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Biomedical subjects

P Lemoine

Publications and source records attributed to P Lemoine.

At least 19 recordsLinked to original sources
PubMed1992

A double-blind comparison of moclobemide and toloxatone in out-patients presenting a major depressive disorder.

A double-blind comparison of moclobemide and toloxatone was performed in adult out-patients diagnosed as suffering from a major depressive disorder. Parallel groups of patients received moclobemide, 450 mg/day (n = 135) or toloxatone, 1000 mg/day (n = 133) for 28 days. Both groups showed a significant clinical improvement while on therapy; the response was most marked and rapid in those receiving moclobemide treatment. Improvement was greatest in those patients with the most severe depression at the time of trial onset. A significantly higher number of patients returned to normal sleep patterns following moclobemide treatment than following toloxatone. Overall, tolerance was rated as good or very good in more than 80% of patients. The most frequent complaints in the moclobemide-treated group were hot flushes, dry mouth, constipation and headache, while an increase in anxiety was associated with toloxatone usage. Moclobemide was found to be as effective as toloxatone in the treatment of major depressive episodes, but with the advantages of improved sleep patterns and reduced anxiety.

Adult↗
PubMed1992

[Thrombocytopenia induced by low molecular weight heparin].

Two cases of thrombocytopenia due to a low molecular weight heparin (Fraxiparine) are reported. The first case was a 35-year-old alcoholic man with acute mild pancreatitis. After having been treated with Fraxiparine for 12 days to prevent venous thrombosis, routine laboratory studies revealed a thrombocytopenia (49 G.l-1). At the same time, a minor haemorrhage occurred in the nasogastric tube. Prothrombin time, partial thromboplastin time, fibrin degradation products and D-dimers remained normal. There were no soluble fibrin monomers. Fraxiparine was discontinued. The thrombocyte count continued to decrease (12 G.l-1) up to the thirteenth day, it raised 3 days later to 110 G.l-1, and returned to normal after 9 days more (395 G.l-1). The second patient was a 58-year-old man given prophylactic Fraxiparine between the 5th and 16th days after admission for a severe asthma attack. Here again, after 12 days of treatment, the thrombocyte count decreased to 74 G.l-1. There were no other abnormalities, neither clinically nor in laboratory findings. Heparin administration was discontinued and the thrombocytopenia had resolved 3 days later. In both patients, the diagnosis of thrombocytopenia elicited by low molecular weight heparin was confirmed by finding, in vitro, a platelet aggregating factor in the presence of Fraxiparine. The literature concerning this topic is reviewed and discussed.

Adult↗
PubMed1992

[Outcome of children of alcoholic mothers (study of 105 cases followed to adult age) and various prophylactic findings].

Thirty years after recognition of the fetal alcohol syndrome, a study of 105 affected individuals who reached adulthood provides insight into the long-term outcome of this condition. The typical facial dysmorphism undergoes odd changes, often with a long face and a bulky nose and chin, in contrast to the appearance of affected infants. The growth failure becomes slightly less marked. The malformations, which occur in 3/4 of severe forms, increase the disability although function is sometimes better than expected. In contrast, the microcephaly becomes more pronounced. This explains the psychic disorders which are the main prognostic factor: mental retardation in the most severely affected patients or severe learning disabilities and, in every case, behavior disorders and marked instability. Similar disorders are often found in siblings with no apparent dysmorphism underlining the extent of the problem and the urgent need for prophylaxis. Some of the observations made in adults, confronted to embryologic data, lead to useful inferences with respect to prophylaxis.

Adult↗
PubMed1991

[Sleep disorders with nocturnal bradycardia in 2 depressed patients].

Polygraphic sleep exploration is usually not necessary to evaluate and treat such dyssomnias as nightmares or anguish dreams, but it may be indispensable in case of severe repeated or refractory sleep disorders, particularly in patients with concomitant depression. Two cases of major depression (DSM III R) associated with wakings during the night and dreams of death are reported. In both cases, polygraphic sleep exploration performed after complete, two-weeks long discontinuation of medicines revealed sinus bradycardia during paradoxical sleep, particularly in pre-waking periods. Heart rates ranged from 33 to 43 beats/minute in the most pronounced bradycardic episodes. The possibility of organic cardiac pathology was excluded by additional examinations. Atropine (175 mg) administered alone resulted in complete disappearance of bradycardic episodes and in improvement of objective and subjective sleep parameters. In these two cases bradycardia seemed to be due to vagal dysfunction with exaggeration of the "rebound" bradycardia which follows the initial tachycardia that occurs during the phasic phenomena of paradoxical sleep.

