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Biomedical subjects

R Mester

Publications and source records attributed to R Mester.

At least 37 records · Page 2Linked to original sources
PubMed1996

Neuroleptic malignant syndrome associated with abrupt withdrawal of anticholinergic agents.

Neuroleptic malignant syndrome (NMS) is a severe side-effect of neuroleptic treatment. It is usually related to hypodopaminergic activity. A young schizophrenic patient who developed a typical episode of NMS during abrupt withdrawal of long-acting neuroleptic combined with anticholinergic treatment is described. NMS appeared following combined neuroleptic/ anticholinergic withdrawal and responded to procyclidine administration. The appearance of NMS after discontinuation of antidopaminergic treatment seems to be in conflict with the hypodopaminergic theory of this adverse effect. It is suggested that simultaneous withdrawal of both anticholinergic and neuroleptic medications, mainly long-acting neuroleptics, seems to be a risk factor for NMS.

Adult↗
PubMed1996

Further insights into transsexualism.

Transsexualism is a challenging entity posing diagnostical, etiological, ethical and moral questions with no general consensus of opinion and a controversial management policy. The present article tries to deal with these questions by drawing a parallel with another psychiatric syndrome in which there is also a disturbance in body image, namely anorexia nervosa. The parallel is at the level of clinical presentation, psychodynamic etiology and their common socioepidemic dimension.

Anorexia Nervosa↗
PubMed1996

The use of non-mental health professionals volunteers in a psychiatric hospital.

Volunteers' activities in psychiatric institutions is becoming a widespread phenomenon in Israel with different modalities and approaches implemented in a variety of settings. This paper presents and discusses the historical roots of volunteering, its potentialities and also some of the characteristics of existing programs.

Hospitals, Psychiatric↗
PubMed1995

Antinuclear autoantibodies in chronic schizophrenia.

We determined the presence of antinuclear autoantibodies (ANA), antinative DNA and histone-reactive ANA in 3 groups of chronic schizophrenic patients (n=85): haloperidol-treated patients (for at least 3 months) (n=35), drug-free for at least 3 months (n=35) and neuroleptic-naive patients (n=15). The autoantibody titers were compared with those of healthy controls (n=37). A significantly higher frequency of positive ANA was found among chronic schizophrenic patients (approximately 20%) as compared with the controls (approximately 5%), irrespective of drug treatment, sex and age. No antinative ANA autoantibodies or histone reactive ANA were detected in either schizophrenic patients or controls. Further studies are needed to isolate and characterize in ANA-positive schizophrenic patients a putative specific ANA profile.

Adult↗
PubMed1995

Problems in implementing the 1991 Treatment of Mental Patients Law in Israel.

The application of the new Treatment of Mental Patients Law, 1991, has been responsible for significant changes in the work of mental health workers, in particular those involved in the often complex process of civil commitment for examination/hospitalization. The experience of implementing this new law shows that some of the clauses related to this process contain controversial concepts. These concepts will be the focus of this paper.

Ambulatory Care↗
PubMed1994

Platelet serotonin transporter in drug-naive migrainous children and adolescents.

Platelet [3H]imipramine binding was measured in 17 children and adolescents suffering from common (n = 10) and classical (n = 7) migraine and 10 healthy control subjects. All patients had more than a 1-year history of the disease and suffered at least one attack per month. All subjects had been drug-free for at least 4 weeks prior to the study and had never been treated with drugs active at the serotonergic system. An increased density in [3H]imipramine binding sites was detected in the migraine patients (+51%; p < 0.05). The increase in maximal binding was more prominent in the classical migraine group (+63%) than in the common migraine group (+43%). These results disagree with previous studies that reported decreased platelet imipramine binding in adult migraine patients. The discrepancy may be related to chronicity of drug treatment, long-term duration of disease and comorbidity of depression and anxiety disorders in adult migrainous patients.

Adolescent↗
PubMed1994

Clozapine treatment in very early onset schizophrenia.

