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Biomedical subjects

R Gil

Publications and source records attributed to R Gil.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Psycho-social aspects of children and adolescents with diabetes.

The diagnosis of diabetes mellitus, a life-long disease with many possible complications, has a dramatic impact upon the entire family, precipitating a state of "shock". The psychological problems in diabetes should be divided in 3 periods: at diagnosis (other diseases or tension existing in the family and not related to diabetes, socio-economic state); initial adaptation period (acceptance to be "different", adjustment to rules of control such as daily injection of insulin, self blood glucose monitoring or urine testing, changing of nutritional habits, etc.), and long term coping (self-image, family dynamics, social activities, school achievements, vocational rehabilitation and continuing compliance. Counselling of the psychological problems is an ongoing need and is best delivered when the treating team included psychologists and social workers.

Adolescent↗
PubMedDate not supplied

Event-related auditory evoked potentials and multiple sclerosis.

Long latency event-related auditory evoked potentials, particularly the P300 wave, constitute an objective electrophysiological index of cognitive function. For this reason, these potentials have been studied in a series of 101 patients with multiple sclerosis (MS), classified according to McAlpine's criteria into definite, probable and possible cases. The patients were also classified as depressed or non-depressed according to the DSM-III and Research Diagnostic Criteria. They were also subjected to a battery of psychometric tests. In the patient population the N200 and P300 latencies were increased, as were the P200 latencies, when compared with a control population. This electrophysiological pattern had previously been observed in other conditions characterised by subcortical lesions. Partial correlations (at constant disease duration) between the disability score and the cognitive deficit were found to be significant. Patients with an increased P300 latency had a greater disability and the P300 latency was significantly correlated with the duration of the illness. The N200 and P300 latencies were increased in depressed MS subjects, but this increase did not reach the level of significance. Depression was more frequent in the more severely handicapped patients. This suggests that the origin of the depression seen in multiple sclerosis is only partly organic, and that it is one of the factors contributing to the subcortical cognitive deficit in multiple sclerosis. Progressive forms of the disease exhibited the most profound cognitive deficit, and the most marked increase in P300 latency.

Acoustic Stimulation↗
PubMedDate not supplied

[Late recurrence of Miller-Fischer syndrome. Physiopathogenic reflections about a case].

The physiopathology of the syndrome of ophtalmoplegia-ataxia-areflexia-hyperproteinorachia, firstly described by FISHER in 1956, remains a matter of controversy among neurologists. We report a new case of recurrence of a MILLER-FISHER's syndrome. The involvement of peripheral and central structures is discussed according to recent knowledges about the immunopathology of inflammatory polyneuropathies.

Cerebellar Ataxia↗
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[Neurological manifestations of Rendu-Osler-Weber disease. Apropos of 4 cases].

Rendu-Osler-Weber disease is a generalized vascular dysplasia which also involves the central nervous system. The neurological manifestations of the disease are due either to primary intracranial or spinal vascular lesions or to neurological complications of other visceral lesions, notably those of the lung (arteriovenous fistulae). The prevention of ischaemic or infectious cerebral accidents rests on the anatomical (excision) or functional (selective embolization) exclusion of pulmonary arteriovenous fistulae, when present.

Adult↗
PubMedDate not supplied

Functional recovery and social outcome after cerebral infarction in young adults.

