[Evaluation of autonomy in chronic mental patients. Problems, assessment tools, results].

The autonomy of adult patients suffering from chronic psychiatric disorders is a notion in which we need to take an interest due to evolutions in patient care. The tendency of deinstitutionalization in the United States, in Italy and to a lesser degree in France has generated certain perverse effects when: capacities for self sufficiency, learning abilities to be developed, and substitutes to be set up, were not correctly evaluated from the outset. Many methods conceived mainly in the United States and in Canada were elaborated with such a diversity of approaches that, even today, for self-sufficiency, an instrument for evaluation which is universally prevalent and used, still does not exist in the way that has been possible for other clinical dimensions.

[Leponex: experience of the hospital pharmacist].

Clozapine's monitoring, with a co-responsibility between psychiatrists and pharmacists, was very efficient for the prevention of neutropenia's side effects. This intensive drug safety has lowered the agranulocytosis' cases in France to a 0.5% prevalence.

[Arguments for early treatment of refractory schizophrenia].

The authors, taking up their experience and the literature, attempt to view the precociousness of alternative, classical neuroleptic treatments in schizophrenia, from notion of treatment-resistant schizophrenia, precocious refractory and intolerance. Until now, clozapine was administrated to patients lasting resistant and in mainly cases hospitalized since many years. As such as quality of life and economy of health, it would be desirable to quickly think of alternatives neuroleptic's therapeutic protocols and clozapine in the treatment-resistant schizophrenias or those presenting an intolerance.

[Hereditary amyloidosis].

Amyloidoses are characterized by the deposition of non soluble proteins in tissues. Clinical aspects of hereditary amyloidoses are very diverse, and they offer many diagnosis problems to the physician. Biochemical and genetic aspects are also various.

[Multicenter study of toxoplasma serology using various commercial ELISA reagents. Work Group Toxoplasmosis of the National Agency for Quality Control in Parasitology].

A collaborative study conducted by the French National Agency for Quality Control in Parasitology (CNQP) and various manufacturers of ELISA kits, represented by the Association of Laboratory Reagent Manufacturers (SFRL) compared the toxoplasmosis IgG antibody titres obtained with different ELISA-IgG kits and determined the relationships between the titres obtained by these techniques and the titre defined in international units (IU). Fifty-one serum samples with toxoplasmosis antibody titres ranging from 0 to 900 IU were tested in two successive studies with 16 ELISA-IgG kits. For the negative sera, false-positive reactions were observed with one kit.

[Effect of aging on schizophrenia].

The problem of the senescence's influence on schizophrenia and the right to detach this variable from those who take care of temporal evolution is complicated. From a population of 99 schizophrenic patients (DSM III criteria's) having most of 60 year old and most of 20 years schizophrenia's disease evolution; we have study the whole or partial imputability to the senescence of residential statute's modification; frequency, reason, duration of hospitalization's change, psychotic's symptom levelling; and therapeutic's instability.

[Research in schizophrenia: necessity to include patients of multiple diagnostic systems].

The discrepancies of studies on symptomatology and treatment of schizophrenia could be related to the selection of different patients diagnosed by one diagnostic system, different from a study to another. Therefore, we tested whether 14 diagnostic systems could include 51 patients differently as regard to the intensity of positive, negative or depressive symptomatology and to the phase of illness. The distribution of the patients in different sets of diagnosis has been carried out by a computer program and the symptomatology has been evaluated with PANSS and MADRS.

[Carcinoma of the oral cavity independent of tobacco and alcoholic beverages. Apropos of 23 cases in elderly persons].

Twenty-three cases of carcinomas of the buccal cavity have been observed and treated in persons aged more than 60 years, for whom tobacco and alcoholic drinks, the usual factors of these carcinomas, were not involved. The result of these treatments indicates that the vital and functional prognosis is relatively favorable in these persons, who are free from any alcohol- or tobacco-induced affections.

[What is the status of clinical examination in orthopedic surgery of the jaw in 1991?].

The author endeavours to make a detailed description of the clinical examination of the face, which, if performed systematically, allows establishing an accurate diagnosis of the lesions in dysmorphosis and thus locating the latter's seat. The precise modalities of the surgical procedure are defined on the basis of cephalometry and of casts. Cephalometry does not define the site of surgery; it merely confirms it.

[Evaluation trial on the efficacy of neuroleptics on the outcome of schizophrenia].

Feasible and ideal methodological conditions lacking, we have tried an evaluation concerning the efficacy of neuroleptics upon the course of schizophrenia by comparing the evolution of homogeneous studies before and since the neuroleptic period. On the short term, neuroleptics are significantly more effective than the placebo upon schizophrenic symptoms and prevent the relapses in an noteworthy manner. On the long term, the evolution is significantly better for follow-up studies treated by neuroleptics (60% of patients improved) than for the non-treated follow-up studies i.

[From virginity to mysticism].

Through a clinical observation illustrated with a borderline state described by Bergeret and in a variety of nervous breakdown, the problem of narcissism is set through the quest for an ultimate and an idealization. With the arrival of a late and disorganizing traumatism, is realized an exchange between a narcissic ideal (pureness/virginity) and a megalomaniac one (mysticity). It is the punctual established fact of a cure of a narcissic loss (loss of virginity) by a narcissic recival (God).

[Spontaneous regression of disk herniation. Apropos of 7 cases].

The author report 5 cases of lumbar radiculopathy and 2 cases of low-back pain with disc herniation in which a CT Scan shows spontaneous disappearing or regression of disc herniation. This spontaneous regression is especially observed in young patients on average: 18 to 19 months. His mechanism is discussed.

[Panic disorder in general medicine. Epidemiological data and treatment with clomipramine].

Fifty-six general practitioners, experienced in the use of diagnostic criteria from DSM III for affective and anxiety disorders, have taken part in a study involving 352 patients, 92 males (26%) and 260 females (74%) with an average age of 38.6 +/- 13.5.

[Blood concentrations of maprotiline in depressive patients].

Blood levels of Maprotiline were analysed and their relationship to the clinical response was examined in 89 depressed inpatients, according DSM III criteria for Major Depressive Episode, given the drug treatment for 3 weeks. Maprotiline produced marked decreases in mean MADRS and COVI scale scores by the end of treatment. On day 21, no correlation between blood levels of Maprotiline and MADRS or COVI scores were found when all patients were considered.

[A benign tumor of the cavum: Thornwald's cyst].

The non neoplastic diseases of the nasopharynx are uncommon especially in adults. Cyst of pharyngeal bursa or Thornwald cyst are located in the supero-posterior nasopharynx, in the location of the normal pharyngeal bursa which open into the pharyngeal mucosa. When it persists, a cyst can develop if the orifice becomes occluded.