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F Vauzelle-Kervroedan

Publications and source records attributed to F Vauzelle-Kervroedan.

14 recordsLinked to original sources
PubMed1999

[Epidemiology, management and costs of type 2 diabetes in France in 1998].

Almost 10 years after the Saint Vincent declaration, a large effort was undertaken in France to improve medical care of type 2 diabetes and to limit the dreadful complications of this pathology. As expert recommendations grow in number, it appears necessary to update knowledge on the epidemiological, medical care, and cost aspects of this illness in France. In this aim, a systematic review of the medical and economic literature on type 2 diabetes was performed. Prevalence of type 2 diabetes probably reaches 2.2% in the general population, which represents 1.3 million people in France. Among these people, almost 60% are overweighted, 50% suffer high blood pressure and 30% have a treated dyslipaemia. Coronary pathologies concern 20% to 30% of type 2 diabetes patients, neuropathies 10% to 30% and ocular problems 10% to 35%. Medical care consumption of type 2 diabetes patients probably represents almost 20,000 FF per patient and per year, i.e., twice the average medical care consumption in the French population. Yet, these estimates should be considered with caution since a lot of uncertainty remains on the epidemiological, medical care, and cost aspects of type 2 diabetes in France. As diabetes has become a national public health priority, it is important to initiate new studies to have precise indicators in these different fields.

Aged↗
PubMed1998

[Retrospective survey of fluoroquinolone use in children].

BACKGROUND: Fluoroquinolones (FQ) are contraindicated in children because of the risk of cartilage damage. POPULATION AND METHODS: A retrospective survey concerning the use of FQ in children during the first 6 months of 1993 was organized in 1994. One hundred and sixty-seven Heads of pediatric departments were questioned. RESULTS: One hundred and fifty (90%) of those surveyed responded: 62 (41.3%) were FQ prescribers, 83 (55.3%) were non prescribers and five (3.4%) were not able to answer. Among the 62 prescribers of FQ, 17 departments (27%) were not able to indicate the number of prescriptions and 45 departments (73%) reported one to 75 prescriptions during the study period. Twenty-one departments out of the 45 were not able to identify the children treated with FQ. We obtained a group of 104 children aged 9.0 +/- 5.0 years (mean +/- standard deviation [SD]), treated with 165 courses of FQ during 20 +/- 45 days (1-535 days) with concomitant treatments for 132/165 courses (80%). Fifty children (48%) were suffering from cystic fibrosis, 37 children (36%) were not, and, in 17, the diagnosis was not determined (16%). The FQ treatment administered either orally (73%) or intravenously (26%) was ciprofloxacin in 69% of the courses with a 25.1 +/- 7.0 mg/kg/day oral dose (mean +/- SD dose), and a 23.5 +/- 11.4 mg/kg/day intravenous dose, pefloxacin in 23 courses/165 (14%) with a 17.2 +/- 3.8 mg/kg/day dose, ofloxacin in 15 courses/165 (9%) with a 21.0 +/- 11.9 mg/kg/day dose, norfloxacin in 13 courses/165 (8%) with a 25.6 +/- 7.5 mg/kg/day dose. Twenty-one adverse events were reported in 17 children (16%) (11 of them with cystic fibrosis). These were cutaneous events (photosensitivity, cutaneous eruption) in eight courses, rheumatologic events (arthralgia, arthritis) in seven courses and gastrointestinal events (nausea, vomiting, diarrhea) in three courses. CONCLUSION: This survey shows that FQ are prescribed in children although their use is not approved in this age group and that numerous side effects have been recorded. The absence of exhaustive information (due to the retrospective nature of the survey) and the difficulties in interpreting the side effects for which validity and causal assessment have not been worked out according to a standardized method and in the absence of a control group stress the need for a prospective study.

Adolescent↗
PubMed1997

Metoclopramide plasma concentration in neonates.

