PubMed Health⌕ Search

Biomedical subjects

S Ramon

Publications and source records attributed to S Ramon.

At least 19 recordsLinked to original sources
PubMed2001

Experiencing personality disorder: a participative research.

As Personality Disorder continues to be a subject of intense public and professional debate, this study has explored by means of an in-depth interview the views of fifty people to whom this diagnosis has been attributed, to include: demographic data, type of personality disorder and other diagnoses; its meaning for them; how they found out about the diagnosis; its impact; related life events, and value of different types of support. The interviewers were also people with the same diagnosis, who have been trained specifically for this purpose. The findings highlight the mainly negative impact of the label, and the gap between the users' perception of the problems they face in the context of having this diagnosis, and professional perspectives. The likely implications of the findings for the validity and usefulness of the diagnosis are outlined. The methodological innovation of engaging service users with personality disorder is looked at in terms of usefulness and feasibility.

Adolescent↗
PubMed1998

Traumatic spinal cord injury complicating ankylosing spondylitis.

The aim of this paper is to review the incidence and characteristics found in traumatic spinal cord injury (SCI) occurring in patients with long-standing ankylosing spondylitis (AS). The incidence of patients with traumatic SCI admitted to our unit from January 1984 to February 1996 was 2% (15 out of 893). They were all men with a mean age of 56 years. Most frequently the etiology of the lesion was a motor vehicle accident and the injury was mainly due to a hyperextension mechanism. Acute spinal fracture occurred in 13 patients, all involving the cervical region. No fracture was observed in two patients with thoracic neurological level. Three patients presented with an interval free period of neurological symptoms in whom a spinal epidural hematoma was visualized with magnetic resonance imaging. On admission eight patients were diagnosed as having complete SCI and the other seven an incomplete SCI. In the acute phase, respiratory complications were most frequent, causing six patients to die. Treatment was conservative in 14 patients. Multidisciplinary management of these patients should be implemented in an institution equipped with both a Spinal Injury Unit and an Intensive Care Unit.

Adult↗
PubMed1997

Myocardial protection in normal and hypoxically stressed neonatal hearts: the superiority of blood versus crystalloid cardioplegia.

OBJECTIVES: Blood cardioplegia predominates in the adult because it provides superior myocardial protection, especially in the ischemically stressed heart. However, the superiority of blood over crystalloid cardioplegia in the pediatric population is unproved. Furthermore, because many pediatric hearts undergo a preoperative stress such as hypoxia, it is important to compare the different methods of protection in both normal and hypoxic hearts. METHODS: Twenty neonatal piglets were supported by cardiopulmonary bypass and subjected to 70 minutes of cardioplegic arrest. Of 10 nonhypoxic hearts, five (group 1) were protected with blood cardioplegia and five (group 2) with crystalloid cardioplegia (St. Thomas' Hospital solution). Ten other piglets underwent 60 minutes of ventilator hypoxia (inspired oxygen concentration 8% to 10%) before cardioplegic arrest. Five (group 3) were then protected with blood cardioplegia and the other five (group 4) with crystalloid cardioplegia. Myocardial function was assessed by means of pressure volume loops and expressed as a percentage of control. Coronary vascular resistance was measured with each infusion of cardioplegic solution. RESULTS: No difference was noted between blood (group 1) or crystalloid cardioplegia (group 2) in nonhypoxic hearts regarding systolic function (end-systolic elastance 104% vs 103%), diastolic stiffness (156% vs 159%), preload recruitable stroke work (102% vs 101%), or myocardial tissue edema (78.9% vs 78.9%). Conversely, in hearts subjected to a hypoxic stress, blood cardioplegia (group 3) provided better protection than crystalloid cardioplegia (group 4) by preserving systolic function (end-systolic elastance 106% vs 40%; p < 0.05) and preload recruitable stroke work (103% vs 40%; p < 0.05); reducing diastolic stiffness (153% vs 240%; p < 0.05) and myocardial tissue edema (79.6% vs 80.1%); and preserving vascular function, as evidenced by unaltered coronary vascular resistance (p < 0.05). CONCLUSION: This study demonstrates that (1) blood or crystalloid cardioplegia is cardioprotective in hearts not compromised by preoperative hypoxia and (2) blood cardioplegia is superior to crystalloid cardioplegia in hearts subjected to the preoperative stress of acute hypoxia.

