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J Nizard

Publications and source records attributed to J Nizard.

25 records · Page 2Linked to original sources
PubMed2000

Do we use morphine often enough? An opinion survey in 100 rheumatology department patients.

PATIENTS AND METHODS: Shortly before their discharge from a rheumatology department, 100 patients with a mean age of 54 +/- 16 years completed a 20-item questionnaire on morphine therapy. Pain scale scores were 77.1 +/- 19 at admission and 44.2 +/- 24 at questionnaire completion. RESULTS: Thirty-three patients, including 27 with spinal or nerve root disorders, received morphine during their stay. Five of these patients had a malignancy. Among patients who received morphine, 21% (6/29) were disappointed with the drug. Only four of the patients who did not receive morphine (4%) wished they had. Thirty-six percent of patients (30/83) reported previous morphine therapy given by a primary care physician (10/30) or a specialist (14/30) and/or in a hospital (22/30). Only five patients (5/100, 5%) said they regretted not having received morphine for past pain; however, 45% (35/78) of patients agreed with the suggestion that French physicians do not use morphine often enough. Most patients (82%, 65/77) agreed that morphine can be used to treat pain due to rheumatic disorders, although 92% (83/90) felt that morphine should be reserved for "intolerable" pain. Only 37% (34/92) of the patients were apprehensive about using morphine, 57% (45/79) were aware of the risk of dependency, 66% (44/79) of the risk of behavioral or attention disorders, and 53% (41/78) of the risk of tolerance. CONCLUSION: Expectations of French rheumatology department patients about morphine use were roughly satisfactory. The mean pain scale score above which the patients felt morphine should be given was 70.5 +/- 20.

Analgesics, Opioid↗
PubMed1999

[Sickle cell anemia and pregnancy. Complications and management].

An increasing number of sickle cell disease patients are deciding to bear children. The high risk of fetal and maternal complications in pregnant sickle cell disease patients mandates multidisciplinary management. Risks include spontaneous abortion, vasculorenal syndrome, fetal growth retardation, and fetal death in utero. The rates of cesarean section, maternofetal infection, and maternal death are higher than in the population at large. The diagnosis should be made prior to conception or during early pregnancy. Frequent visits with the obstetrician, hematologist, and anesthesiologist/intensivist are mandatory. Exchange transfusion or blood transfusion may be indicated in patients with a history of serious obstetrical or hematologic complications. Risks are highest in late pregnancy, during delivery, and in the postpartal period. However, the entire pregnancy is a high-risk period that warrants close monitoring.

Anemia, Sickle Cell↗
PubMed1998

Evaluation of efficacies of different classes of antidepressants in the forced swimming test in mice at different ages.

1. The efficacies of different classes of antidepressants were investigated using the forced swimming test with mice at different ages. 2. Imipramine (4-32 mg/kg), desipramine (2-16 mg/kg) and bupropion (32, 64 mg/kg) showed activity in all age groups. 3. The selective serotonin reuptake inhibitors (SSRIs) citalopram (16 and 32 mg) and paroxetine (4 and 8 mg) were inactive in the oldest (40 weeks) group of mice, despite showing activity at the same doses in mice ranging in age from 4-24 weeks old. 4. Both SSRIs showed anti-immobility effects at low doses, (paroxetine: 1 and 2 mg/kg; citalopram: 4 and 8 mg/kg) in the 40-week old mice. These effects were not evident in the three younger groups of mice. 5. Moclobemide, a reversible selective inhibitor of monoamine oxidase-A, showed activity only at a high dose (128 mg/kg) and only in 12-week old animals. 6. Since SSRIs have been reported to have relatively selective effects on 5-HT1B receptors, the present results suggest that further studies comparing the effectiveness of SSRIs and other antidepressants in elderly patients should be done. Studies of the effects of aging on the density and/or affinity of 5-HT1A and 5-HT1B/1D receptors are also warranted.

Age Factors↗
PubMed1993

[Extramedullary hematopoiesis. An unusual cause of Pagetic spinal cord compression].

An original case is reported: spinal cord compression due to extramedullary hematopoiesis of the epidural space, related to Paget's disease of bone, successfully treated by surgery. Extramedullary hematopoiesis, usually occurring in cases of hematological disease, can also complicate Paget's disease, probably by bone effraction mechanism. A review of literature has found 5 other cases of extramedullary hematopoiesis occurring in Paget's disease, without hematological disease. Medullar scintigraphy (Indium111, Technetium99 Sulfur colloid) can confirm the diagnosis after X-ray findings, without the need for biopsy. Awareness knowledge of this complication can sometimes avoid invasive investigation. Low dose radiotherapy is useful in the case of hematological disorders. In Paget's disease, there is a risk of sarcomatous degeneration. In our patient, surgery cured cord compression, but it relapsed because of extensive fibrosis, in complicating surgical hemorrhage.

Aged↗