Erectile dysfunction with antipsychotics: prevalence and associated factors

The presence of associated or antipsychotics induced sexual disorders complicates the management of schizophrenia. These disorders are not well diagnosed and studied. Evaluate the prevalence of erectile dysfunction in a population of schizophrenic patients taking antipsychotics, and search for associated risk factors. This is a cross-sectional study on 52 schizophrenic patients stabilized on antispychotic. We used the [International Index of Erectile Dysfunction] scale, and the data analyzed by statical software. The prevalence of this disorders is 63.5%. Univariate logistic regression shows that it is related to the type of schizophrenia [paranoid] and antipsychotics association. Related studies show that antipsychotics improve desire and frequency of sexual thoughts, but cause erectile and orgasm dysfunction and decreased sexual satisfaction. Drug combinations are generally not recommended. Sexual disorders induced by antipsychotics in schizophrenics patients are very harmful. These sexual dysfunction must be diagnosed, explained and treated quickly

Post-traumatic stress disorder in a veteran

Military, operational circumstances exposed to potentially traumatic situations involving life-threatening and complicated by both a state of post- traumatic stress events reflect the specific effects of psychological trauma. We report the case of a former 79-year-old fighter who has a state of post- traumatic stress disorder, whose symptoms were not suggestive. The patient reported having multiple events occurring after events threatening his life. He presented flashbacks of the event, with avoidance behavior and significant distress. The treatment was a basis of the associated Sertraline has adapted psychotherapy. The diagnostic identification of posttraumatic stress remains difficult. Support is a biological, psychological and social. Cells medico-psychological emergency is essential to prevent complications of victims of war, disasters, collective accidents, or accidents strong psychological impact. Posttraumatic stress is common with a chronic course, but sometimes it is difficult to recognize

Somatoform disorders and depression: comorbidity and problems of management

Somatoform disorders are characterized by the presence of physical symptoms without organic lesion or pathophysiological mechanism. The use of antidepressants is quite common, even in the absence of associated depressive disorder. We will assess the prevalence of depression in a population of patients with somatoform disorders, and discuss the difficulties of management of these disorders. This is an observational cross-sectional study, about 152 patients. Diagnoses were made according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders in its fourth revised version. Data evaluation was performed using statistical software. This population is represented mostly by women [116[76.3%]], with low socioeconomic status [114[75%]] above 40 years age [43.5 +/- 14.6]. Prevalence of depression is 34%, with a predominance for somatization disorder [47.9%]. Comorbidity of these two disorders is common. The difficulties encountered in the management of these patients are especially of sociocultural nature, necessitating the adoption of appropriate psychotherapeutic measures. Clinicians should redouble their efforts to adapt the management of these disorders in our context

[Neuropsychiatric disorder revealing carbon monoxide poisoning]

We report a unique and distinct clinical observation of a patient aged 52 years with acute reversible encephalopathy with late onset occurred 3 weeks after a mass poisoning of carbon monoxide [CO]. The clinical picture was dominated by cognitive associated with behavioral disorders, mood and judgment. Brain MRI [Magnetic resonance imaging] shows T2-weighted sequence Flair hyperintense extensive periventricular white matter and the centrum ovale and a bilateral hippocampal damage. The patient received hyperbaric oxygen therapy sessions. The evolution was marked by a dramatic improvement with complete disappearance of clinical and radiological signs. Finally, all isolated coma occurred in uncertain circumstances especially during winter and whose negative was etiology should encourage thinking about a toxic cause including carbon monoxide. Therefore, reflects a coma mass poisoning and should require very close clinical monitoring due to the subsequent development of a post-interval syndrome of neuropsychiatric order

[Relationship between diabetes mellitus type 2 and depression]

Relation between diabetes and depression is bidirectional. Diabetics are at higher risk for developing depression, which is a risk factor for the onset of type 2 diabetes and its complications. We will illustrate these links through the cases of two patients. The first patient had a major depressive episode that has resisted treatment, and in whom the management of a discovered diabetes has improved the depressive symptoms. The second patient suffered from diabetic complications stabilized after treatment of a neglected depression. Several factors favor the occurrence of depression in diabetic patients: the low socioeconomic and education level, loneliness, stress, high levels of glycated hemoglobin and the presence of diabetic complications, especially neuropathic ones. Furthermore, depression can lead to eating disorders and sedentary lifestyle, favoring the development of obesity and type 2 diabetes; depression is also accompanied by biological changes that may increase vulnerability to diabetes. Therapeutic response to antidepressants is probably lower in diabetics

[Sexual assault and post-traumatic stress disorder]

Sexual assault is an assault on the physical and psychological integrity of the child. She is qualified when it is incest within the family. The posttraumatic stress disorder is a psychological reaction that can be substantial. Mr B. Nabil aged 25 was hospitalized for a psychiatric depressive syndrome. At the age of 6, his older brother was sexually assaulted. The child took refuge in silence and presented problems which regressed spontaneously rained a few weeks later. His adolescence was marked by relational instability, impulsivity and manifest a tendency to consumption of toxic substances. In adulthood, he enlisted in the army which he could difficultly adapted to the new situation until to the occurrence of an incident [sexual advances by a friend] who reactivated her painful memories. He presented a state of post-traumatic stress disorder complicated by depression and decided to break the silence wanting consultant in psychiatry. The posttraumatic stress disorder and depression are psychological consequences of sexual assault. The disclosure process is long, complex and painful. A multidisciplinary approach allowed the patient to overcome the shame, guilt and fear and to manage invasive and painful memories. The state of posttraumatic stress may persist for several years in the absence of treatment. An early care, sensitive and multidisciplinary improves prognosis

