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Biomedical subjects

D Guez

Publications and source records attributed to D Guez.

At least 73 records · Page 4Linked to original sources
PubMed1990

Effects of indapamide on left ventricular mass and function in systemic hypertension with left ventricular hypertrophy.

Left ventricular hypertrophy (LVH) is frequently associated with hypertension and constitutes a major cardiovascular risk factor, the reduction of which should be considered when initiating antihypertensive therapy. To assess the effects of indapamide on LVH, 18 hypertensive patients were included in the study (11 men and 7 women, age 53.6 +/- 2.9 years, mean +/- standard deviation) whose supine diastolic blood pressure was greater than 95 mm Hg without (n = 11) or with (n = 7:6 beta blockers, 1 calcium antagonist) antihypertensive therapy. All presented with LVH, echocardiographically defined by a left ventricular mass index greater than 110 g/m2. After a 2-week preinclusion period, all patients received indapamide, 2.5 mg/day, for a period of 6 months. Physical examination including blood pressure measurement was performed on selection (M-1/2), before (M0), and after 1 (M1), 3 (M3) and 6 (M6) months of indapamide treatment, and echocardiography was performed at M0 and M6. Quality of life was evaluated by means of questionnaires completed by the patient and the physician, and a visual analog scale was completed by the patient at M-1/2, M0 and M6. All clinical parameters remained stable during the 2-week preinclusion period. Indapamide administration induced a highly significant reduction in both supine systolic and diastolic blood pressures from 173.9 +/- 2.9/100.5 +/- 1.2 mm Hg at M0 to 150.9 +/- 1.9/90.5 +/- 1.3 mm Hg at M1 (p less than 0.001), and 145.0 +/- 1.7/86.0 +/- 1.5 mm Hg at M6 (p less than 0.001). Similar favorable effects were observed in the upright position.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Clinical efficacy and quality of life with indapamide alone or in combination with beta blockers or angiotensin-converting enzyme inhibitors.

A multicenter study was performed to assess the efficacy and the acceptability of indapamide in hypertensive patients previously untreated, or treated and unsatisfactorily controlled with either angiotensin-converting enzyme (ACE) inhibitor or beta-blocking therapy. Four centers participated in the study, which included patients whose supine diastolic blood pressure was between 95 and 115 mmHg with no treatment (group I, n = 40), those taking captopril (group II, n = 40) or those taking propranolol (group III, n = 40). After a 2-week single-blind placebo run-in period, patients received indapamide either alone (group I) or in combination with the previous therapy (groups II and III) for 4 months. Blood pressure, heart rate, weight, and clinical and biochemical acceptability were measured before and after 2 and 4 months of treatment. At the same time points, quality of life was determined using standardized questionnaires completed by the patient (20 items) and the physician (10 items) and a visual analog scale completed by the patient. In all groups, administration of indapamide induced a clinically and statistically significant reduction in both systolic and diastolic blood pressures in the supine position after 2 months. Indapamide alone controlled blood pressure in 82% of the patients previously untreated, and indapamide in combined therapy controlled blood pressure, respectively, in 67 and 85% of patients previously uncontrolled with ACE inhibitors or beta blockers. In all groups, questionnaires on quality of life showed a progressive and significant improvement in general well-being. After 4 months of treatment, the percentage of improvement in the physician questionnaire was 77.1% in group I, 60.6% in group II and 71.4% in group III.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

A review of the EEG effects of the combination of almitrine and raubasine in animals and humans.