Animals↗
PubMed1996

Myocardial protection in normal and hypoxically stressed neonatal hearts: the superiority of hypocalcemic versus normocalcemic blood cardioplegia.

OBJECTIVES: The ideal cardioplegic calcium (Ca+2) concentration in newborns continues to be debated. Most studies examining cardioplegia calcium concentrations have been done with a nonclinical model (i.e., isolated heart preparation), the results of which may not be clinically applicable, and they have not examined the effect of calcium concentration in a clinically relevant stressed (hypoxic) heart. METHODS: Twenty neonatal piglets 5 to 18 days old were placed on cardiopulmonary bypass, and their aortas were crossclamped for 70 minutes with hypocalcemic or normocalcemic multidose blood cardioplegic infusions. Group 1 (n = 5; low Ca+2, 0.2 to 0.4 mmol/L) and group 2 (n = 5; normal Ca+2, 1.0 to 1.3 mmol/L) were nonhypoxic (uninjured) hearts. Ten other piglets were first ventilated at an FiO2 of 8% to 10% (O2 saturation 65% to 70%) for 60 minutes (i.e., causing hypoxia) and then reoxygenated at an FiO2 of 100% with cardiopulmonary bypass, which produces a clinically relevant stress injury. They then underwent cardioplegic arrest (as described above) with a hypocalcemic (n = 5, group 3) or normocalcemic (n = 5, group 4) blood cardioplegic solution. Myocardial function was assessed with pressure volume loops and expressed as a percentage of control values. Coronary vascular resistance was measured during each cardioplegic infusion. All values were reported as the mean +/- standard error. RESULTS: In nonhypoxic hearts (groups 1 and 2), good myocardial protection was achieved at either concentration of cardioplegia calcium, as demonstrated by preservation of postbypass systolic function (104% vs 99% end-systolic elastance), minimally increased diastolic stiffness (152% vs 162%), no difference in myocardial water (78.9% vs 78.9%), and no change in adenosine triphosphate levels or coronary vascular resistance. Low-calcium blood cardioplegia solution repaired the hypoxic reoxygenation injury in stressed hearts (group 3), resulting in no statistical difference in myocardial function, coronary vascular resistance, or adenosine triphosphate levels compared with nonhypoxic hearts (groups 1 and 2). Conversely, when a normocalcemic cardioplegia solution was used in hypoxic hearts (group 4), there was marked reduction in postbypass systolic function (49% +/- 4% end-systolic elastance; p < 0.05), increased diastolic stiffness (276% +/- 9%; p < 0.05), increased myocardial water (80.1% +/- 0.2%; p < 0.05), rise in coronary vascular resistance (p < 0.05), and lower adenosine triphosphate levels compared with groups 1, 2, and 3. CONCLUSIONS: This study demonstrates that, in the clinically relevant, intact animal model, good myocardial protection is independent of cardioplegia calcium concentration in nonhypoxic (noninjured) hearts; hypoxic (stressed) hearts are extremely sensitive to the cardioplegic calcium concentration; and normocalcemic cardioplegia is detrimental to neonatal myocardium subjected to a preoperative hypoxic stress.

Animals↗
PubMed1996

[Myelodysplasia and tuberculosis].

