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Biomedical subjects

F Goldenberg

Publications and source records attributed to F Goldenberg.

At least 37 records · Page 2Linked to original sources
PubMed1994

Improvement in Obesity-associated Medical Conditions following Vertical Banded Gastroplasty and Gastrointestinal Bypass.

Thirty-nine patients undergoing either Silastictrade mark ring vertical banded gastroplasty (SRVG, n = 23) or Roux-en-Y gastrointestinal bypass (RGB, n = 16) over a 1-year period were analyzed retrospectively. Weight loss averaged 40 kg (89 lb). Clinical diabetes mellitus was markedly improved in seven out of nine patients (p = 0.023). Shortness of breath resolved in all 26 patients who had this condition preoperatively (p < 0.001). Orthopedic problems, high blood pressure, and self-assessment of general health and quality of life were also dramatically improved. We conclude that bariatric surgery serves as an effective method to alleviate a multitude of conditions associated with morbid obesity.

Journal Article↗
PubMed1993

[Sleep and biological rhythms in depression. Changes caused by antidepressants].

Sleep in depression is characterized by an increase in the number and duration of awakenings, sleep instability, and SWS decrease. REM sleep occurs earlier. REMs density during the 1st REM period is higher than in normal controls matched in age. Accordingly, sleep in depression is similar to sleep in normal aging. Endogenous depression cannot be distinguished from other types of depression by means of polygraphic criteria. Sleep recordings at the beginning of tricyclic compound treatment could be predictive of clinical response to treatment. Sleep modifications induced by antidepressive drugs are reviewed. Sleep recordings enabled us to formulate several physiopathological hypotheses of depression mechanisms: cholinergic-aminergic hypothesis, phase advance, deficiency of process S. Other hypotheses are reviewed: flattening of a hypothetical circadian rhythm of arousal, depressogenic property of sleep in itself (or only of SWS) or timing delay for the start of sleep. A significant phase advance of biological rhythms (temperature, cortisol) is rarely found. A reduction in the amplitude of rhythms (temperature, TSH, melatonine) is more frequent.

Antidepressive Agents↗
PubMed1993

[Alcohol, sleep and biological rhythms].

Alcohol reduces sleep latency but notably alters sleep structure: sleep is fragmented, particularly at the end of the night. Slow wave sleep duration is enhanced in the first part of the night and REM sleep duration and density are diminished. Alcohol withdrawal provokes inverse effects in alcoholic patients: sleep onset is delayed, slow wave sleep durations diminished and REM sleep duration is enhanced. REM sleep is associated with motor inhibition failure. Sleep remains disturbed in long term evaluations. Alcohol promotes the occurrence of sleep apneas and hypopneas. This effect persists in alcoholics after alcohol withdrawal. Sleep disturbances in alcoholism can be partly understood as the expression of amplitude diminution and phase advance of biological rhythms. Thus, the chronobiologic characteristics of alcoholics resemble those of depressives or the elderly.

Circadian Rhythm↗
PubMed1992

Sleep apneas and high altitude newcomers.

Sleep and respiration data from two French medical high altitude expeditions (Annapurna 4,800 m and Mt Sajama 6,542 m) are presented. Difficulties in maintaining sleep and a SWS decrease were found with periodic breathing (PB) during both non-REM and REM sleep. Extent of PB varied considerably among subjects and was not correlated to the number of arousals but to the intercurrent wakefulness duration. There was a positive correlation between the time spent in PB and the individual hypoxic ventilatory drive. The relation between PB, nocturnal desaturation, and mountain sickness intensity are discussed. Acclimatization decreased the latency toward PB and improved sleep. Hypnotic benzodiazepine intake (loprazolam 1 mg) did not worsen either SWS depression or apneas and allowed normal sleep reappearance after acclimatization.

Acclimatization↗
PubMed1992

Risk factors for oxygen desaturation during sleep, after abdominal surgery.

The postoperative period after major abdominal surgery is known to be a period of increased episodic oxygen desaturation. In order to assess the risk factors for episodic desaturation, we have studied 29 surgical patients using pulse oximetry during the preoperative night (Npre) when they received benzodiazepine premedication and breathed air, and also during the first three nights after operation when they received nasal oxygen supplementation. Modal oxygen saturation (SpO2) exceeded 95% during all nights studied. The time spent at less than 90% (t90) and 85% (t85) SpO2 and the average SpO2 nadir (SpO2, nadir) did not differ each night. Heart rate was greater (mean 90.1 (SD 16.6) vs 68.2 (12.0) beat min-1, P < 0.001) during the second night after operation (N2) than during Npre. Before operation, the number of desaturations, t90 and t85 correlated with pharyngeal hypertrophy (P = 0.003, P = 0.002, P = 0.001, respectively). At the same time, t90 and t85 correlated with body mass index (P = 0.02 and P = 0.05, respectively). During N2, t90 correlated with radiological lung consolidation (P = 0.05) and SpO2, nadir correlated with FEV1 (P = 0.03). We conclude that there are several mechanisms responsible for oxygen desaturation and that these mechanisms differ before and after surgery.

