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Biomedical subjects

C Ferber

Publications and source records attributed to C Ferber.

At least 19 recordsLinked to original sources
PubMed2005

[Motivational interviewing for patients with comorbid schizophrenia and substance abuse disorders: a review].

Patients with schizophrenia and substance abuse disorders [dually diagnosed patients (DD)] show an unfavourable course of the illness and little interest in participating on specific integrated treatment programmes. Motivational interviewing (MI) has been shown to be effective among other substance abuse disorders and it aims to enhance intrinsic motivation to change problem behaviour. MI has been adapted for DD. The present paper reviews the empirical evidence for the efficacy of MI in DD. A search in the databases MEDLINE, EMBASE, PsycINFO was conducted and the methodological quality of the identified trials was assessed according to the Cochrane Collaboration and to the JADAD Scale. We identified 4 randomised studies with a total of 346 participants, in which MI interventions of 1 to 3 sessions were compared with various control conditions over a follow-up period of up to 6 months. With regard to the main outcome measures "subsequent participation at integrated treatment programme" (1 x positive, 2 x negative) and "substance use" (1 x positive, 1 x negative,) the studies gained contradictory results. In all 4 studies, there were relevant general methodological limitations (randomisation, blindness of raters, description of the reasons for drop-outs) and specific methodological shortcomings (sample size and sample homogenity, numbers of MI sessions, assessment of motivational status). Hence, at present the evidence for supporting MI in DD is not clear. This may be due to the methodological problems mentioned above or it may be that there is, in fact, no effect. Therefore, there is an urgent need for further research of MI in DD.

Diagnosis, Dual (Psychiatry)↗
PubMed1999

Development of human cochlear active mechanism asymmetry: involvement of the medial olivocochlear system?

To study the functional development of the medial olivocochlear system, transient-evoked otoacoustic emission suppression experiments were conducted in 73 ears of 38 pre-term and 11 full-term neonates. The continuous contralateral stimulation was a broad band white noise, presented at 70 dB SPL. Efferent suppression was determined by subtracting the without-contralateral stimulation condition from the with-contralateral stimulation condition. Across this population, a mean suppression effect of contralateral stimulation on transient-evoked otoacoustic emissions was found, with most of the suppression effect observed after 8 ms. The amount of suppression is linearly, positively correlated with the conceptional age. In the subgroup of bilaterally tested neonates, the suppression of transient-evoked otoacoustic emissions is similar in the right ear and the left ear in subjects whose conceptional age is less than 36 weeks and significantly higher in the right ear than in the left ear in older neonates. This last observation was seen at frequencies where transient-evoked otoacoustic emission amplitudes became higher in the right ear than in the left ear as the conceptional age increased, a finding already reported in adults. This study shows that the functional adult pattern of the medial efferent system, probably involved in the detection of signals in noise such as speech sounds, seems to appear gradually in neonates and represents one of the several arguments in favor of functional auditory lateralization in humans, with a right ear advantage.

Acoustic Stimulation↗
PubMed1999

The nonresilient hybrid removable prosthesis: treatment of choice for the atrophic maxilla.

This article presents the ments of the nonresilient hybrid removable prosthesis, which is the treatment of choice for the atrophic maxilla. The technique described may be adapted to yield a predictable outcome that provides functional and biomechanical stability that are superior to a resilient over-denture, along with a cosmetic and phonetic result that often proves superior to that of the fixed prosthesis.

Alveolar Bone Loss↗
PubMed1996

Development of cochlear active mechanisms in humans differs between gender.

Despite onset of function early during the third term of gestation, the human auditory system demonstrates continued maturation, thought previously to occur primarily at the neural level. The electromotile properties of outer hair cells appear to contribute substantially to hearing sensitivity and frequency selectivity and lead to the generation of otoacoustic emissions (OAEs). This report demonstrates continued development of cochlear active mechanisms (i.e. end-organ level) after onset of cochlear function, as reflected by OAEs. Significant gender differences also are reported, corresponding to recently observed intersex differences in cochlear length and precursory to gender differences observed in the adult.

Cochlea↗
PubMed1995

Spontaneous otoacoustic emissions in preterm neonates: prevalence and gender effects.

