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Biomedical subjects

C Delcourt

Publications and source records attributed to C Delcourt.

At least 19 recordsLinked to original sources
PubMed2006

[ADEM: a rare and serious demyelinating disorder of adults].

Acute Disseminated Encephalomyelitis is a serious demyelinating disorder of childhood that typically occurs following vaccination or a viral prodrome. Some etiologies remain unrecognized, and multiple mechanisms of immune response may explain the pathophysiology of this syndrome. Based on a report of two adult cases presenting with neurologic deficit and ataxia, we report our experience with this syndrome that may affect adults without evident infectious disorder. Prompt treatment is important to avoid rapid progression.

Adrenal Cortex Hormones↗
PubMed2006

[The French glaucoma and ocular hypertension 1-day study].

PURPOSE: The purpose of this study was to describe the distribution and characteristics (age, duration, type, treatment, etc.) of ocular hypertension and glaucoma in French ophthalmologic practices. METHODS: The French glaucoma and ocular hypertension 1-day study is a descriptive cross-sectional "1-day" type survey, conducted among all ophthalmologists of mainland France. They had to include all patients aged 18 years and over with ocular hypertension or glaucoma who were seen on November 25th 2003. The participation rate was 24.0% (1.173 ophthalmologists). Among the 3.919 patients included, 3.896 subjects (99%) had usable data for the statistical analyses. RESULTS: The ophthalmologists reported treating 16 patients with ocular hypertension or glaucoma on average per week. Among the patients, 29.5% had ocular hypertension, 61.7% had open-angle glaucoma, 3.4% had normal tension glaucoma, and 5.5% angle-closure glaucoma. The ophthalmologists used surgery or laser treatment for 74.1% of angle-closure glaucoma, while for other pathologies, treatment with drugs only was preponderant. More than 87% of patients received one or several ocular treatments: beta-blockers (59.3%), prostaglandins (50.1%), carbonic anhydrase inhibitors (21.6%), or mydriatic sympathomimetics (6.3%). CONCLUSIONS: The characteristics of glaucoma and ocular hypertension (type of glaucoma, age, duration, etc.) correspond to those of other Western populations. The therapeutic habits of French ophthalmologists is in line with current international guidelines.

Aged↗
PubMed2006

[Prevalence and description of treatment with intraocular pressure-lowering topical medications in continental France].

PURPOSE: The first objective of the present study was to estimate the prevalence of patients treated for glaucoma or ocular hypertension (OHT) with an IOP (intraocular pressure) -lowering topical medication. Subjects were 40 years old and living in continental France. The second objective was to describe the type of therapy, compliance, and the quality of life of the subjects treated. METHODS: This study was a telephone survey conducted in a general population on a representative sample of 5726 subjects in 2004. Subjects treated for glaucoma or OHT were defined as those declaring use of eye drops for more than 1 month and mentioning one of the 52 registered IOP-lowering topical medications and/or stating that they were taking eye drops for glaucoma or OHT. Quality of life was measured using the GlauQOL-17 questionnaire. RESULTS: 237 subjects (4.1%) corresponded to this definition. The prevalence increased with age, from 0.7% in subjects aged 40-44 years to 10.6% in those aged 80 years or more. The age-standardized prevalence was higher in the Paris area (5.3%), the Mediterranean (4.5%), and the Southwest (4.7%), and lower in rural areas (3.2%), and in subjects with less than high school education (2.9%). Beta-blockers (49.5%) and prostaglandins (37.4%) were the most frequent treatments, followed by carbonic anhydrase inhibitors (15.3%), sympathomimetics (5.7%), and myotics (1.3%). Compliance was not total in 39% of the patients (22% of those treated with once-a-day dosage). DISCUSSION: The results of the present study are in line with French health authority data and with the results of the French "Glaucoma and intraocular high pressure, one day" study results. Moreover, the lower prevalence in regions with low medical density, low socioeconomic level, and rural areas, suggest that glaucoma or OHT might be underdiagnosed. CONCLUSION: On the basis of this first nationwide study, it can be estimated that the prevalence of subjects treated with IOP-lowering topical medications is about 1.2 million in France. The number of daily doses appears to influence compliance.