Abdomen↗
PubMed1991

[Sleep in normal aging].

Sleep in the elderly is characterized by a decrease in the ability to stay asleep resulting in a more fragmented sleep. Spindles are less frequent and less ample, shorter, without an increase during the night contrary young subjects. Delta activity in slow wave sleep is decreased in the 0.5-2 Hz frequency band only. REM sleep occurs earlier the first REM period duration increases. The REM sleep appearance is almost uniform during the night. REMs density does not increase toward the end of the sleeping period. The sleep-wake circadian rhythm is advanced (bedtime and morning awakening occur earlier). The temperature rhythm is also advanced. The rise in temperature after the nadir begins earlier for females and the initial ascent is more rapid. This explains why women wake up earlier and sleep for shorter durations than men. The nocturnal and diurnal mean plasmatic norepinephrine values increase. The rhythm of cortisol secretion is advanced. The GH and melatonin peaks of secretion are decreased. The acrophase of melatonin rhythm is occurring later in the elderly. These results suggest a weakening of circadian structure in the course of aging and an altered relationship between the pacemakers driving melatonin and cortisol circadian rhythms.

Aging↗
PubMed1991

Insomnia and use of hypnotics: study of a French population.

A cross-sectional study of insomnia and hypnotic use was performed in a sample of the French population. The quota method was used to select the sample of 1,003 subjects, with less than 3% substitution. Subjects were 15 years old and older and were representative of the French population based on gender, age, marital status and living environment. Subjects were asked questions relevant to the complaint of insomnia and hypnotic use and filled out questionnaires measuring anxiety and depression. The complaint of insomnia is common, even in the 15-24-year-old group. Overall, more women than men were afflicted. The largest group of insomniac subjects, and the group who most often used hypnotics "frequently and chronically", were women 45 years and older. Men presented a sharp increase in hypnotic use after 65 years of age. Ten percent of the entire sample used hypnotics, 8% for more than 6 months and 6.17% on a chronic and frequent basis. Retired and unemployed elderly were also chronic and frequent hypnotic users: aging and social isolation correlate with chronic and frequent hypnotic usage. Higher scores on anxiety and depression scales correlate with more frequent complaints of nocturnal sleep disturbances. Young individuals are a significant complainer group but use hypnotics rarely. A rural environment was associated, overall, with fewer insomnia complaints, but environment had much less impact on complaints and hypnotic use in the elderly than in other age groups. One may question whether, in the French population, hypnotic prescription and intake are not responses to a social rather than a medical problem.

Adolescent↗
PubMed1988

[Periodic respiration during sleep at high altitude. Effects of a hypnotic benzodiazepine, loprazolam].

Sleep and respiration studies were carried out in 12 subjects (9 males, 3 females) at an altitude of 4,800 metres, during effect of a French expedition in the Himalayas. The effect of loprazolam, a hypnotic benzodiazepine, was investigated in a double-blind, 2 parallel group, 1 mg loprazolam versus placebo trial. Sleep was evaluated by means of electroencephalographic recordings and questionnaires. The effects of altitude in each subject were intercurrent wakefulness increase, slow wave sleep and paradoxical sleep decrease and nocturnal periodic breathing. The mean duration of sleep apnea episodes was 12 seconds with a maximum of 24 seconds. These episodes occurred during stages 1 or 2 of sleep and during paradoxical sleep. Female subjects exhibited less periodic breathing than males. Acclimatization to high altitude increased total sleep time, stage 3 duration and percentage of paradoxical sleep. Loprazolam tended to decrease stage 2 latency and did not worsen slow wave sleep depression or episodes of apnea. Normal amounts of slow wave sleep and intrasleep wakefulness appeared in the loprazolam group after acclimatization.

Acclimatization↗
PubMed1988

Psychological profile and sleep organization in young subjects with poor quality of sleep.

The personality traits defined by the Minnesota Multiphasic Personality Inventory (MMPI) and sleep data were analyzed in 45 young subjects with poor quality of sleep. The subjects were divided into three groups: Group 1 had no T score greater than or equal to 70, Group 2 had one or more single T scores greater than or equal to 70, and Group 3 had T scores greater than or equal to 70 in one or more specific groups of scales. The first 2 nights of sleep were polygraphically recorded. Subjects in Group 1 were considered to be normal, those in Group 2 were characterized by depression and anxiety, and those in Group 3 had psychopathic personality traits and somatic disorders. Differences in sleep data were noted among groups. The severity of the sleep disorders was related to the degree of the psychological problems.

Adult↗
PubMed1988

[Reflections on the place of polygraphic recordings in the study of hypnotic drugs].

Polygraphic recordings are important for studying a new hypnotic molecule. Night recordings are used in the assessment of the objective hypnotic effect over short and long-term periods. They show sleep architecture modifications caused by the hypnotic drug and quantify rebound insomnia following abrupt withdrawal. The comparative usefulness of sleep laboratory recordings and ambulatory monitoring is discussed. Polygraphic recordings also allow to evaluate diurnal residual effect upon vigilance. Twenty-four-hour recordings as well as multiple sleep latency test (MSLT) are used.

