PubMed Health⌕ Search

Biomedical subjects

E Brottier

Publications and source records attributed to E Brottier.

12 recordsLinked to original sources
PubMed1987

Prevalence of legionellosis among adults: a study of community-acquired pneumonia in France.

Over a 24-month period, 274 patients with community-acquired pneumonia were hospitalized in Departments of Medicine at hospitals in Bordeaux, Lyon, Marseille, and Toulouse. Etiology of the pneumonia was determined either by organism identification or by indirect immunofluorescence in only 139 cases (51%). The most frequently isolated etiological agents were Streptococcus pneumoniae (34 cases), Legionella pneumophila (29 cases) and Mycoplasma pneumoniae (24 cases). The majority of patients with legionellosis were male (79%), middle aged (mean age: 53 years), and living in urban areas (69%). Their clinical features were atypical and did not differ from those of other pneumonias. Four patients with legionellosis (13.8%) died. L. pneumophila was isolated directly in only three instances. The study confirms the high prevalence of legionellosis (20%) among pneumonias of identified etiology. The fact that these cases had an atypical clinical presentation and that isolation of the organism was difficult reinforce the need to apply the CDC criteria for the interpretation of positive serological titers.

Age Factors↗
PubMed1987

Use of the glucose clamp technique for confirmation of insulinoma autonomous hyperinsulinism.

The diagnosis of insulinoma on the basis of persistent hypoglycemia requires further confirmation. The insulin suppression test has been used to support this diagnosis prior to surgical intervention. In this study the euglycemic clamp technique was used to compare five control volunteers with four hypoglycemic patients with suspected insulinoma. Insulin was infused over successive two-hour periods at 2, 4, and 8 mU/kg/min. Plasma glucose levels were clamped at 80 mg/dL (4.4 mmol/L) using an artificial pancreas. High insulin levels were measured in all subjects, ranging from 225 +/- 30 microU/mL (1614 +/- 215 pmol/L) to 1018 +/- 239 microU/mL (7304 +/- 1714 pmol/L). Levels of C peptide fell to 0.1 ng/mL (0.028 nmol/L) in control subjects but remained at high levels in the patients. Insulinoma was confirmed on laparotomy in all four patients. In two patients tested after removal of the tumor the results were found to have returned to normal.

Adenoma, Islet Cell↗
PubMed1985

Metformin improved insulin resistance in type I, insulin-dependent, diabetic patients.

The biguanides have been shown to reduce insulin requirements in type I (insulin-dependent) diabetic patients with an increase in insulin binding to insulin receptors. The aim of this was to measure the effect of metformin (850 mg/twice daily) on insulin sensitivity. Ten type I diabetic patients of normal weight received metformin or placebo in addition to their insulin therapy for seven days. On the last day of metformin or placebo treatment, tissue sensitivity was measured by the euglycemic hyperinsulinaemic clamp procedure using the artificial pancreas. An 18% improvement in glucose uptake was observed after metformin therapy (P less than 0.01). Metformin was therefore effective in improving the insulin action in type I diabetic patients, although its use in such circumstances requires consideration of several other factors.

Adolescent↗
PubMed1985

[Peripheral sensitivity to insulin in aged subjects].

Insulin sensitivity has been studied in ten young patients (22 years old means) and in eleven elderly patients (72 years old means). They were free of family diabetes history, glucose intolerance, hypertriglyceridemia, hepatic or renal failure or factor of insulin resistance such as infectious diseases. A two hours hyperinsulinic euglycemic clamp was done with an artificial pancreas (Biostator GCIIS Miles). The ten young patients and the eleven old patients had a stable hyperinsulinic level (93.3 +/- 5 uu/ml and 90 +/- 8 uu/ml) they respectively required 8.08 +/- 0.73 and 5.5 +/- 2.5 mg/kg/min of glucose. Metabolic clearance of insulin does not seem altered with aging. For a same hyperinsulinic level the glucose requirement is less in old patients. So there is an apparent insulin resistance in aging.

Adult↗
PubMed1985

[Bromocriptine in Parkinson's disease: pleuropulmonary toxicity].

