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Biomedical subjects

G Garrone

Publications and source records attributed to G Garrone.

At least 19 recordsLinked to original sources
PubMed2005

Changing prevalence of asthma in Turin school children between 1994 and 1999.

BACKGROUND: Asthma is a widespread chronic disorder in children and its prevalence has been on the increase in Europe. Only few studies have described the prevalence variation in respiratory symptoms in Italian regions. The aim of this study, conducted in Turin during the 1998/1999 school year, is to investigate the distribution of respiratory symptoms in a sample of Turin school children and to compare the obtained results with the findings of the SIDRIA study performed in 1994-95. METHODS: The sample in study is composed of all the children attending to three elementary schools in Turin. All of the selected schools had already participated in the 94-95 ISAAC-SIDRIA study. A total of 448 pupils aged 6-10 years received a standardised questionnaire to be filled by parents. RESULTS: Response rate is higher than 97% in all the studies. In 1999 we found that the prevalence of wheezing in the past 12 months was 7.3%. The 13.3% of children had asthma at least once in life and the 5.3% reported an attack in the last year. The comparison of our study results with the ISAAC-SIDRIA (1994-95) shows that the prevalence of asthma and asthma-like symptoms is rather stable among children, while the prevalence of bronchitis reveals a reduction of about 5.5%, but not statistically significant (p=0.094; 95%CI:-11.9;0.9). A considerable reduction in exposure to parents' passive smoke is shown: deltaP%=-4.7 (95%CI: -9.4;-0.1) for maternal smoking in pregnancy, deltaP%=-8.2 and -15.2, respectively for maternal and paternal smoking in the first two years of life. CONCLUSIONS: The results indicate a stable prevalence rate in asthma symptoms in children. A possible explanation of slight variation in asthma prevalence may be due to a reduced exposure to outdoor and indoor risk factors as reported in the questionnaires.

Asthma↗
PubMed1992

Immunity, major depression, and panic disorder comorbidity.

Because recent research reports indicated clinical and biological differences in major depression with and without comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) panic disorder, and as altered immune measures were reported in selected subgroups of depressive patients, we investigated 51 pairs of major depressive episode (MDE) subjects, and gender- and age-matched healthy controls in order to determine if T lymphocytes number and function abnormalities were associated with Panic Disorder comorbidty. We found that those MDE subjects with DSM-III-R panic disorder (PD) had greater numbers of T cells (p less than 0.05) and PHA mitogen (p less than 0.05) responses than depressive patients without PD, as well as increased phytohemagglutinin (PHA) (p less than 0.05) concanavalin A (ConA) (p less than 0.02) mitogen responses compared to their controls. These data suggest that panic disorder comorbidity significantly contributes to the variance of immunologic parameters in major depression and has to be carefully assessed within psychoimmunological studies of psychiatric patients with affective disorders.

Adult↗
PubMed1990

Clomipramine metabolism. Model-based analysis of variability factors from drug monitoring data.

A steady-state model is here developed as a framework for the analysis of blood concentrations of clomipramine, obtained during routine drug monitoring. A model is proposed to account for its major metabolic pathways, hydroxylation and demethylation, including first-pass effect. Impaired hydroxylation capacity is shown to lead to a dramatic increase in the concentration of demethyl-clomipramine, with a concomitant moderate increase in that of the parent drug. Deficient demethylation capacity is associated with a reduced ratio of demethyl metabolite to parent drug. A nomogram is provided to allow easy determination of hydroxylation and demethylation capacities from routinely measured blood concentrations. Data from 150 patients are analysed in order to identify interindividual variability factors. Average pseudo-clearances, calculated from trough blood concentrations at steady-state, are 17 L/h for hydroxylation, 23 L/h for demethylation and 40 L/h for elimination of hydroxylated metabolites. Maximum to minimum ratios are 8, 27 and 11, respectively. The metabolising capacity through either process significantly decreases with increasing age, clearance estimates being 40 to 50% lower for patients 75 years or older than for those 40 years or younger. Tobacco smoking and chronic alcohol consumption induce and reduce the demethylation clearance, respectively. Inhibition of hydroxylation in the presence of phenothiazine comedication is also shown. Finally, small but significant differences according to sex are observed. Potential implications of the proposed model-based approach include adaptation of the dosage regimen to individual characteristics at the very beginning of antidepressant therapy, and early detection of patients with impaired metabolising capacities.

