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Biomedical subjects

S Daini

Publications and source records attributed to S Daini.

4 recordsLinked to original sources
PubMed1995

[Making real].

OBJECT: This paper has the aim to explore psychopathological traits of anorexia nervosa leading to somatization, in critical periods of this disorder, in the clinical framework of analytically oriented psychotherapy performed in hospital setting. DESIGN: Psychodynamic observations in high risk cases, with at least three years of follow-up, are compared with different crisis situations, of psychosomatic or psychic nature. Common and specific psychopathologic features are outlined. BACKGROUND: General Hospital background, liaison problems, and integrative needs between medical and psychotherapeutic caregivers are not only aspects of real situation, but also a group matrix of change for anorexic patients. PATIENTS: Twelve high risk subjects with restricting anorexia were studied, out of a sample of 36 women with eating disorders, admitted to hospital between 1989 and 1991. They were treated by integrated psychotherapeutic and medical methods, in a supportive, unprescriptive therapy plan. RESULTS: Psychosomatic crisis points out that the process that makes real death risks and fantasies is both intrapsychic and interpersonal one. Absence of a cohesive inner organization leads patients to try to establish fusion with other and to search for cohesion in hospital field turning away from adaptive integration in real life. Psychotherapy, in this setting, is a first movement of integrating identity as separate from family and field. From doctor's point of view, to be only concretely oriented involves the risk of losing patient's thought dimension, and, from psychotherapist's point of view, to pay attention only to mind or interactions involves the risk of losing real subject's and field's coordinates. Converging attention and investment by both caregivers seem to rapidly reverse somatization process and to help a first step of integration by the anorexic patients.

Anorexia Nervosa↗
PubMed1994

Opioid dysregulation in anorexia nervosa: naloxone effects on preprandial and postprandial growth hormone response to growth hormone-releasing hormone.

Previously, we have shown that in the opposite extremes of nutritional status, obesity and anorexia nervosa (AN), growth hormone (GH) response to growth hormone-releasing hormone (GH-RH) is not inhibited by the ingestion of a normal 800-cal meal consumed at lunch time (1 PM), which is at variance with results in normal subjects. However, in obese patients the postprandial increase in GH response to GH-RH is inhibited by an infusion of naloxone (NAL). In this study we have tested anorectic patients, performing the following tests at 1 PM: GH-RH test (50 micrograms IV) or, in a different day session, NAL (1.6 mg/h, starting 30 minutes before GH-RH) + GH-RH test (50 micrograms IV). The tests were performed in the following three different experimental conditions: (1) short-term fasting studies (lasting from breakfast), (2) long-term fasting studies (from midnight of the day before) and (3) postprandial studies (after a standard meal consumed 1 hour before the test). In AN, the GH response to GH-RH was not influenced by NAL infusion at 1 PM, in both short- and long-term fasting studies (short-term fasting: peak values after GH-RH alone, 26.5 +/- 6.5 ng/mL, during NAL, 28.0 +/- 3.3 ng/mL; long-term fasting: peak values after GH-RH alone, 32.2 +/- 6.8 ng/mL, during NAL, 30.6 +/- 4.0 ng/mL). A partial NAL-inhibitory effect was instead observed in postprandial studies, as evidenced by the calculation of areas under the curve ([AUCs] 1,662.1 +/- 90.0 after GH-RH alone v 1,090.5 +/- 245.4 ng/mL/h during NAL).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Transanal electrostimulation for fecal incontinence: clinical, psychologic, and manometric prospective study.

A prospective study was carried out to analyze the clinical, psychologic, and manometric short-term results of transanal electrostimulation (TES) in the treatment of fecal incontinence. Fifteen patients underwent TES. An initial clinical and manometric assessment was carried out before and 1 month after the procedure. A psychologic evaluation was also performed by means of interviews and appropriate tests. Early improvement of symptoms was noted in 10 patients. The nonresponders were women with gross daily incontinence to solid stool. At anal manometry, resting tone and rectal sensation remained unchanged, whereas a significant increase of voluntary contraction was observed following TES (from 48 +/- 26 to 59 +/- 39 mm Hg, P = 0.03). Psychologically, TES led to a significant decrease of both latent and paranoid anxiety related to symptoms (P = 0.02). At a clinical reassessment 6 months later, one of the nonresponders became continent after a further course of TES. In conclusion, TES is well accepted by the patients, is followed by positive emotional response, and, by improving striated sphincter function, seems to be effective in the treatment of partial fecal incontinence.

Adolescent↗