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Biomedical subjects

C Chouza

Publications and source records attributed to C Chouza.

29 records · Page 2Linked to original sources

[5 years of experience in the treatment of parkinsonism with L-dopa and its combination with Ro4-4602].

Eighty-one Parkinsonic patients were treated with L-dopa alone and/or combined with Ro4-4602, during 27 to 60 months. The results are reported. 7.2% of the patients, who are still being treated, showed good, very good or excellent results. There was a relation between the duration of the illness and the degree of improvement, the most prolonged Parkinsonisms showed the least improvement. The 4:1 proportion of L-dopa and Ro4-4602 was more effective than the 3:2. Adding small amounts of L-dopa to the combinations improvement and secondary effects increased. No advantages were found using high combined dosages. The main secondary effects at the end of treatment were abnormal movements (45% of cases) and distonic attitudes (53%). Patients who stoped the medication showed less sustained improvement and a high degree of Parkinsonism. This reveals that Parkinson's disease continues to envolve in spite of the medication. The "long-term syndrome" includes the late decrease of effectiveness of the drugs and/or the increase of secondary effects.

Adult↗

[Long-term syndrome in the treatment of parkinsonism with L-dopa and decarboxylase an inhibitor].

In 28% of patients treated for a long time with L-dopa, alone or combined with a decarboxilase inhibitor, the following "long-term syndrome" was observed: decrease in effectiveness, psychic disorders, intense abnormal movements, distonic attitudes, speech and gait disorders, orthostatic hypotension and/or general reprecussion. In 11% of the patients the "on-off" effect was studied (brisk alteranting Parkinsonic and improved states). Clinical observation during 14 hours a day was repeated with different dosages and different regimes of the drug; these modified the daily variations but did not eliminate the syndrome. The electromyographic studies also revealed the "on and off" phenomenon in different patients. When the "long-term syndrome" is severe, at times it is necessary to stop the drug; the secondary effects are thus decreased and, when the medication is given again, the therapeutic effectiveness is temporarily restored. When the drug is stopped the patients should be watched, since a "withdrawal syndrome" may appear.

Adult↗

[Long-term syndrome in the treatment of parkinsonism with L-dopa].

A group of 71 patients with Parkinson's disease were treated with L-Dopa and benserazide during periods ranging from 27 to 60 months. In 28% of cases a decline in therapeutic effects and or delayed appearance or increase of secondary actions were observed constituting a long-term syndrome. Its most complex and dramatic expression, the on-off effect, was present in 11% of cases. Those patients with more severe symptoms were studied by means of continuous clinical observation enabling the design of daytime follow-up curves. Observations were repeated with varying dosage patterns, showing variations but no substantial changes or disappearance of the symptoms described. Electromyographic recordings and films were taken in certain cases defining the characteristics of on and off effects. Several procedures were implemented in an attempt to control Long-Term Syndrome manifestations: Change of dosage, variation of L-dopa/decarboxilase inhibitor ratio, association of anticholinergic agents with antidepressants, hypoprotein diets. Improvement was moderate and/or transient, with the exception of Nortriptilline which permitted total or partial control of certain symptoms, especially hypokinetic periods, bouts of tremor and dystonic attitudes. It was occasionally necessary to interrupt administration of L-Dopa, readministering it later with recovery of the therapeutic effect and/or avoidance of undesirable effects for varying periods of time. Loss than optimal doses proved beneficial in reducing or postponing Long-Term Syndrome manifestations. Although L-Dopa does not detain the course of the disease, the persistence of favourable results in most patients for prolonged periods of treatment confirms the long-term therapeutic value of this drug.

Benserazide↗

[The use of biological markers in the diagnosis and follow-up of patients with multiple sclerosis. Test of five fluids].

PATIENTS AND METHODS: We studied five biological fluids which were easily accessible to immunological examination (cerebrospinal fluid, plasma, tears, saliva and urine) in 25 patients with multiple sclerosis, clinically definite according to the criteria of Cleveland, Ohio (1991) and tabulated according to the Kurztke's expanded disability status scale. The samples were obtained simultaneously during a clinical bout of the disease before any pharmacological or immunosuppressive treatment had been given. RESULTS: The soluble interleukin-2 levels were significantly raised in at least three of these fluids--always absent from the urine--when compared with normal controls. The sensitivity and specificity of this determination for diagnosis of the condition was greater than that of other immunochemical parameters--oligoclonal distribution of immunoglobulins (specifically of IgG), imbalance of the light Kappa and Lambda chains--and physiological studies (evoked potentials). The dosification and quantification of basic myelin protein of the central nervous system, rich in citruline in the urine, may be a parameter of progressiveness. CONCLUSION: This methodology (five humours test) may be used to establish an earlier, more certain diagnosis of multiple sclerosis and also monitor its biological activity together with nuclear magnetic resonance with intravenous contrast.

Adult↗