A number of lines of evidence indicate that the human cochlea is fully functional as a mature sound transducer by 6 months of age. However, information about the development of the active cochlear mechanisms and notably the development of outer hair cell (OHC) activity is yet incomplete. Recording and analysis of otoacoustic emissions (OAEs), probably generated by the OHCs of the organ of Corti, have led to a better understanding, in humans, of how sounds are analysed in the cochlea by means of active mechanisms. Evoked OAEs (EOAEs) and spontaneous OAEs (SOAEs), when they can be recorded in full-term and preterm neonates, show different characteristics from those in adults, suggesting that maturation of the peripheral auditory system is incomplete at birth. To learn more about this maturation, using the best-established facts concerning SOAEs in adults, such as their greater prevalence in females and also in right ears, SOAEs were studied in more detail in 81 preterm neonates, from 30 to 40 weeks of conceptional age, all presenting bilateral EOAEs according to objective criteria. The first finding of this study was that SOAEs existed and could be recorded as of 30 weeks of conceptional age in humans. Some SOAE characteristics in preterm neonates, such as prevalence, peak number and acoustic frequencies, showed similarity with full-term neonates. Comparison of other criteria between the two populations, such as greater SOAE prevalence in right ears and higher SOAE peak number in females, suggested that these developmental factors emerge around term in humans. Comparison of SOAE characteristics between male and female preterms suggested that male preterms were less advanced in peripheral auditory development than were female preterms.

Acoustic Stimulation↗
PubMed1994

Lack of association between transiently evoked otoacoustic emission amplitude and experimentation linked-factors (repeated acoustic stimulation, cerebrospinal fluid pressure, supine and sitting positions, alertness level).

Changes in transiently evoked otoacoustic emissions (TEOAEs) occur during sleep and during tasks requiring attention. This can be due to a central nervous system effect on the cochlea. But, an additional or dominant influence by non-controlled factors is possible. In this paper, the effect of click-stimulus repetition, lying and sitting positions, state of alertness (awake or asleep) and CSF pressure variation on TEOAE features were studied. None of these factors affected TEOAE amplitude. In 2 subjects, TEOAE amplitude increased considerably during the night while remaining stable in 7 subjects during daytime sleep. This may be due to circadian variations of TEOAE amplitude.

Acoustic Stimulation↗
PubMed1994

Factors related to sleep apnea syndrome in sleep clinic patients.

We examined 129 patients recruited from two sleep clinics to study the sleep apnea syndrome (SAS), defined by the apnea-hypopnea index (AHI) > or = 10. Information was registered from a self-administered questionnaire, basal physical measurements, and polysomnography. In 68 subjects recorded for two consecutive nights, a high correlation was found between first- and second-night AHIs (r = 0.89). Habitual loud snoring and breathing arrests during sleep were associated with AHI > or = 10. A model including these two variables, sex, age, and body mass index was created in order to predict AHI > or = 10 and with which it was possible to successfully classify almost three of four patients. Among subjective sleep questionnaire items, only daytime sleepiness was related to drops of transcutaneous oxygen tension. These discrepancies in the observed relationship between sleep parameters and subjective sleep items reduce the questionnaire value in epidemiologic settings where it aimed to detect SAS, as defined solely by the AHI value.

Blood Gas Analysis↗
PubMed1993

Naltrexone improves blood gas patterns in obstructive sleep apnoea syndrome through its influence on sleep.

