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Renaud de Beaurepaire Michael Lukasiewicz Patrick Beauverie Sophie Castra Odile Dagorne Renaud Espaze Bruno Falissard Patrick Giroult Michle Houery Georges Mahuzier Isabelle Matheron Philippe Niel Pierre Padovani Nicole Poisson Jean-Paul Richier Jrme Rocher Odile Ruetsh Didier Touzeau Andr Visinoni Robert Molimard 《European psychiatry》2007,22(8):540-548
BACKGROUND: Asking psychiatric in-patients about their drug consumption is unlikely to yield reliable results, particularly where alcohol and illicit drug use is involved. The main aim of this study was to compare spontaneous self-reports of drug use in hospitalized psychiatric patients to biological measures of same. A secondary aim was to determine which personal factors were associated with the use of tobacco, alcohol, and illicit drugs as indicated by these biological measures. METHODS: The consumption of substances was investigated using biological measures (urine cotinine, cannabis, opiates, cocaine, amphetamines and barbiturates; blood carbohydrate-deficient transferrin [CDT] and gamma-glutamyl transferase [GGT]) in 486 consecutively admitted psychiatric patients, one day following their hospitalization. Patients' self-reports of alcohol, tobacco and illicit drugs consumption were recorded. Socio-professional and familial data were also recorded. RESULTS: The results show a low correlation between biological measures and self-reported consumption of alcohol and illicit drugs. Fifty-two percent of the patients under-reported their consumption of illicit drugs (kappa=.47). Patients with schizophrenia and personality disorders were more likely to disclose their illicit drug consumption relative to patients suffering from mood disorders and alcohol dependence. Fifty-six percent of patients underreported alcohol use, as evaluated by CDT (kappa=.2), and 37% underreported when using the CDT+GGT measure as an indicator. Smoking appeared to be reported adequately. In the study we observed a strong negative correlation between cannabis use and age, a strong correlation between tobacco and cannabis use, and correlations between tobacco, cannabis and alcohol consumption. CONCLUSION: This study is the first to compare self-reports and biological measures of alcohol, tobacco and illicit drug uses in a large sample of inpatients suffering from various categories of psychiatric illnesses, allowing for cross-diagnosis comparisons. 相似文献
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Fogli A Wong K Eymard-Pierre E Wenger J Bouffard JP Goldin E Black DN Boespflug-Tanguy O Schiffmann R 《Annals of neurology》2002,52(4):506-510
Cree leukoencephalopathy is a rapidly fatal infantile autosomal recessive leukodystrophy of unknown cause observed in the native North American Cree and Chippewayan indigenous population. We found in the brain of affected individuals the typical foamy cells with the oligodendroglial phenotype described in central hypomyelination syndrome/vanishing white matter, a syndrome related to mutations in the genes encoding the five subunits of the eucaryotic translation initiation factor eIF2B. In three patients of two Cree families, we found a homozygous missense mutation resulting in a histidine substitution at arginine 195 of epsilon-eIF2B. 相似文献
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Can a delusional idea be contagious? This question may seem paradoxical when we know that the very definition of delirium correspond to “an erroneous belief (…) maintained despite the very generally shared opinion” (DSM4) and so implies that peers do not share the beliefs expressed by the subject. However, cases of collective delirium have been described for many years, and have been the subject of numerous scientific publications since the 19th century. Among them, an entity emerged : “folie à deux”, in which a primary active subject could induce his delusions to a secondary subject, more vulnerable, said induced and passive. In 1877, Lasègue and Falret first introduced the term “folie à deux” and proposed the diagnostic criteria. They describe nine essential criteria among which, three would be the sine qua non conditions that can allow the outbreak of a delirium shared by two. They are the presence of an active element of superior intelligence, the existence of a common life between the two individuals, sufficiently long and intimate and a “closed and isolated” environment. These criteria were subsequently supplemented to arrive at the current definitions of induced delusional disorder (ICD10) and shared psychotic disorder (DSM4). This rare disorder has been the subject of numerous publications. However, these publications were often divided over both its epidemiology, its diagnostic criteria, and the specific treatment to be offered. The two recent definitions resulting from current classifications can also illustrate this dichotomy on certain criteria, beyond the very semantics which here oppose the terms “induced delusional” and “shared psychosis”. Moreover, this disorder has the particularity to question its real existence as it is currently challenged in the new classifications of the DSM V and ICD 11. We can therefore see that if the subject fascinates, it divides. What is it really? Can a delirium really be transmitted? Can a psychosis really be shared? And if so, is one of the two definitions more suitable to describe this disorder? What future can we imagine for this pathology? During the hospitalization of a patient for a “délire à deux”, concerning two persons from two different families sharing a delirium of filiation, we observed the current issues around this disorder and we asked ourselves which treatment to administer to these patients. The hospitalization took place over two stages: the first stage to understand the disorder, the second one to treat it. À family interview was conducted in the presence of the dyad of patients, to explore the interactional elements together, and establish the diagnosis. A preliminary step essential to therapeutic work on the question of loyalty and differentiation. This clinical case recalls the value of an integrated approach based on the systemic epistemology, both for the diagnostic phase than during therapeutic support. The objective of this work is to study, through an atypical clinical case and a review of recent literature, the different diagnostic, therapeutic and evolutionary perspectives of this particular pathology. 相似文献
46.
