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Biomedical subjects

R Poirrier

Publications and source records attributed to R Poirrier.

22 records · Page 2Linked to original sources
PubMedDate not supplied

[The general practitioner and insomnia].

A complaint of insomnia has to be analysed, and differentiated from hypochondria and, overall, from hypersomnia. Once confirmed and assessed as acute or chronic, it is often considered a disorder of hyperarousal, that is an imbalance between a central nervous system activating and a central nervous system inhibiting system with subcontinuous overflow from the former. An acute insomnia is less than one month of duration. As a disease, insomnia has to be categorized as a secondary or a primary disorder. Thereafter, it remains to assess the extent of social, psychological and economical interactions. These factors intervene as consequences or perpetuating factors. The capacity to assess the whole situation is really the great strength of the general practitioner who, more than anybody else, is on home ground. Laboratory findings and specialist examination come only as supporting evidence for causal links. A polysomnography realized in a sleep disorder center provides data reinforcing or correcting the diagnosis. From a sound assessment of the disease, the treatment has to be deduced by following a rigorous reasoning, devoid of guilty feelings as they are suggested to patients by mass-media talking, as well as freed from fashionable non medical practices. Today, we know that chronic insomnia is a disease with potential severe consequences and that it does not heal spontaneously.

Acute Disease↗
PubMedDate not supplied

[Seasonal affective syndrome and phototherapy: theoretical concepts and clinical applications].

Since 1984, there has been a great interest in the phenomenon of a particular seasonally recurrent mood disorder called seasonal affective disorder (SAD) or winter depression and its treatment: the phototherapy. Seasonal affective disorder is a syndrome described by Rosenthal in 1984. This mood disorder is characterized by depression with onset recurrent in autumn or winter and spontaneous spring or summer remission. It is associated with hypersomnia, anergia, increased appetite, weight gain and carbohydrate craving. The population prevalence in the north of the USA is estimated between 3 and 5%, but it changes with sex, age and also latitude. A long time ago, we know that animals are photoperiod sensitive and that the melatonin secretion in mammals is suppressed by the light. In 1980, Czeiler reported for the first time that human melatonin secretion can be suppressed by high light exposure (+/- 1500 lux). In 1982, Rosenthal, Lewy and al. reported an antidepressant effect of light exposure of a manic-depressive patient. The phototherapy was born. To treat the SAD, the most common procedure of phototherapy is to expose the subject during 2 hours early in the morning, between 06:00 and 09:00 AM. The subject is sitting before a light screen, he can work and has to fix the screen one time every minute. The most common side effects are headache, eyestrain, muscle pain. The ocular phototoxicity is controversed and it seems to be potentially dangerous if phototherapy is associated with tricyclic antidepressants, neuroleptics and other medication containing a tricyclic, heterocyclic or porphyrin ring system. Since this finding, many questions are asked about photoperiod and its effects in the human being. Lewy proposes for the winter depression the hypothesis of a phase delayed circadian rhythm, that can be treated by a morning light exposure. At the present time, many trials are going on to study the effects of phototherapy in other problems like insomnia, maladaptation to night work, jet lag and Alzheimer disease.

Animals↗