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Biomedical subjects

B Verges

Publications and source records attributed to B Verges.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Prognostic factors of survival in medullary cancers of the thyroid. Apropos of 51 cases. Clinical, biochemical and immunocytochemical study].

The aim of this study was to assess the main clinical biochemical and immunocytochemical factors influencing survival in 51 patients operated for medullary thyroid carcinoma (MTC). There were 55% of women and 37% of familial cases. Mean age was 43 +/- 3 years. The following survival variables were tested: sex, age, stage, familial disease, Serum Carcino Embryonic Antigen (CEA) and Calcitonin (CT) levels three months postoperatively, intensity of CEA and CT immunostaining, percentage of cells stained for CEA and CT. The actuarial survival rate, including postoperative mortality (N = 1), was studied by uni and multivariate analysis using a Cox model (N = 31). The 5-year survival was 69 +/- 7%. By univariate analysis, stages I or II (p < 0.0001), age of 45 years and less (p < 0.0001), normalized CEA levels (p < 0.006), percentage of CT stained cells greater than 80% (p < 0.04) and weak CT and CEA staining (p < 0.02) were significant predictors of increased survival rates. Age less than 45 and stages I or II were significant prognostic factors of goof survival on multivariate analysis (p < 0.001). We conclude that clinical criteria constitute good survival prognostic factors in patients operated for MTC. The better prognosis of familial cases was probably related to their earlier detection. The prognostic value of immunostaining remains controversial and requires further studies.

Actuarial Analysis↗
PubMed1996

[Primary hyperparathyroidism and pregnancy].

We report a case of primary Hyperparathyroidism (HPT) occuring in a 36 year old woman, during pregnancy. This woman received medical therapy to the delivery, then underwent parathyroidectomy in post-partum. Primary HPT during pregnancy is associated with increased risk of fetal loss, neonatal and maternal morbidity. Neonatal hypocalcemia is due to transient hypoparathyroidism consequent to abnormal suppression of fetal parathyroid hormone secretion by maternal hypercalcemia. Maternal hypercalcemia may be masked by hypoalbuminemia during pregnancy and often leads to aspecific symptoms which will differ the diagnosis. The recommanded treatment is parathyroidectomy which should preferably be performed during the second trimester of pregnancy; the efficacity of medical treatment is poor and transient.

Adult↗
PubMed1995

Apolipoprotein A-IV in diabetes mellitus.

Apolipoprotein A-IV is considered to play a role in triglyceride-rich lipoprotein metabolism, in reverse cholesterol transport, and in facilitation of CETP (Cholesterolyl Ester Transfer Protein) activity. Moreover, apoA-IV is genetically polymorphic in humans, in whom two major isoproteins (apoA-IV 1 and apoA-IV 2) are present and have differences that influence the apoA-IV phenotype in lipid metabolism. In non-insulin-dependent-diabetes, increased apoA-IV levels are found, mainly related to hypertriglyceridemia and to a lesser extent to HDL cholesterol level; apoA-IV phenotype distribution is not different from controls; in the control population, the potential protective lipid profile (characterized by increased HDL and HDL2 cholesterol levels) related to the apoA-IV 1-2 phenotype, is no longer found in NIDDM patients (the metabolic state of NIDDM appears to have effected the potential protective lipid profile related to the apoA-IV 1-2 phenotype); and plasma apoA-IV levels is associated with increased prevalence for macrovascular disease. In non-insulin-dependent diabetes treated with insulin, apoA-IV levels are increased. Unlike results for NIDDM patients undergoing oral treatment, the increase in apoA-IV level is not related to hypetriglyceridemia, so that the effect on lipid metabolism may be different.

Apolipoproteins A↗
PubMed1994

[Effect of rehabilitation after myocardial infarction on muscular metabolism. Contribution of phosphorus 31 NMR spectroscopy].