Juana Angel Odile Colard Franoise Chevy Catherine Fournier 《Arthritis \u0026amp; Rheumatology》1993,36(2):158-167
Objective. Interleukin-1 (IL-1), an important mediator contributing to joint destruction in rheumatoid arthritis, is known to stimulate the release of arachidonic acid (AA) and prostaglandin E2 (PGE2) from adherent synoviocytes. To study the intracellular pathways involved in these functions, we stimulated cultures of human synovial cells with recombinant IL-1β. Methods. AA liberation was measured after labeling synovial cells with 3H-AA, and PGE2 levels were determined by high performance liquid chromatography or radioimmunoassay. Identification of 3H-AA-labeled phospholipids was performed by thin layer chromatography. Cell-associated phospholipase A2 (PLA2) enzymatic activity was determined by an assay with cell-free systems and exogenous substrates. Results. Stimulation of synovial cells with recombinant IL-1β induced a decrease in phosphatidylcholine (PC), phosphatidylinositol (PI), and phosphatidylethanolamine (PE), and a marked increase in cell-associated PLA2 activity as compared with controls. In the presence of either quinacrine, an inhibitor of PLA2 pathway activation, or neomycin, which binds to PI mono- and biphosphate thus blocking their degradation by phospholipases, AA and PGE2 secretion were reduced in a dose-dependent manner. Kinetic studies revealed that quinacrine had little blocking activity on the IL-1-mediated AA release after 1 hour of stimulation but completely abolished it after 5 or 8 hours. In contrast, neomycin exerted a partial but significant inhibitory effect from the first hour of stimulation onward. Addition of quinacrine was also demonstrated to abolish the IL-1-induced hydrolysis of PC and PE but not PI, indicating that PC and PE are the preferred substrates for PLA2 enzymatic activity in human synovial cells. Conclusion. Our findings strongly suggest that AA and PGE2 production by IL-1-triggered synoviocytes are largely dependent upon PLA2-mediated hydrolysis of PC and PE and to a lesser extent upon the earlier degradation of PI. 相似文献
47.
Does taking endurance into account improve the prediction of weaning outcome in mechanically ventilated children? 总被引:1,自引:0,他引:1 下载免费PDF全文
Noizet O Leclerc F Sadik A Grandbastien B Riou Y Dorkenoo A Fourier C Cremer R Leteurtre S 《Critical care (London, England)》2005,9(6):R798-R807
Introduction
We conducted the present study to determine whether a combination of the mechanical ventilation weaning predictors proposed by the collective Task Force of the American College of Chest Physicians (TF) and weaning endurance indices enhance prediction of weaning success. 相似文献48.
Postoperative spondylodiskitis due to Stomatococcus mucilaginosus in an immunocompetent patient 总被引:1,自引:0,他引:1
Bureau-Chalot F Piednoir E Bazin A Brasme L Bajolet O 《Scandinavian journal of infectious diseases》2003,35(2):146-147
A case is reported of postoperative spondylodiskitis due to Stomatococcus mucilaginosus in an immunocompetent woman. The route of infection remains unknown. Intravenous treatment with cefotaxime and fosfomycin was given, followed by oral administration of rifampin and pristinamycin until resolution of infection. This report shows that this bacterium can cause severe infections in immunocompetent patients. 相似文献
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Montagna G Teijido O Eymard-Pierre E Muraki K Cohen B Loizzo A Grosso P Tedeschi G Palacín M Boespflug-Tanguy O Bertini E Santorelli FM Estévez R 《Human mutation》2006,27(3):292
Nine new unrelated patients presenting vacuolating myelinopathy with subcortical cysts were identified and analyzed for variations in the MLC1 gene. We detected 12 mutations (p.Leu37fs, p.Met80Val, p.Leu83Phe, p.Pro92Ser, p.Ser93Leu, p.Ile108fs, p.Gly130Arg, p.Cys171fs, p.Glu202Lys, p.Ser269Tyr, p.Ala275Asn, and p.Leu310_311insLeu) of which nine were novel. In one patient we did not detect mutations. Using a heterologous system, three new missense variants (p.Glu202Lys, p.Ser269Tyr, and p.Ala275Asn) and a single leucine insertion (p.Leu310insLeu)--lying in a stretch of seven leucines--were functionally assayed by determining total protein levels and mutant protein expression at the plasma membrane. No correlation was observed between mutation, clinical features, and plasma membrane expression of mutant protein. 相似文献