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Biomedical subjects

J L Schlienger

Publications and source records attributed to J L Schlienger.

At least 127 records · Page 7Linked to original sources
PubMed1993

[Thyrotropin assay by chemiluminescence in the diagnosis of dysthyroidism with low thyrotropin and normal thyroid hormones levels].

The performances of a new "3rd generation" chemoluminescence TSH assay (TSH ICMA) with a functional sensitivity of 0.005 mU/l were compared with those of an "ultrasensitive" TSH immunoradiometric assay (TSH IRMA) in a series of patients characterised by a TSH IRMA less than 0.20 mU/l and normal free thyroxin (T4 L) and triiodothyronine (T3 L) concentrations. The 95% cut-off value for hyperthyroidism was 0.03 for TSH ICMA and 0.05 for TSH IRMA. In a first group of 41 subjects undergoing Tc99m thyroid scan, images of multifocal increased uptake or toxic adenoma were associated with a lower TSH ICMA than in patients with a normal isotope scan. TSH ICMA was also lower than TSH IRMA (p < 0.01). At the cut-off value of 0.03 mU/l, the specificity of TSH ICMA was higher than that of TSH IRMA, but the sensitivity were identical. In a second group of 36 patients with severe non-thyroid diseases, TSH ICMA was lower than the cut-off value for hyperthyroidism in 30% of cases, while TSH IRMA was lower than the cut-off value in 40% of cases. A satisfactory concordance was observed between the two methods. In conclusion, the two TSH assays, IRMA and ICMA, provide globally comparable information in subjects with a low TSH and normal T4 L and T3 L. However, the better specificity of TSH ICMA and a smaller overlap with the frank hyperthyroid zone in patients with non-thyroid disease argue in favour of the use of this new assay method.

Aged↗
PubMed1991

Explicit memory and repetition priming in depression. Preliminary findings.

Explicit memory and repetition priming, a form of implicit memory, were examined in depressed patients and controls. Explicit memory of depressed patients was severely impaired, whereas repetition priming was intact. These results are consistent with the hypothesis that the impairment of memory in depression is linked to a failure of effort-demanding cognitive processes. Repetition priming might be useful in differentiating between depression and dementia.

Dementia↗
PubMed1991

Alteration in the temporal organisation of insulin secretion in type 2 (non-insulin-dependent) diabetic patients under continuous enteral nutrition.

Concomitant oscillations of plasma glucose, insulin and C-peptide levels with a period of about 80 min between peak levels have been identified in normal man. To determine whether these oscillations persist in Type 2 (non-insulin-dependent) diabetic patients, peripheral plasma levels of glucose, insulin and C-peptide were measured at 10 min intervals over 12 h in six patients and in six matched control subjects during continuous enteral nutrition (90 kcal.h-1;50% carbohydrate, 35% fat, 15% protein). The insulin secretion rate was estimated from peripheral C-peptide levels using an open two-compartment model. For the control subjects, mean plasma glucose, insulin and insulin secretion profiles rose sharply and then attained a steady-state; in contrast, for the diabetic patients, the mean insulin and insulin secretion profiles were characterized by a slow ascending trend throughout the day. Mean glucose levels rose sharply and reached higher levels than in the control subjects. The individual 12 h profiles revealed synchronous oscillations of plasma glucose, plasma insulin, and insulin secretion in the control subjects. In the diabetic patients, the number of plasma insulin and insulin secretion pulses was significantly lower; they had a smaller amplitude and were less frequently associated with the glucose pulses. However, plasma glucose levels had a similar oscillatory pattern in the diabetic patients compared with the control subjects, albeit with a higher absolute amplitude. The poor association between glucose and insulin secretion pulses in the diabetic patients suggests that insulin pulses are insufficient to account for the glucose pulses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Nutritional status: haematology and albumin. Euronut SENECA investigators.