During the course of a multiple-dose metoclopramide (M) oral treatment, M plasma concentrations were measured just before (Cmin) and 1 hour after the administration (C1h) at steady-state in 5 (3 premature and 2 term) neonates. Mean Cmin was equal to 91.6 +/- 45.5 ng/ml and higher than C1h (87.4 +/- 43.2 ng/ml), but not significantly. A significant negative correlation was found between Cmin plasma concentration and gestational age as well as with postconceptional age, suggesting that the lower the gestational and postconceptional age, the lower the metoclopramide dosage should be.

Child↗
PubMed1996

Effect of stiripentol on carbamazepine plasma concentration and metabolism in epileptic children.

OBJECTIVE: To study the relationship between the plasma concentration of stiripentol (STP), a new antiepileptic drug, and its inhibitory effect on the formation of carbamazepine epoxide (CBZE) in epileptic children treated with carbamazepine (CBZ) either alone or in combination with another antiepileptic drug. METHODS: Minimum plasma concentration of antiepileptic drugs was measured before initiation of STP therapy (day 0) and on days 28 (STP 60 mg.kg-1.day-1) and 84 (STP 90 mg.kg-1.day-1) by HPLC. RESULTS: The CBZE/CBZ plasma concentration ratio decreased exponentially with increasing minimum plasma STP concentration (r = 0.80). The asymptote of the curve allowed the calculation of the minimum plasma STP concentration required to obtain the maximum inhibitory effect, i.e. 6.7 mg.l-1. CONCLUSION: The inhibitory effect of STP on CBZ metabolism expressed as the CBZE/CBZ plasma concentration ratio is dependent on STP plasma concentration, with a maximum effect at an average of 7 mg.l-1. The present data suggest that in order to evaluate the anticonvulsant efficacy of STP as add-on therapy, the minimum plasma STP concentration should be maintained above 7 mg.l-1 and the dosage of CBZ should simultaneously be decreased in steps by more than 50% to minimize the change in CBZ plasma concentration.

Adolescent↗
PubMed1996

Non invasive in vivo study of the maturation of CYP IIIA in neonates and infants.

OBJECTIVE: Cytochrome P450 III (CYP III) has previously been demonstrated in vitro in fetal liver. METHODS: A study was performed in 7 premature, 13 term neonates and 30 infants to assess whether or not maturation had any influence on CYP IIIA activity in children from birth to 1 year of age. A simple non invasive procedure was used (6 beta OHF/FF concentration ratio in a morning spot urine sample). RESULTS: The 6 beta OHF/FF ratio was 7.2, 7.9 and 5.0 in premature and term neonates and infants, respectively. CYP IIIA activity is present at birth, with a 6 beta OHF/FF ratio comparable to adults. Its activity seemed lower in infants. This might be due to the decrease in CYP IIIA7 activity during maturation after birth, which might be more rapid than the increase in CYP IIIA3/4 activity.

Age Factors↗
PubMed1996

Clinical correlates of advanced retinopathy in type II diabetic patients: implications for screening. The CODIAB-INSERM-Zeneca Pharma Study Group.

The clinical correlates of advanced retinopathy were determined in a sample of 427 type II diabetic outpatients, aged 35 to 74 years, recruited in eight centers from all parts of France. The presence of retinopathy was assessed by fluorescein angiography with centralized interpretation. Advanced retinopathy (proliferative and/or macular edema) was independently linked with nephropathy, peripheral neuropathy, and insulin therapy. Prevalence of advanced retinopathy was 1.6% in the absence of signs of nephropathy and/or peripheral neuropathy, 10.4% in patients with mild signs, and 17.5% in patients with moderate to severe signs. Overall, 87% of the patients with advanced retinopathy had signs of nephropathy and/or peripheral neuropathy. In conclusion, patients showing signs of nephropathy and/or peripheral neuropathy should be sent in priority to an ophthalmologist. Prospective data are necessary to determine if screening is necessary in patients with no signs of nephropathy or peripheral neuropathy.