P 31 NMR spectroscopy is a recent technique which allows a non-invasive and direct analysis of oxidative metabolism and pH changes, an indicator of acidosis due to lactic acid accumulation in the skeletal muscles. The authors investigated oxidative muscular metabolism of the sural triceps in 10 patients after myocardial infarction by performing a study after the acute phase and repeating the study after a programme of physical training. At rest, there were no significant differences. On the other hand, for the same level of maximal effort, the depletion in phosphocreatinine (PCr) and the accumulation of inorganic phosphate (Pi) were significantly lower after physical training: the PCr/PCr + Pi increased from 0.467 +/- 0.179 to 0.538 +/- 0.20 (p < 0.02) and the Pi/PCr ratio decreased from 1.570 +/- 1.440 to 1.181 +/- 1.069 (p < 0.05). The pH at the same level of maximal exercise did not change significantly between the two periods: 6.85 +/- 0.16 vs 6.88 +/- 0.15 (NS). The peak oxygen consumption (VO2) measured during bicycle ergometry increased significantly from 23.4 +/- 10.5 to 28.3 +/- 12.14 ml/min/kg after exercise training (p < 0.01). In addition, a correlation was observed between the improvement of the peripheral parameters (PCr/PCr + Pi) and the increase in VO2 max (r = 0.757, p < 0.01). The authors results confirm the effects of physical training on oxidative metabolisms of the peripheral muscles and its influence on improvement of global performance of coronary patients.

Adult↗
PubMed1994

Elevated serum CA19-9 levels in poorly controlled diabetic patients. Relationship with Lewis blood group.

Many non-malignant diseases may be associated with elevated serum CA19-9 levels. Recent reports suggest that diabetes mellitus may also be responsible for some elevations. In this study we investigated the influence of the glycaemic level and Lewis phenotype on the serum CA19-9 levels in diabetic patients. In 15 out of 84 patients (17.8%) serum CA19-9 exceeded 100 kU/L (highest value: 208 kU/L). CA19-9 concentrations were significantly correlated with glycosylated haemoglobin levels. On the other hand, no correlation was found between CA19-9 levels and the type of diabetes, lipase levels, or the presence of anti-islet cell antibodies. Le(a-b-) patients had significantly lower serum CA19-9 levels. This study emphasizes the frequency of CA19-9 elevations in diabetic patients without cancer.

Adult↗
PubMed1993

The energetic cost of some daily activities: a comparison in a young and old population.

We compared the energetic costs of some daily activities in two groups, 10 young people (24.3 +/- 2.8 years) and 10 old people (74.4 +/- 2.2 years): rising and sitting back down on a seat, getting up from and lying down on a bed and getting up from the floor. We measured the oxygen consumption and the time necessary for the activities. The results showed a noteworthy economical energetic procedure when rising and sitting back down on a seat among the older group. The values of the energy expenditure were respectively 3.9 +/- 1.3 cal/kg in the older group and 5.8 +/- 1.6 in the younger one with a standard seat (45 cm) and 2.7 +/- 1.2 vs 5.2 +/- 1.5 with a raised seat (60 cm). The activities did not vary significantly in time in the two age groups. This procedure could be understood as an adaptation of the energy expenditure to the reduced aerobic capacity with ageing. Conversely, getting up from and lying down on the floor or a standard hospital bed involved the same energy expenditure in the older and younger group, but performing these activities took significantly longer for the older people (+60% for getting up from the floor, +33% from the bed). As these activities revealed no economical energetic procedure in the older group, they appeared responsible for a strong factor of dependence. The importance of a learning process particularly for the most usual movements in everyday life is discussed.

Activities of Daily Living↗
PubMed1993

Rapid in vivo transport and catabolism of human apolipoprotein A-IV-1 and slower catabolism of the apoA-IV-2 isoprotein.

