Biomedical subjects

J-B Daeppen

Publications and source records attributed to J-B Daeppen.

5 recordsLinked to original sources

PubMed2006

[Optic neuropathy while taking disulfiram].

INTRODUCTION: Disulfiram has been used since the late 1940s to treat chronic alcoholism. This drug interferes with alcohol metabolism resulting in an acetaldehyde increase. This causes painful symptoms, encouraging abstinence. Side effects include rare cases of bilateral optic neuropathies. Visual recovery occurs frequently upon cessation of therapy. METHOD AND OBSERVATION: We retrospectively studied patients referred for visual loss while treated with disulfiram between 1987 and 2005. Fourteen patients (three females, 11 males; aged 35-62 years) complained of visual loss, but a toxic, disulfiram-related, optic neuropathy was diagnosed in only five patients. Following cessation of disulfiram therapy, visual acuity and field improved in all five patients. DISCUSSION: and conclusion: When disulfiram toxicity is suspected with optic neuropathy, cessation of treatment is mandatory. Visual prognosis is good in the majority of cases, as illustrated by our series. Disulfiram toxicity can be diagnosed only after excluding all other possible causes of visual loss.

Adult↗

PubMed2005

[Content and efficacy of remedial interventions with drinking and driving offenders].

In Switzerland, 20% adults drove under the influence of alcohol over the last 12 month, 30% motor vehicle crashes are related to alcohol and over 18,000 people were sentenced for driving under the influence in 2001, 15-25% for repeated offence. This article reviews the scientific literature about the current prevention measures in Europe and North America, assessing the effectiveness of prevention measures. On average, prevention programs reduce repeated offence of 40%. The effectiveness of such programs appears superior for programs combining various measures, educational and behavioral, matched with repression measures, i.e., probation and driving license suspension. Efforts should be undertaken to pursue research and development in this major domain of public health concern.

Accidents, Traffic↗

PubMed2005

[Does disulfiram still have a role in alcoholism treatment?].

What is the place of disulfiram in the treatment of alcohol dependence since anti-craving pharmacological molecules (acamprosate, naltrexone) were launched on the market? Considering methodological limitations, available studies do not allow to conclude about disulfiram's efficacy. Clinical observations indicate however that disulfiram should keep a place in the treatment of alcohol-dependence considering favourable outcome for some patients. Disulfiram implants have however to be avoided. Side effects and possible adverse reactions should not be a barrier to its use. Disulfiram shouldn't be given during pregnancy and to patients with instable cardio-vascular disease. Its prescription justifies a close monitoring of liver tests for patients with abnormal hepatic function.

Alcohol Deterrents↗

PubMed2005

[Prevalence, prophylaxis and treatment of Wernicke encephalopathy. Thiamine, how much and how do we give it?].

Wernicke's encephalopathy (WE) is an acute neuropsychiatric condition due to thiamine deficiency (vitamin B1) most commonly associated with chronic alcohol abuse. WE is difficult to diagnose because the classical triad of signs (confusion, ataxia and ophthalmoplegia) occurs in only 10% of cases. The presentation is often one of a non-specific confusional state which may easily be attributed to intoxication, alcohol withdrawal or to a concurrent morbidity such as head injury. To improve the outcome, it is important to make a presumptive diagnosis of WE and treat the patients as soon as possible with high-dose parenteral thiamine. Patients with an alcohol problem associated with malnutrition should all be offered a preventive treatment with parenteral thiamine in view of the impaired oral thiamine absorption.

Alcoholism↗

PubMed2005

[Assessment and treatment of coexisting mental illness or dual diagnosis].

Substance abuse touches around a quarter of psychiatric patients, which brings up various therapeutic problems. Literature shows us that between the "parallel", "series" and "integrated" approaches, it is the integrated approach which proves to be the most effective in terms of reducing symptoms, hospitalisations and criminality. An improvement in the patients' quality of life can also be observed. The integrated approach is developed by a team of in-patient and out-patient workers, whose job is to identify and evaluate clinically the motivation and the psychological and social functioning of the patients, and to propose suitable treatments according to the pathology and context of each case. A designated "case manager" guarantees the long term therapeutic project for each patient.

Diagnosis, Dual (Psychiatry)↗