During recent years many studies on the electroencephalogram (EEG) changes induced by almitrine-raubasine (Duxil) have been performed in elderly patients and in animals. This article gives an overview of three questions raised by their results. Is there a simple addition of the raubasine and almitrine effects when they are coadministered? Are the EEG effects of this treatment dependent on the patient's disease? To what extent could EEG studies provide some knowledge about the mechanism of action of almitrine-raubasine therapy? In adult (8 months) and aged (22 months) rats the EEG changes induced by the coadministration of almitrine and raubasine were significantly different from the addition of individual almitrine and raubasine EEG effects. In adult rats the coadministration induced slighter EEG changes than those predicted by the addition of almitrine and raubasine effects. In aged rats, the coadministration induced a decrease in delta-theta power not predictable from the effects of almitrine or raubasine. These results could be taken as an indication that some biological targets are common for the two drugs and that the coadministration results in pharmacological effects more complicated than a simple addition of raubasine and almitrine properties. After 3 weeks of treatment in aged healthy subjects, the coadministration induced an increase in the alpha and beta power with a slight decrease of delta and beta-1 powers. In patients with cognitive decline of probable degenerative origin, 3 months of therapy with almitrine-raubasine was mainly associated with a decreased delta and theta power and a slight increase in high frequency components of the alpha band.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Almitrine-raubasine and cognitive impairment in the elderly: results of a 6-month controlled multicenter study.

Two-hundred four patients between 70 and 85 years of age were included in a double-blind randomized controlled multicenter study (almitrine-raubasine/placebo). Inclusion criteria were a complaint of cognitive disorders and an objective cognitive impairment evaluated by Folstein et al. "Mini-Mental State" (MMS) and by Sandoz Clinical Assessment for Geriatrics (SCAG). Patients were treated for 6 months and evaluations were performed at the beginning of the trial (T0), then 3 (T3) and 6 (T6) months later. Evaluations included a visual analogic self-rating scale and the following psychometric tests: Trail Making A (TMA), Shopping List Task, Word Fluency, Crossing Out Letters, Logical Memory, Digit Span, and Visual Retention. Anxiety and Depression Scales were also used to assess the effects of almitrine-raubasine on affective status. Statistical analysis involving the whole sample did not show any significant difference between the almitrine-raubasine and placebo groups concerning changes in assessment criteria from T0 to T6. However, these results may have been due to the wide heterogeneity of baseline performances in psychometric tests. To prevent this possible bias, further statistical analysis was performed for each psychometric test after patients had been divided into three classes according to baseline score levels. Considering scores on TMA and Digit Span for patients with scores in the intermediate class on TMA, almitrine-raubasine induced a significantly higher improvement in performance from T0 to T6 than that induced by placebo. On the other hand, no side effects were noted with almitrine-raubasine when compared with placebo. These data suggest that almitrine-raubasine enhances concentrated attention in patients with mild to moderate impairment of this function.

Aged↗
PubMed1990

Long-term effects and safety of almitrine-raubasine in age-associated cognitive decline.

Twenty elderly patients (8 men, 12 women, mean age 67.5 years, range 59-74 years) with age-associated cognitive decline (memory impairment, slowing of thought and inability to concentrate, mean Mini Mental State score 22.0, range 18-24) were included by their general practitioners in an open study of the efficacy and safety of long-term combination therapy with almitrine and raubasine. After a 2-week washout period, patients received almitrine-raubasine for 13 months. Efficacy was evaluated at 2-month intervals using two well-being scales (visual analog and psychoaffective profile) and two behavioral scales (Widlocher's scale, and a scale derived from the Sandoz Clinical Assessment Geriatric scale). Memory was assessed every 6 months. Safety was evaluated by full medical examination and routine laboratory parameters at 2- and 6-month intervals, respectively. On treatment, scores on all scales improved significantly (two-way analysis of variance) throughout the study, as did scores in the two objective memory tests (Friedman test). Safety was demonstrated by the lack of any changes in clinical or laboratory parameters outside the normal range.

Aged↗
PubMed1990

[Duxil and cognitive deficiency in the elderly. Results of a 6-month controlled multicenter study].