Very early onset schizophrenic patients only partially benefit from conventional antipsychotic treatment and are at increased risk for developing tardive dyskinesia (TD). Clozapine, which lacks extrapyramidal side effects including TD, has been proved effective for adult schizophrenic patients who are resistant to other neuroleptics. Clozapine, therefore, may offer an alternative treatment for these patients. The authors report four successful trials of clozapine in children aged 10 to 12 years old with schizophrenia, the youngest group reported on to date, who were unresponsive to conventional neuroleptic treatment.

Adolescent↗
PubMed1994

The delusion based will: the question of validity.

The psychiatric evaluation of the testamentary capacities of a delusional person may be hindered by (a) the cognitive, emotional and situational factors affecting the evaluator during the execution of her or his task, and (b) the sometimes very difficult challenge of proving testament invalidity due to the presence of delusions. As an illustration, this article presents a specific case which was recently brought to court in Israel.

Delusions↗
PubMed1994

Verapamil is not an antidepressant in patients resistant to tricyclic antidepressants.

The effects of a calcium channel blocker (verapamil, 160-320 mg/day for 4 weeks) were studied in seven unipolar major-depressed patients resistant to treatment with tricyclic antidepressants. This regimen of verapamil did not alter either the Hamilton rating scales for depression and anxiety or the Beck depression inventory score in these patients. Thus, verapamil appears devoid of antidepressant properties in patients resistant to tricyclic antidepressants.

Adult↗
PubMed1993

Survey of smoking habits and attitudes of patients and staff in psychiatric hospitals.

One hundred and six staff members and 150 patients of three psychiatric hospitals in Israel were administered a smoking habit and attitudes questionnaire. Upon analyzing the data, staff members and patients made up a very high percentage of smokers, 48.1 and 76%, respectively. The staff was not knowledgeable enough about the hazards of smoking. Nurses generously used cigarettes in order to appease the patients. Furthermore, the patients admitted being encouraged to smoke by the staff. According to these findings, a patient hospitalized in the psychiatric hospitals surveyed is significantly exposed to the pro-smoking atmosphere and the hazards of smoking.

Adult↗
PubMed1993

The psychiatric patient as consumer.

The rocketing cost of good standard modern medicine and the constant strengthening of the consumers' voice are powerful factors behind the world-wide reorganization of medical services with the aim of improving cost-efficiency, quality and accessibility. The assumption of this article is that financial waste, redundancy and obsolence of medical systems are related to the non-participation of patients in the evaluation of the services they consume. These problems are demonstrated and analysed using examples from psychiatry, where the patients and their families constitute a relatively silent consumer group.

Cost-Benefit Analysis↗
PubMed1993

The velvet reform of the British medical services: implications for Israeli psychiatry.

Since 1990, the United Kingdom has been reforming its public medical services aiming at decentralization and more competition among the providers of services. To achieve these aims two major administrative changes are being introduced: a) increased direct cooperation between providers and consumers; b) the creation of self-government trusts (similar to the Israeli "taagidim"). Israel is also modifying the structure of its medical services in ways which have some basic similarities to the U.K.'s changes. However, the British process of change is smoother and steadier. The possible effects of the general changes on the psychiatric services in the U.K. and in this country are complex and are already raising controversies. This paper compares the processes in both countries.

Delivery of Health Care↗
PubMed1992

Decreased platelet imipramine binding in Tourette syndrome children with obsessive-compulsive disorder.

[3H]Imipramine binding to blood platelets was assessed in eight untreated Tourette syndrome (TS) children, nine drug-free TS children with obsessive-compulsive disorder (OCD), and nine age-matched and gender-matched control subjects. The density of [3H]imipramine binding sites in TS + OCD patients was significantly lower compared with TS-OCD patients (28%) as well as when compared with controls (31%). This alteration was not accompanied by differences in the affinity of the binding site to the ligand. The decreased density of the platelet serotonin "transporter" might implicate the involvement of the serotonergic system in the pathophysiology of OCD in TS patients, but not in TS per se.

Adolescent↗