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Biomedical subjects

R Behar

Publications and source records attributed to R Behar.

17 recordsLinked to original sources
PubMed2001

[Gender identity and eating disorders].

BACKGROUND: A possible role of the feminine gender role in the genesis of eating disorders is possible, since most patients with these disorders are women. AIM: To compare some traits of gender identity between females with eating disorders and a control group. MATERIAL AND METHODS: An structured clinical interview based on the DSM-IV diagnostic criteria for eating disorders and the Bem Sex Role Inventory (BSRI) were administered to 63 patients that fulfilled the DSM-IV criteria for anorexia nervosa or bulimia nervosa (ED group) and 63 comparison subjects (C group). RESULTS: Forty three percent of patients in contrast with 23.8% of controls were classified within the feminine category. Likewise 19% of patients and 31.7% of controls were qualified as Androgynous; 27% of patients and 43% of controls were qualified as Undifferentiated. There were significant differences between patients and controls in 22 items of the BSRI (p < 0.01). Both groups rejected and were identified with some feminine, masculine and neutral qualities. DISCUSSION: Femininity emerged as the main trait of gender identity in patients suffering of eating disorders. In contrast, Androgyny showed by the control group could result in a better adaptability and flexibility to face difficult life circumstances.

Adult↗
PubMed1998

[Eating disorders in adolescents: clinical and epidemiological aspects].

OBJECTIVE: To compare in female adolescents clinical and epidemiological aspects of eating disorders. METHODS: Three hundred schoolgirls, university students and young girls with weight problems who did not score within the pathological range of the Eating attitudes test (EAT-40) (group S), one hundred and thirty eight schoolgirls, university students and young girls with weight problems who scored within the pathological range of the EAT-40 (group SC) and one hundred eating disordered patients (group THC) were given the Eating disorders inventory (EDI). RESULTS: The EAT-26 emerged as an abbreviated and trustful instrument. The scores on the EAT-40 and EDI were lower in group S, intermedial in group SC and higher in group THC. The same statistically significant differences (p < 0.001) were observed on Interoceptive awareness. Bulimia, Ineffectiveness and Maturity fears. Diet (EAT-40-Factor I) (90%) and EDI-Drive for thinness (87%) had the highest sensitivity. CONCLUSIONS: The EAT-26, EAT-40 and EDI were useful to confirm an eating disorder. On one hand, the profile of the eating disordered patients and the adolescents at risk was characterized by a high Drive for thinness and Body dissatisfaction and on the other, by a low Interoceptive awareness. Diet and Drive for thinness may be helpful for screening large non-clinical groups to predict an eating disorder. Finally, the importance of the nutrition assessment and primary prevention is emphasized.

Adolescent↗
PubMed1992

[Gender role and anorexia nervosa].

The gender role is defined; its physiognomy, adopted by women since the occurrence of the Industrial Revolution, and the intricate status that characterizes the present feminine role are described. Finally, a psychosocial approach of anorexia nervosa is made. This disorder is considered as a paradigm of the present ambiguity of the femininity concept likely to become a transactional phenomenon between sexual identities.

Anorexia Nervosa↗
PubMed1987

Cytomegalovirus polyradiculoneuropathy in acquired immune deficiency syndrome.

A 34-year-old homosexual man with acquired immune deficiency syndrome developed extraocular muscle deficits, chorioretinitis, and paraplegia without sensory symptoms. EMG showed severe diffuse denervation, but only mildly slowed nerve conduction velocities, in both legs. Meningitis persisted for 6 weeks and was exacerbated prior to the patient's death. Necropsy revealed subpial and subependymal cytomegalovirus (CMV) infection. Histology of ventral roots demonstrated proximal CMV infection and massive fiber loss. In this immunosuppressed patient, CMV caused a severe motor polyradiculopathy by selective destruction of the motor neurons of ventral spinal roots and motor cranial nerves.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Meso-2,3-dimercaptosuccinic acid in the diagnosis and treatment of lead poisoning.

Lead poisoning remains one of the hazards of industrialized civilization. CaNa2 EDTA and dimercaprol, the usual therapeutic measures, have many side effects and can be given by parenteral route alone. The authors present a case of chronic lead poisoning caused by ingestion of contaminated flour ground in a primitive flour mill. The diagnosis was confirmed by the CaNa2 EDTA provocative test. Dimercaptosuccinic acid (DMSA) was given orally as a further provocation and resulted in an 11-fold increase in urinary lead excretion. A 5-day course of treatment with DMSA was instituted, during which symptoms abated, urinary lead excretion increased and the blood lead level decreased. No side effects were noticed. There has been no relapse over several months of follow-up. The authors conclude that the oral use of DMSA is effective, safe and convenient both as a provocative test in establishing the diagnosis of lead poisoning and as a therapeutic tool.

