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Biomedical subjects

P Chapuy

Publications and source records attributed to P Chapuy.

At least 19 recordsLinked to original sources

[Depression in elderly patients. Value of tianeptine in 140 patients treated for 1 year].

An open multicenter study of the efficacy and acceptability of tianeptine, a new antidepressant structurally related to tricyclic antidepressants, was conducted by 36 gerontologists. There were 228 patients in the study; 140 were treated for one year. The patients' overall MADRS score started to decrease on day 14 and continued to decline to month 3. An improvement in depression was again observed near the end of the treatment period from month 9 to month 12. This pattern of improvement was also found with the HARS, the first item on the CGI scale and the Zung self-evaluation scale. These findings demonstrate the beneficial effect of long-term treatment in depressed elderly patients. Ten patients (4.4 percent) dropped out because of side effects: mainly drowsiness, anxiety or gastrointestinal disorders. The benefit/risk ratio (CGI, item 3), an expression of treatment effectiveness and acceptability, was very satisfactory even in these elderly patients. Regularly performed laboratory tests and clinical examinations (including weight and blood pressure) revealed no significant changes. Finally, somatic disorders, essentially cardiovascular and neurological diseases often occurring in depressed patients, remained remarkably quiescent throughout the entire treatment period.

Aged

Pharmacokinetics of chlormezanone in elderly patients.

The pharmacokinetics of Chlormezanone (CM) has been determined after a single oral dose of 400 mg CM in 5 young volunteers (28 y) and in 8 elderly patients (79 y). In the young subjects, CM was rapidly absorbed and distributed, and was slowly eliminated with a half-life of 38 h major metabolites were not detected in plasma or urine. Only 3% of CM was excreted unchanged in urine. In elderly patients absorption was delayed but not reduced; the Cmax and AUC did not differ from those in younger subjects, the elimination rate was reduced compared to the younger subjects (mean 54 h). The increase was in part related to the reduction in renal function and metabolism observed in aging. However, the change in pharmacokinetics was moderate and no adjustment in dosage seems necessary for treatments of limited duration in elderly patients.

Administration, Oral

Decreased cyclic nucleotide phosphodiesterase activity in human peripheral blood mononuclear cells from elderly women.

1. Both adenosine 3':5'-cyclic monophosphate and guanosine 3':5'-cyclic monophosphate phosphodiesterase activities of peripheral blood mononuclear cells were markedly decreased in elderly women as compared with young control women. 2. In contrast, the ability of these cells to bind guanosine 5'-[beta, gamma-imido]triphosphate, a non-hydrolysable analogue of guanosine 5'-triphosphate, was the same in both groups. 3. These findings are discussed in the context of the decline in immune function which occurs with increasing age.

2',3'-Cyclic-Nucleotide Phosphodiesterases

Calcium and vitamin D supplements: effects on calcium metabolism in elderly people.

Calcium and vitamin D status were studied in 193 healthy elderly French people. Calcium intake was less than 500 mg/d in 62% of the patients and the vitamin D intake was less than 5 micrograms/d in all patients. They also exhibited reduced levels of serum calcium (SCa) and 25-hydroxyvitamin D (25-OHD) and high levels of parathyroid hormone (PTH) and alkaline phosphatase (SAP). The response to calcium (1000 mg/d) and ergocalciferol (20 micrograms/d) supplementation given for 6 mo was evaluated in 65 patients with 69 subjects taken as controls. The treatment induced a significant increase in SCa and in 25-OHD levels, and a subsequent decrease in PTH levels without modification of the mean calcitriol levels. The biochemical changes were more marked in long-stay hospital patients than in outpatients. All these changes were significantly different from those observed in the control group. Increasing the calcium and vitamin D intake reduces the biochemical signs of secondary hyperparathyroidism in elderly people.

Aged

Age-related changes in parathyroid hormone and 25 hydroxycholecalciferol levels.

Serum parathyroid hormone and 25 hydroxyvitamin D were measured in 124 normal subjects aged from 20 to 90 years. There was a significant progressive increase in serum parathyroid levels with age associated with a progressive decrease in total serum calcium. After the sixth decade there was a significant reduction of 25 hydroxyvitamin D serum levels. In each age group, there were no significant differences between men and women in all parameters measured. In normal elderly subjects there is an age-related decline of calcium absorption associated with reduced calcium intake and sun exposure leading to secondary hyperparathyroidism. These results emphasize the importance of calcium and vitamin D supplementation in elderly European population, not only in long-stay patients but in ambulatory normal people after 60 years.

25-Hydroxyvitamin D 2