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M Matas

Publications and source records attributed to M Matas.

53 records · Page 3Linked to original sources

Evaluation of buspirone as an antianxiety agent: buspirone and diazepam versus placebo.

Buspirone has previously been demonstrated to be efficacious in the treatment of anxiety. This four-week double-blind parallel study compared buspirone to diazepam and placebo in the treatment of 119 outpatients diagnosed as having generalized anxiety disorder. After a seven-day placebo washout period, eligible patients were randomized to one of three treatment groups. Buspirone (5 mg) and diazepam (5 mg) were administered BID and individually titrated to an optimal therapeutic dose by the end of week two. Buspirone and diazepam were equally effective in reducing Hamilton Anxiety (HAM-A) total and psychic factor scores from baseline values. Buspirone alone was significantly better than placebo in reducing the HAM-A somatic factor score. Sixty-seven percent of both active treatment groups who were classified as "ill" on the baseline global psychopathology rating scale achieved a "not ill" status by study end. There were no significant differences between treatment groups at endpoint on the 56-item Symptom Checklist self-rating scale. Buspirone was demonstrated to be as effective as diazepam in relieving anxiety in this outpatient sample.

Adult↗

Diagnosis and treatment of monosymptomatic hypochondriacal psychosis in chronic renal failure.

The authors describe a case of a patient who presents with a delusional interpretation of a somatic symptom, uremic pruritus. The literature on the diagnosis and treatment of monosymptomatic hypochondriacal psychosis (MHP) is reviewed and discussed. There is an effective treatment available for this disabling condition--a neuroleptic agent called pimozide, which appears to have a selective ability to block central dopaminergic receptors.

Adult↗

DSM-III: problems in diagnosis of paranoia and obsessive-compulsive disorder.

The diagnoses of paranoia and obsessive-compulsive disorder are not adequately dealt with either conceptually or phenomenologically in DSM-III. A case of monosymptomatic hypochondriacal psychosis illustrating this point is presented. The question of whether this disorder should be diagnosed as paranoia, obsessive-compulsive disorder or an atypical affective disorder is discussed.

Adult↗

The girl who cried wolf: pseudologia phantastica and sexual abuse.

There has been an explosion of interest recently in sexual abuse and incest, with reported causal links to a wide variety of psychiatric disorders. The integrity of Freud's seduction theory has been challenged by Jeffrey Masson and sexual abuse activists. What is the position of a therapist who finds out that a patient's reports of incest and sexual abuse turn out to be fabrications? These issues are presented and discussed in the context of a brief, illustrative case history. There is also a review of the concept of "pseudologia fantastica", as well as a brief review of a feminist critique of Freudian theory.

Adult↗

A clinical trial of buspirone and diazepam in the treatment of generalized anxiety disorder.

In double-blind trials with hundreds of patients, buspirone has proven to be as effective an anxiolytic as the benzodiazepines. It causes less sedation and motor impairment than diazepam, and may be particularly useful in geriatric patients. We conducted a 4 week double-blind, randomized trial of buspirone versus diazepam and placebo in thirty adult outpatients with generalized anxiety disorder. Maximum doses were 40 mg of diazepam or buspirone or eight placebo tablets a day. There were no significant differences in outcome between the three groups on any physician or subject measures. Some implications of this finding are discussed.

Adult↗

Mental illness and the media: Part II. Content analysis of press coverage of mental health topics.

The public image of psychiatry has been tarnished in recent years. In order to determine the extent to which press coverage has contributed to negative attitudes towards psychiatry, we conducted a content analysis of a random selection of newspaper articles which appeared over a twenty-year period in two different newspapers. We found that although there had been some minor, cosmetic changes over the years, such as more appropriate headlines and more direct quotes from psychiatric experts, on the whole, content and attitudes had changed very little. An accuracy check of media reporting of forensic cases over a 20-year period revealed that when reporters have access to written material, the accuracy levels are greatly improved.

Attitude to Health↗

Mental illness and the media: an assessment of attitudes and communication.