Adult↗
PubMed2006

Follow-up of intracranial aneurysms selectively treated with coils: Prospective evaluation of contrast-enhanced MR angiography.

BACKGROUND AND PURPOSE: The aim of this study was to determine the feasibility and usefulness of contrast-enhanced MR angiography (CE-MRA) for the follow-up of intracranial aneurysms treated with detachable coils, by comparing CE-MRA with digital subtraction angiography (DSA) and 3D time-of- flight (TOF) MRA. METHODS: Thirty-two patients with 42 treated aneurysms were included in the study; 6 had been treated for multiple aneurysms. All MRAs were performed with a 1.5T unit within 48 hours of DSA. We performed 2 types of acquisition: a 3D TOF sequence and CE-MRA. Twenty-eight patients were included 1 year after endovascular treatment, and 4 patients, after 3 years or more. DSA was the technique of reference for the detection of a residual neck or residual aneurysm. RESULTS: Compared with DSA, the sensitivity of MRA was good. For the detection of residual neck, there was no significant difference between the results of 3D TOF MRA (sensitivity, 75%-87.5%; specificity, 92.9%, according to both readers) and CE-MRA (sensitivity, 75%-82.1%; specificity, 85.7%-92.9%). For the detection of residual aneurysm, sensitivity and specificity of both techniques were the same, respectively 80%-100% and 97.3%-100%. Therefore, CE-MRA was not better than 3D TOF MRA for the detection of residual neck or residual aneurysm. For large treated aneurysms, there was no difference between decisions regarding further therapy after CE and 3D TOF MRA, even though CE-MRA with a short echotime and enhancement gave fewer artifacts and better visualization of recanalization than 3D TOF MRA. The interpretation of transverse source images and the detection of coil mesh packing seemed easier with 3D TOF imaging. CONCLUSION: This prospective study did not show that CE-MRA was significantly better than 3D TOF MRA for depicting aneurysm or neck remnants after selective endovascular treatment using coils. For aneurysms treated with coils, 3D TOF MRA seems a valid and useful technique for the follow-up of coiled aneurysms.

Adult↗
PubMed2006

Guidelines for the management of epilepsy in the elderly.

Seizures starting in patients over 60 years old are frequent. Diagnosis is sometimes difficult and frequently under- or overrated. Cerebrovascular disorders are the main cause of a first seizure. Because of more frequent comorbidities, physiologic changes, and a higher sensitivity to drugs, treatment has some specificity in elderly people. The aim of this paper is to present the result of a consensus meeting held in October 2004 by a Belgian French-speaking group of epileptologists and to propose guidelines for the management and the treatment of epilepsy in elderly people.

Aged↗
PubMed2005

Prophylaxis of the epilepsies: should anti-epileptic drugs be used for preventing seizures after acute brain injury?

In many circumstances antiepileptic drugs are used in patients who have never presented any clinical epileptic seizures. These substances are administered on the assumption of a potential risk for the patients of developing acute or delayed chronic seizures after brain injuries such as trauma, stroke, hemorrages or even neurosurgical interventions. The aim of this paper is to propose therapeutic guidelines for the management of this prophylactic attitude in epilepsy based on basic research and clinical practice in the French community in Belgium. We will distinguish between the prevention of acute (early onset-provoked) seizures and a delayed truly post-lesional (unprovoked) epilepsy. Some therapeutic goals can be achieved under the former circumstances whereas in the latter situation we all agree for the absence of any coherent antiepileptic prophylactic behaviour.

Acute Disease↗
PubMed2004

[Transient ischemic attacks: a new definition].

According to its initial definition, which dates back more than 50 years, a transient ischemic attack (TIA) is a sudden focal neurologic deficit lasting for less than 24 hours, of presumed vascular origin, and confined to an area of the brain or eye perfused by a specific artery. Recent data on the pathophysiology of cerebral ischemia and the progress made by the imaging techniques have led an American TIA Working Group to propose a new definition which states that: "A transient ischemic attack is a brief episode of neurologic dysfunction, caused by local brain or retinal ischemia, with clinical symptoms typically lasting less than one hour, and without evidence of cerebral infarction". The advantages and limitations of this new definition, the need for an emergency medical care in the presence of a TIA, the clinical signs associated with this condition, the diagnostic work up, and the differential diagnosis are briefly discussed. A clinical example illustrates the difficulties that can be encountered in a case of TIA.

