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Biomedical subjects

M Timsit

Publications and source records attributed to M Timsit.

At least 19 recordsLinked to original sources
PubMed2003

Long-term results of bladder neck reconstruction for incontinence in children with classical bladder exstrophy or incontinent epispadias.

OBJECTIVE: To review the long-term results of bladder neck reconstruction (BNR) in patients with classical bladder exstrophy or epispadias, and to review the concept of continence surgery in these two groups, stressing the difficulty in finding an adequate balance between urine storage (which implies high outlet resistance and low storage pressure) and complete bladder emptying (which implies low outlet resistance and a transient increase in bladder pressure); surgery cannot achieve 'continence' (which implies active mechanisms) but only 'dryness' (which implies passive mechanisms). PATIENTS AND METHODS: Eighty patients with classical bladder exstrophy (52 male, 28 female) and 25 with incontinent epispadias (17 male, 18 female) had their bladder neck reconstructed after a Young-Dees-Leadbetter procedure, subsequently modified by Mollard. The treatment is detailed and results reviewed after a mean follow-up of 11 years. All patients were treated and followed in the same institution. RESULTS: In the exstrophy group, 36 (45%) patients presented with a dry interval of > 3 h, with urethral emptying after one BNR; 52 (65%) presented with recurrent urinary tract infections, 19 (24%) with urinary stones, 21 (26%) with dilated upper urinary tracts, 13 (16%) with bladder perforations and one with an adenocarcinoma of the bladder. Thirty-eight patients (48%) required further surgery; 51% of all patients required an endoscopic procedure within 3 months after the BNR and 26% had endoscopic procedures for late (> 3 months) urine retention. In the epispadias group, 13 (52%) patients presented with a dry interval of > 3 h with urethral emptying after one BNR; 12 (48%) had recurrent urinary tract infections, five (20%) upper tract dilatation, two (8%) bladder stones, one (4%) bladder perforation and one an adenocarcinoma of the bowels after a ureterosigmoidostomy. Ten (40%) children required further surgery. CONCLUSION: We compared the present results for continence with those in other published series; most complications encountered were related to the obstructive pattern of bladder emptying and the abnormal bladder urodynamic behaviour caused by BNR. We consider that BNR is unpredictable and the roles of the other factors in urinary continence are discussed. Alternative procedures are detailed. The concept of continence surgery in exstrophy and incontinent epispadias is reviewed, stressing the importance of favouring bladder development and limiting obstructive patterns of bladder emptying that cause severe and recurrent complications.

Bladder Exstrophy↗
PubMed2000

Asymmetry of gait initiation in patients with unilateral knee arthritis.

OBJECTIVE: To identify how patients with knee arthritis modify their equilibrium and movement control strategies during gait initiation. DESIGN: Observational study. SETTING: University hospital movement analysis laboratory. PARTICIPANTS: Twelve patients with unilateral knee arthritis and 12 healthy control subjects. MAIN OUTCOME MEASURES: Durations of the phases of gait initiation (ie, postural, monopodal, and double-support phases), center-of-pressure displacements, ground reaction forces, pelvic velocity, step length, and knee range of motion were measured using a movement analysis system and force plates. RESULTS: Gait initiation was slower in patients than in controls no matter which leg was the supporting one. In patients, the durations of the postural and the monopodal phases were modified in an asymmetrical way according to the leg used as the supporting one. The postural phase was lengthened and the monopodal phase was shortened when the affected leg was the supporting one. Opposite effects were observed when the sound leg was supporting. Step length, knee range of motion, and maximal pelvic velocity were reduced in patients whatever the side of the supporting leg. CONCLUSION: Gait initiation is an asymmetrical process in unilateral knee arthritis patients, who develop adaptive posturomotor strategies that shorten the monopodal phase on the affected leg.

Aged↗
PubMed1987

[Value of the study of contingent negative variation in migraine and tension headache].