The authors report a case of pleuro-pulmonary fibrosis after 9 months of high dose bromocriptine therapy for the treatment of Parkinson's disease. When the drug was stopped there was a significant improvement of the clinical state with complete regression of chest pain and dyspnea of effort. The major inflammatory biological syndrome disappeared completely. Chest X-rays showed partial improvement with signs of pleural pneumonitis. The results of ventilatory and respiratory function tests stabilised. After one year follow-up, the causal relationship of this iatrogenic pathology has therefore been established. The initial diagnostic problems are stressed, particularly with respect to malignant disease (mesothelioma) when there has been exposure to asbestos, as in our case. The early stages must be carefully looked for so as to prevent fibrosing complications. The presence of immune complexes in our case could indicate immuno-allergic mechanism.

Bromocriptine↗
PubMed1984

Prosthetic valve endocarditis: diagnosis and prognosis.

From 1972 to 1982, 22 patients were admitted for prosthetic valve endocarditis on homografts (3), bioprostheses (2) or mechanical prostheses (17). Staphylococcus epidermidis was the most common aetiologic agent in early-onset endocarditis and streptococci in late-onset. Echo-cardiographic or cinefluoroscopic findings enhanced diagnosis mainly in advanced stages of the disease. Despite medical therapy and prompt reoperation in most cases, mortality remains high: 66%, 80% in the early group, 50% in the late group; the prognosis was definitely improved, however, by surgical treatment.

Bioprosthesis↗
PubMed1984

Influence of glycaemic normalisation by an artificial pancreas on phagocytic and bactericidal functions of granulocytes in insulin dependent diabetic patients.

Ten insulin dependent diabetic patients were maintained in normoglycaemia for 36 h with an artificial pancreas. Circulating polymorphonuclear leucocytes were extracted and incubated with staphylococcus before and after treatment; phagocytic and bactericidal activities were studied. Granulocytes from diabetic patients showed a decreased ability to absorb staphylococcus and a reduced capacity for intracellular destruction of bacteria. These two functions were improved after 36 h of normoglycaemia but were not corrected.

Adult↗
PubMed1984

[Feasibility and reproductibility of a euglycemic hyperinsulinic glucose clamp technic].

The euglycemic hyperinsulinaemic clamp is a means for the study of insulin sensitivity. Several techniques have been described: some are manual, others are automatic and use hypertonic glucose (50%). A semi-automatic technique is described using an artificial B cell (Biostator Miles) and a pump (Vial). The method and its reproductibility in ten healthy subjects were studied. The choice of appropriate algorithms ensure a constant and stable insulin level of 93,3 +/- 5 uU/ml and good glycemic feedback through graduated glucose perfusion. The use of a supplementary pump in series with an artificial pancreas insures basic glucose input without recourse to strong concentrations (20%); glycemic feedback of the artificial pancreas is thereby dynamically controlled. The glucose requirement is 8,08 +/- 0,73 mg/kg/min. The same values are found in the same patients three weeks later and resemble those obtained using other techniques. Automatic feedback makes the technique objective; low concentration glucose solution avoids damage to veins.

Adult↗
PubMed1984

[Symptoms and incidence of hypoglycemia in 100 insulin dependent diabetics].

The aim of this study was to discover the frequency and the symptoms of hypoglycaemic reaction and coma. One hundred type I diabetic patients answered an oral questionnaire and explained how they were awaken from their hypoglycaemicoma. The frequency of hypoglycaemic reaction was from one a day to one a year. 41 patients had nocturnal hypoglycaemic reactions. Our patients described 27 different symptoms of oncoming attack; however, not all of these symptoms was experienced by any one of the patients. Treatment of hypoglycaemic reaction was administered correctly but at the precise moment of the interview, 13% of patients had no carbohydrates with them. 42 patients had had hypoglycaemic reaction but no coma. Shared between 48 patients were 578 insulin years and 148 comas. Treatment of hypoglycaemic coma was variable: 20 patients remained at home receiving appropriate treatment; 33 were always hospitalised on attack and 20 were still comatous on each admission. The explanation of hypoglycaemic attack was variable; an emotional factor was given by 19% of patients. Both type I diabetic patients and their immediate entourage should be made aware of all the symptoms of oncoming attack and of the treatment of hypoglycaemic coma. Systematic glycemic auto control should testify to the existence of genuine hypoglycaemic reaction and perhaps diminish its supposed frequency.

Adolescent↗