Endogenous opiates have been shown to depress ventilation, and could therefore play a role in sleep apnoea syndrome (SAS). Hence, opiate antagonists have been used to treat SAS. The improvement they seem to give in blood-gas monitoring could derive either from a direct blocking of endorphins that inhibit respiration or else, indirectly, through an influence on sleep patterns. The present study used a double blind cross-over protocol to investigate the relationships between the effects on blood-gas and on sleep patterns of the oral opiate antagonist naltrexone in obstructive SAS. Sleep patterns and transcutaneous blood gas (tcPO2 and tcPCO2) were recorded in parallel. Control recordings, without treatment, were carried out over two nights, followed by two nights of recording after administration either of naltrexone followed by a placebo or of a placebo followed by naltrexone. The number of obstructive apnoea and hypopnoea events per hour of sleep (Apnoea-Hypopnoea Index: AHI), of hypoxic events (defined as a tcPO2 fall of at least 10, 15 or 20 mm Hg) and of hypercapnic events (defined as a tcPCO2 increase of at least 5 mm Hg) were counted. A Metabolic Suffering Index (MSI) was calculated, defined as the product of the number, duration and magnitude of hypoxic and hypercapnic events. Compared to placebo, naltrexone resulted in significant improvements in blood-gas patterns for the duration and MSI of hypoxic events and for the number, duration and MSI of hypercapnic events. Likewise, compared to placebo, naltrexone induced significant decreases in total sleep time, slow-wave sleep and rapid eye movement (REM) sleep, and, on the other hand, significant increases in total wake time and in the number of wakenings per hour of sleep (Nw h-1). Certain naltrexone-linked blood-gas improvements were closely correlated with certain of the sleep pattern changes: the decrease in number and duration of hypoxic events correlated with REM-time decrease and the decrease in number and duration of hypercapnic events correlated with the increase in Nwh-1. These findings suggest that the improvement in blood-gas patterns induced by naltrexone in SAS may be mediated by sleep pattern effects: i.e. a decrease in REM-time and an increase in intra-sleep wakening.

Journal Article↗
PubMed1991

[Sleep disorders with nocturnal bradycardia in 2 depressed patients].

Polygraphic sleep exploration is usually not necessary to evaluate and treat such dyssomnias as nightmares or anguish dreams, but it may be indispensable in case of severe repeated or refractory sleep disorders, particularly in patients with concomitant depression. Two cases of major depression (DSM III R) associated with wakings during the night and dreams of death are reported. In both cases, polygraphic sleep exploration performed after complete, two-weeks long discontinuation of medicines revealed sinus bradycardia during paradoxical sleep, particularly in pre-waking periods. Heart rates ranged from 33 to 43 beats/minute in the most pronounced bradycardic episodes. The possibility of organic cardiac pathology was excluded by additional examinations. Atropine (175 mg) administered alone resulted in complete disappearance of bradycardic episodes and in improvement of objective and subjective sleep parameters. In these two cases bradycardia seemed to be due to vagal dysfunction with exaggeration of the "rebound" bradycardia which follows the initial tachycardia that occurs during the phasic phenomena of paradoxical sleep.

Adult↗
PubMed1991

Increased serotonin platelet uptake after tianeptine administration in depressed patients.

Tianeptine is a new antidepressant drug reported to enhance serotonin (5-hydroxytryptamine [5-HT]) uptake in rat brain. The effect of tianeptine on 5-HT platelet uptake was studied in 10 depressed patients treated for 28 days. Tianeptine increases Vmax of 5-HT platelet uptake during treatment without inducing any change in Km. As early as 2 hr after the first administration, Vmax increased significantly (+23%, alpha = 0.01). Although of a lesser magnitude, 5-HT platelet uptake remains increased after chronic administration (+14% on day 10 and +13% on day 28). This suggests that tianeptine affects 5-HT platelet uptake sites, either directly or via an action on modulators of 5-HT uptake. These results, in contrast with the action of other tricyclic antidepressants, confirm the original action of tianeptine on 5-HT platelet metabolism.

Adolescent↗
PubMed1989

Effects of dexfenfluramine on the feeding behavior of rats foraging in the cold for palatable bait.

An alimentary/thermic conflict of motivation was used to explore the effects of very low doses of dexfenfluramine (dFF), an anorectic serotoninergic agonist, on the parameters of food motivation, drive and incentive (or palatability). Six rats trained to feed 2 hr/day, were given the possibility to feed on chow in a shelter (25 degrees C), and to get a snack of shortcake, a highly palatable bait, from a feeder placed 16 m away in a very cold environment (-15 degrees C). dFF at 0.6 or 1.25 mg/kg decreased neither the chow intake in the shelter, nor the mean duration of the snacks in the cold, which is the parameter believed to be the best indicator of incentive. In contrast, dFF reduced the number of trips to the bait in the cold as well as the total mass of palatable bait ingested and the mean amount ingested by snack. Such an effect was no longer observed after a food restriction had reduced the body weight of the rats to 90% of its initial value. It is concluded that, even at doses too small to reduce the consumption of basic food, dFF decreases the drive to get palatable food.

