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Biomedical subjects

D Malvy

Publications and source records attributed to D Malvy.

At least 73 records · Page 4Linked to original sources

Effects of supplementation with a combination of antioxidant vitamins and trace elements, at nutritional doses, on biochemical indicators and markers of the antioxidant system in adult subjects.

OBJECTIVE: To test the impact of supplementation with nutritional doses of antioxidant nutrients on biochemical indicators of vitamin and trace element levels. DESIGN: A randomized double-blind trial was performed comparing two groups receiving daily either a combination of vitamins (beta-carotene, 6 mg; vitamin C, 120 mg; and vitamin E, 30 mg) and trace elements (zinc, 20 mg; and selenium, 100 micrograms); or a placebo. SUBJECTS: 401 subjects (166 males aged 45 to 60 years and 235 females aged to 35 to 60 years). MEASURE OF OUTCOME: Biological markers of vitamin and trace element status and free radical parameters were measured initially, 3 months, and 6 months after supplemention. RESULTS: Mean serum concentrations of alpha-tocopherol, vitamin C, beta-carotene, zinc and selenium increased significantly after 3 months of supplementation in the group receiving multivitamins associated with minerals. At baseline, 18.2% of the men and 5.1% of the women had low concentrations of serum vitamin C (< 20 mumol/l): 2.4% of the men and 17% of the women presented low concentrations of serum retinol (< 1.4 mumol/l): 18.7% of men and 10% of women had serum beta-carotene < 0.30 mumol/l. None of the study subjects had serum alpha-tocopherol concentrations below the limit cut-off point (< 9.3 mumol/l). Low serum zinc concentrations (< 10.7 mumol/l) were found in 15.1% of men and 23.8% of women. Low serum selenium concentrations (< 0.75 mumol/l) were found in 6% of men and 6.4% of women. A significant increase in plasma and red cell GPx activity was observed in groups receiving supplementation. No modifications were observed after 6 months of supplementation for malondyaldehyde. CONCLUSION: This study demonstrates the efficacy of an intake of antioxidant vitamins and trace elements, given at nutritional doses, on biochemical indicators of vitamin and trace elements status.

Adult↗

Background and rationale behind the SU.VI.MAX Study, a prevention trial using nutritional doses of a combination of antioxidant vitamins and minerals to reduce cardiovascular diseases and cancers. SUpplementation en VItamines et Minéraux AntioXydants Study.

The "SUpplementation en VItamines et MinérauxAntioXydants" (SU.VI.MAX) study is a randomized double-blind, placebo-controlled, primary prevention trial designed to test the efficacy of daily supplementation with antioxidant vitamins (vitamin C, 120 mg; vitamin E, 30 mg; and beta-carotene, 6 mg) and minerals (selenium, 100 micrograms; and zinc, 20 mg), at nutritional doses (one to three times the daily recommended dietary allowances), in reducing the frequency of major health problems in industrialized countries, and especially the main causes of premature death (cancers and cardiovascular diseases). The study involves 12,735 eligible subjects (women aged 35 to 60 years; men aged 45 to 60 years) included in 1994 in France. They will be followed up for 8 years. The objectives and the specific design of this intervention study are linked to its public health aim. The targeted population is the general population (not simply high-risk subjects) and the antioxidant agents tested are being administered at a level which is not pharmacologic and which may be attained by dietary intake of natural sources of these micronutrients and/or enriched foods. The amounts we are testing in the SU.VI.MAX study are those which, in observational studies have been associated with the lowest risk of diseases. This report presents the rationale and discusses the justification of the design, doses and combination of antioxidant micronutrients chosen in the SU.VI.MAX study.

Adult↗

Nutritional status and dietary intakes in human immunodeficiency virus (HIV)-infected outpatients in Abidjan, Côte D'Ivoire, 1995.