The aim of this study was to display the result obtained by the contingent negative variation (CNV) recording in patients suffering from headache. Eighty-five patients were taken into account: 59 with migraines (M) and 26 with tension headache (TH). A typical CNV pattern (high CNV amplitude with no habituation) differentiated M from TH. Moreover, psychological data were collected through Rorschach ink blot test among 42 headache sufferers (31 M and 11 TH). The typical Rorschach repressive pattern of alexithymia was found as well in M as in TH while CNV amplitude was significantly higher in the 31 M (-25 microV) than in the 11 TH (-19 microV FP less than 0.04). Biochemical data collected among 28 patients (17 M and 11 TH) revealed a positive correlation between CNV amplitude and plasma level of noradrenaline, regardless of the type of headache (r = 0.58; P less than 0.01). Thus, besides psychological factors, catecholaminergic mechanisms seem implicated in the determination of the CNV pattern in migraine. CNV may help the clinician both to specify diagnosis and to decide between the many therapeutic strategies available.

Adult↗
PubMed1986

Contingent negative variation in headache.

Contingent negative variation (CNV), an event-related slow cerebral potential, was analyzed in 79 consecutive headache patients. Compared to normal controls (n = 33), CNV did not differ in tension headache (n = 21) or in combined headaches with a predominant tension component (n = 13). The mean amplitude of CNV was significantly (p less than 0.001) increased in migraine (n = 29) as well as in combined headache with predominant migraine (n = 16). All migraineurs were studied between attacks and without prophylactic treatment. CNV may be a useful diagnostic test in headache. Its increased amplitude in migraine might reflect central catecholaminergic hyperactivity.

Adult↗
PubMed1986

Contingent negative variation and efficacy of beta-blocking agents in migraine.

Thirty-three patients with common migraine underwent contingent negative variation (CNV) recordings before receiving prophylactic beta-blocker treatment with either metoprolol (27 patients) or propranolol (6 patients) at mean daily dosages of 110 mg and 122 mg, respectively. After 3 months the therapeutic efficacy of the beta-blocker was assessed in each patient by means of a global severity score and compared with the initial CNV recordings. The mean clinical improvement was 62%. A significant positive correlation was found between CNV amplitude before prophylaxis and the clinical response to beta-blockers: patients with higher CNV tended to respond better to therapy. Eight of 10 patients with a CNV amplitude higher than -25 microV had a more than 50% reduction of the severity score--that is, a good or excellent response to the beta-blocking agent--whereas only 2 of 9 patients with an amplitude lower than -20 microV had a good response.

Adrenergic beta-Antagonists↗
PubMed1976

[Statistical approach to psychosomatic headaches].

Three groups of patients were compared statistically: 79 with the diagnosis psychosomatic headache' (in the strict sense of the term), 450 others whose headache was part of another disorder (termed symptomatic headache'), and 850 patients free from headache symptoms. The following characteristics were found for the group with psychosomatic headache: More psychosomatic diseases in the family, usually the eldest in birth rank, usually living in towns, married, two children, intellectual level above average, overweight, ego-strength with compulsive features, tendency towards oral abuse of different kinds, few other psychosomatic complaints (contrary to the group with symptomatic headache). In the discussion the Authors try to demonstrate the defensive function of this selective somatisation.

Belgium↗
PubMed1975

[Statistical study in psychosomatic headache (author's transl)].

Three groups of patients were compared statistically: 79 with the diagnosis "psychosomatic headache" (in the strict sense of the term), 450 others whose headache was part of another disorder (termed "symptomatic headache"), and 850 patients free from headache symptoms. The following characteristics were found for the group with psychosomatic headache: More psychosomatic diseases in the family, usually the eldest in birth rank, usually living in towns, married, two children, intellectual level about average, overweight, ego-strength with compulsive features, tendency towards oral abuse of different kinds, few other psychosomatic complaints (contrary to the group with symptomatic headache). In the discussion the authors try to demonstrate the defensive function of this selective somatisation.

Age Factors↗
PubMed1975

[Use of computers in clinical psychiatry. Statistical study of a population of treated alcoholics].

According to their own standardized Patient Data Inventory, the authors proceed to a statistical comparative evaluation of 55 males neurotic or psychosomatic hospitalized alcholics and of two control groups of non-alcoholic neurotic or psychosomatic male patients: 252 ambulatory and 72 hospitalized. The authors find significant differences between alcoholics and non-alcoholics, especially: 1 no.) heavier family history (psychoses, dysgenetic disorders), greater incidence of psychosomatic disorders in the previous history, more distrubed parental relations in childhood (maternal overprotection and lack of paternal authority); 2 no.) from the patient viewpoint: a louder expression of somatic and functionnal complaints; 3 no.) from the therapist viewpoint, less emotionality, weaker expression of aggressiveness (either overt or latent).

Aggression↗