We report here the case of a patient with myelodysplasia and concomitant tuberculosis. Refractory anemia with blasts excess diagnosis was based upon morphological and cytogenetical criterias (del 20q), and tuberculosis was diagnosed on a cervical lymph node biopsy. Hematological data remained stable without any specific treatment for several months, cell counts even normalized under antituberculosis tritherapy. Clinical and hematological worsening appeared 3 years later, 1 year after discontinuation of antituberculosis therapy. It was characterized by progressive bone marrow failure and transformation in acute myeloid leukaemia. Concomitantly tuberculosis relapsed. The association of antituberculosis therapy and polychemotherapy (daunorubicine and aracytine) did not allow to obtain a hematological remission. The relationship between tuberculosis and myelodysplasia is discussed.

Anemia, Refractory, with Excess of Blasts↗
PubMed1994

Needs not diagnosis.

Explore the source record for details and available documents.

Cross-Cultural Comparison↗
PubMed1994

Early cytoreduction: a major prognostic factor in adult acute lymphoblastic leukemia.

Prognostic factors in acute lymphoblastic leukemia (ALL) are used for treatment stratification of ALL. Definition of simple parameters such as the presence or absence of peripheral leukemic cells after one week of treatment could help for stratification. A retrospective study was conducted on 79 previously untreated adult patients with ALL followed in the Hematology department of Hotel Dieu from 1981 to 1991. 84% of patients achieved complete remission (CR), 7% were refractory to induction treatment, and 7 patients (9%) died during the first month after diagnosis. After multivariate analysis the only independent statistically significant factors for achieving CR were the absence of peripheral blast cells at day 7 (PBC D7) (p = 0.009) and age (< 50 years) (p = 0.03). For CR duration the same independent statistically significant factors were found (PBC D7 = 0 versus > 0, p = 0.008; and age < or > or = 30 years, p = 0.045). The PBC D7 value was more significant when circulating blast cells were present at diagnosis. In patients with more than 50,000 PBC at diagnosis, the 10- years event free disease was 62% +/- 20% when PBC were absent at day 7 versus 0% when PBC were present (p < 0.002). All 20 patients with prolonged DFS had PBC D7 = 0 achieving CR by 28 days. The persistence of PBC at Day 7 could be used as a factor to identify a subgroup of poor prognosis adults with ALL.

Adolescent↗
PubMed1983

Psichiatria democratica: a case study of an Italian community mental health service.

The Italian Mental Health Act of 1978 signified a major reform of the psychiatric system in that country and included directives for the closing down of all mental hospitals. This paper reports the structure and mode of work of the newly created community mental health services in a Tuscan town. It further investigates the background that made such a major change possible, and details its successes and problems to date. In addition, the relevance of the Italian experience to policy changes in other national psychiatric systems which so far have been unable to produce a comprehensive community-centered service is discussed.

Adult↗
PubMed1979

The meaning attached: attitudes towards the mentally ill.

It was assumed that attitudes to the mentally ill differ among groups following a range of personal and social involvement, the four groups being patients, family members, professionals and non-involved persons. To test this assumption a semantic differential scale of qualities and constructs mental illness and questionnaire of situations on meeting the mentally ill were administered to 120 persons from these groups. Results indicate that a continuum of negative attitudes to the mentally ill exists, the most negative position being taken by the non-involved, the most positive by the professionals, with patients and family members in the middle. In response to the questionnaire it appears that close personal relations with the mentally ill and recent date of occurrence of disturbance are associated with positive reactions to the mentally ill.

Attitude↗
PubMed1977

The Peasant Connection: social background and mental health of migrant workers in western Europe.

The paper represents an attempt to look at mental health and mental illness of migrant labourers in Western Europe in the context of their social background, current developments and the global processes they are involved in. Rates of mental illness among migrants are lower than would be predicted on the basis of the severity of the stress they face. Two facts--coming mainly from a peasant origin and perceiving themselves as peasants-in-town--were singled out as central aspects to the understanding of their capacity to cope with the stress due to migration. The main theories about migration are critically reviewed. It is suggested that peasants' strategies of survival in hostile environments underlie the explanation of the unexpected lower rate of mental illness. Phenomena of mental disturbances specific to the group are described and related to social and historical perspectives.

Attitude to Health↗