Apolipoprotein (apo) A-IV is a polymorphic, intestinally derived apolipoprotein that is genetically linked to and similar in structure to apoA-I, the major apolipoprotein in high density lipoproteins (HDL). ApoA-IV plays a potentially important role in lipoprotein metabolism and reverse cholesterol transport, but its in vivo metabolism is poorly understood. In order to gain insight into factors modulating apoA-IV metabolism in humans, the in vivo kinetics of the two major human apoA-IV isoproteins apoA-IV-1 and apoA-IV-2 were investigated in normolipidemic human subjects. 131I-apoA-IV-1 and 125I-apoA-IV-2 were reassociated with autologous plasma and injected into study subjects. Analysis of the kinetic data revealed a rapid mean fractional catabolic rate (FCR) for apoA-IV-1 of 2.42 +/- 0.11 d-1. The mean production, or transport, rate of apoA-IV-1 was 16.3 +/- 1.4 mg/kg per d. Plasma apoA-IV concentrations were highly correlated with apoA-IV production rate (r = 0.84, P < 0.001) and not correlated with apoA-IV fractional catabolic rate (r = 0.25, P = NS). The mean FCR of apoA-IV-2 was 2.21 +/- 0.10 d-1. In the ten subjects in whom 131I-apoA-IV-1 and 125I-apoA-IV-2 were simultaneously injected, the FCR of apoA-IV-2 was significantly slower by paired t test (P = 0.003). The FCR of apoA-IV-2 in an apoA-IV-2/2 homozygote was only 1.49 d-1, substantially slower than in all other subjects. We conclude that: (a) apoA-IV is a rapidly catabolized apolipoprotein in humans, with a fractional catabolic rate more than 10 times greater than that of apoA-I; (b) apoA-IV has a high absolute transport rate similar to that of apoA-I; (c) plasma levels of apoA-IV are primarily determined by apoA-IV production rate in normolipidemic subjects; and (d) the fractional catabolic rate of the common variant apoA-IV-2 is slower than that of the wild-type apoA-IV-1.

Adult↗
PubMed1989

Adrenal function in HIV infected patients.

UNLABELLED: Since anatomopathological lesions of the adrenal gland have been frequently observed at autopsy in AIDS, we investigated the glucocorticoid function in 63 patients (51 men, 12 women) infected by the human immunodeficiency virus (HIV) in order to determine the incidence and the nature of any adrenocortical abnormalities at various stages of HIV infection. The patients were classified according to the Centers for Disease Control (CDC) recommendations into group II (asymptomatic; N = 13), group III (lymphadenopathy; N = 27) and group IV (clinical manifestations; N = 23). Plasma ACTH and cortisol before and after an exogenous ACTH stimulation test were measured in patients as in 30 age-matched controls. Plasma renin activity and plasma aldosterone before and after ACTH stimulation were also measured in 31 patients (group II: 12; group III: 10; group IV: 9). Compared with controls patients from group II-III had higher levels of ACTH (39.11 +/- 17.01 vs 29.73 +/- 8.53 ng/l; p = 0.003) and basal cortisol (232 +/- 91.2 vs 184.3 +/- 30.9 micrograms/l; p = 0.03). No significant differences were noted between group IV patients and controls as to ACTH and basal and stimulated cortisol levels. Among the 63 patients, only one from group IV had a blunted cortisol response after ACTH stimulation test. Plasma renin activity, and basal and stimulated aldosterone levels in the 3 groups of patients were not different from control values. IN CONCLUSION: 1. Adrenal insufficiency does not seem very frequent in group IV patients and is likely to be a late complication in AIDS. 2. The increased ACTH and basal cortisol levels found in group II and group III patients argue for an early dysregulation of the adrenocortical axis in HIV infection. The exact physiopathological mechanism is not yet known, but an enhanced CRH production by interleukin 1 and/or a direct role of the HIV envelope glycoprotein (gp 120) may explain the high ACTH level in HIV patients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Neuromuscular forms of hyperparathyroidism. Apropos of 2 cases].

The authors report two cases of hyperparathyroidism presenting mainly with muscular weakness. In the first case, a 74 year old woman had become completely bed-ridden and muscular recovery was obtained in 18 months. In the second case, a 24 year old sportsman had to stop all competition. Hypercalcaemia was suspected after finding radiological muscular calcification; the patient was able to start his sporting activities again two months after excision of the adenoma. After a review of the literature the authors discuss the principal physiopathogenic mechanisms; a direct action of parathormone is the probable cause but this has not been proved. Muscular forms of hyperparathyroidism are rare but this "pseudo-myopathic" presentation justifies the systematic exclusion of hyperparathyroidism in all cases of unexplained muscle weakness.

Adolescent↗
PubMed1987

Doppler echocardiography in prosthetic valve dysfunction. Diagnostic value in twenty cases.