Adult↗
PubMed1995

Visual impairment in type 2 diabetic patients. A multicentre study in France. CODIAB-INSERM-ZENECA Pharma Study Group.

The prevalence and causes of visual impairment have been estimated in a sample of 423 Type 2 diabetic outpatients, aged 35 to 74 years, recruited in 8 centres from all parts of France. The presence of retinopathy was assessed by fluorescein angiography with centralized interpretation. The presence of cataract and glaucoma was also recorded. Prevalence of blindness was 1.2%. Moderate visual impairment affected 7% of the patients. The major cause of blindness was cataract, explaining 38% of the cases of blindness. Retinopathy was associated to blindness in 2 cases out of 26. More than half of the patients with proliferative retinopathy and the third of those who had macular edema had been treated by photocoagulation. According to the present patient material, retinopathy is a minor cause of visual impairment in Type 2 diabetic patients, cataract remaining the major cause. This reflects the introduction of photocoagulation into ophthalmologic practice.

Adult↗
PubMed1995

Pharmacokinetics of cetirizine in 2- to 6-year-old children.

Eight children (3.84 +/- 1.17 years old) received a single oral 5 mg cetirizine dose (0.32 +/- 0.07 mg.kg-1) as a 10 mg.ml-1 solution, 1.73 (+/- 0.64) hours before a minor surgical intervention (mean duration +/- SD = 0.90 +/- 0.25 h). Seven venous blood samples were collected before administration (t0) and 0.5 h, 1.5 h, 4 h, 8 h, 12 h and 24 h after dosing, and urine samples were collected up to 24 hours after the dose. The mean +/- SD kinetic parameters were: peak plasma level (Cmax) 607 +/- 231 micrograms.l-1 reached in 1.93 +/- 1.39 h (tmax), elimination half-life (t1/2) 5.55 +/- 0.98 h, area under the plasma concentration time curve (AUC0-infinity) 4,772.1 +/- 1,318.4 micrograms.l-1.h, mean residence time (MRT) 8.13 +/- 1.31 h, apparent plasma clearance (Cl/f) 1.27 +/- 0.80 ml.min-1.kg-1, apparent volume of distribution (Vz/f) 0.60 +/- 0.38 l.kg-1. Urinary recovery was 38.4 +/- 9.9% (n = 4) of the dose. Renal clearance was 0.42 +/- 0.10 ml.min-1.kg-1 (n = 6). No influence of age on the cetirizine parameters was evidenced among this group, except for MRT (p < 0.05) which decreases with age. When compared with results in adults, elimination half-life (t1/2) was twice as short and apparent clearance twice as great. These results suggest that a higher dosage b.i.d. may be required in children.

Administration, Oral↗
PubMed1995

Prevalence of non-insulin dependent diabetes as perceived by general practitioners in France.

A representative, random sample of French general practitioners, reported the number of diabetic patients they treated in their practices. The resulting NIDDM prevalence rate for France was 1.71% (SE +/- 0.03), compatible with the rates found in other studies. Prevalence rates for NIDDM were also calculated by region and a multivariate covariance model was used to correlate the prevalence with known risk factors. The three significant factors were: the quantity of wine consumed, the female/male sex ratio of people over 45 years of age, both positively correlated, and the consumption of animal fats, which was negatively correlated with NIDDM prevalence.

Aged↗
PubMed1994

Maternal effect and familial aggregation in NIDDM. The CODIAB Study. CODIAB-INSERM-ZENECA Study Group.