This study was designed to assess the return to work, the poststroke depression and the quality of life after a cerebral infarction in young adults and was conducted on 71 consecutive young patients (aged 15-45 years) affected by a cerebral infarct who were hospitalized for the first time and discharged at least 1 year before the study. Data about risk factors, etiology, side and territory of stroke, social characteristics of the patient (age, sex, profession, educational level, family situation), poststroke seizures, recurrent stroke, other vascular events, and deaths were collected. Neurological deficits were graded with the National Institutes of Health (NIH) Stroke Scale. Poststroke depression (PSD) was quantified using the DSM-IIIR criteria and the Montgomery Asberg Depression Rating Scale. Outcomes were rated with the Ranking Scale, the Barthel Index and the Glasgow Outcome Scale. Quality of life was assessed with the Sickness Impact Profile. Follow-up information was obtained by interview and neurological examination. Follow-up information was obtained in 65 patients at a mean of 31.7 +/- 13.0 (range 12-59) months, as 2 patients died and 4 were lost to follow-up and were thus excluded from this study. Poststroke seizures occurred in 7 patients (10.8%) and recurrent strokes in 4 patients (6.2%), but none were fatal. The outcome after stroke among survivors was usually good, since more than two-thirds of the patients (69.8%) reported no problem, 11.1% moderate handicap and one-fifth major handicap. Forty-six patients (73%) returned to work: the time period ranging from several days after stroke to 40 months, with a mean of 8 months. However, adjustments in their occupation were necessary for 12 patients (26.1%). PSD was common, since 48.31% of the patients were classified as depressed. PSD was associated with the localization of the infarct (carotid territory), a severe disability, a bad general outcome, and an absence of return to work. Their opinion about their quality of life was negative among approximately 30% of the patients, especially in emotional and alertness behaviors. social interaction, recreation and pastimes. The general outcome after cerebral infarct in young adults is usually good. However, the risk of a PSD is high, and only half of the patients had returned to their previous work. A remaining psychosocial handicap and depression of sexual activity impaired the quality of life. In multivariate analysis, a low NIH score at admission is a significant predictor for return to work, the absence of PSD, and a good quality of life.

Adolescent↗
PubMedDate not supplied

A multidisciplinary, comprehensive, ambulatory treatment scheme for diabetes mellitus in children.

A study has been carried out on 262 children with juvenile diabetes and their parents, treated up to 10 yr on an ambulatory basis by a multidisciplinary team composed of pediatric endocrinologist, nurse, dietitian, psychologist, and social worker. Comparison of the findings with those of a study performed before inception of the Counselling Center for Juvenile Diabetics revealed the following positive influences: the degree of control attained was both higher and sustained with greater regularity; there were fewer complications with no episodes of coma, brittle diabetes, or severe ketoacidosis and almost no need for hospitalization; the attitude of the affected child, his parents, and his teachers was found to be considerably improved; there was better understanding of the nature of the disease and its requirements; the child's motivation to maintain the diabetic regimen was greater and conflicts within the family circle were markedly reduced; the child's self-concept was much higher; and both scholastic achievements and social adjustment were greater. We concluded that psychological stability is a basic factor in the control of diabetes, and the value of the multidisciplinary approach in the treatment of this chronic disease is indicated.

Ambulatory Care↗
PubMedDate not supplied

Crisis intervention program in newly diagnosed diabetic children.

A group of 223 insulin-dependent diabetic patients, aged 7-24 yr, who had been under the regular care of our clinic up to 15 yr, were rated by two independent judges on a two-level scale of adjustment and maladjustment. The patients were divided into two groups. Group A (N = 107) comprised those who had been under care from diagnosis of the disease and had been subjected to the special crisis intervention program offered to every family upon referral of a newly diagnosed patient. Group B (N = 116) comprised patients who were diagnosed and treated initially in a clinic that had no crisis intervention program. Significant differences between the two groups were found in respect to three of the four aspects studied, i.e., compliance, familial relationships, and sociability, with group A showing a better adjustment than group B. There was no significant difference in the fourth aspect studied, i.e., school achievement and work performance. It was found that it took three times the effort, i.e., the time invested in counseling and psychotherapeutic measures, to bring group B to a good level of adjustment than it did to achieve similar results with group A. It is suggested that the initial period after diagnosis of diabetes in a child should be considered a period of crisis, requiring special multidisciplinary services to reduce future psychosocial maladjustments and improve compliance.

Adolescent↗
PubMedDate not supplied

[Clinical and prognostic heterogeneity in Aicardi's syndrome: a description of two cases].