Animals↗
PubMed1988

[Value of transcutaneous blood gas monitoring in fiberoptic bronchoscopy in intensive care patients].

Transcutaneous carbon dioxide and oxygen tensions (PtcCO2 and PtcO2) were monitored in seven critically ill patients under mechanical ventilation during fiberoptic bronchoscopy. In these conditions, both PtcO2 and PaO2 and PtcCO2 and PaCO2 correlated, with correlation coefficients of 0.964 and 0.793 respectively. Fiberoptic bronchoscopy induced an average fall in PtcO2 of 42 +/- 2.57 mmHg and an average increase in PtcCO2 of 12.1 +/- 1.89 mmHg; these two parameters returned quickly to their initial values after the procedure. Holter monitoring showed an arrhythmia in five of the seven patients. Continuous measurement of PtcO2 and PtcCO2 was a safe and reliable method for monitoring mechanically ventilated patients undergoing fiberoptic bronchoscopy.

Aged↗
PubMed1988

[Efficacy of the treatment of sleep apnea using naltrexone. A clinical, polygraphic and gasometric study].

Twelve patients with clinical, polysomnographic and oxymetric features of Sleep Apnoea Syndrome (S.A.S.) were recorded, after a 2-week wash-out period, during 2 nights without treatment and 2 nights after receiving 50 mg naltrexone at bed-time. Clinical symptoms improved immediately in four patients, within one month in three patients and after 3 months of treatment in the remaining five ones. Sleep Apnoea index as well as the number, duration and intensity of hypoxic events were dramatically improved by this treatment that has now been prescribed to 25 patients, for more than 2 years in 14 of them.

Blood Gas Analysis↗
PubMed1987

Influence of noise on gustatory affective ratings and preference for sweet or salt.

Ten adult men were exposed to four different conditions of noise--low noise (70 dB), loud noise (90 dB), loud music (90 dB) and a silence control--while they tasted sweet or salty solutions. In the first experiment, they rated the pleasure/displeasure aroused by ten gustatory stimuli (five sucrose and five sodium chloride from 0.15 to 2.35 M/l). The median affective rating for sucrose was significantly higher in loud noise and with loud music. No change was observed for salt. In the second experiment, the subjects were invited to mix solutions in order to obtain the most pleasant concentration of sucrose or sodium chloride. Subjects' preferred concentrations of sucrose or sodium chloride did not vary with auditory conditions.

Adult↗
PubMed1987

Pleasure and preference in a two-dimensional sensory space.

A matrix of 25 gustatory stimuli combined five sucrose concentrations (0.15 to 2.35 mole/l) with five temperatures (10 to 50 degrees C) or sournesses (pH 1.8 to 5.7). On four different days at the same time of day ten healthy young men served as subjects. Sweet pleasure/displeasure vs. temperature pleasure/displeasure was studied in four subjects and sweet pleasure/displeasure vs. sourness pleasure/displeasure in six subjects. Throughout the first session the 25 stimuli were presented for 5 s each and the subject gave a magnitude estimate of his pleasure or displeasure in response to one dimension of the matrix (e.g. sweetness) regardless of the other. Similarly, throughout the second session, the same stimuli were presented and the subject rated his pleasure or displeasure in response to the second dimension of the matrix (e.g. sourness or temperature) regardless of the first. For the third session however, the subject himself was invited to mix samples, this to allow a behavioural choice in one dimension of the matrix the other being imposed (e.g. he could mix sucrose and water ad libitum for five imposed temperatures). For the last session the subject could adjust the previously imposed dimension, the other previously adjustable dimension being now imposed (e.g. he could modify temperature for five imposed sucrose concentrations). The results of the first two sessions showed that pleasure/displeasure resulted from a two-dimensional combination of the taste modalities offered. The results of the last two sessions showed that the subjects tended to maximize their sensory pleasure. The operant choices coincided with the ratings obtained in the first two sessions. Whether a dimension of the matrix was imposed or operantly adjustable made no difference on the results; the subjects tended to maximize sensory pleasure in the imposed dimension as well as in the adjustable dimension. The subjects therefore maximized their pleasure in the two-dimensional space offered.

Adolescent↗