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Biomedical subjects

G Simon

Publications and source records attributed to G Simon.

At least 91 records · Page 5Linked to original sources
PubMed1997

The education of depressed primary care patients: what do patients think of interactive booklets and a video?

BACKGROUND: Clinicians, policy makers, and health care administrators are attempting to improve depression outcomes in the primary care setting. Despite positive evidence about the efficacy of self-help materials and psychoeducational interventions, use of educational materials designed for the primary care patient are receiving little attention in present depression initiatives. The present study describes the use and evaluation of three educational materials by depressed primary care patients. METHODS: As a part of a randomized control trial, depressed primary care patients were identified by primary care physicians and randomized to a clinical trial exploring a new method of treating depression. Patients assigned to the new method of treatment received a package of educational materials at the time of the baseline interview. These materials included two brief interactive booklets (medication booklet, behavioral health booklet) and a short video. The present analysis concerns data obtained from 108 intervention patients in a telephone survey conducted 1 week after they received the package of educational materials. RESULTS: Approximately three quarters of the subjects reported that they read or viewed all of the educational products. The majority rated the products as somewhat to significantly helpful: medication booklet 81%; behavioral health booklet 82%; and video 69%. Previously reported results include findings of significantly better medication adherence and improved clinical outcomes by patients with major depression who received a primary care intervention that included the educational products discussed in this paper. CONCLUSIONS: Educational materials may play a significant role in improving depression treatment outcomes in the primary care setting.

Adaptation, Psychological↗
PubMed1996

Screening for abdominal aortic aneurysms in a hypertensive patient population.

BACKGROUND: Abdominal aortic aneurysm (AAA) is an important cause of preventable death in the elderly. OBJECTIVE: To search for an effective screening program for the detection of AAA. METHODS: We consecutively and prospectively screened 240 male, predominantly white, patients, aged 60 to 75 years, by ultrasound for the presence of AAA in 2 phases: in screen 1, hypertension (diastolic blood pressure reading > 95 mm Hg) was the only selection criterion; in screen 2, we included hypertensive patients with a systolic blood pressure level higher than 175 mm Hg with or without antihypertensive therapy, transient ischemic attacks and/or stroke, and claudication. RESULTS: The yield of AAAs in screens 1 and 2 was 3% and 11%, respectively (P < .02, (chi)2 analysis). No AAAs were found in patients with uncomplicated hypertension. Of the cardiovascular complications, only claudication was independently associated with the presence of AAA (relative risk, 5.8; confidence interval, 1.8-18.6; P = .004). CONCLUSIONS: Screening for AAA is recommended for elderly white patients with claudication. Uncomplicated hypertension by itself is not an indication for screening.

Aged↗
PubMed1996

A multifaceted intervention to improve treatment of depression in primary care.

BACKGROUND: This research study evaluates the effectiveness of a multifaceted intervention program to improve the management of depression in primary care. METHODS: One hundred fifty-three primary care patients with current depression were entered into a randomized controlled trial. Intervention patients received a structured depression treatment program in the primary care setting that included both behavioral treatment to increase use of adaptive coping strategies and counseling to improve medication adherence. Control patients received "usual" care by their primary care physicians. Outcome measures included adherence to antidepressant medication, satisfaction with care of depression and with antidepressant treatment, and reduction of depressive symptoms over time. RESULTS: At 4-month follow-up, significantly more intervention patients with major and minor depression than usual care patients adhered to antidepressant medication and rated the quality of care they received for depression as good to excellent. Intervention patients with major depression demonstrated a significantly greater decrease in depression severity over time compared with usual care patients on all 4 outcome analyses. Intervention patients with minor depression were found to have a significant decrease over time in depression severity on only 1 of 4 study outcome analyses compared with usual care patients. CONCLUSION: A multifaceted primary care intervention improved adherence to antidepressant regimens and satisfaction with care in patients with major and minor depression. The intervention consistently resulted in more favorable depression outcomes among patients with major depression, while outcome effects were ambiguous among patients with minor depression.

Adult↗
PubMed1996

Different vascular responses to subpressor angiotensin II administration in the mesenteric and renal circulation of rats.

Administered in small doses, angiotensin II (ANG II) potentiates its own pressor responses (autopotentiation). In the present study, we investigated whether potentiation of vasoconstrictor responses in the mesenteric and renal circulation accounted for the autopotentiation of pressor responses. Male Sprague-Dawley rats, 350 to 400 g, were infused with 200 ng/kg/min ANG II intraperitoneally for 7 to 10 days. Control rats were fitted with an osmotic minipump containing vehicle only. Vascular responses to ANG II, norepinephrine (NE), arginine vasopressin (AVP) and nerve stimulation were measured in the mesenteric and renal circulation of rats. In ANG II-treated rats: 1) tail systolic BP was 4 mm Hg higher than in controls (P = NS); 2) mesenteric vascular responses to ANG II (P < .002) and nerve stimulation (P = .03) were increased, and those to NE and AVP were unchanged; and 3) renal vascular responses to nerve stimulation were reduced (P < .02), and those to ANG II, NE, and AVP were unchanged. Thus, we demonstrated autopotentiation of vascular responses to ANG II in the mesenteric, but not the renal circulation. An interaction between ANG II and sympathetic activity may explain these differences in regional vascular responses. Regional hemodynamic measurements may provide important clues to pathogenetic mechanisms in hypertension.