In the context of the Euronut SENECA study of nutrition and the elderly, performed in 19 towns situated in 12 European countries, blood haemoglobin and haematocrit, and serum albumin were measured in a large sample of 70-75-year-old subjects. The mean haemoglobin (Hb) values for the different towns ranged from 144 g l-1 to 157 g l-1 for men and from 131 g l-1 to 150 g l-1 for women. The town haematocrit (Hct) means ranged from 43.0% to 48.9% for men and from 39.7% to 46.4% for women. No clear geographical pattern emerged for either Hb or Hct. The 95% ranges (2.5-97.5 percentile intervals) for Hb and Hct for all towns combined (without any claim of being representative of Europe) were very similar to those reported in the NHANES II study of the USA. Prevalences of anaemia, using the WHO definition (Hb less than 130 g l-1 for men and Hb less than 120 g l-1 for women) were 5.2% for men and 5.7% for women. The town mean serum albumins ranged from 40.3 g l-1 to 44.3 g l-1 for men and from 40.3 g l-1 to 43.2 g l-1 for women. No clear geographical pattern emerged. Mean values were somewhat lower than for younger adults and comparable to other published data. Most albumin values were in the normal range, with only 2.0% of both men and women having levels below 35 g l-1 and only 0.4% of men and no women having levels below 30 g l-1. These results show that these 70-75-year-old subjects who chose to participate in the study were in relatively good health as judged from their haemoglobin, haematocrit and serum albumin levels.

Age Factors↗
PubMed1991

Nutritional status: serum lipids. Euronut SENECA investigators.

Serum lipid levels are considered to be one of the main risk factors for cardiovascular diseases in middle-aged men and women. The significance, however, of serum lipid metabolism as a cardiovascular disease risk factor in the elderly has yet to be clarified. This paper focuses upon the serum lipid levels of groups of elderly people from 18 centres with diversified socioeconomic backgrounds in 11 European countries. Serum cholesterol was measured with an enzymatic colorimetric method by autoanalyser in one laboratory and accuracy was checked by participation in the quality control programme of the Centre for Disease Control, Atlanta, GA, USA. Mean (+/- SD) serum cholesterol levels ranged from 6.56 +/- 0.66 mmol/l (Bellinzona, Switzerland) to 5.22 +/- 0.68 mmol/l (Coimbra, Portugal) in men, and in women from 7.77 +/- 1.61 mmol/l (Elverum, Norway) to 5.86 +/- 1.07 mmol/l (Anogia-Archanes/Greece). The mean levels of high-density lipoprotein (HDL) cholesterol ranged from 1.40 +/- 0.58 mmol/l (Chateau Renault-Amboise, France) to 1.05 +/- 0.28 mmol/l (Elverum, Norway) in men and from 1.62 +/- 0.41 mmol/l (Padua, Italy) to 1.23 +/- 0.29 mmol/l (Anogia-Archanes, Greece; Vila Franca de Xira, Portugal) in women. The highest median serum triglyceride values were found in Norway (Elverum) (men: 1.50 mmol/l, women: 1.75 mmol/l), and one of the French groups (Chateau Renault-Amboise) had the lowest median values (men: 1.07 mmol/l, women: 1.15 mmol/l). Significant differences between participating centres and between sexes were found for the following variables: serum cholesterol, HDL, and the ratio total HDL cholesterol/total cholesterol. For triglycerides the differences were significant only between centres, not between the sexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Short-term effect of delayed-action injectable bromocriptine in macroprolactinoma. French multicenter study].