OBJECTIVE: To evaluate nutritional status and dietary intakes in HIV-outpatients in Abidjan, Côte d'Ivoire. DESIGN: Cross-sectional study. SETTING: In the Outpatients and Counselling Unit in the University Hospital in Treichville, and in the follow-up Unit of Blood Donors. SUBJECTS: 100 HIV-infected patients at different stages of the infection recruited consecutively in the two consultation services. MAIN OUTCOME MEASURES: Clinical, biological and anthropometric data were collected: weight, baseline weight, height, triceps skinfold (TS), arm circumference (AC), body mass index (BMI), muscular circumference (MC) and weight loss (WL). Dietary intake was estimated by the 24 h recall method. RESULTS: The M:F sex ratio was 1.1:1. Mean age was 32.5 y (30.7-34.4); 64% of the patients were symptomatic (S+). Mean weight was 58.7 kg (56.8-60.6) and mean BMI, 20.9 k/m2 (20.7-21.1); 67% of the patients had a BMI < 21.5 kg/m2. S+ patients had mean weight, BMI, AC and MC significantly lower than asymptomatic patients (P < 0.0001 = 0.001, 0.0003 and 0.004 respectively) and had suffered a more important WL (P < 0.0001). Immunodepressed patients had mean weight, AC and MC significantly lower than patients with a CD4 count > or = 200/mm3 (P = 0.04, 0.005 and 0.04 respectively). WL was independent of CD4 count. Protein, carbohydrate and fat intakes were respectively 59 g/24 h (52-66), 266 g/24 h (240-292) and 59 g/24 h (51-66). Energy mean intake was 7.6 MJ/24 h (6.9-8.4) and lower than WHO recommended intakes. CONCLUSIONS: In Abidjan, anthropometric parameters and dietary intakes of HIV-infected patients are worsened by clinical events. Nutritional intakes are generally lower than recommendations. Further studies are needed to determine if, in the African context, a causal relationship could exist between dietary intakes and nutritional status in HIV-infected patients.

Acquired Immunodeficiency Syndrome↗

[HIV infection, tuberculosis and tuberculin test in Switzerland. The Swiss HIV Cohort Study].

BACKGROUND: The usefulness of the tuberculin skin test (TST) for HIV-infected subjects may be questioned because false-negative results are increasingly common with advanced immune deficiency. The objectives of this research were thus to describe the use and the results of TST among patients with HIV infection in Switzerland and to measure the usefulness of isoniazid preventive chemotherapy and the incidence of tuberculosis (TB) relative to TST and CD4 cell count at the time of TST. DESIGN: Prospective multicentric cohort study of HIV infected patients; comparison of patients tested and non-tested, and of those with positive and negative TST. Multivariate comparison (Cox model) of TB incidence taking into account TST results and CD4 cell count at the time of TST. RESULTS: Out of 5802 patients followed up in the Swiss HIV cohort study as of September 1994, 34.6% were tested. Native Swiss were more likely to be tested than patients from high TB prevalence countries (36% vs 21% of native Africans). Patients registered after 1990 were more often tested than before (50% vs 26%). Of 2010 tested patients, 6.8% had a > 5 mm induration. African patients were more frequently TST positive (26%) than Swiss nationals (6%). Among patients with CD4 > 500 per mm3 at the time of the test, 16% were TST positive compared to 1% of those with CD4 < 200 per mm3. Out of 25 cases of tuberculosis among tested patients, 84% (21) occurred among TST-negative patients. Tuberculosis incidence among TST-negative patients with CD4 > or = 200 per mm3 at the time of the test was 0.3 per person-year. In comparison, the adjusted relative risk of tuberculosis among TST-positive patients with CD4 > or = 200 per mm3 was 5.5 (95% confidence interval [CI]: 1.2-23.9) and 6.6 (CI: 2.3-19.0) among TST-negative patients with CD4 < 200 per mm3. CONCLUSION: Despite its usefulness, TST is often performed too late and is therefore difficult to interpret. TST should be done as early as possible. TST should be done as early as possible. Among patients with CD4 < 200 per mm3, a negative TST should not preclude the use-of preventive chemotherapy, particularly in those originally from countries with a high incidence of tuberculosis.

AIDS-Related Opportunistic Infections↗

[A method to estimate the nutritional value of food sold by street vendors].

Food bought outside the house from woman vendors accounts for a significant part of the nutritional intake in urban areas in Africa regardless of age and socio-economic category of the inhabitants. Despite this fact outdoor food consumption is not adequately taken into account in relevant studies. The great variability in space and time of recipes used by vendors makes it very difficult to estimate the nutritional value of the food consumed. The purpose of the present study which was carried out on some female vendors in Bamako, Mali, was to evaluate a simplified assessment method. Assessment is based on information that vendors can easily provide: recipes including ingredients and quantities and sales figures. The results obtained were coherent and appeared to be fairly accurate. However they have to be confirmed by laboratory analyses. Compared to average per capita wages in Mali, the income of these female vendors appears to be high.