Brain Ischemia↗
PubMed2003

Therapeutic issues in women with epilepsy.

Approximately 20% of people with epilepsy are of childbearing potential and about 3 to 5 births per thousand will be to women with epilepsy. Both epilepsy and antiepileptic drugs can cause specific problems in women and embryos (less than 8 weeks of gestational age) or foetuses (more than 8 weeks of gestational age). The aim of this paper is to discuss therapeutic issues for the management of women with epilepsy: initiation of antiepileptic therapy, contraception, pregnancy, breast feeding and menopause. Some fertility issues are also discussed.

Anticonvulsants↗
PubMed2003

[How I treat ... essential tremor].

Essential tremor is the most prevalent movement disorder. This condition is often considered as benign but it can be the cause of considerable social, professional, and psychological handicap. It affects people of all ages but its prevalence increases with age (up to 5% of patients 65 or older). After discussing clinical aspects of this disorder, we review the current medical and surgical therapeutic options. Surgery may bring up spectacular improvement.

Diagnosis, Differential↗
PubMed2001

Light exposure and the risk of age-related macular degeneration: the Pathologies Oculaires Liées à l'Age (POLA) study.

BACKGROUND: The role of light exposure in the development of age-related macular degeneration (ARMD) has been questioned. We present the relationship between lifetime light exposure and ARMD as examined in the Pathologies Oculaires Liées à l'Age (POLA) study. METHODS: The POLA study is a population-based study on cataract and ARMD and their risk factors. It included 2584 residents of the town of Sète, located in the South of France. The presence of early and late ARMD was assessed on the basis of 50 degrees color fundus photographs using an international classification system. A questionnaire about light exposure was administered. RESULTS: Late ARMD (n = 38) was not significantly associated with any light exposure variable. Subjects exposed to high ambient solar radiation and those with frequent leisure exposure to sunlight had a decreased risk of pigmentary abnormalities (odds ratio [OR] = 0.61; 95% confidence interval [CI], 0.39-0.93, and OR = 0.70; 95% CI, 0.52-0.95, respectively) and of early signs of ARMD (OR = 0.73; 95% CI, 0.54-0.98, and OR = 0.80; 95% CI, 0.64-1.00, respectively). Subjects who had used sunglasses regularly had a decreased risk of soft drusen (OR = 0.81; 95% CI, 0.66-1.00). These relationships were not modified by further adjustments for potential confounders. CONCLUSION: Our study does not support a deleterious effect of sunlight exposure in ARMD.

Aged↗
PubMed2001

Associations of age, smoking habits and diabetes with plasma vitamin C of elderly of the POLA study.

The objective of this study was to determine the associations of age and sex with plasma vitamin C (vit C) concentration taking into account smoking habits and the presence of age-related pathologies, such as diabetes. The POLA study is a population-based study on age-related eye diseases and their risk factors, and plasma Vitamin C evaluation is part of the biological parameters measured in the 1987 volunteer subjects living in Sète (South of France) and aged more than 60 years. Men had lower average plasma vit C levels than women (31.6 microM.L-1 versus 40.3 microM.L-1, p = 0.001). Plasma vit C was stable as a function of age in women but decreased in men (p = 0.02), enhancing the difference in vit C concentration between men and women with advancing age. Smoking more than 10 cigarettes a day was associated to a lower plasma vit C concentration in men (p = 0.001) but not in women, and diabetic subjects tended to have lower vit C concentrations, the difference being significant only in women (p = 0.003). We conclude that there is a clear influence of sex on plasma vit C. This difference may be due to dietary habits, or metabolism, but may also be due to different sensitivity of age, smoking and to some pathologies.

Age Factors↗
PubMed2001

Relationships between physical activity, obesity and diabetes mellitus in a French elderly population: the POLA study. Pathologies Oculaires lieés á l' Age.

