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Biomedical subjects

A Pradignac

Publications and source records attributed to A Pradignac.

At least 19 recordsLinked to original sources
PubMed2004

[Statins and cerebral and cardiovascular risk in elderly people].

INTRODUCTION: The rationale for the treatment of hypercholesterolemia in the elderly is less clear than in middle-aged patients because of several conceptual, epidemiological, economical facts, a higher prevalence of polypathology and a weaker relation between hypercholesterolemia and cardiovascular risk when age increases. CURRENT KNOWLEDGE AND KEY POINTS: However, cardiovascular events-stroke and myocardial infarction occur mainly in people aged more than 65 years. The data of recent randomised clinical trials have demonstrated that the use of statins in the elderly remained associated to a reduced all-cause mortality, cardiovascular mortality and stroke. Statins were effective in elderly with average LDL-cholesterol in primary and secondary prevention trials. The drug tolerance was as good as in middle-aged patients. However, convincing data concerning subjects over 80 are lacking. CONCLUSION: On the basis of disponible data it may be considered that statins are useful in older persons with a serum LDL cholesterol level above 1.3 g/l and or a high cardiovascular risk, with or without cardiovascular disease, when their life expectancy is consequent.

Aged↗
PubMed2004

Retrospective study of laparoscopic adjustable silicone gastric banding for the treatment of morbid obesity: results and complications in 127 patients.

OBJECTIVES: Laparoscopic gastric banding is currently the most popular surgical technique for morbId obesity. This wIdespread use of surgery has been evaluated by a number of clinical studies, particularly on weight change. METHODS: In a retrospective study of 127 obese patients operated between 1996 and 2000, data were collected for weight change, medical and surgical complications. RESULTS: Of 127 patients, failures of gastric banding were noted during 2 surgical operations. The average follow-up period was 33 +/- 20 Months. Average weight loss in all patients was 19.9 +/- 5.3 kg (15.3 +/- 4.2%). No difference in weight loss was observed between diabetic and non-diabetic patients. During the follow-up, data were collected on 53 complications (42.4% of all gastric banding operations). 3 main types of complication were found: access port related complications (22.6% of the total), band slippage (20.7% of the total) and tubing related complications (16.9% of the total). No prognostic factor for these complications could be Identified from multivariate analysis. CONCLUSIONS: Our results are very similar to those of other weight evolution studies. We found that there was a significant incIdence of surgical and medical complications during the follow-up because of the meticulous way all complications were recorded, even the most insignificant. This morbIdity must be borne in mind before surgery is performed.

Adult↗
PubMed2003

[Gastroplasty: complications and their prevention].

Bariatric surgery is now frequently proposed for the treatment of morbid or complicated obesity since the introduction of minimally invasive laparoscopic anti-obesity operations such as the adjustable silicone gastric binding gastroplasty. However this reversible procedure in not always as safe as presumed and the results in weight loss may be sometimes disappointing. Side effects are common and early or late complications occured in more than 20% out of the patients. They are favoured by post operative eating disorders. Nutritional consequences are probably underestimated and are not limited to uncomfortable digestive symptoms. Some deficiencies in micronutriments have been described. The worsening of previous eating disorders or psychosocial abnormalities are not seldom. Gastroplasty is not an harmless procedure. A good selection in patients, a regular follow up, nutritional advices and psychosocial management by a multidisciplinar team are required to reduce complications after gastroplasty.

Gastroplasty↗
PubMed1998

[Cholesterolemia and pathology: update].

The relationship between plasma cholesterol levels and disease is more complex than presumed. If the pathogenic role of hypercholesterolemia in ischemic myocardial disease is now undoubted, the deleterious effect of hypocholesterolemia induced by diet or drugs, mainly on cancer mortality and violent death, is still controversial. In a prognostic point of view it seems that the degree of diminution of cholesterol levels is more important than hypocholesterolemia itself. Several hypothesis were formulated; however, hypocholesterolemia does not appear as a causal factor. A prudent approach of hypercholesterolemia remains desirable but without special alterations of the recent recommendations concerning the management of hypercholesterolemia.

