Biomedical subjects

M Dierick

Publications and source records attributed to M Dierick.

13 recordsLinked to original sources

PubMed2006

Chemical and morphological changes of historical lead objects as a result of the use of electrolytic reduction as a stabilization treatment.

This paper focuses on the evaluation of the treatment related to chemical and morphological changes of corroded lead artifacts when using electrolytic reduction as a stabilization method. Synchrotron radiation X-ray diffraction and X-ray photoelectron spectroscopy were used to study the chemical changes of the corrosion layer and on the top nanometer of surface, respectively. Neutron tomography and scanning electron microscopy were used to visualize potential morphological changes on millimeter and micrometer level, respectively. The results of this study have shown that electrolytic reduction is a reliable way to stabilize and conserve active corroded lead artifacts. The corrosion products are actually converted into metallic lead, while the morphological changes due to the treatment are limited.

Journal Article↗

PubMed2005

Electroconvulsive therapy in Belgium: a nationwide survey on the practice of electroconvulsive therapy.

OBJECTIVE: To review and describe the practice of electroconvulsive therapy (ECT) in Belgium. METHODS: A 30-item questionnaire on the practice of ECT was sent to all institutions providing ECT. RESULTS: In 2003 ECT was offered in 32 hospitals. Although ECT hospitals are equally spread over three regions, there is a significant difference in the ECT utilization rate. There are no major regional differences in the practice of ECT. Fifty-three percent of the hospitals reported less than 10 treatment sessions per month. The major indication for ECT was depression (89.7%). Propofol was the anesthetic most commonly used (75%). Eleven departments (34.3%) used a sine wave device. Bitemporal electrode placement was the preferred option in 65.6% of all departments, and 37% of these used the combination of bitemporal electrode placement and a fixed high stimulus dose. Continuation ECT and outpatient ECT were rarely used. LIMITATIONS: This questionnaire study relies upon answers given by psychiatrists, and did not audit actual practices. CONCLUSIONS: Although ECT is widely available in Belgium, it remains underused and the practice of ECT is amenable for improvement. Guidelines should be implemented and continuing education is needed.

Belgium↗

PubMed2004

High prevalence of mental disorders in primary care.

OBJECTIVE: To determine the prevalence of common mental disorders in an adult primary care population. DESIGN: Cross-sectional survey in randomly selected subjects, using the PRIME-MD questionnaire. SETTING: Eighty-six general practices in Belgium. SUBJECTS: A total of 2316 randomly selected patients, aged 18 years or older and consulting their general practitioner for other than administrative reasons alone, with slightly more women (58.1%) than men (41.3%). MAIN OUTCOME RESULT: Prevalence rates of mental disorders most commonly seen in primary care practice (mood, anxiety, somatoform, eating and alcohol disorders). METHODS: To facilitate data collection and processing, the entire PRIME-MD questionnaire was programmed on a handheld computer. Patient answers and physician assessments were immediately electronically recorded during the interview. All investigators were trained on the use of the PRIME-MD. The recruitment period lasted 6 weeks: from 15 February to 25 March 1999, and patients were randomly selected for the interview based on a computerized procedure. RESULTS: Although only 5.4% of all patients consulted for a psychiatric reason, a threshold/subthreshold psychiatric disorder was detected in 42.5% of all patients. Most commonly detected disorders were mood disorders in 31.0% (major depressive disorder, 13.9% and dysthymia, 12.6%), anxiety disorders in 19.0% (generalized anxiety disorder, 10.3%), somatoform disorders in 18.0% and probable alcohol abuse/dependence in 10.1%. The results also showed the important rate of comorbidity between these disorders. CONCLUSION: The present study confirms the high prevalence of mental disorders in a general practice setting, and their frequent association. Prevalence rates of our study are even higher than those obtained in previously conducted trials. Our study also demonstrates the utility of the PRIME-MD as a screening tool for mental disorders in primary care. In addition the use of the handheld computer software version of the PRIME-MD allowed us to screen for mental disorders in patients who are unable to attend the GP office and are seen during 'home' visits.

Adult↗

PubMed1996

A double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients.

