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Biomedical subjects

M Sigal

Publications and source records attributed to M Sigal.

At least 55 records · Page 3Linked to original sources
PubMed1992

Advances in the treatment of acquired and developmental defects of hard dental tissues.

With the decline in dental caries, the dental profession and the general public have become sensitized to the "new" specialty of cosmetic dentistry. As a consequence, research in the field of dental materials for the ideal, most natural restorative materials and techniques has become a primary focus and has had a profound influence on dental education and practice. This brief article will highlight some of these newer concepts.

Composite Resins↗
PubMed1992

Short term versus long term psychotherapy in opioid dependence: a pilot study.

A multicenter prospective open study was performed in order to compare the effectiveness of 2 modalities of individual dynamic psychotherapy in a group of recently detoxified opioid dependent patients. Thirty four patients were assigned to receive either short-term dynamic psychotherapy (ST) or long-term dynamic psychotherapy (LT); both modalities were offered along with drug counselling. At the end of the treatment, the short term therapy group was followed up for 2 years, while the long term therapy group continued the follow up for one year, due to the different time span of the treatment approaches. Dropout rates for ST (47%) and LT (53%) patients were similar, and the re-entry rate for the ST group was superior (62.5% vs. 28.5%). Short term interventions appear to be at least as effective as long term interventions, and have the advantage of a high rate of program re-entry. Further studies conducted on larger samples are needed.

Adult↗
PubMed1992

A naltrexone double blind placebo controlled study in Israel.

In a double blind study, out of 31 newly abstinent patients who underwent opioid free detoxification, 15 were started on the opiate antagonist Naltrexone for 2 months, and 16 were put on placebo for the same period. Given Naltrexone's known efficacy in blocking euphorigenic effects of opioid intake, and in decreasing cravings for the drug, the authors have tried to assess eventual drug taking, specifically in the context of suburban housing projects, and evaluate the rate of retention in a rehabilitative program for both the Naltrexone and placebo groups. An Opioid free condition was followed up for a year, also respecting double blind conditions. Naltrexone did not appear to be superior to the placebo with regards to retention rate. In the Naltrexone group (n = 15), 9 finished the two-month treatment, and 8 remained opioid-free for a year. In the placebo group (n = 16), 8 finished the 2 month trial and 6 remained opioid-free for a year. Naltrexone blocked opioid-induced euphoria and decreased the craving for opium, but it did not inhibit drug usage. The retention rate registered during the course of the study, as well as an opioid-free condition in the follow-up year, correlated with a patient profile defined by good social functioning and stable relationships. The inherent methodological limitations of this study did not allow for the discrimination of the role of non-pharmacological factors, such as psychotherapy, supportive family framework, community assistance, and staff motivation, concerning the clinical results. Further investigation of Naltrexone in larger samples is needed.

Adult↗
PubMed1991

[Treatment of mental disturbances by the family physician].

A group of 64 patients with symptoms of mental disturbance was treated by 5 family physicians according to the recommendations of a psychiatric consultant and under his guidance. The group was compared with a control group of 22 patients treated by a psychiatrist or psychologist. Both groups improved significantly as determined at follow-up 3 months after psychiatric intake and 5-6 months later. The study emphasizes the importance of liaison between the psychiatrist and the family physician, and of supervision by the psychiatric consultant in the implementation of the recommended treatment.

Follow-Up Studies↗
PubMed1991

[Munchausen syndrome: need for centralized administrative health-care management].

The clinical picture of Munchausen syndrome is that of feigned or self-induced illness with the aim of being hospitalized and/or receiving unnecessary medical interventions, peregrination from 1 hospital to another, and disruptive behavior when hospitalized. These patients are a danger to themselves and heavily burden inpatient facilities that care for them. We present a case that illustrates the problems of diagnosing and managing such patients. We stress the need for adequate centralization and distribution of the relevant information concerning these patients.

Adult↗
PubMed1991

[Commitment of drug abusers in Israel: medical or social responsibility?].

In 1977 a new paragraph was added to Israel's penal law allowing rehabilitation of convicted drug abusers by compulsory psychiatric treatment. The commitment was implemented on the basis of a court order. Notwithstanding the doubts of psychiatrists the law permitted the commitment of a significant number of drug abusers to psychiatric wards. The rehabilitation treatment through commitment and some of its negative consequences are described in a study that covers 10 years of activity at the Pardessia Menta Health Center. We present 3 typical profiles of drug abusers who were treated in our center as specified by the law. None needed medical help in physical withdrawal from the drug. All took advantage of the opportunity to spend part of their incarceration time in the hospital instead of in jail. The law was amended in July 1989 and since February 1990 treatment is conducted under the supervision of probation officers and not in a medical institution. The amended law reflects the approach to drug abuse as a social not psychopathological problem, so that social agencies and no medical instances are in charge.

Attitude to Health↗
PubMed1991

Munchausen syndrome by adult proxy revisited.

A new variant of Munchausen Syndrome by Proxy (MSbP) case is presented here: Munchausen by Adult Proxy (MSbAP). The article discusses the case of a man (publicly known as the "Gasoline Injector") who is serving a 46-year jail term for attempted murder and manslaughter. His behavior is reminiscent of MSbP but his victims were two female adults, and his cell mate (on whom he repeated his actions). A description is given in terms of egosyntonic irresistible pathological impulses involving sexual objects. A common ground is proposed for paraphilias, Munchausen syndrome, MSbP and MSbAP.