Cholesterol↗
PubMed1998

Improved specificity of a new direct assay for urinary cortisol: application in corticoid treated patients.

Twenty four hours urinary free cortisol (UFC) excretion has been determined in 35 eucortisolic control patients, in seven of them before and after tetracosactide (Synacthen) stimulation and in 18 patients treated by anti-inflammatory steroids. Results of the new direct Immunotech RIA (DIm) were compared to those of the INCSTAR RIA kit with (ECA) or without methylene chloride extraction (DCA). In controls DIm UFC (106.2+/-45.8 nmol/24h) was significantly lower than DCA UFC (397+/-119 nmol/24h) and than ECA UFC (127+/-49 nmol/24h). After tetracosactide stimulation, median of DCA/DIm ratio decreased from 3.61 to 1.88 whereas ECA/DIm ratio did not change significantly (1.31 to 1.06). In treated patients most DCA and ECA results were over the upper limit of controls but only 5 DIm results were increased. DIm assay showed good specificity and practicability and may be used with benefit in the evaluation of the adrenal gland function.

Anti-Inflammatory Agents↗
PubMed1995

Relationships between macronutrient intake, handicaps, and cognitive impairments in free living elderly people.

It is still unknown what if any relationships exist between intake of macronutrients by the elderly, and their functional or cognitive handicaps, particularly for free living elderly people. We investigated 226 men and 215 women, aged 65 or more, free living and in good health. They were randomly selected in the département of Bas-Rhin, after stratification for age, sex and residence (rural or urban). Handicaps and cognitive functions of each subject were assessed with the Géronte scale and the Mini-Mental State Examination (MMSE), respectively. Food intake was measured by a three-day record. A multiple correspondence analysis concluded that functional parameters and macronutrient intakes were rather independent. The relationships found were detailed by a backward stepwise logistic regression. In men, alcohol intake was associated with an improvement in functional and cognitive parameters, and polyunsaturated fatty acids with the capacity to move outside the home. In women, lipid intake increased the MMSE score. Overweight in women was linked with better functional and cognitive performances, and in men with the capacity to move outside the home. In both sexes, age worsened the score of functional and cognitive parameters. In conclusion, macronutrient intakes and functional or cognitive parameters were found to be mutually independent; this suggests that macronutrient deficiencies are of little importance in the worsening functional or mental autonomy of the elderly. The relationships found between functional variables and alcohol or polyunsaturated fatty acid intakes in men, and lipid intakes in women, and overweight in both sexes might evidence a better state of health.

Aged↗
PubMed1995

Low cholesterol concentrations in free-living elderly subjects: relations with dietary intake and nutritional status.

Hypocholesterolemia has been reported in epidemiologic studies to be associated with increased mortality from noncardiovascular causes. Low cholesterol concentrations have been reported in various pathologic conditions and in institutionalized elderly patients, and seem to be associated with poor outcome. The role of nutritional factors in the genesis of hypocholesterolemia was investigated in 380 free-living elderly subjects. Subjects in the lowest cholesterol quartile had lower free triidothyronine and prealbumin concentrations and a lower Folstein's score (a minimental test) than did those in the other quartiles. They did not differ from the other subjects for energy or nutrient intakes. Only 12 subjects (9 men and 3 women) had cholesterol concentrations < 3.62 mmol/L: the men had low free triidothyronine, free thyroxine, and prealbumin concentrations but normal energy and nutrient intakes, whereas the women differed from those with normal cholesterol concentrations for biological and nutritional data. These results indicate that low cholesterol concentration is a nonspecific feature of poor health status that is independent of nutrient or energy intake. The role of nutrient factors as a determinant of cholesterol concentration appears marginal in free-living elderly subjects.

Aged↗
PubMed1995

Nutrition of the elderly: a challenge between facts and needs.

