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Biomedical subjects

L Lacomblez

Publications and source records attributed to L Lacomblez.

71 records · Page 4Linked to original sources

Manic-like state after bilateral orbitofrontal and right temporoparietal injury: efficacy of clonidine.

A manic-like state occurred in a 44-year-old right-handed woman with bilateral orbitofrontal and right temporoparietal traumatic contusions. In a brief trial, we assessed the effect of clonidine, carbamazepine, dopa therapy, and placebo on manic symptoms and cognitive functions. Clonidine rapidly reversed the manic syndrome. The patient's behavior did not change with carbamazepine and worsened with levodopa. We suggest that the manic-like syndrome was related to noradrenergic overactivity secondary to the fronto-orbital lesions.

Adult↗

Assessment of erectogenic properties of apomorphine and yohimbine in man.

1. In a four period, double-blind, placebo-controlled study, apomorphine (0.009 mg kg-1 subcutaneous route) and yohimbine (0.30 mg kg-1 i.v. route) were administered to 10 male healthy volunteers. Penile circumference was monitored using plethysmography and subjective sexual arousal was self-assessed. Data were collected before, during and after a stimulation session during which 50 erotic slides were projected to the subjects. 2. Apomorphine induced an erection starting from the fourth minute post-injection, and potentiated the visually-induced response. Self assessment showed increased tumescence and rigidity without modifications of sexual arousal. 3. Yohimbine did not modify penile diameter without stimulation and did not affect the physiological response to erotic stimuli. 'Sexual excitement' was decreased by yohimbine during the post-stimulation phase. One subject experienced severe anxiety while he was infused with yohimbine. 4. These results are discussed with reference to animal data and to recent studies carried out in impotent patients.

Adult↗

[Extrapyramidal syndrome during treatment with flunarizine].

A 68 year-old woman had been taking flunarizine 10 mg daily for 10 weeks when she developed severe bradykinesia and rigidity, resting tremor of both hands, akathisia, buccolinguofacial dyskinesias and depressed mood. Flunarizine was discontinued. After 3 months the patient was asymptomatic. This case and data from the literature suggest that extrapyramidal symptoms and depression may be observed even at the recommended daily dose of 10 mg. Flunarizine should be avoided in patients with Parkinson's disease. Patients on flunarizine should be watched for depressive and extrapyramidal signs, especially those aged over 60.

Aged↗

[Cerebral x-ray computed tomography and tuberculous meningitis. Radio-clinical correlations].

Two cases of tuberculous meningitis showed that there is a delay between the C.T. images and the clinical signs. The computed tomography which was still normal one and two months after the first clinical signs did not permit an early diagnosis of the tuberculous meningitis. It did not give either, at least in the beginning, a good appreciation of the results of the treatment, since most of the C.T. images appeared and/or increased while the patient's conditions had already been improving under treatment for several days or weeks. In a long range, however, the C.T. images usually disappear.

Adult↗

[Meningo-myelitis with a favorable course after measles vaccination].

A 27 year-old woman complained of symptoms and signs due to a meningo-myelitis, 5 days after anti-rubella vaccination. Among the earliest symptoms she experienced pain and sensory deficit in the inoculated arm. The disease worsened until the 15th day, then improved spontaneously.

Adult↗

[Memory complaints: epidemiology and diagnostic approach].

IN THE ELDERLY: Complaints of poor memory for everyday activities are common in the young as well as in the elderly. However, in the elderly, memory complaints are especially of interest on account of their frequency and the fear of being related to early Alzheimer's disease. Two types of memory complaints should distinguished. ENCODING/STORAGE DEFECTS: Memory difficulties related to early Alzheimer's disease are mainly related to a deficit in encoding and/or storage. They are restricted to the recent past and rapidly associated with temporal disorientation, limitation in everyday activities and behavioral modifications alerting the family responsible for seeking medical advice in most cases. Short examination of memory performance shows a free recall deficit which is not improved by cued recall. BENIGN DIFFICULTIES: Memory difficulties of benign type are due to a pure recall deficit: they are experienced as well for ancient as for recent past and the difficulty in recall is transient. There are no behavioral modifications or limitation in everyday activities: the disorder is purely subjective. At examination, the deficit in free recall is corrected by cueing. Benign type of memory complaints is mostly related to psychoaffective disturbances and subjects experiencing this type of memory difficulties are not at high risk for developing dementia.

Activities of Daily Living↗

[Study of combined anticoagulant (fluindione)-aspirin therapy in patients with atrial fibrillation at high risk for thromboembolic complications. A randomized trial (FFAACS)].