Angiotensin II↗
PubMed1996

The periplasmic TorT protein is required for trimethylamine N-oxide reductase gene induction in Escherichia coli.

Expression of the Escherichia coli torCAD operon, which encodes the trimethylamine N-oxide reductase system, is regulated by the presence of trimethylamine N-oxide through the action of the TorR response regulator. We have identified an additional gene, torT, located just downstream from the torR gene, which is necessary for torCAD structural operon expression. Insertion within the torT gene dramatically reduced the expression of a torA'-'lacZ fusion, while presence of the gene in trans restored the wild-type phenotype. Overproduction of TorR in a torT strain resulted in partial constitutive expression of the torA'-'lacZ fusion, suggesting that TorR acts downstream from TorT. The torT gene codes for a 35.7-kDa periplasmic protein which presents some homology with the periplasmic ribose-binding protein of E. coli. We discuss the possible role of TorT as an inducer-binding protein involved in signal transduction of the tor regulatory pathway.

Amino Acid Sequence↗
PubMed1996

Unchanged intestinal absorption in rats fed a high sweet paprika-containing diet.

The absorption rate of radiolabelled nutrients (22Na, 45Ca, [35S]methionine, [3H]leucine) was investigated in vivo in Sprague-Dawley rats at the end of a feeding period of 135 days on a semisynthetic diet containing 32% sweet paprika powder. No effect was seen on the intestinal absorption of these compounds, nor on the nutritive experimental parameters in these animals.

Animals↗
PubMed1996

The prevalence and impact of psychological disorders in primary care: HMO research needed to improve care.

OBJECTIVE: To estimate the prevalence and impacts of psychological disorders among primary care patients. SETTING: Primary care clinics at Group Health Cooperative of Puget Sound participating in a multi-center, international World Health Organization study. DESIGN: Prevalence survey of a stratified sample of consecutive primary care patients. MAIN OUTCOMES MEASURES: Psychiatric diagnosis, work disability, and health care costs. RESULTS: Depression, anxiety and somatoform disorders were common among primary care patients. They were associated with significant disability, unfavorable health perceptions and increased health care costs. CONCLUSIONS: Psychological disorders are common among primary care patients and these disorders have significant societal impacts including work disability and increased health care costs. HMOs with integrated delivery systems that have developed public domain research capabilities have a critical role to play in efforts to reduce the burden of these disorders by evaluating innovations in health care services for psychological disorders.

Health Maintenance Organizations↗
PubMed1996

[France, the European migratory system, and globalization].

"The overwhelming trend of migratory flows to become globalized, which is manifesting itself in all the major immigrant countries and the planet's main pools of employment, henceforth concerns France and Europe. One of the main challenges confronting these two entities is related to the spatial expansion and rising diversity of their recruitment spaces, and the great difficulty involved in controlling mobility which increasingly tends to function on a global scale. It is essential to revise analytic paradigms based on a strictly national vision which is blind to and repressive of phenomena that are more planetary every day. The global approach will have to combine national management, the functioning of the community's migratory space, relations with increasingly distant and increasingly ¿foreign' lands of origin, and the globalization of migratory dynamics." (SUMMARY IN ENG AND SPA)

Demography↗
PubMed1996

[Evaluation of multidrug resistance phenotype on medullary specimens from patients with acute leukemia by determination of nuclear efflux of tetrahydropyranyl-doxorubicin. Approach by confocal laser microspectrofluorometry].

Confocal microspectrofluorometry allows the analysis of fluorescent molecules such as anthracylines in isolated living cells. An optical microscope fitted with a phase-contrast 100 X water-immersion objective enables simultaneous observation of the sample, focusing of the laser beam on the selected cell fraction (nucleus) and collection of the fluorescence emitted from the sample. The resulting intranuclear spectra are interpreted according to a quantitative model of the fluorescence spectra of both free and DNA-bound anthracycline. The intranuclear drug concentration can thus be determined. This technique has been applied to blast cells collected in patients with acute leukemia. Leukemic cells are aspirated from bone marrow, separated by Ficoll sedimentation and resuspended in RPMI-1640 containing 10% fetal calf serum and 200 nM tetrahydropyranyl-doxorubicin (THP-DOX). After one hour, 20 cells are analyzed and the mean nuclear drug content is determined (C1). Cells are then resuspended in the same medium but without anthracycline for 3 hours and the mean intranuclear drug concentration is then also determined (C3). From C1 and C3 the retention rate (RR) is calculated. Firstly, the accuracy of the method was checked. In 4 AML patients, two different samples aspirated on the same day were divided into two portions. Thus, two measurements were made on each one (4 values per patient). Coefficients of variation were satisfactory (4, 6, 12, and 12%). Secondly, blast cells collected in patients with AML and ALL at diagnosis or in relapse were studied. P-glycoprotein (P-gp) and CD34 expression was also studied using respectively immunohistochemistry land flow cytometry. Results obtained from the first 21 patients showed that there was no correlation between RR and either P-gp or CD34 expression. This could result from the efflux of THP-DOX by other mechanisms and/or low sensitivity of the staining technique.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1996

The relationship between pain and depression.

