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Biomedical subjects

P Bovier

Publications and source records attributed to P Bovier.

At least 19 recordsLinked to original sources
PubMed2006

[Quality care in primary care: the importance of patients' reports].

Patients' evaluation of care is an important element of quality of care, especially for patients with chronic conditions. Our objective was to expose physicians in training to a quality improvement program and study how continuity of care could influence patients' experience of care. Physicians in training valued this approach, but deplored no to be actively involved in its planning. They also underlined the importance of keeping physicians' individual results absolutely confidential. Positive patients' reports toward communication and physician-patient relationship were associated with longer duration of follow-up at the medical outpatient clinic. Following this project, several changes have been made to improve aspects of care that were problematic.

Communication↗
PubMed2006

[Initial management of hypertension in a primary care service].

The management of hypertension in Switzerland follows the Guidelines of the European Society of Hypertension and Cardiology (ESH-ESC 2003). The aim of our survey was to evaluate to what extent initial check-up and determination of the absolute cardiovascular risk of hypertensive patients are performed by residents of a medical outpatient clinic. Hypertension is a very frequent condition in this kind of consultation, 1 patient in 3 being treated for a high blood pressure. Despite of this, the initial evaluation of the absolute cardiovascular risk is not performed in accordance with the guidelines. The assessment of diabetes or dyslipidemia and the search for target organ damage are not systematically done, even in case of high blood pressure values (grade I-III).

Aged↗
PubMed2000

[L-tryptophan plasma levels in treatment resistant depressive states].

10 to 30% of depressions are resistant to standard treatment. Different therapeutic strategies are used to treat the resistant depressions. Therefore, before initiating an antidepressant treatment, it would be important to know which patients will probably not respond to a standard treatment. Numerous studies have shown that serotonin is involved in depressive illness and its synthesis in the brain is dependent on the availability of tryprophan from plasma. As tryptophan plasma level is decreased in depression, resistant depressions may also be characterized by alterations of tryptophan plasma level. 141 depressed patients were admitted in our psychiatric unit in Geneva between 1984 and 1990. 36 were diagnosed as treatment resistant depression. Although treatment resistant patients group had more women and a more severe score of depression on the AMDP-4 scale, we did not observe a significant difference in tryptophan plasma level compared to patients who respond to treatment.

Adult↗
PubMed1998

The effect of clinical outcome on platelet G proteins of major depressed patients.

Platelet G protein subunits (G alpha i2, G alpha q and Gbeta) were measured in 15 non-treated depressed patients (recurrent major depression) and 15 age- and sex-matched healthy controls by using the Western immunoblot method. The depression severity was measured by the AMDP depression rating scale before start of treatment. The AMDP score ranged between 12 and 44. Patients were then treated with different antidepressant drugs (ATD) for 1 month, after which G protein and depression were reassessed. Results indicated that drug-free depressed patients displayed increased levels of G proteins subunits, in comparison to healthy controls. Antidepressant drug administration resulted in decrease of depression severity but only seven patients showed a net response to drugs (AMDP depression score less than 12). These drug-responding patients have also reduced G protein levels, while patients without significant improvement continued to display either the same levels of G proteins or higher, whatever the class of the drug administered. These results suggest that depression is associated to increase in G protein subunit levels and that the clinical outcome seemed to be the determining factor in further decrease occurring in G protein levels.

Adult↗
PubMed1997

Weak association between blood sodium, potassium, and calcium and intensity of symptoms in major depressed patients.

In previous reports, we showed that plasma and erythrocyte magnesium were increased in many drug-free hospitalized depressed patients. Furthermore, we observed that erythrocyte magnesium content was related to the intensity of the symptoms. Highly depressed patients had the highest magnesium values. Today, we report the results of plasma and erythrocyte sodium and potassium, and of total and ultrafilterable plasma calcium in 66 hospitalized patients with major depression compared to 58 healthy controls. No consistent differences in these biochemical parameters are observed between patients when separated according to intensity of anxiety, psychomotor retardation, and moral distress. Plasma sodium is higher and plasma potassium lower in female patients of all subgroups as compared to controls. Both male patients and controls have erythrocyte sodium and potassium levels that are significantly different from those of females. This clearly suggests a separation into genders in such studies. In conclusion--in contrast to blood magnesium--sodium, potassium, and calcium levels do not seem to be related to the intensity of the main clinical symptoms in hospitalized patients with major depression.