INTRODUCTION: Aicardi's syndrome is characterized by infantile spasms, agenesis of the corpus callosum and ocular lesions. Clinically it presents as severe mental retardation, severe limitation of motor development and of language, with a prognosis of survival for only a few months or years. We present two new cases of this uncommon syndrome and describe the heterogeneity of its clinical and prognostic severity. CLINICAL CASES: Case 1. A ten-month old patient had flexion spasms of the limbs at the age of 4 months, bilateral corioretinal lesions and generalized hypoplasia of the corpus callosum. During the clinical course of the disorder, the epileptic crises were controlled, there was mental retardation, the head was held steady and the baby could sit. Case 2. A nine year old patient had had flexion spasms when aged 2 months, had bilateral retinal lesions and generalized hypoplasia of the corpus callosum. During his clinical course the epileptic crises were controlled, there was severe mental retardation, the patient could pay attention and collaborate, articulate single words, walk on his own and manipulate objects. CONCLUSION: Aicardi's syndrome should be considered to be a syndrome in which the clinical findings and prognosis are heterogeneous, as seen from new cases with less clinical and functional limitation than the patients first described.

Agenesis of Corpus Callosum↗
PubMedDate not supplied

[Procedural learning and neurological disorders].

INTRODUCTION AND DEVELOPMENT: We review the current state of learning procedures in six neurological conditions: amnesia, Alzheimer-type dementia, Huntington's disease, Parkinson's disease, progressive supranuclear paralysis and cerebellar pathology. In each condition the conservation or deterioration of different types of ability is specified: motor and percepto-motor abilities were evaluated using different tests such as following a rotating disk or signal, the labyrinth test, percepto-motor adaptation test or tests using paradigms of time of serial reaction; percepto-cognitive abilities evaluated by 'mirror-reading' and cognitive abilities evaluated by the Tower of Hanoi, of Toronto, or of London. CONCLUSION: Most of the papers published describe conservation of learning procedures in amnesic syndromes, relatively conserved in Alzheimer's disease and relatively deteriorated in Huntington's disease, in progressive supranuclear paralysis and in cerebellar dysfunction.

Brain Diseases↗
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[Programmed atrial and ventricular stimulation in patients with mitral valve prolapse--a personal experience].

Electrophysiological tests were performed in 60 patients aged between 18 and 63 years (mean age 38 years), and divided into two groups: with mitral valve leaves prolapse syndrome, and without this abnormality, in whom no other heart disease was diagnosed. Refraction of the right atrium, atrio-ventricular node, and right ventricle was evaluated together with cardiac response to different types of electrostimulation. A supraventricular dysrhythmia (most frequently atrial fibrillation) has been produced in 17 patients (42.5%) with mitral valve leaves prolapse syndrome whereas in the control group the same was produced in 2 patients (10%). Programmed stimulation of the ventricles did not produce ventricular tachycardia in none patient of both groups. Multiple ventricular beats have been produced in 3 patients with mitral valve prolapse syndrome and pairs of ventricular beats in other 3 patients of this group. Results suggest that "arrhythmogenic tendency", especially supraventricular dysrhythmia is more frequent in patients with mitral valve prolapse syndrome than in the general population.

Adolescent↗
PubMedDate not supplied

[Arrhythmia in patients with mitral valve prolapse].

An incidence of cardiac arrhythmias was evaluated in 119 patients with mitral valve prolapse. The disease was made basing on the results of clinical symptoms, echo-, angio- and phonocardiography. Electrocardiograms were recorded from the standard 12 lead and Holter technique for 24 hours in each patient to assess present arrhythmias. It was found that the most frequent cardiac arrhythmias accompanying mitral valve prolapse are ventricular extrasystolic contractions of Lown's class 1a and 1b. Only examination of strictly selected groups of patients (age groups with or without co-existing mitral valve insufficiency for adequate period of time) will facilitate precise evaluation of an incidence of different cardiac arrhythmias accompanying the underlying disease.

Adolescent↗
PubMedDate not supplied

[The blink reflex and stimulus detection by the facial nerve in 50 cases of Guillain-Barré polyradiculitis].

The blink reflex combined with stimulo-detection of the facial nerve was studied in 50 patients presenting Guillain-Barré polyradiculoneuritis. The reflex was normal in more than half the cases. The most frequent electrological picture consisted in bilateral lengthening of the early and late reflex responses of the blink reflex with unilateral or bilateral increase of motor facial latency. The blink reflex showed various abnormalities in slightly more than one third of the cases of polyradiculoneuritis presenting no clinical signs of facial involvement, thus constituting subclinical lesional evidence of the reflex arc.

Adolescent↗