[Prolactin response to protirelin in reactive arthritis and ankylosing spondyloarthritis. Failure of treatment of 4 reactive arthritis with bromocriptine].
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Adult↗
Biomedical subjects
H Mayaudon
Publications and source records attributed to H Mayaudon.
[Hormonal profile of idiopathic gynecomastia in young adults. Apropos of 488 cases].
Gynecomastia, a very frequent disorder, is present in almost 40% of young men. In this population the investigations often fail to find any aetiology, therefore defining idiopathic gynecomastia. The aim of this work is to compare clinical and hormonal characteristics of 488 subjects with gynecomastia to 41 healthy controls. Their are many explanations for the occurrence of idiopathic gynecomastia, including modification of hormonal balance, change of aromatase activity, or a receptor anomaly. Our works demonstrate a significant decrease in mean testosteronemia, linked to a high prevalence of incipient hypogonadism in the studied population, especially in patients with an history of testicular disease.
Adolescent↗
[Cardiovascular autonomic neuropathy and blood pressure variability in insulin-dependent diabetes].
The aim of this study was to analyse the role of cardiac autonomic neuropathy (CAN) in the changes of Blood-Pressure (BP) variability among insulin-dependent diabetics and to determine the relationship between BP variability and diabetic complications. Ambulatory BP monitoring was performed during 24 hours on 93 insulin-dependent diabetics and 77 normal subjects of similar age (Group 1). CAN was assessed by the cardiovascular autonomic function tests described by Ewing and the diabetics were divided in two groups: Group 2 including patients without CAN (n = 46) and Group 3 including patients with CAN (n = 47). The 24 h standard deviation (variability) and the day/night difference for systolic and diastolic BP were calculated for each subjects. Systolic and diastolic BP variability is more elevated in Group 3 than in the other groups during the diurnal period. Furthermore, the day/night difference of systolic and diastolic BP is lower in Group 3 compared to groups 2 and 3. Diabetic complications are also more frequently observed among diabetic patients with CAN (p < 0.001). So CAN seems to have two types of consequences on BP curve among diabetic patients: a decrease of day/night BP difference which can be responsible of relative hypertension during the night and an increase of BP variability. As frequency of diabetic retinopathy and nephropathy is more elevated among diabetic patients with CAN, it is possible that CAN plays a role in the occurrence of these complications. Therefore, a simple juxtaposition of these facts is also possible.
Adult↗
An atypical myeloproliferative disorder with high thrombotic risk and slow disease progression.
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Adult↗
[Mycobacterium kansasii extensive subcutaneous infection in dermatomyositis].
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Adult↗
[Headache: epidemiology, economic data].
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Adolescent↗
[Influence of blood pressure profile on erythropoietin levels in diabetics].
UNLABELLED: The purpose of this study was to investigate the relationships between 24-h BP profil and erythropoietin level in diabetics. PATIENTS AND METHODS: This study included 58 patients (26 women and 32 men, mean age: 58.7 +/- 14.6 yrs, diabetes duration: 16 +/- 11.2 yrs). Patients were divided by 24 hrs ABPM into 2 groups, one in which night-time pressures dipped by more than 10% (dippers, n = 16) and the other in which pressures dipped by less than 10% (non-dippers, n = 42) when compared to daytime pressures. Haemoglobin (Hb) and erythropoietin (EPO) levels where compared between diabetics and a control group (n = 110) and between dippers and non-dippers. RESULTS: Hb concentration of diabetics was significantly lower than those of control subjects (13.5 +/- 1.5 vs 14.5 +/- 1 g/dL; p < 0.0001) but EPO levels did not differ from significant manner between these two groups. EPO concentrations were lower in dippers than in control subjects (13.7 +/- 5.4 vs 17.9 +/- 5 mU/mL; p < 0.01), but there was not significant difference in Hb levels. Non-dippers had a Hb level lower than dippers (13.1 +/- 1.5 vs 14.6 +/- 1.1 g/dL, p < 0.0001), but EPO concentrations did not differ from significant manner. Hb was correlated with between daytime and night-time BP difference (SBP: r = 0.262; p < 0.05 and DBP: r = 0.396; p < 0.002). Hb was negatively correlated with albumin excretion rate (r = -0.335, p < 0.01) and with creatinine level (r = -0.419: p < 0.001). CONCLUSION: These data indicated that EPO production could be impaired in diabetics with abnormal diurnal BP variation. Nephropathy and cardiac autonomic dysfunction could explain these results.
