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A Chevalier

Publications and source records attributed to A Chevalier.

At least 55 records · Page 3Linked to original sources
PubMed1996

Occupational factors of anxiety and depressive disorders in the French National Electricity and Gas Company. The Anxiety-Depression Group.

Very few studies described the prevalence of mental disorders in the workplace by using standard diagnostic criteria. A two-stage case-control study of anxiety and depression was initiated by Electricité de France and Gaz de France, the French Nationwide Company producing electricity and gas, using the General Health Questionnaire with 12 items as a screening test and the Composite International Diagnostic Interview as diagnostic instrument. Its aim was to point out occupational situations that promote the occurrence of anxiety and depression crises. Annual prevalence of depression was estimated at 7.6% in men (95% confidence interval [CI], 5.5 to 9.7) and at 17.9% in women (95% CI, 9.9 to 25.8), and that of anxiety at 9.6% (95% CI, 6.9 to 12.3) in men and 26.3% (95% CI, 17.2 to 35.4) in women. Workers in hazardous occupations were found to be protected from these disorders, whereas supervisory staff tended to be prone to developing them. Important changes in work or in its organization seemed to be risk factors. Extra-professional variables and occupational characteristics were included in a logistic regression model. The odds ratios corresponding to recent job changes and a supervisory position were significantly elevated (odds ratios = 1.7 and 2.4, respectively). These results suggest that some occupational events, such as major changes in work content or organization may cause or precipitate anxiety and/or depressive disorders.

Anxiety Disorders↗
PubMed1996

Lack of effect of an acute ileal perfusion of short-chain fatty acids on glucose metabolism in healthy men.

Dietary fiber intake is associated with several beneficial effects on carbohydrate metabolism. Some authors have speculated that this improvement may be due to short-chain fatty acids (SCFA) produced by the colonic fermentation of dietary fibers. To test this hypothesis, six healthy men aged 26 +/- 2 (SE) yr with a body mass index of 20.9 +/- 0.7 received on three occasions an 18-h ileal perfusion infused at a flow rate of 3.3 ml/min, containing either 90 mmol/l of SCFA (60% acetate, 25% propionate, and 15% butyrate) (A), SCFA during the first 12 h and then a saline solution (A/S), or a saline solution (S). Basal hepatic glucose production (BHGP), insulin sensitivity (3-step euglycemic-hyperinsulinic clamp), and erythrocyte insulin binding (EIB) were studied 12 h after the beginning of the ileal perfusion. There was no change in BHGP or insulin sensitivity. However, maximal EIB was significantly different: 7.1 +/- 0.1 (A), 6.8 +/- 0.1 (A/S), vs. 6.5 +/- 0.1% (S) (P = 0.03). We conclude that acute administration of SCFA does not significantly alter glucose metabolism in healthy subjects.

Acetates↗
PubMed1996

[Cancer incidence among active male workers at Electricite de France-Gaz de France].

The social security department of the French national electric and gas company has established a cancer register among a population of about 150,000 active employees based on sick leaves of both short and long duration as well as deaths recorded along with their medical cause. A first study conducted in male workers, aged 20-59, during the 1978-1989 period showed a lower cancer incidence for almost every site of cancer except for leukaemias and others reticuloses tumors of lymphoid and histiocyte tissues, compared with the French general population (SIR = 148 and 218 resp.). Between the 1978-1982 and 1983-1989 periods, a marked decrease (statistically significant) was observed in the incidence of larynx cancer and cancers of all sites usually related with excessive alcohol consumption. During the same period the incidence of pancreatic cancer has almost doubled. Large variations according to socio-economic status were observed for cancers of the lung, the pharynx, the oral cavity and the oesophagus and, also, to a lesser degree, for tumours of the testis and the bladder and leukaemias. The results suggest further studies of occupational factors. Interest and limits of such a compagny register are discussed.

Absenteeism↗
PubMed1995

Occupational respiratory cancer and exposure to asbestos: a case-control study in a cohort of workers in the electricity and gas industry.