Adult↗
PubMed1989

Clinical and pharmacokinetic evaluation of zuclopenthixol acetate in Viscoleo.

The purpose of the present study was to evaluate zuclopenthixol acetate in Viscoleo, a new preparation to be administered once every 3 days, in the early treatment of acute psychotic episodes and acute deterioration of chronic psychosis. 21 cases were included in the study: patients received 1 to 3 injections. Clinical evaluation was made at 24, 48 and 72 hours after each injection, using the Clinical Global Impressions (CGI) and the Brief Psychiatric Rating Scale (BPRS). Results at end-point indicated a marked or moderate therapeutic effect in the 11 cases of acute psychosis. A statistically significant decrease was observed for the total BPRS score as well as for its subscales. Among 8 cases of exacerbation of chronic psychosis, 4 patients showed a moderate therapeutic effect, and minimal or no effect was found in the other 4 subjects. The total BPRS decreased significantly, but to a lesser extent than for acute psychosis. Two patients suffering from mania showed a moderate therapeutic effect according to CGI. 8 cases of acute psychosis and 5 cases of chronic psychosis did not suffer from any neurological side-effects. Plasma concentration measurements suggest that a dose of 50 mg per 3 days may be sufficient for early treatment of most acutely ill psychotic patients.

Adolescent↗
PubMed1989

[Long-term clinical follow-up (2 years) of 78 patients hospitalized in a crisis situation].

This is a preliminary study focusing on a 2 years follow-up of 78 patients addressed to psychiatric hospitalization and psychodynamically oriented crisis intervention. Relationship between psychopathological, clinical and interactional profile at first medical interview and clinical/social assessment at 1 and 2 years follow-up were studied, indicating different predictors for long-term treatment (DSM III R diagnosis and psychotic symptoms scores) and global improvement (age and sex) as well as poorer outcome for social functioning than for symptomatic measures. Comment is also provided on the observed high concordance between clinical predictions at crisis treatment completion and research staff assessments at 1 and 2 years follow-up. The evaluated crisis intervention model was found to provide a valuable setting to structure acute psychiatric episode treatment and long-term care, even though transition from clinical recovery to effective social-interpersonal reinvestments was observed to raise problems in the addressed psychiatric population.

Bipolar Disorder↗
PubMed1989

[Stress, depression, immunity: current trends in research in the field of psychoimmunology].

For more than two decades, a number of experimental findings are raising an increasing interest and evidence of S.N.C. regulatory function in immune response modulation. By this paper, we provide a large review of major recent studies aimed to investigate immune response, depression and stress conditions relationships. Assessment methods and study design issues are also discussed by special reference to the major psychiatric and psychosomatic interest of the demonstrated psychoneuroendocrine pathways of T-Lymphocytes response modulation.

Central Nervous System↗
PubMed1989

High blood concentrations of imipramine or clomipramine and therapeutic failure: a case report study using drug monitoring data.

Eight patients are described who displayed excessive concentrations of nortriptyline, imipramine, or clomipramine on routine blood level monitoring. Under these conditions, the patients did not respond to the treatment. All patients were markedly improved when the daily dosage of the antidepressant was reduced with a simultaneous decrease of the blood concentrations. Among these eight patients, seven suffered from side-effects, three were characterized as poor hydroxylators of debrisoquine, while three had concomitant treatment with a phenothiazine.

Aged↗
PubMed1986

[Depressive states in the elderly and their treatment].

The clinical classification of depressive states has undergone considerable modification in the past few years. More particularly, the various clinical forms described earlier in relation to age or dubious etiological hypotheses have been reorganized within the framework of general categories of depression established according to clinical criteria. This development has been largely due to the work accomplished by the American Psychiatric Association Task Force and its Diagnostic and Statistical Manual of Mental Disorders, which has become a standard reference work worldwide. With its precise criteria, this classification enables clinicians to adjust therapeutic indications more readily to each particular case. Monotherapy is the rule of thumb for the pharmacological treatment of depression, particularly in the elderly. Combination of medications in the treatment of agitated or melancholic depressive states must be limited to situations in which it is absolutely necessary, and in such cases it is even more important to monitor blood levels than in monotherapy. When there is a significant psychotic component to major depression (hallucinations, delusions), it is advisable to undertake specific antipsychotic treatment before initiating antidepressant medication. In the majority of cases it is possible to treat depressive states in the elderly by appropriate selection of both medication and dosage, and by careful clinical attention to the patients' physical and psychological well-being.