Adult↗
PubMed1997

[Affective disorders in Alzheimer's disease].

The links between depressive syndrome and Alzheimer's disease are problematic concerning the diagnosis and the therapeutic choice. The concepts of pseudo-dementia and late onset depression are shortly discussed. The hypothesis concerning the relationship between depression and Alzheimer's disease are summarized. The clinical data relevant for the diagnosis and the therapeutic guidelines are discussed.

Alzheimer Disease↗
PubMed1996

Platelet phosphoinositide signaling system: an overstimulated pathway in depression.

In order to test a possible depression-associated defect in signal transduction, platelet alpha 2-adrenergic-mediated phosphoinositide (PI) hydrolysis was measured, both in drug-free major depressed patients and in control healthy subjects. Results that express phospholipase C activity have shown significant increase in the metabolites of epinephrine-stimulated tritiated phosphatidyl-4,5-biphosphate (3H-PIP2) with respect to basal activity (saline-stimulated). Thrombin (2 units) and 10 mM sodium fluoride (NaF) also induced an increase in 3H-PIP2 metabolites. These increases were potentiated in drug-free depressed patients both in epinephrine-and thrombin-stimulated platelets. In contrast, sodium fluoride, which directly stimulates G protein without receptor interaction, did not differentiate between patients and controls with respect to PI hydrolysis. This result suggests a possible depression-associated defect in heterologous receptor-G protein interaction.

Adrenergic alpha-2 Receptor Antagonists↗
PubMed1995

Relationship between erythrocyte magnesium, plasma electrolytes and cortisol, and intensity of symptoms in major depressed patients.

53 male and female drug-free major depressed patients were separated into three groups according to the severity of the depression. In the entire regrouped population, plasma and erythrocyte magnesium (Mg) were shown to increase as compared with 48 healthy controls, confirming our previous studies. The middle and highly depressed patients had higher erythrocyte and also plasma Mg levels than either lowly depressed patients or controls. Only, a few differences were noticed in plasma sodium, potassium and calcium (Ca) in the three groups of patients, except for ultrafiltrable plasma Ca, measured for the first time in affective disorders. Thus, erythrocyte and also plasma Mg are shown to be associated with the intensity of the depression. As blood hypomagnaesemia is often related to hyperexcitability, further investigations are actually in process to shown whether hypermagnesaemia might be, in contrast, associated with psychomotor retardation as observed in many depressed patients.

Adult↗
PubMed1995

Sodium-magnesium exchange in erythrocyte membranes from patients with affective disorders.

The Vmax of erythrocyte sodium-magnesium exchange was measured for the first time in 63 patients suffering from affective disorders and compared to that in 33 healthy subjects. Depressed patients had a significantly higher Vmax (215 +/- 13 vs. 151 +/- 14 mumol/l.cells/h; p < 0.005; mean +/- SEM). This tendency was conserved after division of the 63 patients into three clinical subgroups according to the DSM-III-R criteria. Thirty-four patients from this panel were divided into three subgroups according to the chemical class of the antidepressant drug used and were followed up during a 3-month period of drug treatment. Mood improvement over the 3-month period was associated with a slow increase in Vmax of Na/Mg exchange (delta increase approximately 25 mumol/l.cells/h), except in the subgroup of patients treated with non-tricyclic antidepressants (n = 8). These results are consistent with the previously reported link between high erythrocyte magnesium content and affective disorders. Indeed, enhanced Na/Mg exchange Vmax, which probably results from an increased number of transport units per cell, contributes to the normalization of red blood cell magnesium content correlated with mood improvement.

Adolescent↗
PubMed1994

Inactivated virosome hepatitis A vaccine.

Immunopotentiating reconstituted influenza virosomes (IRIV) are efficient carrier systems for small virion particles such as hepatitis A virus (HAV). We evaluated immunogenicity and tolerability of an IRIV-HAV vaccine and the effectiveness of a booster by immunising 104 healthy HAV seronegative volunteers. A single dose was highly immunogenic, since 98% of volunteers had seroconverted after 2 weeks. Anti-HAV titres remained high, with 100% seroconversion rate 1 year later, when the booster was given. The vaccine was effective, with a 22-fold increase in geometric mean titres 1 month later. No serious adverse reactions were observed.

Adjuvants, Immunologic↗
PubMed1994

Platelet serotonin and plasma tryptophan in depressed patients: effect of drug treatment and clinical outcome.