Adult↗
PubMed1991

Increased serotonin platelet uptake after tianeptine administration in depressed patients.

Tianeptine is a new antidepressant drug reported to enhance serotonin (5-hydroxytryptamine [5-HT]) uptake in rat brain. The effect of tianeptine on 5-HT platelet uptake was studied in 10 depressed patients treated for 28 days. Tianeptine increases Vmax of 5-HT platelet uptake during treatment without inducing any change in Km. As early as 2 hr after the first administration, Vmax increased significantly (+23%, alpha = 0.01). Although of a lesser magnitude, 5-HT platelet uptake remains increased after chronic administration (+14% on day 10 and +13% on day 28). This suggests that tianeptine affects 5-HT platelet uptake sites, either directly or via an action on modulators of 5-HT uptake. These results, in contrast with the action of other tricyclic antidepressants, confirm the original action of tianeptine on 5-HT platelet metabolism.

Adolescent↗
PubMed1991

Compared efficacy of prazepam and clomipramine in major depression with anxiety: a multicenter controlled study.

UNLABELLED: The efficacy of antidepressants is well established in major depressions, especially those with melancholic features. However, some anxiolytics also appear to have antidepressant properties at least for outpatients. 118 outpatients (25 males, 93 females, age: 18-60) with major depression according to DSM-III criteria, neither melancholic nor suicidal, reaching at least 27 on Montgomery and Asberg depression rating scale (MADRS) and 19 on Hamilton anxiety rating scale (HARS) accepted to participate this double blind study carried out by 15 G.P.s coordinated by 3 psychiatrists. After a one week placebo wash-out-single-blind period, they were randomly, double blind, assigned to one of the two following groups: PR treated with prazepam (30-60 mg), a benzodiazepine anxiolytic or CL treated clomipramine, an imipramine antidepressant (75-150 mg). Patients were evaluated at days 0, 7, 14, and 28, using MADRS, HARS, Clinical Global Impression and Hopkins symptoms check list 58. In addition, G.P.s had to meet monthly for a case discussion group. RESULTS: groups were comparable at day 0. A highly significant improvement of MADRS and HARS scores (p less than 0.001) was observed in the total population. For the completer population evolution was also significantly positive in all the parameters studied but, considering MADRS and HSCL scores, a difference in favor of CL is observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Low doses of insulin as a treatment of tardive dyskinesia: conjuncture or conjecture?

Tardive dyskinesia (TD) induced by antipsychotic drugs represents a great concern for patients and psychiatrists. Considering its pathophysiological mechanisms, there exists a convergence towards the development of postsynaptic dopaminergic hypersensitivity as a possible cause of TD. Hypersensitivity following receptor blockade is the consequence of an increased number of receptors and such a synthesis is energy-dependent. In the brain, under normal conditions, energy is almost exclusively provided by glucose utilization. We thus hypothesized that, if glucose availability were reduced, the metabolically hyperactive structures should represent the best functional target of a reduction in fuel availability. Twenty chronic schizophrenic outpatients (13 males, 7 females), aged 20-67 (mean: 38.3), accepted to participate in this double-blind, placebo-controlled study. They were randomly assigned to either the insulin treatment group (10 patients) or to the insulin-placebo group (10 patients). They received a subcutaneous injection of 10 units of standard insulin or placebo at 10 a.m. From day 1 to day 15, injections were performed daily and, thereafter, every other week for 5 weeks totalizing 20 injections in 90 days. At day 7, the insulin treatment group showed a sharp decrease in the intensity of TD symptoms which persisted throughout the duration of the study. By contrast, no change in TD symptomatology was observed in the insulin-placebo-treated group. Although a direct effect on DA neurones, or at least the participation of such an effect, cannot be excluded, our data favor a role of decreased glucose availability in reversing receptor hypersensitivity.

