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Biomedical subjects

L Arbus

Publications and source records attributed to L Arbus.

At least 19 recordsLinked to original sources
PubMed1999

Are prescribed medications effective in the treatment of insomnia complaints?

Although frequently investigated in the general population, the epidemiology of insomnia complaints and their treatment have received little attention in general practice. This study recruited patients > or =15 years of age, consecutively, from 127 general practitioners in France. The physicians collected data from 11,810 of their patients, of whom 55.5% were women. Insomnia complaints were reported by 26.2% (25.4% to 27%) of the sample and use of sleep-promoting medication by 10.1% (9.7% to 10.7%). About 47% of the prescribed drugs used were anxiolytics and 45% hypnotics. Most consumers took sleep-enhancing drugs on a daily and long-term basis and most reported that the medication improved their quality of sleep. However, few distinctions emerged between elderly drug-taking insomniacs and elderly nontreated insomniacs with respect to the various dimensions of sleep. Results underscore the persistent general tendency among French general practitioners to overprescribe anxiolytics for the treatment of insomnia complaints and that they do so on a long-term basis, despite the findings of numerous studies showing that benzodiazepines are ineffective in the treatment of sleep complaints over the long term.

Adolescent↗
PubMed1998

Soft tissue tumors following traumatic injury: two observations of interest for the medicolegal causality.

Two cases of tumors of the soft tissues developing at the site of a previous traumatic injury occurring a few years earlier are reported. One was finally diagnosed as aggressive fibromatosis and the other as low-grade fibrosarcoma. Among the pathogenic mechanisms and the etiologic factors involved in such tumors, the posttraumatic causality is discussed, and in addition to the initial trauma, the role of iterative surgery in the first case and mineral muscular inclusions in the second case are examined. The different therapeutic approaches of such lesions are also reviewed.

Back Injuries↗
PubMed1994

Questions raised by artificial prolongation of life of the aged patient.

The existence of treatments which now make it possible to prolong life beyond the point when it would previously have ended, gives rise to particular questions in the context of the care of aged patients: the distinction between curative and palliative treatment, the evaluation of incurability, the right to refuse treatment, competence to make such a decision and the use of the limited objective and pure objective tests in the event of incompetence. The natural role of the physician as protector adds a further ethical dimension to what is also a medicolegal question.

Aged↗
PubMed1994

Fatal injuries caused by guns using shotshell: case reports and ballistic studies.

The authors present six cases of homicide and suicide in which the weapon involved was a handgun using shotshell. The injuries caused are described and the ballistic characteristics of the weapons are studied. Such weapons, which are relatively easy to obtain, are not as innocuous as they may appear, since they may be modified either by changing the barrel or by removal of the device inside the barrel which is intended to prevent the firing of solid slugs.

Adolescent↗
PubMed1993

Radiographic identification of human remains through deformities and anomalies of post-cranial bones: a report of two cases.

Human remains can be identified radiographically by anomalies and deformities of the post-cranial bones when there are no old fractures and the cranium and extremities are not available. These anomalies and deformities of the sternum, vertebrae, sacrum and innominate bone are often protected from damage by scavengers. We report their use to exclude a proposed identity in one case and to confirm identity in another case. The value and number of these criteria and their pathogenesis is discussed with reference to their prevalence and their expression of inter- and intraindividual variability.

Forensic Medicine↗
PubMed1991

[Drowsiness and traffic accidents. Importance of diagnosis].

"Tiredness", often cited in civil and penal responsibilities secondary to car accidents, hides neurophysiological phenomena which must now be taken into account. The problems of watchfulness in car-driving, is sleepiness, are indeed linked to a genuine disorder in the sleep-wake rythm and attention should be drawn to them in medico-legal cases. Investigations and clinical examinations concerning 110 experts' reports confirm the role played by sleep' disorders in the occurrence of car accidents. Prevention in actually possible. Early detection can take place at various levels and concerns general practitioners, specialists of industrial medicine and specialists for driving tests. In France, the list of diseases associated with, and retraining of a driving license refer only to concentration disorders induced by drug administration, but do not mention sleep pathologies (sleep apnea syndrome, narcolepsy, etc). What is the responsibility of a driver who ignores or says nothing about a sleep pathology from which he is suffering? Is it really necessary to include these pathologies on such a list? It could be more useful to make a large audience; including children, aware of the physiology and pathology of sleep. It appears, from experts' reports, that the management of the problem requires a "driving hygiene".

Accidents, Traffic↗
PubMed1990

[Development of jurisprudence concerning the medical contract in esthetic surgery].

The authors report a study of 60 years of French Jurisprudence in relation to the medical contract in cosmetic surgery. Although the obligation can only be in the form of means in the case of surgery of living tissues, a special obligation nevertheless applies when the operation is not performed as a therapeutic procedure but at the patient's wishes. It is an obligation of caution and diligence, respecting the role of proportionality in the indications and the means applied to obtain the desired objective and the safety of the patient. The application of these means will be judged by the magistrate more severely than in therapeutic surgery. A certain degree of laxity in the investigation of a causal relationship in civil law has led to the use of the concept of decreased chance of survival for the compensation of victims of serious complications occurring during cosmetic surgical operations.

France↗
PubMed1989

[Chronobiologic organization of sleep].

Interrelations between sleep and chronobiology as been studied in isolated experimental situations. A succession of hormonal regulations has been described to explain these mechanisms. Some disruptions of these regulations might be at the beginning of a lot of sleep pathologies (jet lag syndrome, burn out syndrome, insomnia...).

Chronobiology Phenomena↗
PubMed1986

[Urinary stress incontinence in women: contribution of electromyography of the striated urethral sphincter].

Fourteen women within their menopausal period and suffering from stress urinary incontinence were studied. Electromyographic studies show that sphincter weakness is almost constant (9/14), usually associated with a bladder instability and/or a lack in abdominal urethral transmission, both conditions being known as possible causes of urinary stress incontinence. However, neurological causes at the origin of urinary stress incontinence, such as neurogenous sphincter, may be found (3/14). Electromyography, coupled with urodynamic evaluation, therefore presents itself as the most accurate method for a good assessment of correct pathophysiology in urinary stress incontinence and thereby for good therapeutic prescription.

Adult↗
PubMed1986

[Somatotropin secretion during sleep. Application to partial somatotropin deficiency in the child].

The authors studied somatotropic secretion during sleep in 122 children who had a backward growth of at last 2 standard deviations from the mean growth. Diurnal pharmacological tests showed 73 normal responses, 49 intermediate or dissociated responses orienting toward a partial deficit of STH secretion. The study of sleep secretion shows, among normal children, a secretory response superior to those pharmacological tests with a late secretory response in 20% of cases. In the group of children suspected of having a partial deficit, the study of sleep secretion permits to discover 27 children presenting a normal secretion, and to isolate a group of real partial deficit (22 children) who should have a treatment with the human growth hormone.

Adolescent↗