Cancers of the pleura, lung, and larynx between 1978 and 1989 among active male workers of Electricité de France-Gaz de France were studied in association with asbestos exposure using a case-control design nested within the cohort of workers of the company. The cohort included about 1,400,000 person-years, corresponding to a mean of 117,000 men per year. Exposure to asbestos and to some potential occupational confounders selected among agents from groups I, IIa, and IIb of the International Agency for Research on Cancer was assessed by a job-exposure matrix specific to the company. During the observation period, 12 cases of pleural cancer, 310 cases of lung cancer, and 116 cases of larynx cancer were registered in the cancer register of the company social security department. Four controls per case, matched for year of birth, were randomly selected among the cohort. Conditional logistic regression was used to estimate the odds ratios. A first analysis was conducted in order to assess the validity of the job-exposure matrix by investigating already known relationships between asbestos exposure and asbestosis. For asbestosis, a strong exposure-response relation was found with an odds ratio (OR) of 57.4 [95% confidence interval (CI): 17.0-194.0] in the highest exposure group. There was an elevated risk of pleural cancer (OR, 4.8, CI, 1.2-19.8). For lung cancer, significant ORs of 2.0 (CI, 1.3-3.2) and 1.9 (CI, 1.2-3.0) were found among the two highest cumulative exposure groups; adjustement for confounders slightly decreased the ORs. Squamous cell neoplasm of the lung was associated with asbestos exposure. The association between larynx cancer and asbestos exposure showed a tendency towards a nonsignificant increase in ORs in the highest cumulative exposure categories; this tendency disappeared when adjusting for occupational confounders. This study showed that occupational exposure to asbestos could increase the risk of pleural and lung cancer in a sector in which exposure levels are not considered to be high compared with other industrial settings.

Asbestos↗
PubMed1995

Reactivity of islet cell antibodies (ICA) to recombinant glutamic acid decarboxylase (GAD).

To study the heterogeneity of islet cell antibodies (ICA), recombinant rat and human GAD65 expressed as bacterial fusion proteins were used to inhibit ICA reactivity in sera from recent onset type 1 diabetic children and ICA-positive first degree relatives of diabetic patients. Rat GAD65 was expressed as a fusion protein in the expression vector RSET and inhibited ICA (GAD+ICA) in 26% of 23 recent onset patients, 29% of 14 ICA positive first degree relatives (FDR) who progressed to diabetes (prediabetics) and 50% of 20 FDR who did not progress to diabetes 18 months to 5 years (31 +/- 14 months) after collection of the sample. GAD+ICA were inversely associated with the presence of insulin autoantibodies (IAA) (P = 0.006). GAD antibodies (GAD-Ab) were also detected by immunoprecipitation of in vitro transcribed and translated [35S] methionine-labelled human GAD65. GAD-Ab were present in 83% of recent onset patients, 86% of prediabetics and 95% of the relatives who did not progress to diabetes. The level of GAD-Ab was higher in the presence of GAD+ICA (1.39 +/- 0.57 vs 0.79 +/- 0.6 index units; P = 0.001). ICA levels were higher in GAD-Ab negative than in GAD-Ab positive sera (377 +/- 256 vs 195 +/- 231 JDFU; P = 0.03). Our results confirm that a recombinant GAD65 fusion protein can be used to detect ICA heterogeneity. However, neither inhibition of ICA with recombinant GAD, nor direct detection of GAD-Ab improved the prediction of progression to clinical diabetes in ICA positive FDR.

Adolescent↗
PubMed1995

A fructose-rich diet decreases insulin-stimulated glucose incorporation into lipids but not glucose transport in adipocytes of normal and diabetic rats.

To study the cellular mechanisms underlying fructose-induced insulin resistance in rats, the effects of fructose feeding on insulin-stimulated glucose transport, oxidation and incorporation into lipids in epididymal adipocytes were evaluated in 27 normal and 27 noninsulin-dependent diabetic male Sprague-Dawley rats. Diabetes was induced by streptozotocin injection 2 d after birth. At 5 wk of age, both normal and diabetic rats were fed a diet containing 62% carbohydrate as fructose, dextrose or cornstarch. Fructose feeding for 6 wk induced glucose intolerance in normal rats (P < 0.05) and aggravated that of diabetic rats (P < 0.05). Plasma triacylglycerol concentration was higher in fructose-fed than in starch-fed or dextrose-fed rats (P < 0.05). Adipocytes of fructose-fed rats had significantly lower maximum insulin-stimulated glucose incorporation into total lipids than those of rats fed starch, and tended (P = 0.22) to have lower production of CO2 from glucose than adipocytes of the other dietary groups. Glucose transport in adipocytes of dextrose-, starch- and fructose-fed rats did not differ. We conclude that in both normal and diabetic rats, a chronic fructose-rich diet induced hypertriacylglycerolemia, glucose intolerance and insulin resistance of adipocytes.