1. This was a randomized, double-blind comparison of the efficacy and safety of venlafaxine and fluoxetine in outpatients with major depression. 2. Three hundred fourteen patients were randomly assigned to either venlafaxine 37.5 mg twice daily or fluoxetine 20 mg once daily for a maximum of 8 weeks. 3. If the response was inadequate after two weeks of treatment, the dosage of venlafaxine could be increased to 75 mg twice daily. 4. A clinical response, defined as at least a 50% decrease from baseline in the total HAM-D score, was attained at week 6 in 72% of patients on venlafaxine and 60% of patients on fluoxetine (p = 0.023). 5. Among patients who increased their dose at 2 weeks, venlafaxine was significantly (p < 0.05) superior from week 3 onward on the HAM-D. 6. Venlafaxine 75 mg daily is comparable to fluoxetine, but at 150 mg daily, it may be superior to fluoxetine in outpatients with major depression who do not respond early to treatment.

Adult↗

PubMed1996

An open-label evaluation of the long-term safety of oral venlafaxine in depressed elderly patients.

This open-label, multicenter study of depressed men and women > or = 65 years old was conducted at 18 European hospitals to evaluate the safety, efficacy, and clinical acceptability of venlafaxine in elderly depressed patients during 1 year. Patients received venlafaxine orally as 25-mg tablets two or three times daily for up to 12 months, Dosages were titrated upward during the first 15 days and then maintained between 50 and 150 mg/day. Safety was assessed on the basis of study events, vital signs, electrocardiograms tracings, and laboratory determinations. Efficacy was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impressions (CGI) scale, and the Hospital Anxiety and Depression scale. Patients' subjective ratings of the drug's tolerability and efficacy were collected. Study events were reported by 62% of patients. Few clinically or statistically significant changes occurred in vital signs or electrocardiogram or laboratory findings. No serious study events, including three deaths, were considered unexpected given the nature of the population and the length of treatment. Most patients (81%) believed they had no side effects. Clinical response was achieved in 67% of patients by month 2 (as measured by improvement on the CGI) and by 64% of patients by month 3 (as measured by improvement on the MADRS), suggesting that venlafaxine demonstrates antidepressant efficacy. Eighty-five (73%) patients were still in the study after 6 months and 77 (66%) were still participating at 12 months. Overall, most patients (80%) felt much or very much improved at the end of the study. Venlafaxine was safe, effective, and clinically acceptable treatment for depression in elderly patients.

Aged↗

PubMed1995

Mirtazapine is more effective than trazodone: a double-blind controlled study in hospitalized patients with major depression.

Two hundred hospitalized patients with DSM-III diagnosis of moderate to severe major depressive episode were randomized to receive mirtazapine or trazodone for 6 weeks in a double-blind trial. The dosages were 24-72 mg/day for mirtazapine and 150-450 mg/day for trazodone. The improvement on all depression rating scales used was generally greater for mirtazapine, with statistically significant differences over trazodone in the Hamilton Psychiatric Rating Scale for Depression total score and two subscores (the Bech melancholia factor and retardation factor), the Brief Psychiatric Rating Scale total score, the General Psychiatric Impression Global Assessment Scale, the Beck score and responder rates. Mirtazapine was well tolerated, while the trazodone-treated patients experienced somnolence more frequently, particularly during the first 2 weeks of treatment. Furthermore, postural symptoms were a clinical problem in 6% of the trazodone-treated patients. In this trial, mirtazapine showed significant clinical advantages over trazodone in terms of overall efficacy and tolerability.

Adult↗

PubMed1994

Controlled comparison of nefazodone and amitriptyline in major depressive inpatients.

Nefazodone, a phenylpiperazine antidepressant, exhibits novel dual activity on serotonin (5-HT) neurons; it binds to 5-HT2 receptors and inhibits 5-HT reuptake. Flexible doses of nefazodone (100-400 mg/day) and amitriptyline (50-200 mg/day) were compared in 106 major depressive inpatients in a 6-week double-blind study. Results showed significant superiority of amitriptyline over nefazodone on all rating instruments: Montgomery and Asberg depression rating scale (P < 0.0001), Hamilton depression scale (P < 0.0006), Clinical Global Impressions (P < 0.0001) and Patient Global Assessment (P < 0.01). A total of 65% of patients under amitriptyline and 56% of patients under nefazodone reported adverse events during the study, with significantly more dry mouth in the amitriptyline group (39% versus 11%, P = 0.001). Modal daily doses within the last treatment week reached 242 mg with nefazodone and 124 mg with amitriptyline. The lower efficacy of nefazodone, which contradicts comparative trials with imipramine in US patients, is discussed with regard to the dose of nefazodone, probably below the optimal therapeutic range for melancholic patients, and to the clinical differences between the patient samples.

Adolescent↗

PubMed1990

Moclobemide versus clomipramine in the treatment of depression: a double-blind multicentre study in Belgium.