OBJECTIVE: To analyse the relationships between body mass index, waist circumference, waist-to-hip ratio, physical activity and the risk of type 2 diabetes in a French elderly population. DESIGN AND SUBJECTS: We conducted a cross-sectional study on 1113 men and 1419 women aged 60 y or more, participating in the POLA Study. RESULTS: The prevalence of diabetes was two-fold higher in men than in women (19.1% and 9.3%, respectively). The anthropometric variables studied-body mass index (BMI), waist circumference (WC) and the waist/hip ratio (WHR)-were all positively related to the prevalence of type 2 diabetes. The strongest relationships were found for BMI in men and WHR in women. In both genders, sport activity and diabetes were inversely linked whereas no relationship was shown between the amount of household activity and diabetes mellitus. CONCLUSION: In the elderly, overall obesity in men and abdominal fat accumulation in women appeared strongly related to diabetes. Sport activity was negatively and independently associated with the prevalence of diabetes mellitus.

Adipose Tissue↗
PubMed2001

Associations of cardiovascular disease and its risk factors with age-related macular degeneration: the POLA study.

The POLA study (June 1995 through July 1997) is a population-based study on cataract and age-related macular degeneration (AMD) and their risk factors in 2584 residents of Séte (South of France), aged 60--95 years. Classification of AMD was performed on 50 degrees fundus photographs, according to an international classification. The presence of cardiovascular disease and its risk factors was determined by interviewer-based questionnaire, clinical examination (anthropometry, blood pressure) and fasting plasma measurements. Using a logistic model adjusted for age and gender, late AMD was not significantly associated with a history of cardiovascular disease, diabetes, use of hypocholesterolemic drugs, hypertension, blood pressure or plasma lipids. Obese subjects (body mass index greater than 30 kg/m( 2)) had a 2.29-fold (95% confidence interval (CI): 1.00--5.23) and 1.54-fold (CI: 1.05--2.26) increased risk of late AMD and pigmentary abnormalities in comparison with lean subjects. Finally, the risk of soft drusen was decreased in those subjects with a history of cardiovascular disease (odds-ratio (OR) = 0.72, CI: 0.54--0.97), and increased with increasing levels of HDL-cholesterol (OR = 1.52, CI: 1.14--2.02). None of these results were modified by further adjustments for smoking, educational level and plasma alpha-tocopherol. These results need to be confirmed by other studies, which ideally should be longitudinal and prospective.

Aged↗
PubMed2000

Risk factors for cortical, nuclear, and posterior subcapsular cataracts: the POLA study. Pathologies Oculaires Liées à l'Age.

The POLA (Pathologies Oculaires Liées à L'Age) Study is a population-based study of cataract and age-related macular degeneration and their risk factors being carried out among 2,584 residents of Sète, southern France, aged 60-95 years. Recruitment took place between June 1995 and July 1997. Cataract classification was based on a standardized lens examination by slit lamp, according to Lens Opacities Classification System III. This paper presents results obtained from cross-sectional analysis of the first phase of the study. In polytomous logistic regression analyses, an increased risk of cataract was found for female sex (cataract surgery: odds ratio (OR) = 3.03; cortical cataract: OR = 1.67), brown irises (cortical, nuclear, and mixed cataracts: OR = 1.61), smoking (cataract surgery: OR = 2.34 for current smokers and OR = 3.75 for former smokers), known diabetes of 10 or more years' duration (posterior subcapsular, cortical, and mixed cataracts and cataract surgery: OR = 2.72), use of oral corticosteroids for at least 5 years (posterior subcapsular cataract: OR = 3.25), asthma or chronic bronchitis (cataract surgery: OR = 2.04), cancer (posterior subcapsular cataract: OR = 1.92), and cardiovascular disease (cortical cataract: OR = 1.96). Decreased risk of cataract was found with higher education (all types of cataract and cataract surgery: OR = 0.59), hypertension (cataract surgery: OR = 0.57), and high plasma retinol levels (nuclear and mixed cataracts and cataract surgery: OR = 0.75 for a 1-standard-deviation increase). Most of the risk factors identified in this study confirm the findings of other studies. The association of cataract with plasma retinol level requires further investigation.

Adrenal Cortex Hormones↗
PubMed2000

Light exposure and the risk of cortical, nuclear, and posterior subcapsular cataracts: the Pathologies Oculaires Liées à l'Age (POLA) study.

