in 3 patients, and by nephroureterectomy in 1 patient. Endoscopic treatment of upper urinary tract tumours should be reserved for benign tumours and selected cases of low-grade, non-invasive urothelial carcinoma.

Adult↗
PubMed1988

[Intraperitoneal textiloma. Apropos of 5 cases].

Five cases of foreign textile bodies left in the peritoneal cavity are reviewed the corpus delictus was an abdominal field packing in 4 cases (in 1 case 2 packings were involved), and in one case a compress. The 5th patient, operated upon in the department, presented a delayed pseudo-tumoral picture after a course of 4 years. The 4 cases referred from another department presented signs of sepsis identified at an early stage. Etiologic, clinical, diagnostic and prophylactic aspects are reviewed.

Adult↗
PubMedDate not supplied

[Psychotropic drug use and associated factors in a professional environment].

Drug use has been evaluated from a study conducted in a large french firm during 1992. The main objective of this study was to estimate prevalence of depressive and anxiety disorders and define professional factors. Psychotropic drug use has been measured by the percentage of subjects reporting their regular or occasional use during the 12 last months. Self-reported resort to medical system and sick leaves for psychiatric reason has been also examined during the same period. Lifetime and 12-month prevalence of depressive and anxiety disorders have been measured with a standardized questionnaire (CIDI, Composite International Diagnostic Interview) according to the criteria for the DSM III-R. A randomized sample of 540 subjects was obtained from two stages procedure. In first, a screening stage on 10,000 employees with the 12-items General Health Questionnaire (GHQ-12). The screened population was stratified on the global score GHQ-12 (> or = 3 and < 3). 270 subjects were randomized in each group and interviewed with CIDI. Occasional and regular psychotropic drug use is respectively 41.1% and 6.8% in women, 16.7% and 3.4% in men. It is much higher after 45 years (regular use: 18.8% in women and 7.6% in men). Only 6% of men and 7% of women with depressive disorders use regularly psychotropic drugs, the occasional use is 27% and 73%. In one third of the cases use regularly psychotropic drug.

Anxiety Disorders↗
PubMedDate not supplied

[100 percutaneous endopyelotomies. Technique, indications, results].

100 percutaneous endopyelotomies were performed in 95 patients from October 1985 to February 1991 to treat 46 cases of acquired stenosis and 54 cases of congenital hydronephrosis. The acquired stenoses were treated by scalpel incision, while the congenital hydronephrosis were generally treated by electrocautery. The evaluable results for 81 ureteric units with a mean follow-up of 37 months showed an overall success rate of 84%. No significant difference in the results was observed in relation to the patient's age, the technique used or the stage of the hydronephrosis (81% success rate): the results in the treatment of congenital hydronephrosis (86%) are slightly inferior to the results of surgical pyeloplasty.

Adolescent↗
PubMedDate not supplied

[Value of clozapine in treatment of psychotic disorder in Parkinson disease].

Psychosis secondary to dopaminergic therapy can limit the ability to manage motor symptoms of advanced Parkinson's disease (PD). Scholz and Dichgans (1985) were the first to report the use of clozapine in drug-induced psychosis in PD. The rationale for use of clozapine in parkinsonian patients is supported by his original pharmacological profile with weak extra-pyramidal side effects. A Medline search was performed of literature from 1985 to 1994. The literature search was not limited to the English language. Numerous authors (23 articles) using case reports or open trials among more than 100 patients suggested that clozapine would be useful in treating drug-induced psychosis in PD. We analysed the available information addressing: 1) clinical efficacy, 2) clinical predictors of outcome, 3) delay of action, 4) influence of clozapine on extrapyramidal symptomatology, 5) adverse effects and treatment withdrawal causes, 6) long-term follow-up data. However, the partially negative result of the only double-blind placebo-controlled trials, it may be stated that in some clinical situation of psychosis in PD, the use of clozapine may represent an opportune alternative when other therapeutic strategies have failed.

Antiparkinson Agents↗