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Biomedical subjects

M Escande

Publications and source records attributed to M Escande.

At least 19 recordsLinked to original sources
PubMed1999

[Atypical depression].

The principal atypical aspects of depressive disease are: minor and attenued aspects, monosymptomatic and atypical aspects (food disorders and sleep disorders), masqued aspects (somatoform, anxious, characterial and addict disorders), atypical aspects of child (anxious nevrotical disorder), pseudo-demented and characterial aspects of aged subjects. Facing to these aspects, the diagnosis of depression is evoqued on: the recent and fast advent of these disorders, their morning predominance, their recurrent character, the state of attenued depressive symptoms (anhedonia), the positive responsiveness to treatment.

Adolescent↗
PubMed1995

[Delay of the antidepressant effect: clinical studies].

The first controlled trials of antidepressants show up a delay of antidepressant effect to one or two weeks, with sedative or stimulant early effects. More recently, several controlled trials founded on more stringent criterions (DSM III, period of pre-therapeutic placebo of one minimal week, frequent quotations etc.) have showed up a delay of antidepressant effect assigned between the fourth and the sixth week, with all antidepressant drugs. Nevertheless, there are more early effects, either specific antidepressant but incomplete either non specific (sedative, stimulant). These early effects are more marked with the antidepressant drug than with the PBO, but they have not a predictive value of terminal response. Several factors have an influence on the delay of antidepressant effect. The clinical characteristics are not correlated with this delay. The intravenous administration does not reduce the length of this delay. The pulse loading doses with intravenous and oral antidepressant drug seem to reduce the length of this delay. The most important factor is the placebo effect (Quitkin et al.). Nevertheless, the differences of efficacy between antidepressant and PBO appear only towards the third week. There are some differences during the first two weeks. In fact the PBO effect is early and late longer than the antidepressant drug. With PBO, when the improvement is progressive and fasting, it is a spontaneous remission. These data have practical implications if we must know the delay of antidepressant drug.

Affect↗
PubMed1994

[A new generation of tranquilizing agents].

The newer anxiolytics include compounds whose the molecular structure, the mechanisms, and the pharmacological properties are heterogeneous. Nevertheless, the most of them have clinical and adverse effects like to the most known: buspirone, after the commercial shrinking for hepatic toxicity of alpidem. These anxiolytics are efficacious against generalized anxiety disorder, like the benzodiazepines. The principal interest consists in minimal adverse effects and the safety of the use. These compounds have not a sedative effect, do not induce rebound, dependence, abuse and withdrawal, do not impair the psychomotor, cognitive and memory performances. The big ratio efficacy/tolerance allows to use them in long treatments, old subjects, alcoholic and drug-addicted patients. Nevertheless to become ideal anxiolytics, these compounds must be efficacious in other anxious disorders and increase the efficacy of various psychotherapies.

Anti-Anxiety Agents↗
PubMed1992

[Nursing problems in intensive care for psychiatric patients].

Two cases illustrate psychotherapeutic aspects of surgical intensive cares for psychiatric patients. Comparison with their style of expression in art-therapy allows a better understanding in their relations with the technical and non human environment.

Adaptation, Psychological↗
PubMed1990

Des-enkephalin-gamma-endorphin in the treatment of schizophrenia.

Ninety-three patients with an exacerbation of chronic schizophrenia were included in a 4 week trial comparing placebo with 1, 3 and 10 mg des-enkephalin-gamma-endorphin (DE gamma E; beta-lipotrophin 66-77; Org 5878) per day (i.m.). Maintenance antipsychotic and other medications were continued unchanged. Treatment effects were assessed by means of the Comprehensive Psychopathological Rating Scale--subscale schizophrenia (CPRS-S), Brief Psychiatric Rating Scale (BPRS) and Global Assessment Scale (GAS) rating scales at weekly intervals. Safety data, i.e. laboratory investigations, vital signs and ECG recordings, were assessed before and during the trial. Side-effects were evaluated by means of a Record of Symptoms Emerging. Sixty-eight patients completed the trial, the reason for drop-out mainly being inadequate treatment effects and refusal of medication administration. One patient violated the protocol. After 4 weeks of treatment the mean CPRS-S score of the group receiving 10 mg DE gamma E daily had decreased statistically significantly more than the corresponding score of the placebo group (p less than 0.01). The same trend was apparent with BPRS (p = 0.08) and GAS (p greater than 0.1) scores. Therefore, the study should be considered inconclusive. No clinically relevant side-effects attributable to DE gamma E were observed.

