Search PubMed⌕ Search

Biomedical subjects

J F Chevalier

Publications and source records attributed to J F Chevalier.

At least 19 recordsLinked to original sources
PubMed2004

Acid aspiration prophylaxis in obstetrics in France: a comparative survey of 1998 vs. 1988 French practice.

BACKGROUND AND OBJECTIVE: To survey French anaesthetic practice regarding acid aspiration prophylaxis and compare it with an earlier survey. METHODS: A confidential questionnaire was sent to all 800 maternity units in France to assess three major topics: (a) drugs used for pharmacological prophylaxis; (b) regional anaesthesia for labour and Caesarean section and (c) techniques used for general anaesthesia and endotracheal intubation. RESULTS: Two-hundred-and-two units responded. Pharmacological prophylaxis was regularly used for labouring women in 78% of the responding units in 1998 (compared with 63% in 1988, P < 0.05). Antacid drug use before Caesarean section had increased from 75% in 1988 to 97% in 1998 (P < 0.05). General anaesthesia was used for Caesarean section by less than 2% of responding units (vs. 21% in 1988, P < 0.05). In contrast, there was little change in the use of endotracheal intubation for instrumental delivery (53% vs. 50%) or manual removal of the placenta (15% vs. 16%) between 1988 and 1998. The use of cricoid pressure increased significantly during the 10 yr period (50% vs. 88%, P < 0.05) and the technique was correctly described by 80% of the responding units (vs. 50%, P < 0.05). Similarly, the use of succinylcholine increased significantly from 25% (1988) to 479 (1998) (P < 0.05). CONCLUSIONS: There was a significant overall improvement of French practice regarding acid aspiration prophylaxis in obstetrics. However, the complete prophylaxis strategy is still not used in every patient emphasizing the need for continuing medical education.

Anesthesia, Conduction↗
PubMed1999

Plasma serotonin level after 1 day of fluoxetine treatment: a biological predictor for antidepressant response?

RATIONALE: Antidepressant treatments present a delayed onset of action. OBJECTIVE: The present study investigated whether plasma or serum serotonin, 5-hydroxytryptamine (5-HT), could predict clinical improvement. METHODS: Biological parameters were determined after a 4-week drug-free period (day 0) and 1, 14 and 28 days after the beginning of the treatment with fluoxetine 20 mg daily in depressed patients. Clinical evaluations were assessed on days 0, 14 and 28. RESULTS: One day after a single dose, the mean values of plasma 5-HT (5.4 +/- 2.6 nmol/l) and serum 5-HT (484 +/- 215 nmol/l) were not statistically different from basal mean values (4.5 +/- 2.5 nmol/l and 523 +/- 263 nmol/l, respectively). The repeated treatment significantly reduced serum 5-HT to 34% (P = 0.002) and 17% (P = 0.0004) of pretreatment values after 14 and 28 days of treatment, respectively; plasma 5-HT was also reduced significantly to 28% and 15% of pretreatment values (P < 0.05 in both cases). At day 28, four of the eight patients responded by showing a reduction in MADRS score of at least 50% of the baseline score. No correlation was found between pretreatment values of serum or plasma 5-HT and clinical evolution, even if a tendency (P < 0.07) to lower serum 5-HT pretreatment values was observed in responders. Plasma 5-HT after 1 day of treatment was significantly different between responders and non-responders: the plasma 5-HT concentration in responders was 3.4 +/- 1.7 nmol/l versus 7.4 +/- 1.6 nmol/l in non-responders (P = 0.02). Moreover, plasma 5-HT levels after 1 day of treatment were positively correlated to the final MADRS score (r = +0.89, n = 8, P = 0.003) and inversely correlated to its change from the initial score (r = -0.76, n = 8, P = 0.02). CONCLUSION: These preliminary data show that fluoxetine and norfluoxetine might influence 5-HT peripheral venous blood parameters and that plasma 5-HT after 1 day of treatment might be a biological predictor for antidepressant response.

