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H Mayaudon

Publications and source records attributed to H Mayaudon.

At least 73 records · Page 4Linked to original sources
PubMed1996

A prevalence survey of diabetes in Mauritania.

OBJECTIVE: To perform an epidemiological study of the prevalence of diabetes in Mauritania, West Africa, with little data available on diabetes in West Africa. RESEARCH DESIGN AND METHODS: The study was performed with a representative sample of the Mauritanian population. A random selection of the study population (n = 744) was drawn by a cluster sampling method. Screening for diabetes was made by capillary blood glucose (CBG) measurement, using strips analyzed by reflectance meter. Criteria for the diagnosis of diabetes were those of the World Health Organization (WHO). RESULTS: The survey performed a screening of 744 subjects whose sex distribution was 307 men and 437 women. Their mean age was 34.6 +/- 15.2 years, and their mean BMI was 22.7 +/- 5.1 kg/m2, with a significant difference for BMI between men (20.0 +/- 2.9 kg/m2) and women (24.3 +/- 5.5 kg/m2). According to the study criteria, we found 14 diabetic patients (4 men, 10 women). The crude prevalence of diabetes was 1.88% (95% CI 0.90-2.86). The difference in prevalence by sex was 1.30% (95% CI 0.00-2.60) for men and 2.29% (95% CI 0.89-3.43) for women. For the truncated 30- to 64-year-old age-group, the crude prevalence was 2.84%; the age-adjusted prevalence for the same 30- to 64-year-old age-group, using the standardized age distribution of Segi (10), was 2.61%. CONCLUSIONS: With a crude prevalence of diabetes of 1.88% and an age-adjusted prevalence of 2.61%, Mauritania may be classified among the countries with a low prevalence of diabetes, a finding which is not surprising, considering the low level of development of this region of Africa.

Adolescent↗
PubMed1996

[Prolactinoma and pregnancy. Six cases and review of the literature].

Prolactinoma is the most frequent of secreting pituitary adenomas. It is often discovered among women of childbearing-age presenting an association of amenorrhea and galactorrhea. Data in the literature from large series indicate the current risks of interaction between prolactinoma and pregnancy. Risks have been overestimated in the past and it is now recognized that pregnancy can be allowed providing strict follow-up is assured. Dopaminergic drugs have no teratogenic side-effects and are known to allow tumoral control and recovery of fertility in the majority of cases. The use of these medications explains the reduction of indications for surgery. Microprolactinomas are highly influenced by pregnancy and can even lead to tumor retrogression. Macroprolactinomas give complications more often, and require a good tumor control and a rigorous follow-up.

Adult↗
PubMed1996

[Blood prolactin under the effect of protirelin in spondylarthropathies. Treatment trial of 4 cases of reactive arthritis and 2 cases of psoriatic arthritis with bromocriptine].

Prolactin radioimmunoassay was carried out before and 15, then 30 min after intravenous infusion of protireline (0.2 mg) in 3 groups of male patients: 7 with reactive arthritis (HLA B27: 6; age: 25 +/- 6.3 yr), 13 with ankylosing spondylitis (HLA B27: 11; age: 33.2 +/- 14.7 yr), 5 with psoriatic arthritis (HLA B27: 1; age: 28.8 +/- 6.3 yr). The same test was carried out in sex-age-body mass index matched controls. Only the patients with reactive arthritis presented dynamic hyperprolactinaemia 15 and 30 min after protireline infusion and none of ankylosing or psoriatic arthritis groups. A complete failure of bromocriptine was observed in reactive arthritis. In 2 cases of psoriatic arthritis, adding bromocriptine to gold salts and nonsteroidal anti-inflammatory drug was followed by a drastic efficacy with spectacular improvement in clinical, biological and occupational status. Because none of the cases had hyperprolactinaemia, bromocriptine acted probably had an intrinic anti-inflammatory effect independent of its antiprolactinic effect.

Adult↗
PubMed1996

[Development of blood pressure level over a three years period in non-insulin dependent diabetic subjects according to their microalbuminuria].