Empirical results from epidemiological studies on pain-depression comorbidity in primary care and population samples have shown that: (a) pain is as strongly associated with anxiety as with depressive disorders; (b) characteristics that most strongly predict depression are diffuseness of pain and the extent to which pain interferes with activities; (c) certain psychological symptoms (low energy, disturbed sleep, worry) are prominent among pain patients, while others (guilt, loneliness) are not; (d) depression and pain dysfunction are evident early in the natural history of pain, but dysfunction and distress are often transient; and (e) among initially dysfunctional pain patients whose dysfunction is chronic, depression levels do not improve but neither do they increase over time with chronicity alone. These results seem consistent with these mechanisms of pain-depression comorbidity; (1) a trait of susceptibility to both dysphoric physical symptoms (including pain) and psychological symptoms (including depression), and a state of somatosensory amplification in which psychological distress amplifies dysphoric physical sensations (including pain); (2) psychological illness and behavioural dysfunction being interrelated features of a maladaptive response to pain evident early in the natural history of the condition, and often resolving during an early recovery phase; (3) pain constituting a significant physical and psychological stressor that may induce or exacerbate psychological distress. Thus, pain and psychological illness should be viewed as having reciprocal psychological and behavioural effects involving both processes of illness expression and adaption, as well as pain having specific effects on emotional state and behavioural function.

Anxiety Disorders↗
PubMed1995

[Successful treatment of cyclic neutropenia associated with hyperimmunoglobulin M syndrome using recombinant granulocyte-colony stimulating factor].

Hyper-IgM syndrome associating with severe neutropenie presenting in irregularis cycles was diagnosed in a 3-year-old male patient. His elder brother died of sepsis which appeared as a consequence of dysgammaglobulinaemia and neutropenia at the age of 9. We could not achieve a parmanent good result with the monthly immunoglobulin substitution and supportive treatment. The candida infection of the gingiva and of the oral mucous membrane expanded to the esophagus resulting in its complete occlusion and temporarily a gastrostomy was needed to feed him. We started with the recombinant human granulocyta colony stimulating factor (rh-G-CSF) treatment at the age of 6. We tried several ways of applying and finally the 10 micrograms/kg/dose given subcutan, for 5-10 days from the nadir of the neutropenic cycle seemed the most effective. The rh-G-CSF treatment resulted in an increase of ANC and the complete resolution of gingivostomatitis. The incidents of infections, the requirement of antibiotics and the duration of hospitalisation were markedly reduced. The consequent improvement in his physical condition made it possible to finally resolve the esophageal stricture surgically. We have not observed any neutropenic cycle since the end of the 14 month rh-G-CSF treatment. Though the medicine was discontinued there has been no recidiva for more than 22 months.

Candidiasis, Oral↗
PubMed1995

[Rheumatic fever, a disease undergoing change, based on the experience of the past 15 years].

The authors reviewed the records of paediatric patients treated at the cardiology department of the Svábhegyi Gyermekgyógyintézet during the period from 1 January 1979 to 31 December 1993. All the patients elected for the survey had rheumatic fever and represented about 20 percent of the national patient pool. Among the 62 children referred for suspected rheumatic fever 26 had carditis, and 3 suffered from pancarditis. Two children had chorea minor with carditis and there were 2 additional cases with chorea minor only. Valvular heart disease has developed in 21 patients. There were 16 patients with mitral regurgitation, these conditions have occurred in combination with mitral stenosis in 3 cases, whereas the insuffitientia of the aortic valve developed in two patients. The authors analysed the clinical signs of the patients and established that the chronic syndromes came in front. The authors have observed a favourable trend in the epidemiology of the disease, in particular, while 34 patients were referred during the first 5 years, there were only 18 cases in the second 5-years period. During the interval from 1989 to 1993, only 10 children with rheumatic fever have been referred to or treated at the authors' institute.

Adolescent↗
PubMed1995

Preparative-scale amino acid separation by thermal parametric pumping on an ion-exchange resin.

Thermal parametric pumping was experimentally investigated for the concentration and separation of amino acids. Previous theories of parametric pumping were improved by taking into account dissociation equilibria in the liquid phase. Experiments were carried out with a mixture of glutamic acid, aspartic acid, serine and threonine in a highly acidic solution (HCl). A multi-component equilibrium model was mainly used to simulate the experimental results and to investigate the effect of chloride concentration over a wide range. It is shown that it is always possible to concentrate the amino acids and to separate some of them under certain conditions.

Amino Acids↗