Adult↗
PubMed1997

Heterogeneity in cognitive functioning of schizophrenic patients evaluated by a lexical decision task.

BACKGROUND: The disorganization pattern in schizophrenia, which involves formal thought disorders, is thought to be correlated with a deficit in integrative processes of contextual information. We tested the hypothesis that thought disordered schizophrenics, unlike non-though disordered schizophrenics, would present a deficit in the processing of the context during a task which involves these integrative processes. METHODS: A group of 22 schizophrenic patients diagnosed in accordance with DSM-III-R criteria and a group of 11 control subjects were compared using a semantic priming version of the lexical decision task. The experimental design used low-level structuration of verbal material to reveal the difficulty that schizophrenic patients encounter in using semantic regularities. RESULTS: A significant difference in priming effect was found between the three groups. Control subjects and non-thought disordered schizophrenics exhibit a priming effect for related word pairs when compared with unrelated pairs (respectively F(1,10) = 17.7; P < 0.002 and f(1,10) = 14.5; P > 0.003) but thought disordered schizophrenics did not (F(1,10) < 1; NS). CONCLUSIONS: This finding provides evidence for the cognitive heterogeneity of schizophrenic subjects. This absence of priming effect in thought-disordered schizophrenic subjects supports the hypothesis that these patients present a deficit in the post-lexical controlled information processing that permits the integration of semantic information.

Adult↗
PubMed1996

Initial increase of plasma serotonin: a biological predictor for the antidepressant response to clomipramine?

Hypofunction of the serotonin (5-HT) system might be involved in depression. Initial effects of the 5-HT reuptake inhibitor clomipramine (CMI) on plasma 5-HT have never been assessed. On Day 1, 27 depressed patients received either a 25-mg CMI slow infusion or a 25-mg CMI tablet in a randomized, double-blind, double-dummy design. The daily dose was subsequently titrated up to 75 mg i.v. or 150 mg orally. The Montgomery-Asberg Depression Rating Scale (MADRS) was rated on Days 1, 4, 7 and 14. High-performance liquid chromatography (HPLC-EC) assays of plasma 5-HT, platelet 5-HT, and CMI were performed on Day 1 before and after the infusion. On Day 1, both groups experienced a mean (nonsignificant) plasma 5-HT increase; in the i.v. group this initial increase correlated with MADRS decrease over 14 days (r = 0.76, p = .0025). Correlations between platelet 5-HT and MADRS decrease were not significant. These preliminary data show that: i) CMI administration results in initial changes in plasma 5-HT; and ii) i.v. CMI-induced initial plasma 5-HT increase is consistent with the CMI 5-HT profile, and might predict the clinical response to CMI.

Administration, Oral↗
PubMed1996

Citalopram versus fluoxetine: a double-blind, controlled, multicentre, phase III trial in patients with unipolar major depression treated in general practice.

Two selective serotonin reuptake inhibitors (SSRIs), citalopram and fluoxetine, both at a daily dose of 20 mg, were compared in patients with unipolar major depression treated in general practice. This was a multicentre, double-blind, randomized trial carried out in France. The duration of treatment was 8 weeks. Patients were assessed by means of the Montgomery-Asberg Depression Rating Scale (MADRS), the 17 items Hamilton Depression Rating Scale (HAMD) and the investigator's Clinical Global Impressions (CGI), Observed and spontaneously reported adverse events were also recorded. A total of 357 patients of both sexes, aged between 21 and 73 years, entered the double-blind phase of the trial. A clear reduction of both the MADRS and the HAMD mean total scores was observed in both treatment groups with no statistically significant differences between treatments. Apart from back pain recorded more frequently in the citalopram group, no significant difference was found between the two treatment groups with regard to adverse events, and both citalopram and fluoxetine were considered to be well tolerated. It was concluded that citalopram was as effective as fluoxetine in the treatment of unipolar major depression. Citalopram showed an earlier onset of recovery than fluoxetine.