Aged↗
PubMed1986

Importance of oxidative polymorphism and levomepromazine treatment on the steady-state blood concentrations of clomipramine and its major metabolites.

The relationship between the debrisoquine oxidation status and the metabolism of clomipramine was studied in nine healthy volunteers (five rapid hydroxylators, three slow hydroxylators and one of intermediate status). The hydroxylation of clomipramine and demethylclomipramine were found to covary with that of debrisoquine, whereas demethylation of clomipramine seemed to be independent of the debrisoquine hydroxylation phenotype. The steady-state blood concentrations of clomipramine and its three main metabolites were measured in 122 depressed patients. Thirteen patients who concomitantly received a neuroleptic tended to have higher levels of demethylclomipramine and clomipramine, whereas the levels of the hydroxylated metabolites were hardly affected. Benzodiazepine co-administration did not modify the pharmacokinetics of clomipramine. The results suggest that benzodiazepines rather than levomepromazine should be used in depressed patients with anxiety and/or agitation in combination with the antidepressant treatment.

Adult↗
PubMed1986

Sociotherapy and depression.

Every depression is accompanied or preceded by a series of internal or external losses. They determine a situation of loneliness, sometimes material and always psychological and relational. It is therefore important to consider beyond pharmaco-therapy and psychotherapy the application of a sociotherapy including: a material and emotional help in the social sphere practical life and hygiene advises the creation of feed-backs by using interactions caused by the patient's participation to therapeutical groups.

Adult↗
PubMed1986

[Crisis interventions in the psychiatric sector].

The concept of crisis is defined from the point of view of the actual practice and is compared with the concepts of illness, of acute states and emergency psychiatry. The crisis intervention means of the psychiatric sector in Geneva are described as well as their place in the general organisation of the psychiatric care.

Adaptation, Psychological↗
PubMed1985

[Quantitative approach to treatment with incisive neuroleptics by therapeutic monitoring].

The problems encountered during the longterm treatment of psychotic patients with neuroleptics are illustrated by six typical case reports. A group of patients who had had a new acute episode despite seemingly adequate treatment were selected. In these six cases it was demonstrated that the neuroleptics dosage was inappropriate, being either too high or too low as judged from the plasma concentrations. Ways of improving the adequacy of the treatment of psychotic patients with neuroleptics are discussed.

Adult↗
PubMed1985

Plasma flupentixol concentrations and clinical response in acute schizophrenia.

Twenty-three acutely psychotic inpatients treated with flupentixol were included in the study. Steady-state plasma concentrations were compared with therapeutic outcome in a routine clinical setting. The threshold concentration for satisfactory antipsychotic effect appeared to be approximately 2 ng/ml. Controlled studies are needed to establish the existence and exact limits of a therapeutic window.

Acute Disease↗
PubMed1984

[Emotions and cardiovascular psychosomatic disorders].

The psychological and environmental factors involved in cardiovascular psychosomatic disorders are reviewed. Attention to these factors makes it possible not only to suggest preventive measures, but also to supplement the usual treatment with educational, dietetic and hygienic measures which will help to facilitate rehabilitation.

Cardiovascular Diseases↗
PubMed1984

Plasma haloperidol levels and therapeutic response in acute mania and schizophrenia.

In an open study, 18 patients suffering from an acute episode of schizophrenia and 18 patients with severe mania were given haloperidol at different dosage levels. Haloperidol plasma concentrations were measured and the status of the patients was evaluated at intervals using the Brief Psychiatric Rating Scale (BPRS). No correlation was found between the oral dose and the plasma concentrations in the schizophrenic group, but there was a low correlation for manic patients. In both groups, however, there was a correlation between these two parameters when the drug was given intramuscularly. There was no correlation between haloperidol plasma concentrations and the BPRS scores. Of the 36 patients 28 responded well to the treatment and were discharged from hospital. A good relationship between the clinical status as observed by the clinicians and the BPRS score was found. Plasma haloperidol concentration measurement was found to be a useful tool for the detection of non-compliance or excessive plasma levels. Accordingly, the present study indicates the value of drug level monitoring as a means to improve therapy.

Administration, Oral↗