Interactions between nutrition and the ageing process are a fascinating field of research. The assessment of the nutritional status is an important part of medical examination. Generally it is assumed that energy intake and energy expenditure decrease with age. In fact they vary widely and are very different in healthy, in sick or in institutionalized elderly. Nutritional requirements depend on many social and physiological factors in the free-living elderly population. Surveys indicate that dietary requirements are qualitatively grossly comparable to those in middle-aged adults. However the elderly are particularly at risk of marginal deficiencies of vitamins and trace elements. Today the early recognition of malnutrition is an important challenge. Its prevention may influence the evolution of nonspecific intercurrent disease and restore immunocompetence. Another challenge is to promote health by adequate recommendations in order to prevent deficiency diseases and to increase longevity. Some studies suggest that nutrition-based preventive medicine remains useful in the elderly. Caloric restriction, weight loss in case of obesity, decrease in blood lipids, increase in calcium intake which depend mainly of prior nutritional habits may have an effect in the elderly. However, prevention of protein caloric malnutrition is more relevant in the elderly.

Aged↗
PubMed1994

Eating behaviour and depression before and after antidepressant treatment: a prospective, naturalistic study.

Eating behaviour of severely depressed patients was assessed before (n = 56), after acute (n = 46) and during maintenance (n = 35) treatment and compared to matched normal controls in order to investigate the behavioural mechanisms underlying the weight gain induced by antidepressants. Assessments included food intake, appetite and food preferences. Before treatment, there was a decrease in appetite and in food intake with a relative excess of carbohydrates and a preference for sweets. Maintenance treatment was associated with substantial weight gain. All differences in eating behaviour between patients and controls disappeared, with the exception of a decrease in appetite in a subgroup of less-improved patients. These results suggest that antidepressant treatment induces weight gain by mechanisms that are largely independent of their action on mood.

Adult↗
PubMed1994

[Acute myelitis in the post-eruptive phase of measles].

An acute isolated myelitis occurring at the post-eruptive phase of measles is reported. This unusual complication of measles has a favourable outcome in the most of cases. An immunological mechanism, identical to this responsible of perivenous encephalitis seems to be involved.

Acute Disease↗
PubMed1994

Anthropometric values in an elderly French population.

We compared anthropometric indices in samples of elderly people aged 65 years and over living in two French areas. The samples were divided into four age-groups (65-69, 70-74, 75-79 and over 80 years). We observed interregional differences in women aged 65-69 years and in men aged 65-74 years. Weight and anthropometric variables related to body fat percentage and to muscle mass showed a decline with age as already reported by others. We established anthropometric percentile values according to sex in pooled subjects when no integrated difference was found. The 50th percentile of arm circumference, muscle arm circumference and triceps skinfold was higher, and the 50th percentile of body mass index was lower than the one reported for the same indices from an elderly Welsh population. Our results show that an interregional difference in anthropometric indices exists in the elderly. The differences which are observed between our results and those reported from a British population emphasize the importance of establishing local values for the elderly population.

Aged↗
PubMed1994

Thyroid hormone status and nutrient intake in the free-living elderly. Interest of reverse triiodothyronine assessment.

Fasting or hypercaloric diets are established methods of inducing low triiodothyronine (T3) levels that resemble the sick euthyroid syndrome in adults, but little is known on the mechanisms of this syndrome in the elderly. Decreasing T3 does not seem to be an unavoidable consequence of ageing, but the role of illness or other factors in this decline remains unclear. The aim of this work was to study the influence of nutritional factors on thyroid hormone levels in free-living elderly subjects. A 3-day dietary survey was conducted in 440 randomized subjects aged between 65 and 96. Cholesterol, apoproteins, prealbumin, hemoglobin, thyrotropin-free thyroxine (FT4), FT3 and reverse T3 (rT3) were assayed in each subject. Only 11 subjects had low FT3 levels, and they also had low levels of cholesterol, prealbumin and hemoglobin and a lower Folstein score compared to the rest of the population. Twenty-one subjects had isolated elevated rT3 levels, they were older and had significantly lower energy and fat intakes than the rest of the population. There was a clear reduction in FT3 levels and an increase in rT3 levels with age, although in the normal ranges, which occurred despite maintenance of a high-energy intake even in the oldest group. The FT3 level was lower in the subjects with poor health status, whereas high rT3 levels were associated with low energy intake in men. Stepwise regression showed that hemoglobin, age and prealbumin were the best predictors of FT3 levels, whereas age and energy intake were the main predictors of rT3 levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Effects of blood transfusion on the serum assays of iron, the total binding capacity of transferrin, vitamin B12 and folates].

