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Biomedical subjects

R Mester

Publications and source records attributed to R Mester.

84 records · Page 5Linked to original sources
PubMed1978

A programme for the establishment and functioning of a community mental health service in the area of Beit Shemesh and the Jerusalem Corridor, Israel.

The area of Beit Shemesh, situated in the Jerusalem Corridor has a socioeconomic structure of the pluralistic type characteristic of modern Israel. It includes a small but quickly growing industrial city, several cooperative (moshav) and communal (kibbutz) agricultural settlements, and has a population of colourful ethnic heterogenity. The main effort in the community mental health program which was established and developed in this area was made on the levels of primary and secondary psychiatric prevention. The psychiatric community work was accomplished with a highly flexible approach and an abundance of tactics and techniques, examples of which are presented in this article.

Acculturation↗
PubMedDate not supplied

Lifetime psychiatric comorbidity rate in Israeli non-help-seeking patients with combat-related post-traumatic stress disorder.

BACKGROUND: Most of the data on lifetime psychiatric comorbidity in combat-related posttraumatic stress disorder (CR-PTSD) were collected in help-seeking patients. METHODS: In the present study we used the Schedule for Affective Disorder and Schizophrenia-Lifetime Version to examine a relatively large sample (n=80) of Israeli non-help-seeking CR-PTSD patients. The diagnosis of PTSD was based on the DSM-III-R criteria. RESULTS: We found a low rate of lifetime psychiatric comorbidity, especially drug dependence (2.25%), alcoholism (2.25%) and major depressive disorders (5%). CONCLUSION: It seems that in contrast to help-seeking CR-PTSD, non-help-seeking CR-PTSD is associated with a low frequency of comorbid psychiatric disorders. LIMITATION: Only non-help seeking CR-PTSD patients who agreed to participate in the study were included in this investigation. CLINICAL RELEVANCE: The detection and diagnosis of CR-PTSD comorbidity is important for establishing appropriate psychotherapeutic and pharmacological treatment.

Adult↗
PubMedDate not supplied

The impact of clozapine treatment on serum lipids in chronic schizophrenic patients.

The aim of this retrospective study is to determine whether lipid levels rise in neuroleptic-resistant chronic schizophrenic patients during clozapine treatment and if this rise is correlated with a decrease in aggressive and suicidal behavior. Seventy neuroleptic-resistant schizophrenic patients treated with clozapine for at least 6 months were compared with 30 chronic schizophrenic patients treated with classic antipsychotic agents for the same length of time. Data on serum levels of cholesterol and triglycerides and on aggressive and suicidal behavior, as measured by the Overt Aggression Scale (OAS), were collected in both groups before treatment and 6 months later. A significant reduction in aggressive and suicidal behavior was noted in the clozapine-treated group but not in the classical antipsychotic-treated group. Clozapine treatment was associated with an elevation in serum triglyceride level, whereas classic antipsychotic treatment was associated with an increase in serum cholesterol level. We conclude that serum cholesterol level does not play a role in the clozapine-induced attenuation in aggressive and suicidal behavior in neuroleptic-resistant schizophrenic patients, though the accompanying elevation in triglycerides may be relevant to a behavioral effect.

Adolescent↗
PubMedDate not supplied

Combined electroconvulsive-clozapine therapy.

We reviewed 36 reported psychiatric patients who were treated with a combination of electroconvulsive therapy (ECT) and clozapine. The indication of the ECT-clozapine treatment was resistance to classical antipsychotic agents, clozapine, or ECT alone. Sixty-seven percent of the patients benefited from the combined treatment. In most of the patients, the combined treatment was safe and well tolerated. Adverse reactions occurred in 16.6% of the patients and included prolonged ECT-induced seizures (one case), supraventricular (one case) and sinus tachycardia, and blood pressure elevation. It seems that combined ECT-clozapine treatment is effective and safe. This strategy may be a therapeutic option in treatment-resistant patients.

Adult↗
PubMedDate not supplied

Oral health status and dental needs of an autistic population of children and young adults.

Behavior of patients with autistic syndrome makes delivery of oral hygiene and dental treatment a problem. In this study, the oral health and needs of two groups of patients with autism were evaluated: noninstitutionalized children with a mean age of 11 and institutionalized adults with a mean age of 22. The latter group had severe periodontal problems; almost half required periodontal surgery. Many of the children also needed periodontal treatment. Adults were found to have lower decayed, missing, and filled teeth (DMFT) scores than functionally independent Israeli persons of the same age. This finding was surprising because institutionalized adults are predisposed to development of dental caries; they frequently consume sweets, have poor oral hygiene, and do not use fluoride. Noninstitutionalized children with autism had caries rates that were similar to rates of functionally independent peers.

Adolescent↗
PubMedDate not supplied

Diminished suicidal and aggressive behavior, high plasma norepinephrine levels, and serum triglyceride levels in chronic neuroleptic-resistant schizophrenic patients maintained on clozapine.

Impulsiveness and aggressiveness may be the most common behavioral correlates of central serotonergic dysfunction. The aim of this study was to determine whether clozapine, an atypical antipsychotic agent with a potent serotonergic antagonistic activity, affects impulsiveness and aggression. Its effects on serum lipids, platelet-poor plasma serotonin (5-HT), and norepinephrine (NE) levels were also studied. Thirty neuroleptic-resistant chronic schizophrenic patients, maintained on clozapine for 1 year, were evaluated for aggressiveness, impulsiveness, and suicidality in comparison with 30 chronic schizophrenic patients maintained on classical antipsychotic agents for the same period of time. Clozapine treatment was associated with less impulsiveness (p < 0.05), aggressiveness (p < 0.01) and fewer suicidal attempts (p < 0.05). Serum triglycerides and plasma NE levels were significantly higher (p < 0.01 and p < 0.0001, respectively) in the patients treated with clozapine, as compared with patients treated with classical neuroleptic drugs. The authors conclude that long-term clozapine treatment may be effective in controlling aggressive, impulsive, and suicidal behavior in neuroleptic-resistant chronic schizophrenic patients. The elevated plasma NE levels in patients treated with clozapine as compared to those treated with classical neuroleptic drugs may be relevant for the anti-aggressive/antisuicidal activity of clozapine.

Adult↗