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Biomedical subjects

V Colin

Publications and source records attributed to V Colin.

9 recordsLinked to original sources

Attachment and feeding problems: a reexamination of nonorganic failure to thrive and attachment insecurity.

OBJECTIVE: To examine the relationship between attachment patterns, degree of security, and feeding problems. METHOD: Three groups of toddlers (age range = 12-37 months) were included: toddlers with infantile anorexia (n = 33), picky eaters (n = 34), and healthy eaters (n = 34). Participants in each group were matched for age, socioeconomic status, gender, and ethnicity. Attachment patterns and degree of attachment security were assessed through the Ainsworth Strange Situation. RESULTS: The infantile anorexia group exhibited a higher rate of insecure attachment relationships than the picky eater and healthy eater groups. When measured on a continuous scale, the infantile anorexia group also displayed a higher degree of insecurity than the other groups. Contrary to previous research, elevated rates of type D attachments were not present within the infantile anorexia group. CONCLUSIONS: Feeding problems and growth deficiencies can occur within the context of organized and secure attachment child-parent relationships. However, insecure attachment relationships may intensify feeding problems and may lead to more severe malnutrition. Implications for the treatment of specific feeding problems are discussed.

Analysis of Variance↗

[Internet, a new resource for anatomopathology?].

The Internet network is the largest computer network in the world. It can be accessed by a telephone line and a modem. Its different functions are the electronic mail (e-mail), the discussion forums ("newsgroups"), the transfer of files and the navigation between "hypertext" pages ("World Wide Web"). This network offers multiple services for pathology: access to databases, consultation of image banks or electronic journals, teleteaching, informations about congresses and societies, participation to thematic forums. We have connected to this network on October 1995 a french-english web site called "Anapath Web" (http://www.anapath.necker.fr) devoted to pathology. Its purpose is to collect information useful to pathologists and to develop specific applications. We are conceiving several projects for teleteaching.

Computer Communication Networks↗

Clinical similarity and biological diversity in the response to alprazolam in patients with panic disorder and generalized anxiety disorder.

Thirty-six patients with panic disorder (PD) and 35 patients with generalized anxiety disorder (GAD) participated in an open alprazolam treatment phase that preceded controlled withdrawal from alprazolam. Clinical ratings, blood pressure and heart rate were obtained along with plasma measurements of cortisol, ACTH, growth hormone and catecholamines. A similar clinical response profile was evident in both groups with rapid onset of improvement within the first week. The two diagnostic groups differed in their biological response to alprazolam. PD patients had a significant reduction in blood pressure, plasma cortisol and a trend toward significant reduction in plasma epinephrine, which were not seen in the GAD patients. GAD patients showed a significant reduction in plasma norepinephrine. These findings provide further evidence that PD and GAD are biologically distinct syndromes.

Adrenocorticotropic Hormone↗

Anxiety disorders among patients in a general emergency service in Israel.

OBJECTIVE: Several studies have suggested that many patients with anxiety disorders present in nonpsychiatric medical settings such as primary care facilities, emergency services, and general practice. This study examined the prevalence of panic disorder and generalized anxiety disorder among patients admitted to the general emergency service at an urban medical center in Israel. METHODS: Four groups totaling 517 patients were assessed. The groups consisted of patients presenting with somatic complaints for whom no physical condition was diagnosed, patients with somatic complaints found to have a physical disorder, a group of nonpsychiatric consecutive admissions to the emergency service, and a group of referrals to the psychiatric emergency service. RESULTS: The prevalence of panic disorder and generalized anxiety disorder in the entire sample was 2.7 percent, which is comparable to the prevalence rates reported in various community studies. However, the prevalence among patients with somatic complaints but no physical disorder was 6.7 percent, significantly higher than in the nonpsychiatric comparison groups. The prevalence in the group of psychiatric referrals was 4.8 percent. CONCLUSIONS: A population at risk for higher prevalence of anxiety disorders can be identified among patients seen in an emergency service. Physicians in primary care settings and general emergency services should consider anxiety disorders in the differential diagnosis of patients with somatic complaints but without a diagnosis of physical disorder.

Adolescent↗

Alprazolam withdrawal in patients with panic disorder and generalized anxiety disorder: vulnerability and effect of carbamazepine.