Adipocytes↗
PubMed1995

Symptoms, hormones, and glucose fluxes during a gradual hypoglycaemia induced by intraperitoneal vs venous insulin infusion in Type I diabetes.

Intraperitoneal (IP) insulin infusion with programmable implantable pumps is associated with a reduction in hypoglycaemic events when compared to intensive diabetes management with subcutaneous insulin in patients with Type 1 diabetes mellitus. The mechanism may involve more physiological insulin kinetics, lower peripheral insulin levels or a specific hepatic action of portal insulin on hypoglycaemic counter regulation. To investigate the latter two hypotheses, we performed two hypoglycaemic clamps (controlled blood glucose decrement to 2.2 mmol l-1) in random order in 12 Type 1 diabetic patients. Insulin was infused either IP or IV for 150 min, at rates chosen to generate similar peripheral insulin levels (1 mU/kg-1 min-1 IV or 2 mU/kg-1 min-1 IP, n = 6) to evaluate direct hepatic action, or at similar rates (1 mU/kg-1 min-1 IV and IP, n = 6) to evaluate IP indirect effects via lower peripheral insulinaemia. Hepatic glucose production and glucose utilization were measured by [6.6 2H] glucose dilution technique. Glucose production was lower (1.7 +/- 0.4 vs 0.5 +/- 0.4 mg kg-1 min-1, p < 0.05), and utilization was similar at the end of the matched-insulinaemia IV and IP clamps, respectively. By contrast, glucose production was higher (1.7 +/- 0.5 IV vs 2.7 +/- 0.3 IP mg kg-1 min-1, p < 0.01) and glucose utilization lower (4.4 +/- 1.0 IV vs 3.3 +/- 0.2 IP mg kg-1 min-1, p < 0.05) with IP delivery at the end of the matched-dose clamps. Counterregulatory hormones and hypoglycaemic symptoms increased similarly in all clamps. In summary, IP insulin, when compared to IV insulin at similar delivery rates, but not at similar insulinaemia, is associated with a less negative glucose balance (glucose production-glucose utilization) during hypoglycaemia. Such a mechanism may play a role in the reduced hypoglycaemic risk seen with IP implantable pumps.

Adult↗
PubMed1995

Radioiodine therapy of the autonomous thyroid nodule in patients with or without visible extranodular activity.

UNLABELLED: Patients with an autonomously functioning thyroid nodule (ATN) may be present with various clinical, biochemical and scintigraphic features. To optimize 131I dose planning and treatment timing in these patients, relationships between dosimetric data and clinical follow-up events must be established. METHODS: We retrospectively reviewed the records of 88 patients who received 131I (intended dose of 80 Gy) for an ATN, of whom 39 had evidence of extranodular activity (ENA) and 76 presented with overt thyrotoxicosis. In all of the patients, dosage calculation was monitored to estimate precisely both beta and gamma absorbed doses received by the ATN and the nodule-free lobe. The mean duration of follow-up was 75 mo (max 180) and always included biochemical thyroid tests. Finally, we compared the dosimetric profiles of four dosage schemes which had been normalized by simulation to ensure that the same absorbed dose threshold value was always delivered to the ATN. RESULTS: About 75% of the patients were cured at 6 mo for a mean 305 MBq administered. The absorbed doses delivered to the nodule-free lobe ranged from 12% (no ENA) to 86% (ENA) of the values delivered to the ATN, mainly in the form of beta irradiation. Life-table estimates for hypothyroidism and death were 9.6% and 22% at 75 mo, respectively. Hypothyroidism mainly developed in patients with nonsuppressed TSH levels but regardless of ENA, which often accounted for multifocal disease. CONCLUSION: We suggest that fixed doses bordering on 370 MBq are advizable in younger individuals and in patients with mild thyrotoxocosis, while 555 MBq-740 MBq can be administered in other patients and that ENA indicates multifocal autonomy in patients with toxic ATN and is a further indication for radioiodine treatment which should be begun as soon as possible to avoid the development of cardiac complications.