Adult↗
[Impaired urinary flow rate during the day: a new factor possibly involved in hypertension and in the lack of nocturnal dipping].
UNLABELLED: Previous studies suggest that a low urinary flow rate may reduce the capacity of the kidney to excrete sodium and could thus favour hypertension. In the present study, we evaluated the relationships between urinary flow rate (V) during day (D) and night (N), blood pressure (BP), and the day-night BP difference (delta in % of day BP) in 65 diabetic patients (glycosuria < 90 mmol/24 h) (35 F and 30 M, age 59 +/- 2 y) hospitalized for a 24 h urine collection and mean ambulatory blood pressure recording (AMBP). Urine was collected as two separate samples during D (8:00 am to 10:00 pm) and N (10:00 pm to 8:00 am). V, sodium excretion (NaEx) and mean systolic and diastolic BP (SBP and DBP, respectively) were calculated for the two periods. Patients were a posteriori classified according to the D/N ratio of V, and the mean values of 3 tertiles (T1, T2, T3, n = 22, 22, and 21 subjects) were calculated and compared by ANOVA (see table; *: p < 0.05; **: p < 0.01; ***: p < 0.001). [table: see text] Although total 24 h urine volume was similar in the three tertiles (1,670, 1,927 and 2,007 mL, NS), the fraction of urine excreted during D and N differed widely, with parallel differences in NaEx. With lower V during the day, BP tended to be higher and the fall in nocturnal BP to be reduced. CONCLUSIONS: This study shows the advantages of separate day and night urine collections in relation with AMBP. For a similar total diuresis, some subjects exhibit a too low urine flow rate and too low NaEx during the day, and a compensatory rise during the night. This low diurnal diuresis is associated with a higher blood pressure and a lower nocturnal fall (= nocturnal pressure diuresis). The factors responsible for a too low diuresis during the day need further investigation.
Adult↗
[Value of non-esterified fatty acids quantification in diabetes].
Non-esterified fatty acids (NEFA) play a complex role in glucidic homeostasis. This role led us to investigate their quantification in diabetic patients. The plasmatic NEFA concentrations, measured with the FA115 kit of Randox, showed significant differences between control patients (0.42 +/- 0.14 mmol/L, N = 50) and diabetic patients (0.68 +/- 0.35 mmol/L, p < 0.01, 443 diabetic patients (70 with type l and 373 with type 2 diabetes)). NEFA concentrations were significantly higher in type 2 diabetics (0.70 +/- 0.32 mmol/L) when compared to type 1 diabetics (0.59 +/- 0.35 mmol/L, p < 0.05). In type 2 diabetics, a significant correlation was observed between NEFA and glucose concentrations at 8 hrs a.m., and the mean glucose concentrations along the day (p < 0.001). In contrast NEFA concentrations were less correlated to levels of HbA1c. NEFA were well correlated with cholesterol and triglycerides (p < 0.05) but not with Lp(a). They were also correlated with BMI but not with age or duration of the disease. Diabetic patients on metformin associated to lipolytic treatment, presented lower concentrations of NEFA and better glucidic control. The results confirm the role of NEFA in glucidic homeostasis and suggest an interest for their routine determination.
Diabetes Mellitus↗
[Evolution of circadian blood pressure and urinary albumin excretion according to the type of diabetes over a 10-year period].
UNLABELLED: The aim of the present study was to evaluate the circadian blood pressure and rinary albumin excretion (UAE) according to the type of diabetes over a 10-year period. PATIENTS AND METHODS: This study is based on 43 diabetic patients, 24 type 1 and 19 type 2. Ambulatory blood pressure monitoring was used to assess blood pressure at the initial evaluation (A0) and about 10 years later (A10). UAE was also checked at 10 years interval and was <30 mg/day at A0. RESULTS: At A0, ABPM and UAE did not differ in a significant manner between type 1 and type 2 diabetics. Type 2 diabetic patients were older than type 1 (59.7 +/- 15.4 vs 42.9 +/- 12.9; p<0.0001) but the age of diabetes did not differ between the 2 groups. Between A0 and A10, there was an increase in 24 h SBP of type 1 and type 2 diabetics (type 1: 114 +/- 10 vs 124 +/- 12 mmHg; p<0.01 and type 2: 113 +/- 19 vs 135 +/- 13 mmHg; p<0.0001). 24 h DBP, as well as BP differences (day-night) did not differ between the 2 evaluations. At A10, 24 h SBP was higher in type 2 than in type 1 (135 +/- 13 vs 124 +/- 12 mmHg; p<0.001) but differences between day and night BP were not significant. In type 1 diabetes, progression of SBP was not associated with an increase in UAE rate, while this rate increased in type 2 betwwen A0 and A10 (9 +/- 7 vs 70 +/- 101 mg/24 h; p<0.01). AT A10, UAE was higher in type 2 than in type 1 diabetes (70 +/- 101 vs 14 +/- 31 mg/24 h; p<0.02). In type 2 diabetes, the progression of UAE was correlated with SBP at A10 (r=0.495; p<0.03). CONCLUSION: The increase in BP levels and in UAE rate differ between type 1 and type 2 diabetes and these differnces are not due to patients age, nor to modifications in BP curves. They are probably linked to a physiopathology which could be more complex in type 2 than in type 1 diabetes.