To evaluate the influence of blood transfusion on the serum levels of different nutrients, the levels of total iron binding capacity, ferritin, cobalamin and folate were determined before and 24 hours after 2 or 3 packed red cell transfusions, by forty patients with anemia of various causes. No significant change was found in these levels before and after blood transfusion, except for iron and folate.

Adult↗
PubMed1993

The loss of appetite during depression with melancholia: a qualitative and quantitative analysis.

The loss of appetite occurring severe depression was investigated with an experimental method comparing the eating behaviour of 12 melancholic inpatients to 12 matched normal controls. Food intake and appetite, divided into more basic components such as desire to eat, hunger, satiety, prospective food consumption and pleasure from eating, were monitored during a test meal. Patients ate less than controls, but the difference was not significant. The pattern resulting from the temporal tracking of the appetite ratings indicated that patients were disturbed at the beginning of the meal and showed a decreased desire to eat, hunger and prospective food consumption and an increased satiety and that their pleasure from eating was diminished. These findings suggest that the loss of appetite induced by melancholia follows a specific pattern.

Adult↗
PubMed1993

[Relationships between weight and menopause].

Weight gain seen around the time of the menopause justifies a therapeutic action. It seems to be linked more to the effects of age than to the menopause itself. It often causes abdominal obesity which increases vascular risk and predisposes to raised blood pressure. The ability of adipose tissue to concentrate androgens and estrogens probably explains the higher incidence of genital carcinomas in overweight post-menopausal women. Hormone replacement therapy does not seem to have any untoward effects on weight.

Adipose Tissue↗
PubMed1993

[Thyrotropin assay by chemiluminescence in the diagnosis of dysthyroidism with low thyrotropin and normal thyroid hormones levels].

The performances of a new "3rd generation" chemoluminescence TSH assay (TSH ICMA) with a functional sensitivity of 0.005 mU/l were compared with those of an "ultrasensitive" TSH immunoradiometric assay (TSH IRMA) in a series of patients characterised by a TSH IRMA less than 0.20 mU/l and normal free thyroxin (T4 L) and triiodothyronine (T3 L) concentrations. The 95% cut-off value for hyperthyroidism was 0.03 for TSH ICMA and 0.05 for TSH IRMA. In a first group of 41 subjects undergoing Tc99m thyroid scan, images of multifocal increased uptake or toxic adenoma were associated with a lower TSH ICMA than in patients with a normal isotope scan. TSH ICMA was also lower than TSH IRMA (p < 0.01). At the cut-off value of 0.03 mU/l, the specificity of TSH ICMA was higher than that of TSH IRMA, but the sensitivity were identical. In a second group of 36 patients with severe non-thyroid diseases, TSH ICMA was lower than the cut-off value for hyperthyroidism in 30% of cases, while TSH IRMA was lower than the cut-off value in 40% of cases. A satisfactory concordance was observed between the two methods. In conclusion, the two TSH assays, IRMA and ICMA, provide globally comparable information in subjects with a low TSH and normal T4 L and T3 L. However, the better specificity of TSH ICMA and a smaller overlap with the frank hyperthyroid zone in patients with non-thyroid disease argue in favour of the use of this new assay method.

Aged↗