Humans↗
PubMed1988

[Utilization of theta/alpha spectral range as an indicator of vigilance: pharmacological applications during repeated sleep latency tests].

Three successive double-blind, cross-over vs placebo trials with amphetamine 10 mg, amineptine 200 mg, clonidine 150 mcg were made in 12 x 3 healthy volunteers by means of a multiple sleep latency test (MSLT) associated with quantitative EEG. Data were evaluated by a 3-way ANOVA for repeated measurement. The aim of the study was to find out the most efficient parameters from theta/alpha ratio to exhibit a "time effect", i.e. the physiological variation of vigilance during the daytime and a "drug effect", i.e. a stimulant or sedative effect. The best parameter was the difference between the maximum and the minimum values of the theta/alpha ratio during the recording session. The time after which the theta/alpha doubled and the time after which the subject was the most relaxed (theta/alpha minimum) exhibited significant variations due to time effect and only sedative drug effect. The results of the other classical parameters from MSLT, visual analogue scales and sleep questionnaires were discussed as was the use of parameters from quantified EEG in order to make up homogeneous groups of healthy volunteers.

Adult↗
PubMed1986

[Refinement of an EEG diurnal vigilance index. Application to drug trials].

Theta/alpha spectral powers ratio was used to quantify physiological decrease of vigilance occurring after 5 min recording eyes closed, at different times of the day, in normal volunteers with 'high alpha'. Maximum decrease of vigilance occurred at about 2 or 4 p.m. Theta/alpha ratio fluctuations were similar on the homologous right and left scalp areas. This ratio is useful in psychopharmacology to quantify the antagonist activity of a CNS stimulant drug on the physiological decrease of vigilance after 5 min as well as the sedative effect of a drug. It allows to follow the kinetics of the drug action at receptor level.

Alpha Rhythm↗
PubMed1986

[Comparison between good and poor sleep in the 20 to 30-year-old age range: polygraphic findings and psychopathologic aspects].

Fifty-six poor sleepers, aged from 20 to 30, were compared with 46 good sleepers of the same age regarding objective sleep parameters and personality. A gradation of sleep disorders was observed. The degree of sleep disorders was found to be directly proportional to the degree of psychological disturbance. Psychophysiological group of poor sleepers exhibited objective differences from good sleepers during the first cycle only (lack of SWS and REM sleep). Sleep organization in the first cycle seemed important for the estimation of poor or good sleep by the sleeper.

Adult↗
PubMed1981

[Intra-sleep awakenings in poor sleepers, 20 to 30 years of age. Correlation with anxiety level and personality (author's transl)].

Recordings were made from 43 poor sleepers between the ages of 20 and 30 for at least 4 consecutive nights. Three subject groups were formed on the basis of the awakenings occurring up to the sixth hour of sleep. The first group, with an average of 61 min wakefulness, is characterized by the abundance of long-lasting waking periods. The second group, with 18 min average wakefulness, showed the highest absolute number of awakenings, almost all of which were very brief. The third group, with 6 min average wakefulness, showed a slightly lower number of awakenings, but these were almost exclusively micro-waking periods. The temporal distribution of the waking periods was also different in the first group, in which the longest waking periods occur during the first hour of sleep and remain elevated until the fifth hour of sleep. The latency for falling asleep is particularly high for this group. A correlation exists between the amount of time awake up until the sixth hour of the night and the subject's anxiety level and the neuroticism index. 65% of the subjects obtained pathological scores on one or more MMPI scales. According to the order of frequency these were scales Sc, Pd and Pt. No preferential profile was found.

Adult↗
PubMed1979

[Use of the Cerebral Function Monitor in the study of physiological sleep].

After a brief description of the different phases of physiological sleep, the reasons for employing a new appatus, the Monitor of Cerebral Function, are discussed. This instrument, the first designed for continual monitoring of cerebral activity may be employed in neurophysiology. The results obtained are presented, i.e. the demonstration of a perfect correlation between the Monitor of Cerebral Function recording and the polygraphic methods. The paradoxal and rapid phases of sleep are easily distinguished. The study of paradoxal sleep, both in physiology and in pharmacology, could profit greatly from the use of the MCF due to the great advantage of its ease of operation.

Adult↗
PubMed1978

Clinical investigation of the menstrual cycle. II. Neuroendocrine investigation and therapy of the inadequate luteal phase.

Nonhormonal drugs--diphenylhydantoin and nialamide, which act on the central nervous system and have no known endocrine activity--were given to two groups of women with distinct types of electroencephalographic patterns in an effort to regulate menstrual disorders. Equalization of the lengths of both the follicular phase and the luteal phase to the normal range was observed during the drug therapy. Forty-five per cent of the pregnancy rate was achieved in 36 of the 80 infecund patients within 4 months of treatment. The mode of action of these drugs is still unknown.

Adult↗