Adult↗
PubMed1986

Guillain-Barré syndrome associated with Hashimoto's thyroiditis.

A 73-year-old patient developed tetraplegia, cranial neuropathies and autonomic instability and died of clinical complications of Guillain-Barré syndrome. He was incidentally found to have subclinical Hashimoto's thyroiditis. The literature since 1966 is reviewed for the association of Guillain-Barré syndrome with thyroiditis, other endocrine abnormalities, and some diseases thought to be caused by autoimmune mechanisms.

Aged↗
PubMed1986

Hürthle cell tumors: a twenty-five-year experience.

During a 25-year period (1959 through 1983), 54 patients with Hürthle cell tumors were treated and monitored at the University of Chicago Medical Center. Thirty percent were men and 70% were women; mean age at diagnosis was 46.7 +/- 13.2 years (range: 19 to 69 years). Tumors were grouped into three categories at the time of initial diagnosis: group 1, grossly malignant (four patients, or 7.5%); group 2, intermediate (partial capsular and/or subcapsular vascular invasion) (10 patients, or 18.5%); and group 3, benign appearing (40 patients, or 74%). Twenty-one (39%) of the patients had a history of low-dose, external radiation to the head and neck in childhood (including three of four grossly malignant lesions). A separate non-Hürthle cell thyroid carcinoma was found within the thyroid gland in 22 (50%) of the patients--79% were papillary and 21% were follicular carcinomas. In half of these, there was a history of childhood irradiation. During a mean follow-up period of 8.4 years (range, 22 days to 35 years), three additional Hürthle cell tumors were recognized as malignant after metastases were discovered--two were originally classified as intermediate lesions and one was in the benign-appearing group. Thus, seven of 54 of our patients (13%) had Hürthle cell carcinomas. One of the seven patients died of widespread metastases after 35 years, and the other six are currently free of disease. We believe that therapy of these lesions should be individualized. Total thyroid ablation (surgical procedure followed by radioiodine therapy) is appropriate for frankly malignant Hürthle cell cancers, for all Hürthle cell tumors occurring in patients who received low-dose childhood irradiation, for associated papillary or follicular carcinomas, and in those patients who exhibit partial capsular or subcapsular vascular invasion. On the other hand, single, well-encapsulated, benign-appearing Hürthle cell tumors may be treated by lobectomy and careful follow-up, since the chance that they will later exhibit malignant behavior is low (2.5% in our series and 1.5% among patients described in the recent literature).

Adenoma↗
PubMed1986

Graves' disease and thyroid cancer.

The relationship between Graves' disease or its therapy and carcinoma of the thyroid remains uncertain. We studied 20 patients found to have thyroid cancer in glands previously treated for Graves' disease between 1961 and 1986 at the University of Chicago Medical Center. Sixteen (80%) occurred in women and four (20%) occurred in men. The mean age at operation was 37 years (range, 19 to 69 years) and did not differ by sex. Fifteen of the 20 cancers (75%) were papillary while five (25%) were follicular. Six individuals (30%) had a history of external radiation to the head and neck as an infant, child, or young adult. Two others had received radioiodine (RAI) therapy for Graves' disease 1 and 19 years earlier. Patients were divided into three groups: group I: four patients (20%) had a neck mass 4, 14, 20, and 41 years after having had a subtotal thyroidectomy (STT) for Graves' disease; three of four had a history of external irradiation therapy. These tumors behaved aggressively, resulting in the death of two of the four patients. group II: 11 patients (55%) had diffusely enlarge toxic goiters without a nodule. A carcinoma was diagnosed intraoperatively on frozen section in only two of these patients. The others received STT. After recognition on permanent section, those carcinomas that were 4 mm or greater in diameter received postoperative RAI. One recurrence occurred and was treated successfully with further RAI. group III: Five patients (25%) had Graves' disease and a palpable thyroid nodule. None of them had had a prior thyroidectomy for Graves' disease, as in group 1. Thyroid carcinoma was diagnosed in all patients preoperatively or intraoperatively, and a total thyroidectomy was performed. Each patient is alive and well with a mean follow-up of 5 years. Between 1971 and 1981, 194 patients had surgery for Graves' disease, and 10 (5.2%) were found to have an associated carcinoma; six patients (3.1% of the total) did not have a nodule or any other suspicion of malignancy before surgery. During the same time, 303 patients received RAI therapy for Graves' disease and one (0.3%) has subsequently developed thyroid carcinoma. Thyroid cancer associated with Graves' disease is found more commonly in surgically treated patients than in patients after RAI therapy. The greatest risk factor in our patients was previous external radiation to the head and neck. Such individuals should be treated with total thyroid ablation rather than the usual STT, since they are at risk of developing aggressive thyroid cancers if thyroid remnants are left.