Aged↗
PubMed1994

Cancer risks associated with occupational exposure to magnetic fields among electric utility workers in Ontario and Quebec, Canada, and France: 1970-1989.

To determine whether occupational exposure to magnetic fields of 50-60 Hz was associated with cancer among electric utility workers, the authors used a case-control design nested within three cohorts of workers at electric utilities: Electricité de France--Gaz de France, 170,000 men; Ontario Hydro, 31,543 men; and Hydro-Québec, 21,749 men. During the observation period, 1970-1989, 4,151 new cases of cancer occurred. Each participant's cumulative exposure to magnetic fields was estimated based on measurements of current exposure of 2,066 workers performing tasks similar to those in the cohorts using personal dosimetry. Estimates were also made of past exposure based on knowledge of current loading, work practices, and usage. Workers who had more than the median cumulative exposure to magnetic fields (3.1 microtesla (microT)-years) had a higher risk for acute nonlymphoid leukemia (odds ratio (OR) = 2.41, 95% confidence interval (CI) 1.07-5.44). The same observation holds for acute myeloid leukemia (OR = 3.15, 95% CI 1.20-8.27). There was also an elevated risk for mean exposure above 0.2 microT (acute nonlymphoid leukemia, OR = 2.36, 95% CI 1.00-5.58; acute myeloid leukemia, OR = 2.25, 95% CI 0.79-6.46). However, there were no clear dose-response trends with increasing exposure and no consistency among the three utilities. Men whose cumulative exposure to magnetic fields was above the 90th percentile (15.7 microT-years) had an elevated risk for brain cancer (OR = 1.95, 95% CI 0.76-5.00) that was not statistically significant. No association with magnetic fields was observed for any of the other 29 types of cancer studied, including skin melanoma, male breast cancer, and prostate cancer. Controlling for potential confounding factors did not change the results.

Aged↗
PubMed1994

Paracetamol potentiates isaxonine toxicity in vitro.

The toxicity of isaxonine alone and in combination with the known glutathione depletor, paracetamol, was evaluated using rat hepatocyte primary cultures in vitro by measuring morphometric parameters and the leakage of intracellular lactate dehydrogenase into the culture medium. No cytotoxicity was observed with isaxonine at concentrations up to 10(-3) M, whereas paracetamol was cytotoxic at concentrations above 0.6 x 10(-3) M in the culture medium. Paracetamol cytotoxicity (0.6-3.3 x 10(-3) M) was enhanced in the presence of a non-cytotoxic concentration of isaxonine (10(-7) M). Furthermore cytotoxicity was observed when cells were exposed to a combination of non-cytotoxic concentrations of the paracetamol (0.3 x 10(-3) M) and isaxonine (10(-7) M). These findings demonstrate that isaxonine has no direct cytotoxic effect even at high concentrations. However co-administration of isaxonine with paracetamol greatly potentiates cytotoxicity. We suggest that this effect may be related to glutathione depletion within the cell but additional studies are required to verify this hypothesis.

Acetaminophen↗
PubMed1994

Hyperhomocysteinaemia: a significant risk factor for cardiovascular disease in renal transplant recipients.