Adult↗
PubMed1990

Skin conductance responding in schizophrenic patients with abnormal involuntary movements.

The present study tested the hypothesis that neuroleptic treatment modifies the skin conductance response (SCR) to loud tones. Schizophrenic patients with and without drug-induced abnormal involuntary movements were tested before and after drug withdrawal. During the on-drugs session, habituation of SCR correlated with the daily neuroleptic dose, and patients with tardive dyskinesia (TD) showed the fastest habituation of SCR. These findings were interpreted as indicating that SCR is attenuated by neuroleptics present during the examination and that TD patients demonstrate a preferential susceptibility to this effect. Withdrawal of medication resulted in slowing of SCR habituation only in TD patients, following which the entire sample showed a similar rate of habituation. These findings suggest that accelerated SCR habituation is not a stable trait of TD patients.

Adult↗
PubMed1990

Porphyria cutanea tarda and scleroderma--chance association or related disease: a case report.

The concurrence of systemic scleroderma and porphyria cutanea tarda (PCT) seems very rare. Only six cases have been reported to our knowledge. On the other hand, cutaneous sclerodermatous lesions in PCT occur more frequently and can affect 1.8-18% of cases. These observations raise the problem of a possible physiopathological relation between scleroderma and PCT. In fact, Grossman and colleagues have found anti-nuclear antibodies (ANA) in 38% of patients so tested. In the present report, the association of systemic scleroderma and PCT with Sjögren's syndrome and anti-RNP antibodies raises further questions concerning the relationship between PCT and auto-immune diseases.

Aged↗
PubMed1990

Combat-related, chronic posttraumatic stress disorder: implications for group-therapy intervention.

The patient with combat-related chronic Posttraumatic Stress Disorder suffers from a wide spectrum of maladaptive behaviors. This paper delineates the work that has been done with such a population in group therapy. The plan that is proposed takes into account three interrelated sets of factors: factors important for creating an effective working relation; curative factors; and particular themes. Each of these factors is analyzed in the light of the particularities of group work with such a population. Each of the points discussed is based upon the relevant literature, upon the experience of the therapist, and illustrated with examples.

Adaptation, Psychological↗
PubMed1990

The therapeutical implication of a strike in a psychiatric ward.

This paper compares patient functioning during a maintenance workers' strike. Four criteria were used to assess change: 1) patients' functioning as evaluated by five independent judges on a questionnaire; 2) number of days out of the hospital; 3) number of days of closed intensive therapeutic ward hospitalization and 4) number of patients that underwent a major improvement during that period. A positive therapeutical effect in patients as a result of the strike has been found. This effect is thought to be due to the staff's higher expectations towards the patients, and not due to a need of the patients to restore a sense of balance in the threatened family-like system of the ward--as was believed in a previous study (1). The role of the staff in helping the patient to constructively cope with the strike is discussed.

Activities of Daily Living↗
PubMed1990

Medical and legal aspects of the Munchausen by proxy perpetrator.

The Munchausen by Proxy syndrome is described, and illuminated by case histories. A plea is put forward for the adoption into Israeli law of the doctrine of diminished responsibility, as perpetrators of crimes who suffer from the MbP syndrome are treated by the law as if they had no psychiatric disability.

Adult↗
PubMed1990

[Neonatal aspects of 29 triplet pregnancies].

Ovulation induction and in vitro fecundation have increased the incidence of multiple pregnancies. We report the neonatal aspects of 29 triplet pregnancies. The presence of neonatologists at every delivery and during all the transfers to the neonatal unit probably accounts for the low morbidity and the absence of an early and late neonatal mortality of our study.

Female↗
PubMed1989

Primary fibromyalgia syndrome--a variant of depressive disorder?

Primary fibromyalgia syndrome (PFS) is a form of connective tissue rheumatism, characterized by diffuse chronic pain in periarticular tissue, for which no organic cause can be identified. The present study examined the personal and family history, clinical and psychodynamic features of 40 PFS patients, and compared them to a matched control group of patients suffering from rheumatoid arthritis. Depression, either in the past or at present, was seen significantly more often among PFS patients that among controls. Dependence and passivity, idealization of family relationships, obsessive-compulsive personality, maladaptive response to loss, and prepain ergomania were the psychodynamic features characteristic of PFS patients. It is suggested that PFS is a well-defined disorder, in which specific premorbid, familial, and psychodynamic characteristics result in a depressive disorder which takes the form of a physical symptom: pain.

Adult↗
PubMed1987

Lateralized neuroleptic-induced side effects are associated with asymmetric visual evoked potentials.

Recent studies suggest that neuroleptic drugs may have an asymmetric effect on the two cerebral hemispheres. This effect is reflected by emergence of drug-induced lateralized extrapyramidal side effects and by dose-related alterations in electrophysiological asymmetries. The present study examined the hypothesis that asymmetry of visual evoked potentials (VEPs) is associated with lateralized appearance of neuroleptic-induced parkinsonism or tardive dyskinesia (TD). The asymmetry of the amplitudes of later VEP components was significantly higher in patients with lateralized side effects (n = 8) than in patients with symmetrical side effects (n = 6) or free of extrapyramidal side effects (n = 11). The possibility that VEP asymmetry reflects the differential degree to which the two hemispheres are affected by medication is discussed.

Adult↗