UNLABELLED: The purpose of this study is to compare over a three year period blood pressure modifications of type 2 diabetic subjects who suffer of incipient nephropathy to those who remain unharmed of this complication. PATIENTS AND METHOD: This study population is composed of 83 normotensive (BP < 140/90 mmHg) type 2 diabetic patients not receiving cardio-vascular treatment and unharmed of nephropathy (microalbuminuria inferior to 30 mg/24 hours). An evaluation of the diabetes mellitus is undertaken at a three year interval (A0 and A3). These 83 subjects are distributed in two groups according to the 24 hours microalbuminuria rate at A3. In group I (n = 60), patients whose rate is lower than 30 mg/24 hours and in group II (n = 23), patients whose microalbuminuria is over 30 mg. For these two groups, the following elements are compared at A0 and A3: body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), serum creatinine, cholesterol and triglycerides. RESULTS: The two groups do not differ in age (57.1 +/- 12 vs 53.8 +/- 16.4 years), duration of diabetes mellitus (11.7 +/- 8.6 vs 13.3 +/- 10.4 years) or body mass index (25.9 +/- 3.8 vs 26.2 +/- 4 kg/m2). At the time of the initial evaluation at A0, none of the studied parameters shows a significant difference between the two populations. Comparison of statements undertaken at A3 shows that blood pressure of Group II patients is higher than in group I, but the difference is only significant for systolic blood pressure (132 +/- 12 vs 139 +/- 11 mmHg; p < 0.01). The balance of diabetes mellitus, serum creatinine and lipid levels do not differ between these two groups. The blood pressure level of Group I doesn't differ significantly at A0 and A3 (128 +/- 11 vs 132 +/- 12 mmHg for SBP; 77 +/- 9 vs 78 +/- 7 mmHg for DBP). On the contrary, patients who develop a nephropathy see their blood pressure increase, but only SBP has a significant risk (128 +/- 12 vs 139 +/- 11 mmHg; p < 0.01). Apparition of a microalbuminuria and increase of blood pressure of Group II are not accompanied by a significant variation of serum creatinine. CONCLUSION: This study shows that for normotensive type 2 diabetic patients the transition from normo to microalbuminuria is associated with increases in systollic blood pressure. This blood pressure modification occur early, contemporary of the apparition of microalbuminuria, but relationship of causality between this two factors remains to be specified.

Adult↗
PubMed1996

[Evaluation of the degree of diabetic dysautonomy with the analysis of heart rate measured at rest with the FINAPRES system].

In this work, we developped the ERK (Eckmann, Ruelle and Khamporst) method of recurrent plots to analyse Heart Rate Variability (HRV), measured by the FINAPRES system in diabetic subjects. Our aim was to search some indices that might characterize the degree of dysautonomy detected in diabetic subjects, using the Ewing tests. The idea was to analyze the recurrences of the HR to previously observed values. When a value of HR, xi measured at the j-th beat come back to an already observed value, we compare the distances between the following measures (xi + 1 to xj + 1), (xj + 2 to xj + 2)... If the distances are under a given criteria during k beats, xi is deterministic of order k. Let n1 be the number of recurrent points and nk the number of k-order deterministic points, with k = 2, 3, 4... We defined the index of determinism nk + 1/nk and the Shannon entropy of the Nk = nk-nk + 1. These indices will be correlated to the total score of the 5 Ewing tests, which represent the standard measure to evaluate the diabetic dysautonomy. Blood pressure (BP) and HR were measured during about 30 minutes using the FINAPRES system in 44 healthy subjects and 60 non-hypertensive diabetic subjects. In the diabetic subjects, the age, the body weight and systolic and diastolic BP were 56 +/- 13 years (mean +/- standard-deviation), 79 +/- 14 kg, 80 +/- 10 mmHg and 137 +/- 20 mmHg. HR was weakly correlated to age (r = 0.29; p = 0.02) and the Ewing score (r = 0.31; p = 0.01). Its standard-deviation is also weakly correlated to age (r = 0.32; p = 0.01) and to the Ewing score (r = 0.34; p = 0.01). Using the ERK method, we obtained indices which are much more correlated to the Ewing score. In particular, the ratio n2/n1 and Shannon entropy were correlated to the Ewing score with r = 0.51 and r = 0.53, respectively (p < 0.0001 in both cases). These indices are also correlated to age (r = 0.40; p = 0.003) in both cases. The ERK method give some indices which are easy to obtain (measurement of HR during a rest period) and easy to interpret. These indices are strongly linked to the dysautonomy score which required a good cooperation of the patient and a great vigilance during its execution. This method could be applied to BP to explore BP regulation in hypertensive subjects.