Moderate hyperhomocysteinaemia has been shown to constitute an independent risk factor for cardiovascular disease (CVD), a frequent cause of morbidity and mortality in renal transplant recipients (RTR). In these patients few data regarding both total homocysteine levels and their influence on cardiovascular risk have been reported. We therefore studied serum homocysteine levels in deep-frozen sera from 42 kidney transplant recipients with a follow-up of 11 +/- 4.5 years (mean +/- SD) after transplantation. Eighteen patients had one or more ischaemic events (CVD (+)) and 24 patients had none (CVD (-)). Serum samples had been drawn 1-6 months prior to the first vascular event in CVD (+) patients and serum storage time was comparable in both CVD (-) and CVD (+) patients. Serum homocysteine levels were measured using a radioenzymatic method. Mean homocysteine level was significantly higher in 42 RTR males and females (15.5 +/- 6.3, 13.5 +/- 5.5 microM respectively) compared with 35 control subjects matched for age and sex (8.7 +/- 1.9, 7.5 +/- 1.9 microM, P < 0.001). The difference in serum homocysteine levels between CVD (+) and CVD (-) RTR nearly reached statistical significance in male patients (18.6 +/- 7.8 versus 13.1 +/- 3.4 microM, P < 0.06) but not in female patients (P = NS). In the CVD (+) group 11/18 patients had homocysteine levels > 14 microM (the upper limit in healthy controls) versus 7/24 in the CVD (-) group (P = 0.04). In these patients we simultaneously measured in the same serum samples, serum triglycerides, and total and HDL cholesterol, and calculated LDL cholesterol. By stepwise discriminant analysis and by logistic regression analysis in this relatively small patient population, only serum triglycerides and homocysteine were selected as risk factors associated with CVD. We conclude that significant hyperhomocysteinaemia is present in renal transplant recipients and represents a potential risk factor for cardiovascular disease in these patients.

Adult↗
PubMed1994

Methodological aspects of spontaneous crystalluria studies in calcium stone formers.

Despite nearly a half-century of study, the clinical value of spontaneous crystalluria (Cx) examinations in calcium stone formers (CaSF) is still uncertain. The analytical complexity of urine particle study is largely responsible for this situation. As a result, there is no consensus regarding technical methods in Cx with several techniques for urine sampling and three different instruments currently used for particle study, namely, particle counting (PC), light microscopy (LM) and petrographic microscopy (PM). In this work, we first examined urine sampling and instrument methods regarding their appropriateness for Cx studies. Then we performed a comparative analysis of Cx studies in CaSF. Despite many technical and clinical discrepancies, several studies agree that the frequency of "all particles" and of the weddellite and whewellite calcium oxalate (CaOx) crystalline phases are increased in CaSF as compared to normal subjects (NS). Particle sizes and aggregation ratio are also often increased. Altogether, these results reinforce the need for an efficient method for Cx studies in these patients. Examining each technique leads us to conclude that most particle parameters can be studied by "direct LM" observation of freshly voided urine samples, i.e., urine samples without any separation steps. For clinical applications, several examinations should be performed, first to define the specific Cx characteristics in a patient, then for the study of treatment efficiency on Cx control, and finally, during the patient follow-up. Due to Cx variability in each patient, the frequency of Cx examinations during each phase needs to be determined in longterm comparative prospective studies of CaSF.

Calcium↗
PubMed1993

An in vitro investigation of the relationships between potency, lipophilicity, cytotoxicity and chemical class of representative calcium antagonist drugs.

Interrelationships that might exist between potency, lipophilicity and cytotoxicity of the chemically diverse calcium antagonist group of drugs have been examined in the present study. The potency of 11 representative calcium antagonists in inhibiting KCl-induced contractions in rabbit isolated aortic rings and their relative lipophilicity was determined using reversed phase HPLC. Their cytotoxicity in rat hepatocyte primary cultures was also determined. Cytotoxicity failed to correlate with potency, except for the highly lipophilic, non-selective, diphenylalkylamines (DPAs), suggesting that cytotoxicity was not caused by blockade of plasmalemmal voltage-operated calcium channels. Cytotoxicity moderately correlated with relative lipophilicity, the most lipophilic drugs also being the most cytotoxic. Relative lipophilicity may partly determine the cytotoxicity and pharmacological potency of Ca++ antagonists in a broad sense, but this correlation was not valid in each individual chemical series. We suggest that the higher cytotoxicity of the DPAs is at least partly due to a greater incorporation of the drugs into the hepatocyte plasmalemma compared to compounds in other chemical classes investigated. Further studies are required to elucidate the particular cytotoxic mechanisms involved.

Animals↗
PubMed1993

Influence of dose selection on absorbed dose profiles in radioiodine treatment of diffuse toxic goiters in patients receiving or not receiving carbimazole.