Adult↗
PubMed1991

[Vertebral involvement and fetal alcohol syndrome].

Vertebral abnormalities observed in 8 children with fetal alcohol syndrome are described and discussed. They include scoliosis (4 cases), neural tube defects (4 cases) and complex malformations of the cervical spine (2 cases). The latter probably constitute a different entity from that of the Klippel-Feil syndrome. It is probable that alcohol plays a direct role in the genesis of these abnormalities.

Female↗
PubMed1991

["Puerperal psychoses". An overview].

Since antiquity, puerperal mental disorders have always been the field of polemics concerning the different possible etiopathogenic hypothesis. XIXth century has been particularly marked by nosographic descriptions and subsequent hormonal speculations. Psychoanalytic approach has been prominent for thirty years but a trend to a come back of biological hypothesis is now noticeable. This overview represent an effort to synthetize clinical, epidemiological and current biological aspects of puerperal psychosis with a special mention to dopamine-oriented researches. The last part reports the main therapeutical available techniques.

Adolescent↗
PubMed1990

Heart rate circadian rhythm as a biological marker of desynchronization in major depression: a methodological and preliminary report.

Heart rate (HR) was continuously monitored during successive 24-hr periods in 19 healthy subjects and 26 major depressed patients (DSM III-R). Recordings were performed after a 2-week wash-out period and the morningness or eveningness typology of each subject was determined. The chronobiological parameters and rhythm percentage (RP) were calculated by the single cosinor method from the smoothed HR curves of each subject. In normal subjects, HR follows a circadian rhythm (RP greater than 65%) with the lowest values at night. Morning type subjects have an earlier peak time (13:30) than evening type subjects (17:30). Major depressive patients were split into two groups; in the first one HR circadian rhythm was still present (RP greater than 63%) with a decrease in amplitude (24%) while in the second group, no circadian rhythm of HR could be detected (RP less than 25%, decrease in amplitude greater than 70%). In the group of patients with a persisting HR circadian rhythm, no veritable phase advance was observed. Our results suggest that circadian HR rhythm, which can be easily studied with non-invasive methods, might represent a chronobiological marker of some depressions. Given the lag that exists between the rhythms of morning type and evening type subjects, our study also stresses the importance of taking into account this behavioural trait in chronobiological studies.

Adult↗
PubMed1989

Sleep polygraphic effects of trimipramine in depressed patients. Preliminary report.

Preliminary results are presented from an ongoing study in hospitalised depressed patients. Changes in sleep parameters were assessed on days 1 to 3 and 12 to 14 of a 4-week study in which patients received trimipramine 150 mg on day 1 and 100 mg thereafter. On days 1 to 3 and 12 to 14, 7 depressed patients had a significantly increased total sleep time and sleep efficiency index and a significantly decreased total wake time and number of intrasleep wake episodes per hour of sleep. Trimipramine treatment had no significant effect on REM sleep, percentage of REM sleep, REM duration and REM sleep stability index. However, a significant increase in REM latency was noted on days 1 to 3 but not on days 12 to 14. These polygraphic data suggest that trimipramine effects a very rapid and maintained sleep improvement in these depressed patients without significant alterations to the parameters of REM sleep.

Depressive Disorder↗
PubMed1989

[L-tyrosine: a long term treatment of Parkinson's disease].

That l-dopa represents a major advance in Parkinson treatment should not hide that a number of problems remain unanswered: on-off effects, transient improvements... Based on the beneficial effects of l-tyrosine in dopamine dependent depressions and narcolepsy, five naive patients diagnosed after sleep polygraphy criteria and five l-dopa and/or dopamine agonist treated patients were prescribed l-tyrosine as a long-term treatment. For some patients, 3 years of L-tyrosine treatment was followed by better clinical results and many fewer side effects than with L-DOPA or dopamine agonists. However, the theoretical long-term sparing neurons potentiality of approach requires further studies.

Aged↗
PubMed1988

Effects of trazodone on the sleep of depressed subjects--a polygraphic study.