OBJECTIVE: This study was designed to examine the possibility that patients with panic disorder are especially vulnerable to alprazolam withdrawal, as well as to evaluate the efficacy of carbamazepine as adjunctive treatment during alprazolam discontinuation. METHOD: After a 2-month open trial of alprazolam, 36 patients with panic disorder and 35 with generalized anxiety disorder entered a controlled discontinuation phase. Carbamazepine or placebo was added in a randomized, double-blind fashion, followed after 1 week by single-blind dose reduction of alprazolam, approximately 25% every third day. RESULTS: Fifty-two percent of the patients were able to discontinue alprazolam, but only 37% completed the study, maintaining alprazolam-free status for 4 weeks. Survival analysis revealed that among the patients receiving placebo as adjunctive therapy, panic disorder patients had a significantly greater dropout rate than patients with generalized anxiety disorder. While carbamazepine exerted no beneficial effect for patients with generalized anxiety disorder, it appeared to improve outcome in the panic disorder group. CONCLUSIONS: Results of this study indicate that panic disorder patients are more vulnerable to alprazolam withdrawal than patients with generalized anxiety disorder, and this may reflect a general diathesis of panic disorder patients to encounter more difficulty during drug withdrawal. Carbamazepine may selectively assist with alprazolam withdrawal in panic disorder patients. However, these data do not support its widespread use during benzodiazepine discontinuation, especially given its potential toxicity. In light of a proposed greater vulnerability of panic disorder patients to withdrawal, future studies need to account for differential effects related to specific diagnosis.

Adult↗

Sympathetic denervation and chronic serotonin uptake blockade by fluoxetine do not affect pineal gland 5-hydroxyindole acetic acid: evidence that oxidative deamination of pineal serotonin is a property of the pinealocyte.

This investigation tested the hypothesis that oxidative deamination of 5HT in the pineal gland occurs primarily in cellular compartments other than the pinealocyte (i.e., noradrenergic nerve terminals and glia). Following sympathetic denervation of the pineal gland by bilateral superior cervical sympathectomy, pineal levels of 5HT and its oxidative metabolite, 5HIAA, were measured by HPLC from samples collected at six time points over the 24 h photoperiod. The role of glia in 5HT deamination was further examined by chronic treatment with the 5HT uptake blocker, fluoxetine (10 mg/kg). Sympathectomy abolished the circadian rhythms of both 5HT and 5HIAA, but had no statistically significant effect on the ratio of 5HIAA/5HT compared to sham-operated and intact controls over the 24 h period. Pineal daytime levels of both 5HT and 5HIAA were unaffected by fluoxetine treatment. These findings indicate that the pinealocyte is an important cellular compartment for 5HT oxidative metabolism.

Animals↗

The distal axis of growth hormone (GH) in nutritional disorders: GH-binding protein, insulin-like growth factor-I (IGF-I), and IGF-I receptors in obesity and anorexia nervosa.

The endocrine abnormalities along the growth hormone (GH) axis in anorexia nervosa (AN) and in obesity include hypothalamic, pituitary, and peripheral elements. The present study was undertaken to evaluate the effects of these nutritional extremes on GH-binding protein (BP) levels and on Insulin-like growth factor-I (IGF-I) receptors on red blood cells (RBC). Nine patients with AN and 20 obese subjects were compared with normal control children, adolescents, and adults. GH-BP was measured by a binding assay with dextran-coated charcoal separation. IGF-I binding was measured on enriched RBC. Serum GH-BP levels were markedly reduced in the AN patients, and highly increased in the obese. Scatchard analyses showed linear plots with unaltered binding affinities (Ka). The binding capacity (Bmax) was significantly lower than normal control in the AN patients and higher in the obese. GH-BP levels correlated positively with the body mass index (BMI). RBC [125I]IGF-I binding was significantly elevated in the AN patients and low in the obese. Scatchard analyses showed curvilinear plots. The high-affinity constants (Ka1) were slightly, but significantly, higher in the AN patients and in the obese compared with control. The binding capacity of the first binder (Bmax1) was lower in obesity than in AN or control. The low-affinity constants (Ka2) were similar in the three groups, and its binding capacity (Bmax2) was similar in the AN patients and the controls, but significantly lower in the obese. [125I]IGF-I binding correlated negatively and significantly with the BMI and with the GH-BP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Study of dissociative disorders and depersonalization in a sample of young adult French population].