Media coverage of psychiatric issues will reflect or influence public perceptions of the mentally ill. In order to explore the relationship between psychiatry and the media, an attitudinal questionnaire was administered to a systematic sample of 20 reporters, 20 psychiatrists, 20 medical outpatients with no psychiatric history, and 40 psychiatric inpatients. In addition, 4 psychiatric patients who had personal experience with media coverage were interviewed to determine the impact. Their stories are presented as clinical vignettes. The results of the questionnaire survey show that media reporters are no less accepting of mental illness than the other groups. A regression analysis of attitudinal predictors elicit education as more significant than age and media exposure. Yet low scores for the coverage by the media of mental illness were given by all groups with psychiatrists tending to be most critical. Reasons offered by reporters included "sensationalism sells" along with cost and time factors. Recommendations for both reporters and psychiatrists groups were collated, aiming at improving communication and ensuring a more positive emphasis and greater accuracy of media coverage of mental health issues.

Adult↗

[Indications for carotid endarterectomy without arteriography. A validation study using eco-Doppler].

INTRODUCTION: The possibility of diagnosing carotid stenosis and carrying out surgery without arteriography has increased with the use of different diagnostic methods. The eco-Doppler has been shown to be a useful method, although it requires previous individualised validation. OBJECTIVE: We aim to validate our Vascular Diagnostic Laboratory in the diagnosis of stenosis of the carotid bifurcation using eco-Doppler as compared with angiography, and the therapeutic indication thus obtained. PATIENTS AND METHODS: We made a prospective study for one year of 62 consecutive patients diagnosed on eco-Doppler as having carotid stenosis of over 70% and subsequent carotid arteriography. The treatment indicated is given, without waiting for the result of the angiography, on clinical evaluation, computerized tomography or cranial magnetic resonance and eco-Doppler, and subsequently on angiography. The degree of correlation of both methods, both for the therapeutic indication and for the degree of stenosis was determined. RESULTS: In five cases there was discrepancy and the therapeutic indication was different. Three of these were related to the diagnosis of carotid occlusion and in the other two cases there were bilateral lesions of over 50% on eco-Doppler, which were classified as minor on angiographic study. In the group with stenosis of over 70% with < 50% contralateral stenosis, eco-Doppler showed sensitivity and specificity of 100%, with a kappa correlation index = 1. CONCLUSION: It is possible to indicate carotid endarterectomy in patients with unilateral stenosis greater than 70% and contralateral stenosis < 50%, based on the eco-Doppler studies done in our Vascular Diagnostic Laboratory.

Aged↗

[Mobile carotid plaque].

INTRODUCTION: In the literature only seven cases have been published describing a mobile carotid plaque, and lack of precise description makes it difficult to differentiate these lesions from mobile thrombotic lesions. The natural history of these lesions is not known and their treatment is controversial, although there is a tendency to choose the type of treatment to be given according to the embologenic potential of the lesion. CLINICAL CASES: We report two cases with mobile carotid plaques. In both cases diagnosis was made on ultrasound Doppler. The first patient had neurological symptoms and a mobile plaque associated with stenosis of over 70%. Surgical treatment was indicated. The second patient had no neurological symptoms. On ultrasound Doppler studies there was a fragment of mobile plaque in the common carotid artery, in the region of the carotid sinus with stenosis of 30 50%. Distal to this zone, in the bulb of the internal carotid artery there was stenosis of >70%. In this case medical treatment was given in view of deterioration in the patient s general state. Both patients improved. CONCLUSIONS: Including our second case, three patients with mobile carotid plaques (neurologically asymptomatic) have now been reported to have made good progress with medical treatment. Until there is more data regarding the natural history of these lesions, they should not be considered to be in themselves sufficient reason for carrying out carotid endarterectomy. The possibility of indicating surgical treatment depends on the degree of carotid stenosis.

Aged↗

[Distal bypass to the critical ischemia].

Possibilities from the distal popliteal by-pass practiced with the purpose to conserve the extremity in cases of critical ischaemia at lower limbs are analyzed. A variant from the III-Fountaine-stage based on an haemodynamic criterium was established. Authors's experience with such distal by-pass is exposed and indications and results are analyzed.

Adult↗

[New criteria for the classification of the popliteal artery entrapment syndrome. Our experience with 14 extremities].

Authors explain their experiences with eight patients (14 affected limbs) with a popliteal artery entrapment syndrome. Classification, diagnosis and treatment were reviewed. Six limbs, with any malformation and presenting as a unique sign an important hypertrophy of their intern gastrocnemius muscle, couldn't be classified. As a result, a new classification of this pathology is presented being based on the anatomical and arteriographic aspects as well as oh the surgical indication. The important correlation between anomaly, physical complexion typus athletic and sports is noted.

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