The effects of 400-600 mg trazodone on the sleep patterns of ten depressed in-patients treated for 5 weeks were studied during the initial (days 1-3) and terminal (days 26-28) treatment periods. The sleep parameters were compared to those obtained from three sleep recordings performed just prior to the initiation of the treatment and after 2 adaptation nights at the end of a 2-week drug-free period. At the same time, the clinical evolution of patients was evaluated weekly using MADRS and Hamilton-Anxiety scales for anxiety-depression symptomatology and Spiegel and Norris sleep scales. Weekly blood samples were collected to measure plasma levels of trazodone and, at the end of the study, the elimination half-life at steady state was calculated by repeated measurements of plasma levels. Clinical improvement, as assessed by a reduction of more than 60% in MADRS scale scores, was accompanied by evidence of the definitely beneficial effects of trazodone on the disturbed sleep of these depressed patients. From the beginning of treatment, there was a hypnotic-like effect (increase in total duration of sleep and stage II, decrease in sleep latency and intrasleep awakenings). In addition, records at the end of the study showed an increase in delta sleep and an increase in REM latency, an effect classically associated with an antidepressant action. These particularly valuable effects of trazodone on sleep would suggest that this drug should especially be given in cases of depression with major insomnia.

Adult↗
PubMed1988

[L-tyrosine cures, immediate and long term, dopamine-dependent depressions. Clinical and polygraphic studies].

Twelve patients with polysommographic and clinical signs of dopamine-dependent depression (DDD) received, after a short-lasting trial with the dopamine agonist Piribedil, a treatment with oral-tyrosine (3,200 mg/day). On the very first day of treatment a return to mood, as judged by clinical impression and MADRS scores was observed. Sleep recordings performed on nights following days 1, 2, 7 and 8 of treatment showed an immediate improvement of those sleep parameters differentiating the more clearly DDD from other types of depression. More than 50 patients have now been treated successfully for periods ranging from a few months to almost 2 years. This treatment is ineffective in other types of depression.

Clinical Trials as Topic↗
PubMed1988

[Efficacy of the treatment of sleep apnea using naltrexone. A clinical, polygraphic and gasometric study].

Twelve patients with clinical, polysomnographic and oxymetric features of Sleep Apnoea Syndrome (S.A.S.) were recorded, after a 2-week wash-out period, during 2 nights without treatment and 2 nights after receiving 50 mg naltrexone at bed-time. Clinical symptoms improved immediately in four patients, within one month in three patients and after 3 months of treatment in the remaining five ones. Sleep Apnoea index as well as the number, duration and intensity of hypoxic events were dramatically improved by this treatment that has now been prescribed to 25 patients, for more than 2 years in 14 of them.

Blood Gas Analysis↗
PubMed1987

Human brain receptor autoradiography using whole hemisphere sections: a general method that minimizes tissue artefacts.

A general method for the preparation of high-quality, mostly ice-crystal-artefact-free whole human brain hemisphere sections is described. Upon receipt, hemispheres are divided; one is then fixed in buffered 10% formalin for neuropathological analysis while the other is cut in 8-10-mm-thick coronal slices that are then rapidly frozen in 2-methylbutane at -40 degrees C (10-15 sec) before being placed in the brain bank at -80 degrees C. Such rapid freezing markedly decreases the formation of ice-crystal artefacts. Whole-hemisphere 20-micron thick sections are then cut and mounted onto lantern-type gelatin-coated slides. These sections are subsequently used for both qualitative and quantitative in vitro receptor autoradiography. Examples of data obtained are given by using various radioligands labelling "classical" neutrotransmitter, neuropeptide, enzyme, and ion channel receptor binding sites. This method should be useful for the obtention of various receptor maps in human brain. Such information could be most useful for in vivo receptor visualization studies using positron emission tomography (PET) scanning. It could also indicate if a given receptor population is specifically and selectively altered in certain brain diseases, eventually leading to the development of new therapeutic approaches.

Adult↗
PubMed1987

A simplified plaque assay for varicella vaccine.

A simple and accurate plaque assay is described for potency testing of attenuated varicella vaccine. Assays were performed on the African green monkey kidney continuous cell line CV-1, in multidish-plates, under a semi-solid carboxymethylcellulose overlay. The test is economical and yields accurate individual titre estimates, the reliability of which may be assessed by parallel titration of reference preparations.

Animals↗