Adult↗
[Influence of blood pressure level on urinary albumin excretion rate and erythropoietin production in diabetic patients].
UNLABELLED: The purpose of this study was to investigate blood pressure variations during diabetic incipient nephropathy and to evaluate theirs consequences for erythropoietin (EPO) production. PATIENTS AND METHODS: This study included 94 diabetic patients (mean age: 59.9 +/- 15.3 years, diabetes duration: 13.8 +/- 15.3 years). Patients were divided in two groups according to urinary albumin excretion rate (UAE): group 1: UAE <30 mg/24 hrs, N=64 and group 2: 30<UAE <300 mg/24 hrs; N=30 EPO levels and 24 hrs ABPM where compared between these two groups. RESULTS: patients' age and BMI, diabetes duration and Hb A1c levels, blood pressure and creatinine clairance did not differ from significant manner between the two groups. 24 hrs BP and daytime BP did not differ according to UAE rate. Night-time BP was significantly higher in group 2 than in group 1 (SBP: 126 +/- 17 vs. 118 +/- 15 mmHg, p<0.04 and DBP: 71 +/- 10 vs. 67 +/- 8 mmHg, p < 0.02). UAE was positively correlated nigh-time BP (r = 0.263, p = 0.01 for SBP and r = 0.273, p = 0.008 for DBP) and negatively with the difference between daytime and night-time SBP (delta SBP) (r = -0.205, p < 0.05). Hemoglobin levels did not differ significantly between the two groups. EPO levels of group 2 were significantly lower than those of group 1 (15.1 +/- 5.6 vs. 17.7 +/- 6.2 mU/ml, p < 0.05). A negative correlation between UAE and EPO was found (r = -0.266, p < 0.01). UAE and delta SBP explained 12.2% of EPO variance. CONCLUSION: in diabetic patients, elevation of night-time BP and reduction in nightime BP fall participate to the installation of incipient nephropathy. A significant decrease in EPO production is noted in the same time.
Albuminuria↗
[Cardiac autonomic neuropathy. Current realities and future outlook].
Cardiac autonomic neuropathy frequently affects Type 1 and Type 2 diabetic patients. This disease is distinguished by visible clinical consequences which can be tragic. It can also worsen a number of degenerative complications. Therefore, cardiac autonomic neuropathy seems to play a deciding role in silent ischaemia and in dysregulations of blood pressure. Clinical explorations continue to be based on the tests validated by Ewing, but the development of simple and reliable techniques seems to be an objective the interest of which cannot escape any clinician.
Autonomic Nervous System Diseases↗
[Effect of arterial pressure level evaluated using ambulatory measurement on the two year course of microalbuminuria of type 1 diabetic subjects].
The aim of the present study is the evaluation two years apart of the effect of initial blood pressure values on ambulatory blood pressure determinations on the rise of microalbuminuria in 77 Type 1 diabetic patients. At the beginning of the study, subjects with incipient nephropathy have a whole day systolic and diastolic blood pressure greater than those whose microalbuminuria is below than 30 mg/24 h (127.7 +/- 15.1 mmHg versus 115 +/- 14.3 mmHg, p < 0.001; 76.6 +/- 8.1 mmHg versus 72.5 +/- 7.3 mmHg, p < 0.05). Among patients whose initial microalbuminuria was lower than 30 mg/24 h, incipient nephropathy will not be dependent on initial blood pressure values but conditioned by patients' age and duration diabetes of mellitus. On the other hand, blood pressure increases the microalbuminuria of the patients who had incipient nephropathy at the beginning of the study. In patients with diabetes mellitus, ambulatory blood pressure monitoring appreciates the impact of the pressure rise on the kidney, retina and heart.
Adult↗