Platelet serotonin and plasma tryptophan were studied in healthy subjects and in depressed patients before and during their antidepressant drug treatment. Before treatment, mean platelet serotonin level was normal in depressed patients compared with healthy subjects while a significant decrease in patients' plasma TRP was noted (t = 6.0, p < .001). The concentrations of platelet 5-HT level did not correlate with either plasma TRP or with clinical variables, that is, AMDP depression and AMDP anxiety scores. Antidepressant drugs treatment decreased platelet 5-HT level (ANOVA F = 8.27, p < .001) whatever the clinical outcome of the patient, whereas the changes observed in plasma TRP were positively related to the mood state change. These results suggest that platelet serotonin could be a good pharmacological model but has no relevance concerning the mood state.

Affect↗
PubMed1993

New variables for defining sleep continuity.

One very synthetic way to represent a night's sleep is by way of a hypnogram: a graphical representation of the sleep stages as a function of time. The hypnogram is generally quantified by a series of variables that measure the durations and latencies of the various sleep stages including wake. These variables, however, do not fully account for all the information contained in the hypnogram, in particular information on sleep continuity. A series of variables that measure and localize disruption of this continuity are proposed and their utility validated on three groups of patients presenting sleep disorders. Utility is established if the variable is capable of differentiating between patients and healthy controls. Two sets of variables are examined: those that use the entire sleep period as unit of measurement, and those that are measured within each consecutive NREM-REM sleep cycle. The results show that the variables proposed are able to differentiate between groups and, therefore, are useful measures reflecting the hypnogram more precisely. They also show that fragmentation of REM sleep does not present a systematic trend across the night, but that fragmentation of NREM sleep goes up linearly.

Adult↗
PubMed1993

Lack of effect of anxiety on total plasma MHPG in depressed patients.

This report was undertaken to test the noradrenergic deficiency hypothesis of depression and the postulated increase in noradrenergic activity associated to anxiety states. A possible dual effect of both depression and anxiety on total plasma MHPG levels was hypothesized and assessed in anxious and non-anxious depressed patients. The findings show a decrease in plasma MHPG levels in depressed patients whatever their degree of anxiety. There was no difference in total plasma MHPG levels either between anxious and non-anxious depressed patients or between low and high anxiety to depression ratio (ADR) depressed patients. Following antidepressant drug-treatment, a decrease in plasma MHPG was found. A positive correlation between the drug-induced decrease in NA activity and the severity of depression was observed, and suggested a relationship between the severity of depression and the instability of the NA system. No correlation between the drug-induced decrease in plasma MHPG and the degree of anxiety was found. The results do not suggest out an effect of anxiety on total plasma MHPG levels in depressed patients.

Adult↗
PubMed1993

Adrenaline-induced platelet aggregation in depressed patients and control subjects.

We measured alpha 2-adrenoceptor-mediated platelet primary aggregation in depressed patients and healthy subjects. Both initial velocity and maximum amplitudes of platelet response to increasing concentrations of adrenaline were decreased in drug-free depressed patients as compared with controls. The EC50 of both initial slope and maximum amplitude were also increased in drug-free depressed patients. The results suggested a lowered platelet alpha 2-adrenoceptor function. Demographic factors (age and sex) and the time between blood collection and start of aggregation monitoring did not influence the results. This report is consistent with postsynaptic receptor desensitization in depressed patients. The precise molecular mechanism for this impairment remains to be elucidated.

Adolescent↗
PubMed1993

Blood magnesium, potassium, sodium, calcium and cortisol in drug-free depressed patients.

Many biochemical variables, including plasma and erythrocyte magnesium, were simultaneously measured in drug-free depressed patients (n = 34), compared to healthy controls (n = 35). Higher plasma and erythrocyte magnesium concentrations were observed in patients than in controls (+12 per cent, P < 0.0001 and 14 per cent, P < 0.0001, respectively). In contrast, patients showed a lower plasma potassium level (-10 per cent; P < 0.007). Cortisol secretion was much higher in patients (+35 per cent; P < 0.02), particularly in females, showing overactivity of the hypothalamo-hypophyseo-adrenal axis in the patients. Except in a few cases, plasma sodium and calcium in patients did not differ from control values. Significant differences in magnesium and cortisol levels were observed between patients classified in diagnostic groups and by sex, whereas little variation in the other biochemical indices was noted. The increase in blood magnesaemia and its possible association with central hypocatecholaminergic deficiency in affective disorders are discussed.

Calcium↗