[Scoring and validation of the Clock Face Test in psychometric assessment of elderly subjects]. / Cotation et validation du test du cadran de l'horloge en psychométrie chez le sujet âgé.

AIMS: To propose an original evaluation and validation of the Clock Face Test (CFT). METHOD: Outpatients; 163 elderly people, aged over 65 years. Factory analysis, Student's test. RESULTS: The test shows a positive correlation with Folstein's MMSE (r = 0.769) and Signoret's BEC 96 (r = 0.644), a good specificity (75% with MMSE; 79% with BEC 96) and a good sensitivity (87% with MMSE; 74% with BEC 96). Four factors are identified by factory analysis; 74% of the variancy is explained by the first three factors. CONCLUSION: The CFT is a valid tool, easy to conduct. Several applications are possible for diagnosis, psychometric control and therapeutic trials.

[Evaluation of labetalol in general medicine in aged patients with hypertension. Compliance, efficacy and safety in long-term treatment]. / Evaluation du labétalol en médecine générale chez l'hypertendu âgé. Observance, efficacité et tolérance au long cours.

The efficacy and the clinical and biological safety of labetalol were assessed, in primary care, in an ambulatory hypertensive elderly population, with systolo-diastolic hypertension (mean 175 +/- 14/100 +/- 7 mmHg) monitored during a 6 month period by general practitioners. Two hundred and sixty six of the 309 patients recruited (86%) completed the study, with satisfactory compliance. Mean blood pressure reduction after six months treatment was 27.6/17.7 mmHg and 25.9/17.4 mmHg (p less than 0.001) supine and standing respectively; and 75 p. cent of the patients who tolerated the treatment had their blood pressure normalized (BP less than 160/95 mmHg) with monotherapy by labetalol, posology ranging from 100 to 200 mg b.i.d. in 9/10th of them. Maximal antihypertensive effect, almost obtained within 4 months of treatment, was equivalent in smokers and non smokers (blood pressure normalization 84% vs 74.4%, p = 0.29) and less in obese patients compared to non obese (68% vs 80%, p less than 0.05). Drug withdrawal rate for side effects was only 7.4 p. cent and clinical and biological tolerance to labetalol was satisfactory in most patients. This 6 month survey in primary care confirmed the efficacy of monotherapy by labetalol in elderly hypertensive patients, and good compliance to treatment with a drug well tolerated in this population.

[Ambulatory treatment with cefuroxime-axetil of infectious bronchitis in patients sixty years of age or older: comparative study of the combination of amoxicillin and clavulanic acid]. / Traitement ambulatoire par le céfuroxime-axetil des bronchites infectieuses du sujet de soixante ans ou plus: étude comparative avec l'association d'amoxicilline et d'acide clavulanique.

The aim of this multicenter, prospective randomized trial was to compare the efficacy and safety of cefuroxime-axetil and amoxycillin/clavulanic acid for the treatment of infectious bronchitis in the elderly patient. Between January and April 1989, 157 out patients aged 60 years or more and presenting with infectious bronchitis were treated with either cefuroxime-axetil (250 mg bid), or the association amoxycillin/clavulanic acid (500 mg/125 mg bid). The two treatment groups were comparable at the time of inclusion; the mean age was 70 years, 82% of the patients were febrile, 75% presented purulent expectoration, 24% had a history of chronic bronchitis and 19% received symptomatic treatment was NSAIDs. The mean duration of treatment was 9 days. Clinical efficacy was assessed by the investigators. While fever and cough resolved similarly in the two groups, statistically fewer patients presented persistent purulent expectoration in the cefuroxime-axetil treatment group than in the group receiving amoxycillin/clavulanic acid (2% and 13%, respectively, p = 0.03). The proportion of patients who reported at least one side-effect was 3.6% in the cefuroxime-axetil treatment group against 21.6% of those who received the association (p = 0.006).

[Abuse and violence against the elderly]. / Abus et violences contre lés personnes âgées.

If the problem is not new in its nature, it happens frequently considering the increase of potential victims and aggressors. The elderly are special targets regarding to their fragility and life conditions. Abuse and neglect are related to physical, financial and care aspects. Common law aggressions happen on the public thoroughfare and at home. They lead frequently to delirium. In the bosom of the family 20% of old people are victims of physical brutality or moral cruelty. In the institutions their rate is poorly known and usually hidden. All the industrialized countries are preoccupied by this problem since a few years. Numerous speeches, journals and films are dedicated to these problems. The development of a real family politic in the elderly and an improvement of the education program for the personnel and an increase of the number of social care workers in the institutions may lead to a good prevention of abuse an neglect in the elderly.

[Administration of terfenadine in a single dose: comparison to standard treatment, as a double blind study, in patients presenting with allergic rhinitis]. / Administration de la terfénadine en prise unique: comparaison au traitement standard, en double aveugle, chez des patients présentant une rhinite allergique.

This double-blind, randomized multicentre study was designed to compare efficacy and tolerability of 120 mg terfenadine taken once daily (in the morning) with the established regimen of 60 mg terfenadine taken twice daily in the treatment of seasonal rhinitis. Two comparable groups, a total of 191 hay fever patients, were treated for 1 week. Symptom severity was assessed by the investigators before and at the end of the treatment (visual analogue scale), and daily by the patient (four-point rating scale). All symptoms improved to a similar degree in both groups. Differences between the two groups were not statistically significant, except for nasal symptoms in three cases as assessed by the visual analogue scale in one centre (better relief in the group given 120 mg terfenadine once daily). Tolerability was good and similar in both groups. The data presented show that in the treatment of hay fever 120 mg terfenadine given once daily is an effective, convenient and well tolerated alternative to the regimen of 60 mg terfenadine given twice daily.