We retrospectively reviewed the records of 224 patients with diffuse goiters treated with radioiodine, half of which received carbimazole. In all the cases, we carefully monitored the calculation of dosage. A lower percentage of early hypothyroidism but a higher failure rate was observed in the carbimazole subgroup. Nevertheless, after one year, a constant (4.5%) incremental rate of hypothyroidism was found regardless of carbimazole administration. Since we were able to precisely estimate the absorbed doses in our series, we evaluated by simulation the dosimetric profiles of nine methods of dose selection (MDS). These MDS were calibrated in such a way that the same threshold value of absorbed dose would always be reached at the thyroid level. We showed that the more elaborate the MDS, the more accurate the irradiation at the thyroid level and the lower the radiation dose administered. In patients not receiving carbimazole, a rapid MDS using modified early uptake measurements to predict the 24-hr actual value was found to be advisable. With patients receiving carbimazole and if a goal is to delay the occurrence of hypothyroidism, we advise MDS based on either a 48-hr uptake or on the calculation of the individual half-life.

Carbimazole↗
PubMed1992

[Perioperative remote infections in neurosurgery. Role of antibiotic prophylaxis].

We report the results of a randomized, prospective study devised to assess the effectiveness of perioperative cefamandole prophylaxis on the remote infections rate in neurosurgery. Only two kinds of neurosurgical procedures were studied: shunt placement and craniotomy for brain tumour. In the treated patients cefamandole 1.5 g was given one hour before surgery, then repeated twice eight hourly. When the surgical procedure lasted more than three hours cefamandole 1.5 g was administered throughout the operation. No case of local infection was observed in either group, and the percentage of patients with remote infections was the same in both groups. Leucocytosis and temperature were measured during 15 days following the surgical procedure, and there were no differences between the treated and untreated groups in the evolution of these parameters. This study does not suggest that routine perioperative antibiotic prophylaxis is mandatory in neurosurgery.

Adolescent↗
PubMed1992

Comparative effects of 6 week fructose, dextrose and starch feeding on fat-cell lipolysis in normal rats: effects of isoproterenol, theophylline and insulin.

The precise effects of fructose feeding on adipose tissue is not clearly known. Consequently, we studied the effects of fructose feeding on stimulated and inhibited in vitro lipolysis. Twenty seven male Sprague Dawley rats, 5 weeks of age, were fed for 6 weeks on one of three diets containing 57% CHO as fructose (F), dextrose (D) or starch (S). At week 6 the epididymal fat pad weights showed no difference between groups. Stimulation of lipolysis by isoproterenol or theophylline showed: decreased sensitivity of adipocytes to isoproterenol, but not to theophylline, in F (p less than 0.05); the maximal responses were decreased, but NS, after stimulation by either isoproterenol or theophylline. The maximal antilipolytic responses to insulin were increased in F (27%) and D (29%) when compared to S (16%), (p less than 0.05). Only, in F there was an increase (NS) in ED50 (0.63 +/- 0.23 ng/ml) compared to D (0.45 +/- 0.18) and S (0.29 +/- 0.18), indicating decreased sensitivity. Nonfasting plasma insulin and triglycerides were increased at the 6th week in F (p less than 0.01), without any change in plasma glucose levels. However, there was no difference in 12 h fasting plasma glucose, insulin or triglycerides. In conclusion, a 6 week 57% fructose containing diet in normal rats led to: 1) decreased lipid mobilization in the epididymal adipose tissue; and 2) increased nonfasting plasma insulin and triglycerides. Thus fructose, under these experimental conditions, seems to have adverse metabolic effects in normal rats.

Adipose Tissue↗
PubMed1992

Determination of the affinity of monoclonal human IgM for myelin-associated glycoprotein and sulfated glucuronic paragloboside.

We determined the association constant of eight monoclonal IgM with two of their targets, i.e. the myelin-associated glycoprotein (MAG) or the sulfated glucuronic paragloboside (SGPG). All IgM had a 10- to 100-fold higher affinity for MAG than for SGPG. The affinity of the different IgM for MAG ranged from 1.3 x 10(-6) to 7 x 10(-9) mol/liter. The Scatchard plots for MAG were curvilinear, half of the sites being of high or low affinity. In contrast, the plots were linear in the assay using SGPG. No obvious correlations were found between the fine specificity of these IgM for the glucuronyl sulfate epitope and their affinity, although most IgM with a high affinity reacted exclusively with SGPG derivatives retaining a sulfate group. There was no parallelism between the severity of the neuropathy and the affinity of the IgM for MAG or SGPG.

Globosides↗