Adult↗
PubMed1996

[Prevalence of hypertension in a black African diabetic population].

BACKGROUND: It has been established that hypertension prevalence rate was higher in American Blacks than Whites or Mexicans. And hypertension is more frequent in diabetics. The prevalence of hypertension among diabetic African Blacks is not well documented. METHODS: A total of 550 diabetic patients attending to Central Hospital of Yaounde (Cameroon) were followed between 1990 and 1994. The 1993 WHO criteria were used to define hypertension (systolic blood pressure (SBP) > or = 140 or diastolic blood pressure (DBP) > or = 90 mmHg. We also have considered as hypertensive patients being treated with an antihypertensive medication before inclusion. All quantitative data are given as means +/- SD. RESULTS: For the whole study population characteristics were: age (at inclusion): 54.2 +/- 12.8 yrs: sex distribution: 341 men for 209 women (sex ratio: 1.63:1); known duration of diabetes: 5.7 +/- 5.6 yrs; Body Mass Index (BMI): 24.4 +/- 4.8 kg/m2. They are dividing into 136 IDDM, 405 NIDDM and 9 other types. In normotensive patients, blood pressure levels were: SBP 117 +/- 11 and DBP 75 +/- 8 mmHg, while in hypertensive: SBP 156 +/- 23 and DBP 95 +/- 13 mmHg. The difference between normo and hypertensive diabetics was significant (p > or = 0.001). Characteristics of hypertensive group were: age: 57 +/- 11.2 yrs, sex repartition 229 men for 136 women (sex ratio: 1.68:1), BMI: 24.9 +/- 4.8 kg/m2, diabetes classification: 63 IDDM, 297 NIDDM and 5 other types. According to recent WHO criteria (140/90) 365 subjects/550 were found to have high blood pressure, giving an overall prevalence of hypertension of 66.4% in the study population. Using former WHO definition (160/95) the prevalence was 42.2%. There was no statistical difference for prevalence between male (67.2%) and female (65.1%). But the difference was strongly significant (p < 0.001) between IDDM (46.3%) and NIDDM (73.3%). DISCUSSION: Hypertension prevalence studies in Africa have shown varying results (2.5-30%), with higher rates in urban than rural population. In African studies hypertension prevalence rates in diabetes were reported in the range 13-44%. The result of the present study is very near the high limit of known data in Africa. CONCLUSION: Such a prevalence rate of 66.4% in this Cameroonian diabetic population appears to be high, particularly in patients with NIDDM. These considerations bring to light the question of sensitiveness of African Blacks to hypertension when exposed to high blood pressure risk factors such as inadequate food and diabetes.

Adolescent↗
PubMed1996

[Diabetes in Cameroon. Classification difficulties in Africa].

