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Biomedical subjects

Jean-Michel Pinoit

Publications and source records attributed to Jean-Michel Pinoit.

6 recordsLinked to original sources
PubMed2006

[Antipsychotic drugs and cardiovascular safety: need for monitoring the QT interval].

Torsades de pointes (TdP), a form of ventricular arrhythmia that can cause ventricular fibrillation and sudden death, may occur during prolongation of the QT interval. QT prolongation has recently been reported with antipsychotic drugs. Physicians should be able to obtain a corrected measurement of the QT interval. QT is measured from the beginning of the QRS complex to the end of the T wave (QTm). This value must then be corrected to take heartbeat into account. The most common formula in current use is Bazett's. In practice, a QTc interval value greater than 500 ms indicates an increased risk of TdP. Safe combinations of antipsychotic drugs have been recommended by the French drug agency (Agence française de sécurité sanitaire des produits de santé). Many other drugs, including psychotropic drugs such as tricyclic antidepressants, can prolong the QT interval. Combinations of these medications with one another, with antipsychotic medications, or with other concomitant factors, such as hypokalemia, also increase the risk. TdP is most often diagnosed only after observing QT prolongation. This underlines the need to monitor QT intervals attentively to prevent the risk of cardiac arrhythmia in patients treated with antipsychotic drugs.

Age Factors↗
PubMed2006

[Post-stroke depression, another handicap].

INTRODUCTION: Post-stroke depression is a severe complication affecting 30-50% of patients during the first year. Experienced medical and paramedical staff in stroke units, using validated scales, can now identify initial signs of depression in the first days after stroke onset. METHODS: This review of the literature is based on a Medline search for the terms stroke, depression, and epidemiology. It discusses problems of pathophysiology, diagnosis, prognosis, and therapeutics. RESULTS: Depression is an emergency in stroke patients because it impedes rehabilitation and family and social insertion. Early diagnosis is difficult, but possible with clinical somatic and cognitive symptoms. Post-stroke depression may also be a marker of pending cognitive decline. Management requires both antidepressants and psychotherapy. CONCLUSION: There is a pressing need for further research to improve clinical practice in this area of stroke care.

Activities of Daily Living↗
PubMed2006

Brain injured patients versus multiple trauma patients: some neurobehavioral and psychopathological aspects.

BACKGROUND: The study aims to describe the neurobehavioral and psychopathological disorders in road crash victims with cerebral lesions compared with multiple trauma sufferers with no brain damage. METHODS: This study compares the neuropsychological and psychopathological developments of two groups of road crash victims (25 severe brain injuries (SBI) and 25 multiple traumas (MULT)) on the basis of the Neurobehavioral Scale, the SCL 90-R and the State/Trait Anxiety Scale. RESULTS: On the basis of the Neurobehavioral Scale, it was clear that the SBI patients suffered from significantly more disorders of type factor 1 (self-appraisal and flexible thinking), factor II (withdrawal), factor III (mood swings, irritability, disinhibition, excitement), factor IV (attention, slower motor responses, and mental fatigue), factor V (articulatory problems, problems of oral expression, and oral comprehension) and nonfactored disorders (exaggerated somatic concerns). On the SCL 90-R scale, we observed a higher level of obsessive symptoms in the SBI patients, whereas there was no significant difference between the two groups on the State/Trait Anxiety Scale. Unexpected results indicated that the multiple trauma patients suffered from memory troubles (60%), concept disorganization (32%), loss of initiative (36%), irritability (52%), unusual thought content (40%), mood swings (40%), attention difficulties (24%), suspiciousness (48%), and feelings of guilt (36%). CONCLUSION: Even though multiple trauma sufferers do not receive a psychologic assessment of their cerebral functioning, and do not benefit from any rehabilitation, they exhibit neurobehavioral and psychopathological disorders which need to be taken into account when designing rehabilitation programs. This study points toward new therapeutic methods for the treatment of multiple trauma sufferers.

Accidents, Traffic↗
PubMed2005

[Specificity of stroke in the elderly: clinical characteristics and impact on care].

Stroke in the elderly differs from stroke in younger adults in several points. It represents the most frequent consequence of atherothrombotic disease associated with hypertension, diabetes and hypercholesterolemia. It is also the main complication of cardiac arrhythmia. From a clinical point of view, epileptic seizure is frequently observed at the onset, and prognosis is darkened by a high risk of dementia occurrence (20%). Management of stroke in acute phase requires intensive care, which has been shown to decrease mortality and handicap by 20% in Stroke Units. Fibrinolysis with rt-PA can be carried out till 80 years. Primary and secondary prevention are still very efficacious in old patients and decrease not only the risk of stroke, but also the risk of dementia. Moreover, influenzae vaccination has been shown to decrease the risk of stroke in the following year in subjects over 65 years.

Acute Disease↗