Adolescent↗
PubMed1995

[Role of biological clock in human pathology].

Most of the vegetative, hormonal and behavioural functions of the human organism operate under the biological control of a circadian clock which responds to environmental and social stimuli, synchronizing the organism's physiology to daily and seasonal rhythms. The underlying anatomic structures are located in the suprachiasmatic nucleus and the pineal gland. Although the precise physiologic mechanisms involved are still under study, melatonin is known to play a major role. Normal function of the circadian clock is disrupted in jet-lag, night-shift work, and blindness as well as in rare cases of lesions to the pineal gland leading to a shift in biological rhythms including hormone secretion and control of body temperature, for example. Several signs of impaired function have been identified: various types of sleep disorders, memory and concentration impairment, dysphoria, asthenia, irritability. Seasonal recurrence of such signs and frequent depressive complications are also suggestive of a disorder in the circadian clock. Knowledge of specific clinical signs and biological parameters will undoubtedly lead to the discovery of other disease states dependant on the circadian clock and to the development of therapeutic strategies capable of regulating the organism's chronobiology.

Biological Clocks↗
PubMed1988

[Senile dyskinesias and tardive dyskinesias].

Correct recognition of spontaneous linguobucco-facial dyskinesia is at least of interest in that it enables accurate evaluation of the impact of neuroleptic medication on the occurrence of similar neurological disorders. Since 1963, first anecdotal evidence and then series of cases of spontaneous dyskinesia have been reported. This has enabled evaluation of the prevalence of these disorders in subjects aged over 60 to be determined as 10% whereas incidence is over 50% in subjects of the same age receiving neuroleptics. Nonetheless, a number of uncertainties persist. Epidemiological studies produce very variable results suggesting that the concept of tardive dyskinesia is not always adequately defined and that certain disorders of a different type are sometimes confused with that condition. Dyskinetic movements involve the face and trunk, like those of chorea, but do not share the latters' abrupt rapid and unpredictable nature. Dyskinetic movements on the contrary, tend toward a degree of reproducibility, if not stereotypy, in the manner of ballistic movements which may be distinguished by their rotary character and the fact that they are generally localized in one half of the body. Lastly dyskinetic movements frequently have the creeping appearance of athetoid movements from which they may be distinguished by case history. The various characteristics confer a highly specific appearance on dyskinetic movements which was well described by Sigwald back in 1959. It should be stressed that author, who had already studied bucco-lingual dyskinesia in epidemic encephalitis in 1953, discovered, with surprise, the existence of such disorders in an infectious context.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1982

[New antidepressant multicenter study in hospitalized patients: quinupramine (author's transl)].

Quinupramine is a novel and original antidepressant due to its selective and specific affinity for central muscarinic receptors and the lack of subsequent metabolites. These properties enable its use at low doses i.e. tablets and ampoules are dosed at 2.5 mg. A multi-centre trial with quinupramine was conducted in 25 hospital centers, involving 364 patients suffering from all types of depression, of which more than a third constituted by endogenous depression. The results indicated genuine antidepressant activity with notable achievement of manic swing. Its profile appears to be balanced with simultaneous improvement in mood disorders, psychomotor inhibition and insomnia. The onset of activity is rapid (about 8 days in half the cases). Tolerance was considered to be very good, while minimal side-effects only very rarely warranted corrective treatment. Quinupramine appears to be equally active as the reference antidepressants and is particularly well tolerated.

Administration, Oral↗
PubMed1982

[Long-term tolerance of viloxazine].