[ neuroleptic malignant syndrome]

This is one of the serious complications that can occur at any time during treatment with neuroleptics. Its prevalence is estimated at 0.01% - 0.02% in patients treated with neuroleptics. Patient aged 19 years hospitalized in psychiatry for schizophreniform disorder and put on haloperidol 15 mg / day chlorpromazine 200 mg / day. Fifteen days after admission, he shozed gradually: generalized muscle rigidity, difficulty walking and fatigability. All operating in a context of confusion and hyperthermia at 38.5[degree sign] C. determination of CPK was 2396 IU / l. Given this clinical picture, the diagnosis of neuroleptic malignant syndrome was made and the neuroleptic treatment was stopped and the patient put under massive diazepam with rehydration and strict clinical supervision. The clinical and biological evolution was favorable, and he was put under Olanzapine. The patient was young. Neuroleptic malignant syndrome occurred two weeks after the introduction of neuroleptic treatment with haloperidol [15 mg / day] and chlorpromazine [200 mg / day]. The clinical picture is limited to generalized muscle rigidity, confusion, hyperthermia at 38.5 and elevated CPK [2396 UI / l]. Stopping the treatment in question, correction of fluid and electrolyte disorders and prescription of a benzodiazepine conduct to a favorable evolution two weeks later. A practitioner should suspect a neuroleptic malignant syndrome before unexplained hyperthermia in a patient under neuroleptic. Immediate discontinuation of neuroleptic therapy and general measures of resuscitation is the mainstay of treatment

[Telemedicine: evolution of a concept]

Being a medical practice in distance, it can be defined as a form of cooperation in medical practice, linking them remotely, thanks to information technology and communication, a patient and a or more physicians and healthcare professional for medical diagnosis, decision-making, care and treatment in accordance with the rules of medical ethics. Currently, she is the right solution for access to health care in countries with large geographical and situations of isolation or technical skills. There are several forms such as teleconsultation, telemonitoring, telesurgery, the teleconference, distance learning and tele-expertise. Interests of telemedicine are many: high efficiency: speed of decision, a better organization of care, limiting patient transfers and travel medical teams; accessibility of care regardless of location, and a reduction the costs related to health. In practice, it is in the theater she found her first indications particularly telecare surgical field, the most advanced in the field of medicine forward. The example of satellite transmission between five buildings French Navy, Southern and military Teaching Hospital [HIA] Saint Anne in Toulon digitized radiographs using military means of communication is one example. The ultimate development of this hotline will teleoperation that consists of performing Remote surgery [also known as telesurgery] using a robot

[ psychiatric manifestations of HIV infection]

Psychiatric disorders accompanying infection with human immunodeficiency virus are frequent and varied. They can occur in inaugural precede even the discovery of serological abnormalities. Patient of 36 years old, was hospitalized in psychiatry hospital after a confusional syndrome, in which the examinations objectified HIV positive serology cortical and subcortical cerebral atrophy. The clinical evolution course was favorable with risperidone 3mg/daily, diazepam 20mg daily. The Psychiatric symptoms most frequently encountered in infection with human immunodeficiency virus are anxiety and depression, cognitive impairment, which can reach up to dementia, psychotic states and confounding or iatrogenic psychiatric disorders. Patients with human immunodeficiency virus often suffer from psychiatric disorders. An early adapted care stabilize these disorders, thereby improving the disease prognosis

Hepatitis B vaccination. Evaluation of efficacy in a high risk hospital personnel population

B. Viral hepatitis endemo-epidemiological potencial in hospital practice remains a preoccupyng problem. The study of serological status in an order of an active protection has been realised in a group of 100 of the medical staff in university hospital of Casablanca. 49 of the subjects had at least one of the markers of B. hepatitis among them one is chronical carrier of H.B.S. antigen. 51 seronegative and volonteers subjects [51%] have received 3 injections of the vaccine Hevac B [R] of Pasteur Institute, at one month interval. The evolution controls of Anti H.B.S. antibodies have been realised a month later after each injection. At the end of this vaccination 86.2% of the subjects have acquired a protection with rates of anti H.B.S. superior to the minimal protective rate. 5 bad responders have received a forth injection of the vaccine. The control of the antibodies H.B.S. was realised one year after, in 30 subjects [58.8%], 29 have kept Anti H.B.S. antibodies, among them 25 at protective rates

Prevalence of HTLV

The high prevalence of LAV/HTLV[m] virus etiological agent of A.I.D.S. and its transmission by blood and blood products have incit us to study the prevalence of HTLV[m] antibodies in 1.000 Moroccan blood donors. One case was positive in HTLV[m] antibodies. This weakness prevalence has to be confirmed by a large study in different regions in the Kingdom

Prevalence of serological markers associated to hepatitis A and B virus among blood donors in Casablanca

The prevalence of hepatitis B and A markers were studied among blood donors in Casablanca. 7.6% of the tested individuals have HBs Ag. Among them 57.1% are highly infectious because they have HBe Ag. 34.78% of sera contain HBs Ab and 16.85% contain HBc Ab alone, 59.24% of the blood donors have at least one marker associated to hepatitis B virus. This prove the high degree of infectiosity by hepatitis B virus in Marocco. 24.46% of blood donnors have HBc Ab associated or not with HBs Ag and so they are potentially infectious. This study explain the importance of obligatory systematic research of HBs Ag and/or HBc Ab in all blood products which will be transfused in Morocco. 93.80% of the sera contain HVA-Ab, this explain the high epidemiological character of this infection