Cooking↗

[Motivations of volunteers for participation in an interventional study in the field of nutritional prevention: results of a pilot study of the SU.VI.MAX project].

In this paper, we try to understand the motivations and characteristics of people susceptible to be volunteers for the SU.VI.MAX study. The objective of this study will be to recruit and to follow during 8 years, a cohort of 15,000 subjects at a national level, for an intervention trial in the field of nutritional prevention. A short media campaign has been organised to recruit "1,000 volunteers to help to test and to validate tools specifically developed for the SU.VI.MAX study". In total, 15,789 subjects matching selection criteria answered to our invitation. All received a short questionnaire; 10,984 sent back correctly filled up questionnaires (70%) and 1005 were selected at random for a complete analysis. A lexical analysis of motivations disclosed 6 different groups organised in two poles. The pole of true altruists with a speech relative to notions such as "volunteers-benevolent" (7% of subjects), wishes to participate to a "humane task" (9% of subjects) or to progress of medical research (27% of subjects). The other pole corresponds to people interested personally by the theme of the project with 3 kinds of speech: personal past history (13% of subjects), interest for foods fortified with vitamins and/or minerals (19% of subjects) or for relationships between food consumption and health (22% of subjects).

Adult↗

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↗

Failure of thiamphenicol in a penicillin-allergic patient with Listeria meningoencephalitis--delayed cure following penicillin desensitization.

A 27-year-old woman, without compromised immunodefenses, experienced a Listeria meningoencephalitis, with brainstem symptoms. The identified agent exhibited poor susceptibility to usual effective antibiotics, except for penicillins. Knowledge of past history of an allergic reaction to beta-lactam antibiotics lead to appropriate therapy after acute intravenous desensitization of the patient to amoxicillin. Treatment resulted in therapeutic administration rate over 24 h, and in rapid regression of clinical and biological disorders.

Adult↗

Prevalence of malnutrition and vitamin A deficiency in the Diourbel, Fatick, and Kaolack regions of Senegal: a controlled study.

Two hundred and six Senegalese preschool children included in an epidemiological study were selected by their results from impression cytology with transfer (ICT) for assessment of their nutritional state by means of biological variables and for assessment of the diagnostic values of the ICT. A problem of protein-calorie malnutrition existed (transthyretin and retinol-binding protein concentrations were low) associated with vitamin A deficiency (retinol concentrations were low). The sensitivity and specificity of the ICT defined with respect to retinol (threshold fixed at 0.35 mumol/L) varied with the classification criteria of ICT and seemed to be fairly insensitive but specific.

C-Reactive Protein↗

Kawasaki disease and oxidative metabolism.

The plasmid lipid peroxidation products: malonyldialdehyde (MDA), organic hydroperoxides (OHP) and zinc peripheral values were analysed in seven children with Kawasaki disease, in the acute phase, before and after treatment with intravenous immunoglobulins. In the acute phase, plasma levels of MDA (2.95 +/- 0.30 mumol/l, control group: 2.52 +/- 0.08 mumol/l) and OHP (235 +/- 65 mumol/l, control group: 120 +/- 10) were increased (p less than 0.05 and p less than 0.01). Moreover, plasma zinc levels were significantly decreased (10 +/- 2.15 mumol/l versus 15.6 +/- 2.5 mumol/l in control group, p less than 0.05). After treatment with immunoglobulins, MDA, OHP and plasma zinc levels returned to normal. The parallel normalisation of clinical injury draws attention to the possible role of oxygen intermediates in connective tissue degradation and in the pathogenesis of vascular abnormalities in Kawasaki disease.

Acute-Phase Reaction↗

[Evaluation of nutritional status in chronic renal insufficiency].

No nutritional criteria have been validated in uremic patients. Chronic renal failure directly alters biological nutritional criteria. Anthropometric criteria are inadequate to routine follow up, but advisable to compare groups of patients. Quantitative evaluation of nitrogen ingestion and excretion allows to control dietetic compliance. They can not be used to check long term nitrogen balance. Nutritional criteria fail to diagnose mild undernutrition in uremic patients but they help to detect patients at risk to develop undernutrition when ascribed to low protein diets. Food inquiries, conducted by well trained dietitians are quite advisable, and helpful to the patients.

Amino Acids↗