21 depressed patients have been treated by viloxazine (Vivalan) during 15 to 53 months. They, all, underwent their first complete biological health examination after, at least, 8 months of treatment. Amongst there patients, 18 have had two controls under treatment, each being separated by a period longer than one year. The 3 others have had only health examination but after 18,33 and 48 months of treatment. The results of these studies lead us to two main conclusions: On one hand, they have confirmed the lack of chronic biological as electrical toxicity of viloxazine, no significant change having been noticed. On the other hand, in much long periods of prescription, only two cases of progressive decrease in efficacy have been observed. The first, of mild severity, was controlled with an increase in daily dosage of 100 mg. The second occurred after more than 43 months of treatment. It is relevant to insist on the fact that this decrease in efficacy occurred in two depressed women, whose hysterical personality may have been a predisposition for this kind of phenomenon.

Adult↗
PubMed1981

[Pathological laughing and posterior fossa tumours (author's transl)].

Posterior fossa tumours give rise, sometimes, to psychiatric disturbances, which are difficult to diagnose, when they are isolated without any neurological signs. This was the case in our report of a 32-year-old man who had a pathological laugh, unique symptom, during 4 months, of a trigeminal neurinoma. Spasmodic laughs related to posterior fossa tumours are infrequently reported in the literature. They always are the sign of a pseudo-bulbar syndrome, due to a bilateral lesion of the cortico-bulbar tracts. Other involuntary laughs are encountered in third ventricle's lesions, in frontal lobe lesions and in epilepsy.

Adult↗
PubMed1980

[Edemas and myocloni concerning a patient with Parkinson's disease treated by amantadine (author's transl)].

The administration of diuretics to a 64 year old patient with Parkinsonian disease treated by amantadine, orphenadrine and Modopart and presenting an oedemia of the legs, induced the apparition of myoclonic jerks similar to those observed in a bismuth intoxication. The myoclonic jerks remained after the diuretics were stopped and only disappeared with the suppression of amantadine. It is supposed that diuretics increased the intoxication by amantadine, probably by means of an increase of the reabsorption of basic drugs. Myoclonius may be caused by the central anticholinergic properties of amantadine.

Amantadine↗
PubMed1980

[Association of Pick's disease and amyotrophic lateral sclerosis. Pathological study of one case and review of the literature (author's transl)].

An anatomoclinical case of Pick's Dementia secondarily complicated with Amyotrophic Lateral Sclerosis (A.L.S.) has been compared with twelve similar cases from the litterature. These comparisons drive to three hypotheses:--coincidence of two distinct diseases;--extension to motor cortex of the Pick's atrophy;--atypical onset of ALS outside of motor cortex, secondarily reaching the motor area. Against the last hypothesis, one could argue that, in "Pick's disease + ALS", there is no superficial spongiosis such as seen generally in ALS + Dementia in frontal or temporal cortex, or in ALS simplex in motor cortex. Also, there are marked focal lesions, i.e. in uncus hippocampi, similar to that of Pick's disease. However, if the second hypothesis seem to be the best one, there are actually no definite evidence for it.

Amyotrophic Lateral Sclerosis↗
PubMed1979

[Iatrogenic depression (author's transl)].

A number of drugs are traditionally blamed for causing depression: in general medicine, the antihypertensives, the oral contraceptives and the appetite suppressants; in psychiatry, the neuroleptics. The identification of iatrogenic depression is difficult methodologically, for two reasons: 1. Detection of the depression. 2. Linking convincingly that state of depression with the administration of a particular drug, given the presence of many non-pharmacological factors. The literature and the experience of clinicians provide fairly contradictory evidence, but an analysis of published work calls for the following observations: --the type and severity of depression are rarely specified;--a history of psychiatric disorder is commonly stressed;--the specific role of the disability caused by physical or mental illness and the need to use palliative rather than curative measures are usually underestimated;--biochemically, it is surprising that the effects which some of these drugs are known to have upon the cerebral amines do not cause more depression of mood. In fact, if we consider how widely the drugs incriminated are used, it is clear that real drug-caused depression is rather uncommon.

Antihypertensive Agents↗