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Biomedical subjects

D Toussaint

Publications and source records attributed to D Toussaint.

At least 19 recordsLinked to original sources
PubMed1991

First microangiographic abnormalities in childhood diabetes--types of lesions.

An analysis by fluorescein angiography of the first signs of retinopathy in 161 diabetic children showed that microaneurysm-like spot dilatations, microaneurysms, focal capillary dilatations, leakage, generalized capillary dilatations, retinal hemorrhages, areas of capillary non-perfusion and capillary remodelling, in decreasing order of frequency, were features of the onset of retinopathy. However, microaneurysm-like spot dilatations and both focal and generalized capillary dilatations were considered to be too subjective for use in further quantitative analysis. Retinopathy was not found in children less than 12 years of age and was detected only after at least 3 years of diabetes. The mean duration of diabetes before the occurrence of the first lesions in 118 affected eyes was 8.2 years. The mean age at which lesions occurred was 16.4 years. Although capillary non-perfusion was rarely an initial lesion, occurring after a longer duration of diabetes and at a later age than the other lesions, no significant difference could be found between the various types of lesions for either the patient's age at their onset or the duration of diabetes. The type of initial lesion was also unrelated to sex, age at the onset of diabetes, or metabolic control.

Adolescent↗
PubMed1991

[Stable elastic nailing applied to diaphyseal fractures of the forearm in children].

Elastic stable intramedullary nailing is the ideal internal fixation in children; the technique is not aggressive and the physiological periosteal consolidation is respected. This treatment is complementary to the conservative approach. The authors report their experience in 20 patients, aged 4 to 17 years. Primary instability (16 cases) and repeated fractures (3 cases) were the main indications. The operative technique is described. Open reduction was necessary for one or both forearm bones in 9 children. There were technical problems, but without consequences for the consolidation, which was always complete after 2 1/2 months, without cast immobilization. In all patients, the function was normal after 2 months. There were no serious complications. The fixation material should not be removed during the first postoperative year, in order to prevent refractures.

Adolescent↗
PubMed1985

Peroneal motor nerve conduction velocity in diabetic children and adolescents. Relationships to metabolic control, HLA-DR antigens, retinopathy, and EEG.

To investigate incipient diabetic neuropathy, peroneal motor nerve conduction velocity (PMNCV) was measured in 61 diabetic children and adolescents whose type 1 diabetes became clinically apparent before the age of 14 years. PMNCV in diabetic patients (48.3 +/- 5.6 m/s) was significantly lower than in controls (56.5 +/- 5.5 m/s), 23 diabetics (36%) having a value more than 2 SD below the mean for normals. There was a highly significant negative correlation between PMNCV and HbA1 levels concomitant with PMNCV measurement or mean annual HbA1 concentrations preceding PMNCV. The relationship between PMNCV and the clinical score of diabetic control since the onset of the disease was also significant. Age, duration of diabetes and HLR-DR antigens were unrelated to PMNCV. EEG abnormalities and retinopathy, whose pathogenesis is different, were not necessarily associated with subclinical neuropathy. Being easy and sensitive, PMNCV determination provides the paediatric diabetologist and the patient himself with an important motivation to improve diabetic control.

Adolescent↗
PubMed1985

Transient acute disc swelling associated with improved metabolic control in an adolescent with type-I diabetes: role of dexamethazone therapy.

Acute disc swelling in type-I diabetic patients is a distinct syndrome that may be distinguished clinically, particularly from papilloedema due to increased intracranial pressure. This paper reports the first detailed case of this rare condition in which disc swelling seems to be associated with rapid improvement of metabolic control. We suggest that the pathogenesis of disc swelling is related to a local breakdown of the blood retinal barrier at the level of the optic nerve, resulting in an intense leakage. Compression of the optic nerves secondary to this vasculopathy appeared to be reversed by administration of dexamethazone. It is suggested that in diabetic patients with long-standing poor metabolic control, rapid conversion to good metabolic control could have this result. However further information is necessary to substantiate this relationship.

Adolescent↗
PubMed1983

Clinicopathological study of the visual pathways, eyes, and cerebral hemispheres in 32 cases of disseminated sclerosis.

The pathological study of the cerebral hemispheres and visual pathways in 32 cases of disseminated sclerosis, including 15 cases in which the retinal structures were investigated, lead us to point out: 1) the high frequency of histological lesions of the optic nerves, tracts and radiations; 2) the lack of correlation between the extent of demyelination of the optic nerves and the impairment of visual acuity that is mainly related to axonal lesions; 3) the relative high frequency of pathological sheathing of retinal veins; and 4) the high proportion of shadow plaques in the cerebral hemispheres in cases with clear-cut relapses and remissions.

Adult↗
PubMed1982

[Glycosylated hemoglobin and clinical evaluation of the degree of diabetes control. Relation to blood sugar, blood cholesterol, blood triglycerides, and the duration of diabetes and retinopathy. Study of 85 diabetic children and adolescents].

The measurement of HbA1 gives an "objective" estimate of the degree of metabolic control of diabetes during the erythrocyte lifespan. 333 assays in 85 young diabetics aged three to twenty-three years showed a mean HbA1 of 10.9 +/- 2.6% (controls: 7.4 +/- 1.4%). HbA1 levels parallel the clinical evaluation of the degree of control. HbA1 concentrations are correlated with the duration of diabetes (r = 0.26; p less than 0.001), triglyceridemia (r = 0.22; p less than 0.001), cholesterolemia (r = 0.26; p less than 0.001) and glycemia (r = 0.50; p less than 0.001). The HbA1 glycemia correlation grows stronger as glycemia increases. This probably reflects the existence of a labile form of HbA1. HbA1 concentrations measured repeatedly over one year were not significantly different in diabetics with and without retinopathy, probably because the study period was too short. Measurement of HbA1 is also of value in diagnosing non-compliance.

Adolescent↗
PubMed1981

Adult form of basal cell naevus syndrome: a family study.

A 32-year-old patient had marked reduction of visual acuity due to falciform folds of the retina and retinal detachment, and severe neurological abnormality: bilateral pyramidal involvement, fasciculation in all limbs and gait ataxia. Skull radiographs showed internal frontal hyperostosis; CT scan showed calcification of the falx cerebri, and multiple arachnoid cysts were shown by myelography. A naevoid lesion had previously been removed from the left forearm. There was a history of ophthalmological symptoms in the mother and the daughter of the propositus. His son has "café au lait" spot on the abdomen and dentigerous cysts. The diagnosis of an adult form of basal cell naevus syndrome with an autosomal dominant mode of inheritance is discussed.

Adult↗