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Biomedical subjects

R Mester

Publications and source records attributed to R Mester.

At least 73 records · Page 4Linked to original sources
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↗
PubMed1992

Delayed amnesia and disorientation after electroconvulsive treatment.

Memory-related effects of electroconvulsive therapy (ECT) are known to appear immediately after the treatment. The case of a 39-year-old woman who underwent a course of ECT because of a recurrent major depressive disorder is described. After a symptom-free period of 48 hours, transient amnesia developed. Her condition appeared to be associated with the electroconvulsive therapy, thereby raising questions about its pathogenicity and management.

Adult↗
PubMed1991

Ideology and budgeting.

Israel has undergone rapid change and development during the last few decades, and extraordinary advances have been made in the field of psychiatry. At the same time, however, it is this progress that has outdated certain methods and styles of public service planning. Universal accessibility to good treatment is put at risk by the centralized planning that is more concerned with bed utilization and less so with community services, now the heart of the psychiatric system. While general health services are undergoing reorganization, progress has been slow in the restructuring of the psychiatric system.

Community Mental Health Services↗
PubMed1990

Increased serotonin 5-HT2 receptor binding on blood platelets of suicidal men.

In search of a physiological marker of depression and suicidal behavior, serotonin receptors of the 5-HT2 type were studied on platelet membranes from 19 control and 22 suicidal subjects. All were young, drug- and medication free men (18-21-years-old). 5-HT2 receptor binding was assayed using tritiated ketanserin at two concentrations. Receptor binding in the suicidal subjects was significantly higher than controls at both concentrations, the mean difference being around 50%. A similar difference between patients with major depressive disorder and matched controls has been observed previously. These findings support the use of 5-HT2 receptors on platelets as a research and diagnostic tool in depression and suicide.

Adolescent↗
PubMed1990

Prolonged fear of AIDS as an early symptom of schizophrenia.

A modern complaint--fear of AIDS--is making its way into the world of psychopathology and is becoming a symptom of a wide range of psychiatric disorders, including severe ones. We present a case of a young man who developed a pathological bizarre preoccupation of having AIDS and underwent various unnecessary medical procedures, until finally he was diagnosed as suffering from a paranoid schizophrenic disorder. With the high media profile that AIDS has achieved in recent years, it is expected that AIDS has become the object of psychopathological processes. However, the length of time elapsed between the onset of symptoms and the appropriate psychiatric diagnosis, despite being examined by other medical professionals, is surprising. The discussion focuses on the diagnostic questions and on issues related to primary and secondary psychiatric prevention.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Clarification on competence to stand trial.

The assessment of CST is a multidimensional set of operations, including the systematic gathering of data and the formulation of a prognostic opinion. It is a common procedure in forensic psychiatry and usually has a major influence on the future of the examinee. The art of examining competence is dependent on the careful consideration of the semantics of the concept, the ethical implications of the process and on the examiner's awareness of the interpersonal and intrapsychic aspects involved in formulating the assessment.

Criminal Law↗
PubMed1988

Countertransference envy toward the religious patient.

Four illustrations have been presented which demonstrate the uses and interpretations of envy in countertransference reactions to religious patients. To be sure, envy reactions to any patient are significant, whether they simply distort the therapist's perception or contribute to a deeper understanding of the patient. In the case of the religious patient, envy reactions in the therapist may serve as an additional instrumentality for under-standing the ways in which the dynamic determinants of religious behavior and metaphor become enmeshed in and also transform the pathology of the patient as well as the therapeutic process itself. Both the constructive and destructive object relational implications of envy must be borne in mind by the therapist in order to adequately explore the range of reciprocating forces between therapist and patient. Primitive mechanisms such as projective identification and psychotic transference are particularly prone to evoke envy reactions of surprising intensities, yet an empathic attitude will usually enable the therapist to differentiate the true source of his envy as he more carefully comprehends the quality of object relational and dynamic needs such envy serves.

Adolescent↗
PubMed1987

On the use of group therapy in non-combat military psychiatry.

The application of group therapy with hospitalized Israeli soldiers and with their parents reveals specific dynamic themes whose elaboration plays a significant role in the treatment of the crisis and in the subsequent extramural adaptation, including, on occasion, reintegration into the army.

Combined Modality Therapy↗