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I Zabala

Publications and source records attributed to I Zabala.

9 recordsLinked to original sources

[Breakage and embolization of an epicutaneous central catheter with migration ot the right lobar pulmonary artery].

A neonate with meningitis required placement of several catheters for treatment. One catheter broke and a fragment embolized in the lobar branch of a pulmonary artery. This critical situation produced no symptoms and was successfully managed by percutaneous extraction from the femoral artery. Percutaneous central catheters made of silicon are used increasingly for long-term treatment of critically ill neonates. Such catheters are highly useful and effective but are not free of complications that can be serious or even fatal and that must be watched for when catheterization is indicated. The pediatric anesthesiologist should be familiar with the use of silicon catheters, the reasons for their failure and signs of incorrect placement. Although our patient suffered no complication after the break and embolization, the possibility of severe problems means we must monitor catheter use carefully.

Catheterization, Central Venous↗

The use of the Expressed Emotion Index as a predictor of outcome in first admitted schizophrenic patients in a French speaking area of Switzerland.

A 5 year prospective study of 44 first admission schizophrenic patients was conducted in Geneva, in order to evaluate the prognostic value of Expressed Emotion (EE). The predictive power of the EE index was tested on 3 variables of outcome: relapse rates, social adaptation and hospital stays. The EE index and the outcome measures tended to be associated. After the third year, patients living with high EE relatives were significantly more maladjusted and relapsed more than those living with low EE relatives. At intake, the patients presenting more premorbid features lived in high EE households. Our results show that initial measure of EE in a first episode cohort is predictive of outcome over a five-year period. This may not be causal, as it cannot be excluded that poorer premorbid functioning alone may result in poorer outcome, and may also elicit high EE in the relative.

Expressed Emotion↗

[Stability and predictive role of emotions, expressed by families in the development of a cohort of schizophrenic patients in the course of 5 years].

A prospective study of 44 first admission schizophrenic patients was conducted in Geneva, in order to evaluate the prognostic value of Expressed Emotion (EE), as well as its stability. The predictive power of the EE index was tested on three variables of outcome: relapse rate, social adaptation and hospital stay. At intake, the patients presenting more premorbid features lived in high EE households. The EE index and the outcome measures tended to be associated. After the third year, patients living with high EE relatives were significantly more maladjusted and relapsed more than those living with low EE relatives. The EE index was stable during the five years. Our results show that initial measure of EE in a first episode cohort is predictive of outcome over a five year period. This may not be causal as it cannot be excluded that poorer premorbid functioning alone may result in poorer outcome, and may also elicit high EE in relative.

Adult↗

Continuity and discontinuity of psychopathology: a study of patients examined as children and as adults. III--The infancy of "adult personality disorders".

We undertook a prospective study of all the children who, having consulted the Child Psychiatry Services (Service Médico-Pédagogique) between 1963 and 1967, later consulted the Adult Public Psychiatry Service (720 cases). We looked for specific clinical clusters which would enable us to differentiate statistically the groups of children according to their adult diagnoses. We present here the results for the group of children who were diagnosed as suffering from "personality disorders" in adulthood. We were able to establish an infantile cluster that significantly differentiated these children. It includes: aggressiveness, oppositional behaviour, unsociability, conflicts with peers. 54.6% had already been diagnosed as suffering from personality disorders in childhood. According to these results, the more a consulting child fits this profile, the greater the risk that he will suffer from a "personality disorder" in adulthood. We discuss the continuity/discontinuity of the symptomatology, and the implications for diagnoses of "personality disorders" and "borderline personalities".

Adolescent↗

[Continuity and discontinuity of psychopathology: a study of patients examined as children and as adults. II. Childhood antecedents of drug dependent adults].

The demographic stability of the Swiss Canton of Geneva provided us with the necessary conditions for a follow-up study of the entire childhood population who, having consulted the Child Psychiatry Services between 1963 and 1967, later consulted the adult public psychiatric services (720 cases). We looked for specific clusters of clinical signs which would enable us to differentiate, statistically speaking, the groups of children according to their adult diagnosis. We present here the results for the group of children who were diagnosed at adulthood as drug addicts (DSM III R). We found a specific cluster significantly differentiating these children from the other populations. It includes: a personality disorder (undifferentiated behaviour, and solitary and aggressive behaviour), environmental factors (monoparental, rejecting family) and a lack of mental deficiency.

Adolescent↗

[Continuity and discontinuity of psychopathology: a study of patients examined as children and as adults. I. Antecedents of adult schizophrenic disorders].

The demographical stability of the Canton of Geneva made it possible for us to do a prospective study of all the children who had consulted the Child Psychiatry Service between 1963 and 1967 and who later consulted the public adult psychiatry services. On the basis of the adult diagnoses, wo looked for specific clinical "clusters" in childhood which would allow us to differentiate statistically the groups of children. We present here the results of the group of children who developed schizophrenia in adulthood. We found a specific childhood "cluster" which clearly distinguishes these children from the others. It includes: serious relational disorders, neurodevelopmental impairment, attention deficit and school learning disorders.

Adolescent↗

[Expressed emotion: past, present, future].

Expressed Emotion (EE) proved to be the best single predictor of relapse in schizophrenia in 1972. Since then, studies on EE were oriented in three directions: Replication of the original study in different countries, improvement of the methodology and clinical applications. The analysis of different key studies shows that EE is a powerful predictor factor, although it is influenced by other variables such as culture.

Emotions↗

[Four year follow-up of social adjustment of a cohort of schizophrenic patients].

Sixty-seven first episode schizophrenic patients (PSE-Catego criteria) have been included in this study in order to evaluate their prognosis and the factors predictive of their evolution. Potential predictive factors consisted of anamnestic and demographic data, scores on the Disability Assessment Schedule (DAS-WHO) and relatives' Expressed Emotion index (EE), measured by the Camberwell Family Interview (CFI). The outcome was assessed monthly by the Global Assessment Scale (GAS/DSM III-R). At four years, 39 patients (58%) were still being followed. 33% of the patients presented a good evolution (EGF > or = 51) and 67% of the patients a bad evolution (EGF < 51). Four factors predictive of the psychosocial adaptation were extracted using regression analysis: premorbid psychosocial evolution, EE, sex and psychiatric family history. These 4 factors predicted correctly 85% of cases. Moreover, the monthly follow-up of these patients pointed to three types of evolution: the patients presenting a good and stable evolution (22%), those presenting a bad and stable evolution (33%) and those presenting an oscillating evolution which fluctuated between good and bad periods (44%). However, no predictive factors of the psychosocial adaptation of these oscillating patients could be identified through the statistical analysis. These results take all their importance regarding the treatment of schizophrenic patients, for whom the therapeutic plans which have to be settled should take into account their prognosis in the most precise manner. Moreover, the predictive value of EE on psychosocial adaptation for a 4 years period is confirmed.

Adolescent↗