Moclobemide and clomipramine were compared for efficacy, tolerance and safety in 63 mixed endogenous and nonendogenous depressed patients. Treatment was given for at least 4 weeks in a double-blind, randomized, parallel-group design. The mean Hamilton Rating Scale for Depression score decreased gradually during treatment with no differences between groups. Two patients on clomipramine and none on moclobemide were withdrawn for lack of efficacy, and poor tolerance caused 3 patients on moclobemide and 7 on clomipramine to stop treatment prematurely. Patients with endogenous depression responded better to clomipramine, whereas nonendogenous disorders did better on moclobemide. Adverse events were more frequent in the clomipramine group and more of these were severe or very severe than for moclobemide. Thus, although no significant difference in efficacy was seen, moclobemide appeared to be tolerated better than clomipramine. The numbers were small, however, and many patients received concomitant medication, and the results are therefore difficult to interpret.

Antidepressive Agents↗

PubMed1975

Prostaglandin E2 on the electroencephalogram.

Present study was prompted by the report from another center on the occasional occurrence of convulsions and abnormal electroencephalogram (E.E.G.) patterns in women aborted with intra-amniotic prostaglandin F2alpha (PGF2alpha). Fifty four subjects were investigated by means of an E.E.G. taken before and after initiation of PGE2 administration. They included pregnant and non-pregnant patients, nearly half (23) of whom were known epileptics. One seizure was observed during PG administration in a man with daily psychomotor attacks who had not taken his anticonvulsants on the day the test was performed. PGE2 caused no alteration of the E.E.G. in subjects with a normal control tracing; in those with an abnormal E.E.G., a deterioration was seen in one and an improvement in three. It is concluded that PGE2 is not epileptogenic at doses required for termination of pregnancy.

Abortion, Induced↗

PubMedDate not supplied

An open multicentre study to evaluate the efficacy and tolerance of fluoxetine 20 mg in depressed ambulatory patients.

In this study, 544 out-patients suffering from depressive disorders were enrolled in 6 weeks open study with fluoxetine 20 mg. A statistically significant decrease of the Hamilton Rating Scale for Depression (HRS-D) score is observed during treatment. All individual item HRS-D scores and in particular suicidal ideation, sleep disturbances and anxiety showed the same improvement. Side-effects were carefully recorded and presented a lower incidence rate than in other studies. New issues in methodology management concerning ambulatory studies are discussed.

Adult↗

PubMedDate not supplied

Treatment of depressive anxiety states associated with psychosomatic symptoms. A double-blind multicentre clinical study: mianserin versus melitracen-flupentixol.

A four-week randomized multicentre study comparing mianserin and melitracen-flupentixol was conducted in 90 outpatients suffering from depressive anxiety states with a predominantly psychosomatic symptomatology. Both patient groups showed a favourable clinical response to treatment as well as a good tolerance. No significant differences were observed in the drop-out rates or in the incidence of side-effects, although drowsiness tended to develop more frequently during the first days of mianserin treatment. The improvement scores of the groups showed that mianserin has significant advantages when depressed mood, sleep disturbances and autonomic disregulations predominate the depressive anxiety state.

Adolescent↗

PubMedDate not supplied

Periodic electroencephalographic compleses and subacute sclerosing panencephalitis. A case report and a survey of literature.

The authors report the case of a child with a presumable diagnosis of subacute sclerosing panencephalitis (SSPE). But pathological examination of the brain showed only a moderate neuronal loss in the cortical and subcortical grey matter. From this case and from the data in the literature it is concluded that the electroencephalogram in stage II of SSPE is characterized by the appearance of paroxysmal wave complexes which recur pseudo-periodically against a disorganized basic activity. The criteria for these complexes are not as strict and the periodicity is not as regular as formerly believed. Such a tracing is not pathognomonic of SSPE and may also occur-although rarely-in other brain diseases. The theory that the periodic discharges originate from a diffuse alteration of cortical and subcortical grey matter seems the most plausible.

Child, Preschool↗

PubMedDate not supplied

The influence of prostaglandin E2 on the electroencephalogram of normal subjects and epileptic patients.

In 1973 R.C. Lyneham and others warned against the possible epileptogenic effect of prostaglandins. We studied the influence of this substance on the electroencephalogram of 53 subject (31 non-epileptics and 22 epileptics) before and during the administration of PG E2. Forty-eight tracings remained unchanged, four showed a slight improvement and one showed some worsening during infusion of PG E2. One patient, suffering from daily psychomotor attacks had, accidentally a fit during the trial. It can be concluded that PG E2 does not alter the electroencephalogram in a significant way and that it does not induce epileptic seizures.

Epilepsy↗