[Preventive action of an immunomodulator on respiratory infections in elderly subjects]. / Action préventive d'un immunomodulateur sur les infections respiratoires de sujets âgés.

Three hundred and fourteen elderly subjects admitted to chronic medical centers were given either RU 41740 (n = 155) or a placebo (n = 159) at the rate of one course per month during three months. RU 41740 was administered in doses of 2 mg per day during 8 days in the first course and 1 mg per day during 8 days in the second and third courses. The subjects were followed up and regularly examined every three months for one year. The incidence of acute infectious episodes was evaluated in both groups. Compared to those patients who received the placebo, the number of subjects without infection was significantly higher in the treated group during the 0-6 months and the 0-9 months periods and during the 12 months of observation. The number of infectious episodes was reduced during the 0-3 months and 0-9 months periods and throughout the 12 months of the trial. The mean duration of pulmonary infections that occurred during the 0-6 and 0-9 months periods was reduced. Finally, there was a significant decrease in the duration of antibiotic therapy during the 0-3, 0-6, 0-9 months periods and during the 12 months of observation. The drug was well tolerated. This study showed that RU 41740 is effective in protecting elderly and therefore fragile subjects against respiratory infections.

Multi-centre double-blind comparison of terfenadine once daily versus twice daily in patients with hay fever.

This double-blind, randomized multi-centre study was designed to compare efficacy and tolerability of 120 mg terfenadine taken once daily (in the morning) with the established regimen of 60 mg terfenadine taken twice daily in the treatment of seasonal rhinitis. Two comparable groups, a total of 191 hay fever patients, were treated for 1 week. Symptom severity was assessed by the investigators before and at the end of the treatment (visual analogue scale), and daily by the patient (four-point rating scale). All symptoms improved to a similar degree in both groups. Differences between the two groups were not statistically significant, except for nasal symptoms in three cases as assessed by the visual analogue scale in one centre (better relief in the group given 120 mg terfenadine once daily). Tolerability was good and similar in both groups. The data presented show that in the treatment of hay fever 120 mg terfenadine given once daily is an effective, convenient and well tolerated alternative to the regimen of 60 mg terfenadine given twice daily.

A double-blind comparison of terfenadine and mequitazine in the symptomatic treatment of acute pollinosis.

This study was a double-blind, parallel group comparison of terfenadine (TRF) 60 mg b.i.d. and mequitazine (MQZ) 5 mg b.i.d. for 7 days in the symptomatic treatment of acute pollinosis. The trial took place in the same geographic area and during the same pollen season (May-July 85), to ensure homogeneity of the study population. The fourteen investigators participating in this multicentre trial recruited 141 patients (69 TRF; 72 MQZ) suffering from well-documented pollinosis, mainly hay fever and sometimes allergy to tree pollens. Symptoms (nasal itching, sneezing, rhinorrhoea, obstruction, conjunctivitis) and possible somnolence were rated daily using a 4-point rating-scale of 0 to 3 by the patient on a diary card. Assessment of over-all efficacy and tolerability - focusing on atropinic side-effects - was made at the end of the seven-days treatment period by the physician, after reviewing the diary card and questioning the patient. The means score profile of each symptom for the study period was similar with the two treatments. Both had a fast onset of action with the regression of the total symptoms' score being already significant at day 1. Over-all assessment of efficacy at day 7 showed no significant difference between the two treatments. The daily somnolence scores however showed a clear and significant difference between the two drugs: the frequency of moderate to marked somnolence from day 2 to 7 was around 15% with MQZ and around 5% on days 2 to 5 and 0% on days 6 and 7 with TRF, the difference being significant on days 2, 5, 6 and 7.(ABSTRACT TRUNCATED AT 250 WORDS)

Directive principles for trials of cerebrally-acting drugs to be performed by groups of general practitioners. / Principes directeurs de l'expertise de médicaments à visée cérébrale réalisée avec des groupes de médecins praticiens.

The authors explain why clinical trials of drugs acting on the brain should be carried out in ambulatory geriatric patients by groups of general practitioners. On the basis of their experience, they endeavour to lay down the basic principles and conditions required for such trials.

[Evaluation of the effects of psychomotor reeducation in aged patients with dementia]. / Bilans d'évaluation des effets d'une rééducation psychomotrice sur des sujets âgés atteints de démence.

Psychomotor re-education has been attempted experimentally with a population of demented patients in a geriatric ward. It draws on the methods employed at the Bel Air Psychiatric Clinic, in particular the principle of transfer of training. To assess the effect, if any, of the therapy, two psychological rating scales devised specially for demented patients, were established by the team of psychologists at the Grenoble Teaching Hospital. These rating scales are based on the theoretical notions of J. de AJURIAGUERRA and colleagues, that is, the concepts of structural analysis, of involution and homogeneity or inhomogeneity. The psychological test rating scale proposed explores four aspects of mental activity : memory, operating mechanisms, visual defects, space perception and orientation. The rating scale is described in detail, with its references, instructions and scoring.