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Biomedical subjects

M Girard

Publications and source records attributed to M Girard.

At least 487 records · Page 27Linked to original sources
PubMedDate not supplied

[Role of psychotherapy in the treatment of schizophrenia].

Reality-adaptative, supportive psychotherapy, institutional cares, therapeutics with artistic mediations, family therapeutics are unanimously recognized as efficacious therapeutics for schizophrenic inpatients and outpatients. Conversely, the usefulness of psychoanalysis and exploratory, insight-oriented psychotherapy is questionnable. To clear up the question, we have studied controlled and non controlled studies comparing different psychotherapies, as well as the results of individual psychoanalysis. Among the controlled studies, Stanton's study stands out for its methological strictness. This study, in 164 schizophrenics, shows that insight-oriented psychotherapy is not more efficacious than supportive psychotherapy. In the continuation of this work, A. Frank and J. Gunderson show that the determinant factor of the psychotherapy's result is relational continuity and especially therapeutic alliance. Some works made in France show that 6 to 8 months are needed to appreciate the efficacy of institutional cares and psychotherapies can be observed. The psychoanalysis is not always efficacious. But these long acting experiences have provided irreplaceable knowledge towards the understanding of schizophrenic self and transference, effects of institutional cares, therapeutics with artistic mediations, supportive psychotherapy, theoretical reflection (Racamier, Rosenfeld, Searles, etc). Among the metapsychological knowledge, we must see: alterity's denial, struggle against thinking's activity, erotically paradoxical transference, receptacle's and depositary's function of therapists, inexistence of containing function. These knowledges explain that the two principal functions of the care given to schizophrenics are: help to self and presence.

Humans↗
PubMedDate not supplied

[Comparative risks and benefits of drugs. Methodological problems].

A focalizing toxicity is defined here as a specific toxicity which attracts much of the attention devoted to the safety of a drug: the hematotoxicity of "second generation" antidepressants is a typical example of such toxicity. The way in which it is handled is frequently biased, whether this be related to its perception or its reporting; as a result, it hampers the process of assessing the risk/benefit ratio of drugs. An attempt is made here to sketch the principles and methods of the validation of safety data; antidepressants furnish various examples of the different points that we make. Finally, we insist upon the fact that assessment of drug risk/benefit ratio must be global and comparative.

Animals↗
PubMedDate not supplied

[Risk-benefit ratio of drugs. Antidepressive agents as an example].

Medical judgments in therapeutics must be comparative. The toxicity of a drug cannot be considered independently of that of other treatments for the same condition. Such comparison requires new specific methods in order to assess the quantity, quality and validity of available data. A comprehensive analysis is of paramount importance: ideally, all the advantages and disadvantages of different treatments should be simultaneously compared. As far as antidepressants are concerned, the quality of life and the risk of overdose should be borne in mind. Such metaanalyses lead to the identification of a variety of biases likely to distort our judgments related to the risk/benefit ratio of drugs: the bias of perception and of reporting are amongst the most important.

Antidepressive Agents↗
PubMedDate not supplied

[Long-term peridural morphine analgesia in neoplastic and vascular pathology].

Epidural analgesia using morphine has been used on 44 patients with intractable chronic pain, resistant to analgesics (including opiates). The pain was due to cancer in 24 cases, of vascular origin in 20. An indwelling tunnelized epidural catheter afforded repeated injections of morphine for a long period (up to 129 days) either in hospital or at home. The quality of analgesia achieved was rated as excellent or good, in 68 p. 100 of cases. Two cases only were total failures. Side effects, relatively common, were usually transient and minor; no case of respiratory depression or of infection has been recorded.

Adult↗
PubMedDate not supplied

[Multiple hydatidosis: hepatic, splenic, peritoneal and gynaecologic locations (author's transl)].

We report the case of a young Algerian female with a voluminous abdominal tumour suggestive of a hydatic cyst of the liver. Complementary examinations (radiography of adjacent organs, ultrasonography, coelio-mesenteric arteriography, hepatic scanning) revealed two additional abdominal cysts. Furthermore, gynaecologic examination and ultrasonography revealed one intra-uterine hydatic cyst. At laparotomy however, the surgeon removed sixteen abdominal and five pelvic cysts, all of them containing brood capsules. It should be noted that one eleven centimeters-diameter splenic cyst was discovered only at operation. The authors point out the rarity of the uterine location of hydatidosis and stress the difficulty of the preoperative localization of all the cysts. In these widespread forms of the disease, complementary flubendazole treatment could be useful.

Adult↗