BACKGROUND: Exposure to light may be an important risk factor for the development of cataracts. OBJECTIVE: To present the relation of ambient solar radiation and professional and leisure exposures to light with the different types of cataracts. METHODS: Pathologies Oculaires Liées a l'Age (POLA) is a population-based study on cataract and age-related macular degeneration and their risk factors in 2584 residents of Sète (southern France). Cataract classification was based on lens examination at slitlamp according to Lens Opacities Classification System III. A questionnaire about light exposure was administered. RESULTS: After multivariate adjustment, participants who had higher ambient solar radiation had a 2.5-fold (95% confidence interval [CI], 1.2-5.0), 4.0-fold (95% CI, 2.0-8.0), and 2.9-fold (95% CI, 1.5-5.3) increased risk of cortical and mixed cataract and cataract surgery, respectively. Solar ambient radiation was not significantly associated with posterior subcapsular and nuclear cataracts. By contrast, posterior subcapsular cataracts were significantly associated with professional exposure to sunlight (odds ratio [OR], 1.63; 95% CI, 1.01-2.63) and frequent use of sunglasses (OR, 0.62; 95% CI, 0.43-0.90). Mixed cataract was also associated with professional exposure to artificial light (OR, 3.02; 95% CI, 1.03-8.82). CONCLUSION: Our study further confirms the role of sunlight exposure in the pathogenesis of cataract, in particular in its cortical localization.

Age Distribution↗
PubMed1999

Age-related macular degeneration and antioxidant status in the POLA study. POLA Study Group. Pathologies Oculaires Liées à l'Age.

OBJECTIVE: To give the levels of antioxidant nutrients in relation to age-related macular degeneration (AMD). METHODS: Pathologies Oculaires Liees a l'Age is a population-based study on cataract and AMD and their risk factors, carried out on 2584 inhabitants of Sete, France. Age-related macular degeneration was defined by findings from fundus photographs according to an international classification. Biological measurements were taken from fasting blood samples. RESULTS: After multivariate adjustment, plasma alpha-to-copherol levels showed a weak negative association with late AMD (P = .07). Lipid-standardized plasma alpha-tocopherol levels showed a significant negative association with late AMD (P= .003): the risk of late AMD was reduced by 82% in the highest quintile compared with the lowest. Similarly, lipid-standardized plasma alpha-tocopherol levels were inversely associated with early signs of AMD (odds ratio, 0.72 [95% confidence interval, 0.53-0.98]; P=.04). No associations were found with plasma retinol and ascorbic acid levels or with red blood cell glutathione values. COMMENT: These results suggest that vitamin E may provide protection against AMD. Only randomized interventional studies could prove the protective effect of vitamin E on AMD.

Aged↗
PubMed1999

Associations of antioxidant enzymes with cataract and age-related macular degeneration. The POLA Study. Pathologies Oculaires Liées à l'Age.

OBJECTIVE: Oxidative mechanisms may play an important role in the etiology of cataract and age-related macular degeneration (AMD). The authors present the level of two antioxidant enzymes in relation to cataract and AMD. DESIGN: Population-based, cross-sectional study on cataract and AMD and their risk factors. PARTICIPANTS: This study includes 2584 participants recruited among the residents of the town of Sète (in the south of France), who were 60 years of age or older. INTERVENTION/METHODS: Cataract was defined on the basis of slit-lamp examination, according to the Lens Opacities Classification System III, and AMD on the basis of fundus photographs according to an international classification. Biologic measurements were made centrally from blood samples for which the patient fasted. MAIN OUTCOME MEASURES: The presence of early and late AMD and of subcapsular, cortical, nuclear, and mixed cataracts was assessed and related to the levels of plasma glutathione peroxidase and erythrocyte superoxide dismutase. RESULTS: After multivariate adjustment, higher levels of plasma glutathione peroxidase (pIGPx) were significantly associated with a ninefold increase in late AMD prevalence, a sixfold increase in cortical cataract, and a twofold increase in nuclear and mixed cataracts. High levels of erythrocyte superoxide dismutase (SOD) activity were not associated with late AMD and early signs of AMD but were associated with a twofold increase in nuclear cataract. CONCLUSION: The authors show here, for the first time, a strong association of high levels of pIGPx with age-related eye diseases. High levels of SOD also are associated with increased risk of nuclear cataract. More data are needed at the biochemical and epidemiologic levels for a better understanding of these findings.

Aged↗