Non-insulin-dependent diabetes mellitus (NIDDM) is known to have a strong genetic basis, but the mode of inheritance is still unknown. Recent studies have suggested that maternal inheritance is important; this complicates the transmission pattern of NIDDM. In our study, the familial aggregation of diabetes and the maternal effect were investigated through three generations. The CODIAB Study recruited 536 NIDDM patients between 35 and 74 years of age from 10 diabetes centers in France. Familial aggregation was confirmed: among 218 NIDDM patients, 66% had at least one diabetic relative. Mothers were implicated 2 times more frequently than fathers (P < 0.001). This maternal effect was confirmed because more diabetic cases were noted among maternal than paternal aunts and uncles (P < 0.02). When we considered the next generation, women had more diabetic offspring than men (P < 0.01). Other factors susceptible to modify the familial aggregation were considered. The maternal effect was not significantly related to the patients' ages (P > 0.2). The genetic component was more important when the diagnosis was made earlier, but the maternal effect was homogeneous (P > 0.3). In conclusion, we found a familial aggregation of diabetes that suggests a strong genetic component with a mode of inheritance that may be influenced by a maternal environment.

Adult↗
PubMedDate not supplied

Low prevalence of long-term complications in non-insulin-dependent diabetes mellitus in France: a multicenter study. CODIAB-INSERM-ZENECA Pharma Study Group.

The aim of this study was to assess the prevalence of long-term complications in a large sample of French NIDDM patients. Therefore, 427 NIDDM patients 35-74 years old were recruited in ten centers. Standardized clinical criteria and central reading for retinal and electrocardiographic changes were used to assess the presence of complications. The prevalence rates of complications were 29.7% and 3.3% for background and proliferative retinopathy; 21.8%, 6.1%, and 2.8% for microalbuminuria, proteinuria, and renal insufficiency; 19.9 and 11.7% for asymptomatic and symptomatic pheripheral neuropathy; 8.2% for orthostatic hypotension; 10.1% and 8.4% for angina pectoris and myocardial infarction; and 13.1% and 6.3% for mild and moderate to severe peripheral vascular disease, respectively. In conclusion, prevalence rates in this study were lower than in most studies from other countries.

Adult↗
PubMedDate not supplied

[Analysis of diabetes-related mortality in France (1970-1987) from multiple causes of death].

The aim of this study was to analyse the characteristics and the mortality rate of diabetic patients, in France, between 1970 and 1987, as well as the association between diabetes and other pathologies at death. These results are based on both the underlying and the associated causes of death registered on the death certificate, in contrast to most studies which use only the underlying cause. In 1987, there were 16,790 deaths in France for which diabetes was mentioned on the death certificate (as the underlying cause in 38% of cases). There was a higher mortality in male diabetic subjects then in female, for all ages except over 75 years. Between 1970 and 1987, the mortality decreased for both sexes, except for the oldest age group. The death rate varied greatly between geographical regions. A particularly high mortality occurred in the Nord-Pas-de-Calais, Lorraine and Alsace. Diabetes was significantly associated, at death, with other diseases and pathologies. The most frequent were vascular diseases (ischaemic heart disease, cerebral diseases and hypertension) and diseases of the genitourinary system. It if of note that 5% of the death certificates of these diabetic subjects indicated diabetic coma as a cause of death.

Adult↗
PubMedDate not supplied

[Regional prevalence of diabetes treated with oral hypoglycemic agents].

The regional prevalence of diabetes, in France, has been studied using data from a nationwide household survey conducted by INSEE and CREDOC, two national demographic statistics institutes, in a representative sample of 7,323 households (21,007 subjects). Each subject reported, on a form, all the drugs bought during the study period. Subjects reporting, at least once, an antidiabetic oral drug were classified as diabetic. Two hundred and sixty six subjects reported having bought one or more oral antidiabetic drugs, leading to an overall prevalence rate of 1.27%. Prevalence rates were calculated by region (range: 0.86% Pays de Loire--2.77% Franche-Comté) and by large administrative areas (ZEAT) (range: 0.90% Nord-Pas-de-Calais--1.92% Est). In both cases, a North-west, South-east gradient appeared, with the lowest rates in the North and West of France. This trend was maintained after standardization according to the age distribution in the regions studied. The rates are similar to other data in the literature, in particular those derived from national drug sales data, but there is no explanation for this inter regional variability, which merits specific surveys.

Administration, Oral↗