Adult↗
PubMed1989

[Long-term study of propafenone in severe ventricular extrasystole in elderly subjects].

A long-term study of the efficacy and tolerance of propafenone was carried out in cases of severe chronic ventricular extrasystoly in elderly patients (age 70). The patients included presented more than 1,500 ventricular extrasystoles per 24 hours with severe criteria. After the Holter performed upon inclusion, 450 mg/d of propafenone were prescribed (900 mg/d in 4 cases). The Holter tests were then repeated at D8, D30, D60, D180, D360, with possible modification of the dosage. 16 patients were then studied, and the study completed its half of them in one year. The efficacy, evaluated by at least an 83 p. cent decrease of the number of ventricular extrasystoles with disappearance of complex forms, was excellent in 12 out of 16 patients, non-existent or insufficient in 2 patients. The arrhythmia was aggravated in 2 cases. In addition, the efficacy of propafenone was maintained in the 8 patients who responded to the treatment and were followed for one year. A poor tolerance (conduction disorders, aggravated arrhythmia) was noted in 7 patients (44 p. cent of the cases). Conduction disorders were present with a propafenone dosage or on preexisting conduction anomalies. Five deaths occurred during the study, unrelated to the treatment. At a dose of 450 mg/24 h, propafenone is therefore effective, most of the time, effective in the treatment of severe ventricular extrasystoly in elderly patients, with a rather good tolerance, and a long-term efficacy. Higher doses only improve minimally the efficacy and are much less well tolerated.

Aged↗
PubMed1986

Increase in plasma concentration of plasminogen activator inhibitor, fibrinogen, von Willebrand factor, factor VIII:C and in erythrocyte sedimentation rate with age.

Elderly patients have previously been shown to have an increased plasma concentration of tissue plasminogen activator (t-PA) antigen (t-PA Ag). Since the concentration of t-PA Ag depends on both free t-PA and t-PA complexed with inhibitors, mainly plasminogen activator inhibitor (PA inhibitor), we have investigated the relationship between the plasma concentration of PA inhibitor and age in 20 elderly and 20 young individuals. Elderly individuals showed a slight increase in PA inhibitor, in parallel with increase on others, acute-phase proteins, fibrinogen, von Willebrand factor, factor VIII:C, and the erythrocyte sedimentation rate. The increase in PA inhibitor as well as other acute-phase proteins in the elderly may be significant in relation to the increased incidence of thrombotic disease.

Adult↗
PubMed1986

[Prolactin stimulation test using TRH in affective disorders (72 cases)].

Authors report results of stimulation test of prolactin by T.R.H. in 72 inpatients with affective disorders. They find well known effects of physiological factors (age, sex), and treatments (neuroleptics, lithium, L-Dopa). They did statistical analysis on plasma levels before and after T.R.H. stimulation. This test has no value for differential diagnosis between types of depressions. But it shows particular relation between high levels of prolactin and bipolarity.

Adult↗
PubMed1986

[Psychiatric manifestations of Steinert's disease].

Authors report one case of psychiatric manifestations of Steinert's disease, with biological data. They compare it with historical and actual descriptions of these manifestations, particularly for clinical and biological symptomatology. Main hypothesis is a central localization of this polysystemic process, under a genetical determinism.

Electroencephalography↗
PubMed1985

Depression and anxiety: mianserin and nomifensine compared in a double-blind multicentre trial.

Mianserin and nomifensine were compared in 61 depressive patients in a randomized double-blind multicentre study. During the first week the antidepressant dosages were low, mianserin 30 mg and nomifensine 50 mg. After the first week dosages were doubled to 60 mg and 100 mg respectively. At baseline there were no significant differences between treatment groups for sex, age, class of depression, previous treatment, somatic symptoms, previous vital events, global clinical appreciation, global sleep appreciation, and depression assessed on the Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Rating Scale (MADRS) or the Hamilton Anxiety Rating Scale (HARS). Assessments were made at 7, 14 and 28 days. There were no significant differences between treatment groups for HDRS, MADRS or HARS, either globally or when divided into endogenous and reactive subgroups. Compared with nomifensine there were significantly greater scores with mianserin for global clinical appreciation and global sleep appreciation. There were more withdrawals and dosage changes with nomifensine than with mianserin. Regarding concomitant treatment, significantly less anxiolytics were prescribed to the mianserin group. This study confirms that mianserin is an effective and sedative antidepressant whereas nomifensine is an effective and stimulating antidepressant.

Adjustment Disorders↗