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Biomedical subjects

M Guazzelli

Publications and source records attributed to M Guazzelli.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Treatment of insomnia related to depressive disorders. Effects of zolpidem versus flunitrazepam administration and withdrawal evaluated in a double-blind study].

The effects of a 15 day treatment with zolpidem (10 mg) and with flunitrazepam (1 mg) on Insomnia Disorders Related to Depressive Disorders (DSM-III-R) have been evaluated on 30 depressive in-patients (mean age 42.3 +/- 9.8). The trial has been carried out on double blind condition after 5 days of single blind placebo administration. Withdrawal effects have been evaluated in single blind condition on a 10 day period after drugs discontinuation. Patient's diagnosis was Major Depression or Dysthymia according to DSM-III-R; inclusion criteria were insomnia (total sleep time < or = 6 h, sleep latency > or = 30 min, wake after sleep onset > or = 30 min, No of awakenings > or = 3) refractory to clomipramine administration at constant dose (75-150 mg/day among patients). Both drugs have been followed by a rapid, significant diminution of insomnia as demonstrated by significant changes at Stanford Sleepiness Scale and Saint Mary Hospital Sleep Questionnaire and by a significant reduction of HDRS total scores. No clinical phenomena of rebound insomnia were detected after zolpidem and flunitrazepam withdrawal. Drug discontinuation however was followed by the slow increase of the score on insomnia items, approximating basal values at the end of the 10 day period after zolpidem and flunitrazepam withdrawal. A parallel increase of HDRS total score was also detected; HDRS changes were mainly due to the increase of the items anxiety somatic, general somatic symptoms, gastrointestinal somatic symptoms, hypochondriasis. The study confirms the therapeutic efficacy of zolpidem and of flunitrazepam in the treatment of insomnia resistant to antidepressant drugs in depressed patients. They also suggest that early drug discontinuation is frequently associated with clinical relapse of insomnia and of several other symptoms correlated with the affective pathology.

Adult↗
PubMed1986

Sleep spindles in normal elderly: comparison with young adult patterns and relation to nocturnal awakening, cognitive function and brain atrophy.

Visual measurements of sleep spindles were carried out in 48 elderly and 20 young normal adults. Computed tomography brain scans and psychometric testing were also performed. Earlier findings of reduced spindle abundance, amplitude and duration in the elderly were confirmed. In addition, we demonstrated a linear increase in spindle density and duration across NREMPs in young adults that was absent in the elderly, indicating that age affects the temporal pattern as well as the quantity of spindles. Contrary to what seemed a highly plausible hypothesis, the amount of waking in the elderly was not inversely correlated with spindle abundance, confirming earlier observations (Feinberg et al. 1967) but in a much larger group. This finding suggests that spindle abundance does not reflect the integrity of the systems that maintain the brain in NREM sleep. We also were unable to show any clear evidence that relative preservation of spindles in the elderly is associated with relative preservation of cognitive skills: psychometric performance and spindle measures were, in most instances, not significantly correlated. However, the test of this hypothesis was limited by the high level of function and the narrow range of impairment of these Ss. One intriguing positive finding was the significant inverse relation between ratings of sulcal atrophy and spindle amplitude. This observation suggests an etiology for the reduced amplitude of the sleep EEG in old age. This change is one of the most striking effects of age on brain electrophysiology.

Adult↗
PubMed1978

Controlled double-blind trial of camazepam, a new benzodiazepine derivative, versus chlordiazepoxide.

31 in-patients with anxiety entered at random in a double-blind clinical trial of chlordiazepoxide and camazepam, a benzodiazepine derivative. They were assessed by three different rating scales. Statistical evaluation of the results showed similar psychopharmacological activity of both drugs. It is concluded that camazepam is suitable for treatment of mild and severe anxiety states.

Anti-Anxiety Agents↗
PubMedDate not supplied

Independence of sleep EEG responses to GABAergic hypnotics: biological implications.

GABAergic hypnotics are known to depress non-rapid eye movement delta and rapid eye movements and to stimulate non-rapid eye movement sigma (spindles) and beta EEG. This study addressed the question of whether the magnitudes of these effects are significantly correlated. Data were from a study in 16 normal subjects whose sleep was recorded for five nights under placebo and for three nights each under zolpidem (10 mg), triazolam (0.25 mg) and temazepam (30 mg). EEG was analyzed with both period-amplitude and power spectral (FFT) analysis. The magnitudes of the EEG and eye movement density responses were not significantly correlated for any of the three drugs. It is therefore unlikely that sleep responses to GABAergic drugs can be explained by the common cellular action (increased chloride conductance) of these drugs. We suggest that the sleep EEG responses are manifestations of complex (but consistent) interactions of excitation and inhibition in large brain systems although certain aspects of these responses (e.g. the different time courses of delta vs sigma and eye movement responses) may reflect molecular adaptations. A separate observation in this study was the strong traitlike characteristics of the sleep variables studied. These variables were highly correlated across nights of baseline sleep; in addition, individual differences in baseline sleep were significantly retained on the third night of temazepam administration.

Adult↗
PubMedDate not supplied

Psychological and physiopathological study on coronary patients.

In this paper the AA have tried to define the relationship between psychopathological characteristics or symptoms and angina attacks in coronary patients. The research plan was agreed upon and carried out as a collaborative program between psychiatrists and internists with the goal of reaching a more comprehensive approach to the psychosomatic patient. In 20 patients suffering from nocturnal angina attacks the polygraphic sleep recording was performed; 10 of them received psychodiagnostic examination (MMPI). In 8 cases during sleep recordings hemodynamic monitoring was also performed. The MMPI data were compared with 82 other individuals who had myocardial infarction (56 ss) and diurnal angina (26 ss) and 34 control subjects without cardiac disease. The results show that the sleep patterns were strongly affected and the most relevant alterations were recorded during the nights with ischemic episodes. No significant correlations were found between ischemic episodes and sleep stages. In no instance did the hemodynamic monitoring show an increase in the parameters related to myocardial oxygen consumption. The psychological data showed that the most severe symptomatology was observed in the nocturnal angina patients where the disease seems to be mostly related to a functional pathogenic mechanism.

Adolescent↗