We performed a retrospective study of 20 cases of prosthetic valve dysfunction which required reoperation and in which preoperative Doppler studies were performed. There were 13 mitral (3 mechanical, 10 bioprostheses) 5 aortic (1 mechanical and 4 bioprostheses), 1 pulmonary bioprosthesis and 1 mechanical tricuspid valve dysfunction. The aim of the study was to establish the diagnostic value of the Doppler examination by comparing the results with the operative findings. The parameters measured were: peak pressure gradient and mean pressure gradients in all prostheses, together with pressure half times and functional surface area in mitral and tricuspid valve prostheses. Cardiac catheterisation was performed in 6 cases before surgery. The diagnosis of prosthetic valve obstruction was correctly made, even in the 1 case with moderate stenosis. All cases of regurgitation were diagnosed and the topographical location of the leak was identified, except in 1 mechanical mitral valve prosthesis in which the regurgitant jet was detected only by continuous wave Doppler. Fourteen of the 20 cases were reoperated upon without catheterisation. These results suggest that Doppler echocardiography is a sensitive and specific diagnostic method of assessing prosthetic valve dysfunction. However, as the Doppler parameters are variable from one prosthesis to another, it is important to perform pulsed and continuous wave Doppler baseline studies in the immediate postoperative period as a reference in case of suspected valve dysfunction at a later stage.

Adult↗
PubMed1987

[Doppler echocardiography in dysfunctions of valvular prostheses: diagnostic and quantitative significance. Apropos of 20 cases].

We present a retrospective study of 20 patients with cardiac valve prosthetic dysfunction who required reoperation and underwent pre-operative doppler echocardiography. There were 13 cases of mitral valve prosthesis (3 mechanical, 10 xenografts), 5 cases of aortic valve prosthesis (1 mechanical, 4 xenografts), 1 pulmonary valve bioprosthesis and 1 tricuspid valve mechanical prosthesis. Our purpose was to evaluate the diagnostic and quantitative value of this examination in prosthetic dysfunction by comparing doppler data with anatomical findings at surgery. The parameters measured were peak and mean pressure gradients in all cases, gradient half-decrease time and valve surface calculated therefrom in mitral and tricuspid valve prostheses. The results of doppler examination were compared with per-operative anatomical findings in 6 cases, and pre-operative haemodynamic exploration was performed in one case. The diagnosis of prosthetic stenosis was found to be correct in all patients, even in those with moderate stenosis. All leaks and their locations were diagnosed, except in a mitral valve mechanical prosthesis where leaking was detected by continuous doppler. 14 out of the 20 patients were reoperated upon without catheterization. These results suggest that doppler examination is a sensitive and specific method for evaluating cardiac valve dysfunction. However, variations in doppler results from one prosthesis to another make it necessary to perform pulsed and continuous doppler at the end of the operation to be used as reference if dysfunction is suspected subsequently.

Adult↗
PubMed1986

[Phenytoin treatment of motor diarrhea in diabetic patients].

Phenytoin (diphenylhydantoin) was used in doses of 300 mg/24 hours to treat severe motor diarrhoea in 5 diabetic patients. The patients had been insulin-dependent for 2 to 17 years and had advanced neuropathy. In each case, malabsorption, lesions of the colon or small bowel, endocrine tumour or parasitic, infectious and inflammatory causes could be excluded. Under phenytoin the diarrhoea ceased in all 5 patients within 24 to 48 hours. It recurred in 4 of them within 48 hours when treatment was withdrawn to disappear within the same length of time when it was reintroduced. No relapse was observed for periods of 3 months to 5 years under phenytoin maintenance treatment. The mechanism of action of phenytoin may suggest that diabetic diarrhoea is hormone-mediated or caused by an effect on the autonomous nervous system or on the peptidergic system, but no definite conclusion can be reached in the present state of our knowledge.

Adult↗
PubMed1986

Arginine vasopressin in human follicular fluid.

Arginine vasopressin (AVP) was determined in plasma and follicular fluid in 28 women in an in vitro fertilization program. In 23 women, follicular fluid was collected by laparoscopy during general anesthesia, and in 5 women, it was collected transvaginally with no such anesthesia. Plasma AVP increased markedly from its basal (preanesthesia) value in the first group, whereas it did not change in the second group. AVP concentrations were approximately 10-fold lower in the follicular fluid than in the plasma collected simultaneously in the anesthetized women. AVP levels were not significantly different in plasma and follicular fluid in the women of the second group. AVP concentrations were similar in ovarian venous and brachial venous plasma in 4 women during surgery. These results indicate that AVP concentrations in follicular fluid are equal to or lower than those in plasma and that AVP concentrations are not higher in efferent blood from the ovary than in peripheral blood.

Adult↗