Two hundred and four patients, 70-85 years old, were included in a double-blind (Duxil/placebo), controlled, multicentric study. The inclusion criteria were a subjective complaint of a cognitive deficiency and a cognitive deficit objectively determined using the Folstein mini-mental state test and the Sandoz geriatric clinical evaluation score. The patients, treated for 6 months, were examined at the onset of the study (T0), then 3 (T3) and 6 months (T6) later. The assessment criteria included: a visual self-evaluation test measuring cognitive function and the following psychometric tests: trail making A (TMA), memorization of a shopping list, verbal fluidity, letter identification, repetition of a story, immediate recall of numbers and immediate visual memory. Anxiety and depression evaluations were also used to assess the effects of Duxil on the affective state. Statistical analysis of the observations made on the entire population did not reveal a significant difference between the treated group and the control placebo group, in terms of assessment criteria, between T0 and T6. However, this lack of a difference could be explained, in part, by the very wide variation in the initial psychometric performance scores of the subjects. In an attempt to control this possible bias, another statistical analysis was made for each psychometric test, after the patients had been divided into 3 classes based on their initial performance scores. The results of this second analysis showed that Duxil was able to improve memory performances in TMA and number retention better than the placebo. However, this effect was limited to the group of patients whose initial scores were in the intermediate class for TMA. These findings suggest that Duxil improves the concentrating ability of patients with light to moderate deficits in this function.

Aged↗
PubMed1990

[Long-term effects of indapamide in left ventricular hypertrophy in patients with hypertension].

Left ventricular hypertrophy is a major and independent cardiovascular risk factor in hypertension. The effects of a diuretic, indapamide, on the regression of left ventricular hypertrophy were studied in a group of 9 patients with mild hypertension treated in an open therapeutic trial over a 12 month period. At the end of the trial, the left ventricular mass index decreased significantly from 172 +/- 11 to 147 +/- 11 g/m2 (p less than 0.001). Therefore, in contrast to the other diuretics which have been studied, indapamide seems able to induce regression of the left ventricular hypertrophy complicating hypertension.

Adult↗
PubMed1988

Effects of indapamide on the quality of life of hypertensive patients.

This study analyzed the variation in the parameters characterizing the quality of life and well-being of hypertensive patients treated with indapamide. Thirty patients (10 men and 20 women; mean age, 52.5 +/- 2.1 years, SEM) were selected after a three-week observation period during which patients received placebo. They all had essential hypertension, defined as a diastolic blood pressure between 95 and 120 mm Hg. After the three-week placebo treatment period, indapamide was prescribed as single-agent therapy at a dose of one tablet per day (2.5 mg) for three months. The quality of life and the feeling of well-being of the treated subjects were analyzed on the basis of two self-assessment scales completed by patients and on the responses to a clinical observation scale completed during the consultation by the doctor. The decrease in blood pressure was significant (p less than 0.01) by the first month of treatment and the blood pressure was controlled (diastolic blood pressure less than 90 mm Hg) in 79.3 percent of patients by the third month. Statistical analysis of the modifications in the different scores demonstrated a significant improvement between the start and the end of the indapamide treatment period for the three types of scales (p less than 0.01). Analysis of the results also confirmed the homogeneous and significant concordance between the improvement in the responses to the doctor and patient scales. These results on the improvement in quality of life and well-being observed with indapamide demonstrate the importance of taking these aspects into consideration in the drug treatment for permanent essential hypertension.

Adult↗
PubMed1987

[Quantified electroencephalogram: value in the evaluation of therapy of cerebral aging].

Computerized quantification of electroencephalograms enables pharmacological compounds designed to counteract pathological cerebral aging to be evaluated. The results obtained by this method when substances which sedate or stimulate the central nervous system are used suggest the existence of a negative correlation between neuronal activity and electroencephalographic power. More precisely, the application of this method to pharmacology suggests a relation with the activity of one or several neurotransmission systems. By extension, studies of cerebral aging may benefit from this new technique of cerebral exploration because it allows the demonstration of age related changes in the EEG effect of drugs studied in physiological conditions. Thus we have demonstrated an interaction between the almitrine-raubasine combination and the noradrenergic system in rats. In clinical pharmacology, the evaluation of these two compounds is still liable to numerous experimental biases. The almitrine-raubasine combination was tested in controlled trials in elderly people complaining of intellectual deterioration; the results obtained were fairly similar to those observed in old rats, thus demonstrating an effect on the central nervous system and perhaps also an action on the noradrenergic system in human.

Almitrine↗