UNLABELLED: Questioned by several researches about dissociative disorders, the authors study differences established on the nosographic register, through a quantitative study and a psychodynamic argumentation in a sample of french population. From the utilisation of the Dissociative Experiences Scale (DES) created by Bernstein E and Putnam FW (1986), which is an excellent screening tool for dissociative disorders and constructed on DSM II diagnostic criterions, the authors will show the interest of a psychodynamic analysis of dissociative disorders, in the face of the diagnostic difficulty in relation to several approaches of this concept. This difficulty is studied giving the background to dissociative disorders and depersonalization. Ionescu (1999) shows that between 1890 and 1910 dissociation represents one of major themes of psychology, psychopathology and psychiatry. Then, this interest about dissociation decreases and will be almost non-existent in the middle of the twentieth century. The interest for dissociative disorder will grow in the eighties with north-american studies about multiple personality disorders. Until 1980, dissociative disorders exist in DSM II as a list of symptoms included into hysterical neurosis, among the conversive disorders. In 1980, the publication of DSM III replaces the notion of hysteria with the notion of dissociative disorder. In this way, we can see on the one hand somatoform disorders quarterly corresponding to the ancient version of conversive hysteria, and on the other hand dissociative disorders characterized by a perturbation of consciousness, memory, identity or perception of environment. In 1994, The DSM IV delete the notion of hysteria and neurosis and keeps only the notion of dissociative disorders. They include now the five following categories: dissociative amnesia, dissociative fugue, depersonalization disorder, dissociative identity disorder, dissociative disorder not otherwise specified (including derealization). Depersonalization disorders consist of "persistent or recurrent episodes of depersonalization characterized by a feeling of detachment or estrangement from one's self. The individual may feel like an automation or like he or she is living in a dream or movie" (DSM IV). Depersonalization disorder cannot be diagnosed if it is part of schizophrenia, panic disorder, acute stress disorder or dissociative identity disorder. Various depressive disorders, hypocondriasis or obsessive-compulsive disorders can accompany depersonalization disorder. The first purpose of this study will search the frequency of dissociative disorders and depersonalization in a sample of normal population. Further, the inclusion of depersonalization amongst dissociative disorders seems not so evident: depersonalization belongs to self-consciousness disorder in french psychiatry. This fact seems more logical insofar as dissociative disorders have all together a memory and consciousness perturbation, and this perturbation is missing from depersonalization's feeling. The second purpose will be to clarify and specify the particularity of depersonalization among dissociative diorders, from the psychopathological point of view. METHODOLOGY: The sample (n = 248) is made up of french young adults aged 17 to 30 (mean age = 20, SD = 15 and 24% is male population). Subjects were streamming from universities. The screening tool which was used is the Dissociative Experiences Scale, a 28-item patient questionnaire regarding various dissociative symptoms. The subject is asked to indicate the percentage of time, to the nearest 5%, that particular symptom is experienced. The score is made by adding the various percentages and finding a mean that is expressed in numbers from 0 to 100. Normal scores are in the range of 5 to 15 in american adults. RESULTS: The utilization of principal component analysis (PCA) with varimax rotation is justified by the will to compare this study with American's studies. The mean score obtained is 17.44%, and 13.3% of the scores exceed a psychiatric threshold at 30%. The descriptive analysis shows that the component 1 (PCA without varimax rotation) represents 33.02% of total explained variance. This result demonstrates that the structure of the DES is based on one concept, the same as the american population, it is the concept of dissociation. The Principal Component Analysis with varimax rotation of the DES ratings yielded a tree-factor solution: imaginative absorption (F1), depersonalization-derealization (F2) and dissociative amnesia (F3). Mean score for each factor is respectively: F1 = 21.56%, F2 = 13.95%, F3 = 11.04%. DES reliability was studied through computation of Cronbach's coefficient (0.92). The PCA with varimax rotation brings to the fore a full dissociative disorder without any trouble of memory and consciousness. This fact questions again once more the link between hysteria and dissociative disorders. There is here a clinical distinction between depersonalization-derealization and other dissociative disorders. Indeed, the absence of significant alteration of memory and conscience is specific of depersonalization and derealization in this study. CONCLUSION: Finally, this study concurs with DSM IV dissociative criterions. At last, one factor of PCA is composed by the association of depersonalization and derealization, in contradiction with DSM IV definition. This result shows that, into the french population, we cannot divide the two concepts.

Adult↗