BACKGROUND: A combination of low-dose aspirin (A) and anticoagulation (AC) may provide better protection against thromboembolic events compared with AC alone in high-risk patients with atrial fibrillation (AF). METHODS: We performed a multicentric placebo-controlled double blind-trial to test the preventive efficacy against thromboembolic events of the addition of aspirin (A) (100 mg) or placebo (P) to anticoagulant treatment in patients with high-risk atrial fibrillation. A total of 157 patients were included, with atrial fibrillation and previous thromboembolic event or older than 65 years with either a history of hypertension, a recent episode of heart failure or a left ventricular dysfunction. All patients received fluindione (F) and P or F and A, with an INR target between 2 and 2.6. The primary endpoint was a combined endpoint of stroke (ischaemic or haemorrhagic), myocardial infarction, systemic arterial emboli or vascular death. RESULTS: The study had to be stopped prematurely owing to a too low recruitment rate. During follow-up (0.84 years) 3 non-fatal thromboembolic events were recorded (1P, 2A) and 6 patients died (3P, 3A), none of them from a thromboembolic complication. However, 3 deaths were secondary to severe haemorrhagic complications (1P, 2A). Non-fatal haemorrhagic complications occurred more often in group A (n = 10, 13.1 pour cent) compared with group P (n = 1, 1.2 pour cent), p = 0.003. CONCLUSION: The FFAACS study was not able to show any therapeutic benefit from the addition of aspirin to anticoagulant in patients with high-risk AF. Such a combination increased the incidence rate of bleeding complications, which therefore greatly reduces its potential overall benefit.

Aged↗

[Tolerance of riluzole in a phase IIIb clinical trial].

Within the framework of an early drug access programme launched in 1995, a multicentre open study was initiated in France in order to assess, inter alia, the safety of riluzole (50 mg twice a day) in a total of 2069 patients from 28 centres. This programme, a phase IIIb study with direct individual benefit, had two main objectives: to enable patients to receive riluzole therapy pending regulatory approval and commercial availability and to provide further data on the safety of riluzole in a broader ALS population. The most frequent adverse events related to riluzole treatment were: asthenia, nausea and elevation of serum transaminase levels. These observations, similar to data derived from previous pivotal clinical trials, confirm that riluzole has a satisfactory tolerability profile.

Aged↗

[Comparative effects of ginkgo biloba extracts on psychomotor performances and memory in healthy subjects].

The effect on psychomotor and mnesic performances of acute oral dose (600 mg) of 2 Ginkgo biloba extracts were evaluated in twelve healthy female in a dummy placebo-controlled double blind study. Tests were performed comprising: objective measures of vigilance [critical flicker frequency (CFF), choice reaction time (CRT)], memory tasks (pictures and Sternberg scanning tests) and self-rating evaluation (visual analogue scales). Tests session took place before and 1 hour post-dosing. No statistically significant changes from placebo were observed on CFF, CRT or subjective rating of drug effects. No differences between treatment were evidenced on Sternberg scanning test and pictures recognition. Comparing to baseline, free recall score, while decreasing under placebo and Ginkgo, remained the same under Tanakan. As the differences between treatment are localized on one test, it appears important to examine the reproductility in healthy subjects. In order to verify the clinical relevance of these results, they need to be replicated in older healthy volunteers with age-associated memory impairment.

Adult↗

[Personality of healthy volunteers. Normality and paradox].

The personality characteristics of 62 subjects to be screened for eligibility in psychopharmacology studies have been assessed. The psychological screening comprised the Cattell anxiety scale (CAS), the Eysenck Personality inventory (EPI) and the Minnesota Multiphasic Personality Inventory (MMPI) in its complete version (550 items). The comparison of the results to a population matched for age and status showed that the anxiety level was not different, extraversion factor was higher (p less than 0.001) and various personality traits were different. The most striking differences were observed on the factors: Psychopathic deviation, Mania, Schizophrenia greater than controls and social introversion lower than controls. These differences may evoke several biases, such as a recruitment bias or a specific personality pattern of young healthy subjects. In order to discuss these hypothesis, further comparisons with other centers are required to conclude.

Adult↗

[Myasthenia gravis and drugs].

Several drugs are known to aggravate myasthenia gravis or to induce myasthenia like syndromes. Drugs which interfere with neuro-muscular transmission act either through a direct effect at the neuro-muscular junction or as with D. Penicillamine through an immunological action. For some drugs, the information available indicate their harmfulness in myasthenia gravis, so they are contraindicated. For others, the clinical effect is not so well established, nevertheless if necessary they can be used with caution.

Humans↗

[Effects of 3 doses of maprotiline (25, 50 and 75 mg) on alertness and memory in healthy volunteers].

The effects on psychomotor and mnesic performance of acute oral doses of maprotiline (25, 50 and 75 mg) were evaluated in twelve healthy men in a placebo-controlled double blind study. A battery of tests was performed comprising: objective measures (critical flicker frequency, choice reaction time, memory tasks) and self rating evaluation (visual analogue scales). Tests session took place 15 hours after each treatment. Plasma concentrations of maprotiline were determined. Compared with placebo, maprotiline induced psychomotor impairment on both objective and subjective assessment in a dose related manner. No significant difference between maprotiline and placebo on memory test could be evidenced.

Adult↗