Adult↗
PubMed1985

Uncomplicated bilateral intraocular lens implants: intracapsular and extracapsular results in the same patient.

Forty-one patients (82 eyes) underwent bilateral intraocular lens implantation. The first eye of each patient received an anterior chamber lens with intracapsular extraction while the second eye received a posterior chamber lens with extracapsular extraction. Ninety-two per cent of the eyes having intracapsular extraction and 95 per cent of the eyes undergoing extracapsular extraction obtained 20/40 vision or better when surgery was free of intraoperative complications. Statistical difference between groups was not significant. The most common complication was chronic cystoid macular oedema, the incidence of which did not differ between groups. Using patients as their own controls, there does not appear to be a statistically significant difference in results or complications between cataract extraction performed by an intracapsular technique and anterior chamber lens versus an extracapsular procedure with posterior chamber lens.

Adult↗
PubMed1984

Caries, diet, dental knowledge and socioeconomic variables in a population of 15-year-old Israeli schoolchildren.

A population of 163 10th grade, 15-yr-old students of a Jerusalem high school were surveyed for caries prevalence, cariogenic dietary habits, dental knowledge and socioeconomic variables. A mean level of 7.75 DMFT was found, confirming results of previous studies which indicate a general increase of caries prevalence in Israel over the past two decades. None of the independent variables measured constituted significant predictors of caries prevalence. However, father's geographic origin, mother's educational level and social class according to father's occupation demonstrated significant associations with caries treatment levels as expressed by the FT and DT components of the DMFT index.

Adolescent↗
PubMed1981

Changes in the prescription of anticholinergic drugs (1970-1977) in a state hospital.

A study of the prescribing patterns of physicians in a state hospital during 1970-1977 revealed a four-fold drop in the use of combinations of drugs with strong anticholinergic properties. This dramatic shift to more rational practices stands in contrast to reports of persistent inappropriate prescribing in other settings. The time pattern of the changes suggests that an active ongoing educational program combined with a drug monitoring system providing feedback to physicians was primarily responsible for the findings. This study clearly documents the fact that physicians' prescribing patterns are amenable to change in the direction of more appropriate practices.

Antidepressive Agents, Tricyclic↗
PubMed1979

Renin aldosterone system and potassium levels in chronic lead intoxication.

Renin activity and aldosterone were evaluated relative to potassium levels and lead intoxication in 33 patients with a history of "moonshine" ingestion. Patients were divided into three groups: I, lead intoxicated with hyperkalemia; II, lead intoxicated without hyperkalemia; and III, not lead intoxicated without hyperkalemia. Those in group I demonstrated suppressed plasma renin activity, baseline and after furosemide, and blunted aldosterone responsiveness to furosemide. Plasma renin activity was not different in groups II and III, whereas aldosterone responsiveness was less in group II than in III. Group I patients tended to be older, had lower creatinine clearances, and six of nine had mild hyperchloremic acidosis. Diabetes and cortisol insufficiency were not present. Chronic lead intoxication due to illicit alcohol ingestion is associated with hyporeninemic hypoaldosteronism and hyperkalemia which appear to develop as the lead nephropathy progresses with duration and/or aging.

Adult↗
PubMedDate not supplied

Neurology referral patterns.

To examine the indications for referral of patients to neurologists, a survey was conducted of 88 such referrals by general internists in an HMO. In approximately one third of all referrals, the neurologist's advice regarding diagnosis and treatment was of minor or no importance. Instead, such referrals were often responsive to patient and family demands or focused upon the necessity for neuroimaging, even when the likely diagnosis and required treatment were already evident. Referral rates in HMO practice are strongly influenced by the practice styles of primary care providers. The authors conclude that a case manager ("gatekeeper") mechanism in competitive medical plans that excludes patient self-referrals may have a greater effect upon total (and surgical) specialty care, compared with the volume of services provided by medical specialists such as neurologists.

Data Collection↗