Diabetes is a major health problem in Africa where management is complicated by poor socioeconomic conditions. Atypical presentations of diabetes appear to be common in tropical countries although there is still little accurate data in this regard. We describe 550 diabetic patients treated in Cameroon between December 1990 and July 1994. According to WHO criteria 136 of these patients (24.7%) were classified as insulin-dependent (IDDM), 405 (73.5%) as non-insulin-dependent (NIDDM), and 9 as secondary diabetes (1.6%) related to other diseases. There were no cases of malnutrition-related diabetes but 18 patients (3%) met the criteria for "African diabetes" defined by Cuisinier-Raynal. Study of this cohort revealed several differences with diabetic populations in industrialized countries. Insulin-dependent diabetes was observed in all age groups with a mean age of onset 40.0 +/- 14.8 years which is close to the mean age of onset of non-insulin-dependent diabetes (49 +/- 10.9 years). The overall M/F sex ratio was 1.63 demonstrating a clear-cut male predominance. There was a high incidence of non-insulin-dependent diabetes in young, non-obese subjects. In many cases classification was difficult because insulin requirements fluctuated greatly. The incidence of obesity in non-insulin-dependent diabetic patients was lower than in industrialized countries. These findings suggest the existence of a tropical diabetes syndrome unrelated to malnutrition. Thus African diabetes appears to be another aspect of the disease which has a variety of heterogeneous etiologic features that cannot be classified on the basis of available data. The current WHO system does not take atypical African diabetes into account.

Adolescent↗
PubMed1995

[Treatment of rheumatoid psoriasis with bromocriptine].

Non-steroid anti-inflammatory drugs and/or gold salts were unsuccessful alone in providing symptom relief in three men with rheumatoid psoriasis. All three were treated with bromocriptine (5 mg/d in 2 doses) after verification of normal baseline and protirelin-stimulation prolactin levels. There was a beneficial effect in nocturnal pain relief, morning stiffness, the Lee and Ritchie scores and biological markers of inflammation. Two of the patients were able to return to regular work occupation after 15 and 45 days. In the third patient, bromocriptine was discontinued due to nausea and dizziness but was reintroduced successfully in fractionated doses after recurrence of the symptomatology. Treatment was continued without secondary adverse effects for 3 to 9 months providing continued symptom relief. Bromocriptine can be an effective adjuvant for the management of rheumatoid psoriasis.

Adult↗
PubMed1995

[Modification of hemorheological parameters in microvascular complications of diabetes].

The aim of the present study was to assess the possible modifications in the parameters of red cell aggregation and blood and plasma viscosity in 92 diabetic patients compared to 82 non diabetic control subjects. Based on the presence of microalbuminuria (> 30 mg/24 h) and/or retinopathy each group of diabetic patients was divided into two subgroups. This study shows increased red cell aggregation and blood viscosity among diabetic patients with microangiopathy. There was a very good correlation between fibrinogen level and the different rheological measurements. The results of this study confirm the importance of the blood rheology abnormalities observable in diabetes. These disorders increase peripheral vascular resistances and ischemia and therefore worsen diabetic nephropathy and retinopathy.

Adult↗
PubMed1995

[Comparison of the efficacy of enalapril + hydrochlorothiazide and captopril + hydrochlorothiazide combinations in mild-to-moderate arterial hypertension by ambulatory measurement of blood pressure].

This two-centre trial compared the efficacy of combinations of enalapril + hydrochlorothiazide (E + H) and captopril + hydrochlorothiazide (C + H) on mild-to-moderate hypertension, after a two-week placebo period, in 26 patients with mild-to-moderate HT (DBP between 95 and 114 mmHg) not controlled by previous treatment, randomized under double-blind conditions into two groups for two 4-week crossover treatment periods separated by a 4-week wash-out period. One group received E + H (20 mg/12.5 mg) followed by C + H (50 mg/25 mg) and the other group received C + H (50/25) followed E + H (20/12.5), once a day. The efficacy of the two treatments was evaluated by 24-hour ambulatory blood pressure monitoring (ABPM) at the start of the study and after each treatment period. Plasma renin activity, aldosterone and angiotensin converting enzyme were assayed under the same conditions. Analysis was based on 26 cases, as none of the patients were withdrawn from the trial. No difference was observed between the two groups in terms of the main biometric and laboratory characteristics. Blood pressure evaluated by ABPM and intermittently was not significantly different between the two groups at the time of inclusion in the study. On intermittent Bp determinations, E + H and C + H decreased diastolic and systolic blood pressure, with no significant difference between the two treatments. On ABPM, the two treatments significantly decreased mean systolic, diastolic and mean blood pressure during the diurnal, nocturnal and circadian periods.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