In this prospective multicenter trial, 61 patients presenting with a macroprolactinoma were studied over a 1 month-period following a single 50 mg intragluteal injection of the long-acting repeatable (L.A.R.) form of bromocriptine. The effects of the drug were evaluated mainly by repetitive plasma prolactin measurements on days 1, 3, 7, 14 and 28 after injection, and by repeated visual-field and computed tomography scanning examinations. Normalization of PRL levels was obtained in 23% of patients during the first month following injection. In 6 patients (9.8%), PRL values remained within normal range on day 28 after injection. In these latter patients, PRL levels were significantly lower than in the patients whose PRL values were not normal on day 28 (312 +/- 111 vs 2454 +/- 484 ng/ml [m +/- SEM]). The mean lowest PRL levels were achieved on day 3. The mean percent maximal decrease in PRL levels ranged between 70 and 72% from days 3 to 14 but constantly remained below 50% in 6 patients. An improvement in visual field was observed by day 7 in 45% of patients presenting initially with visual field defects. In particular, in half of the patients with bilateral quadranopsia or hemianopsia, such visual impairments had disappeared after 1 month of treatment. Computed tomography scanning examinations showed in 11% of the patients a more than 20% reduction in tumor mass by day 7 following injection. On day 28, the percent reduction in tumor size was 20-40% in 28% and above 40% in 10% of the patients. Most adverse effects (digestive symptoms, dizziness, postural hypotension) were observed during the first 24 hours of treatment. Local and systemic tolerability was in general good. In macroprolactinoma patients, a single 50 mg injection of bromocriptine LAR was thus able to achieve in the short-term a clear cut reduction in tumor size in 2/5 patients and normalization of PRL levels in 1/10 of patients. A study of the effects of monthly administration of bromocriptine LAR is currently under progress to assess the long-term efficacy of this drug.

Adult↗
PubMed1991

[Evaluation of thyroid function after myocardial infarction].

The myocardial infarction (M.I.) constitutes an exemplary acute severe affection able to modifie hormonal concentrations. The total and unbound thyroid hormones, reverse T3 (rt3), TSH, and cortisolemia were determined in 24 patients during a period of 21 days in order to compare them to different markers of severity of MI. The initial phase of the disease is characterized by low concentrations of total and free T3 and high concentrations of rT3 combined with more often than not normal total and free T4 and TSH values contrasting with an increase in cortisol levels. The abnormalities were more pronounced the day after admission and then progressively amend. There are several statistic relationship between the marker of severity of MI and thyroid hormones. In the same way total T3 is all the more decreased especially since myoglobin, CPK-MB, ST amplitude and ventricle ejection fraction are more disturbed. Severe forms of MI induces a pseudo central thyroid insufficiency with low T3, low T4 and a tendency to TSH decrease. Total T3 blood levels may usefully contribute to the elaboration of an MI severity index.

Adult↗
PubMed1991

[Lipid profile in adult population representative of a French district (Bas-Rhin)].

Serum total cholesterol (TC), HDL-cholesterol (HDL-C) and A1, A2 and B apoprotein levels were determined in a population of 967 adults aged 25 to 64 years representative of the general population of the Bas-Rhin region localized in North-Eastern France. Age and sex were found to have a significant influence on most parameters studied; however, HDL-cholesterol, Apo A1, and Apo A2 were independent from age in males. HDL-cholesterol levels were consistently found to be higher in females than in males. Cholesterol, HDL-cholesterol, Apo A1, Apo A2 and Apo B levels, but not the HDL-cholesterol/cholesterol ratio, were higher in females above 45 years of age. A cholesterol level indicating increased cardiovascular risk, i.e., above 5.1 mmol/l, was found in 55% of males and 53% of females; HDL-cholesterol was under 0.9 mmol/l in 46% of males and 29% of females. The close linear correlations seen between cholesterol and Apo B (r = 0.820) and between HDL-cholesterol and Apo A1 (r = 0.580) were used to estimate theoretical threshold levels of apoproteins indicating increased risk: the Apo B level was greater than 0.77 g/l in 60% of males and 45% of females and the Apo A1 level was smaller than 1.58 g/l in 42% of males and 28% of females. Apo A2 level seems less useful as marker of increased risk. In conclusion, increased vascular risk due to unfavorable lipid profiles was common in the studied population especially among males and among females above 45 years of age. Apoproteins A1 and B reliably reflect cholesterol and HDL-cholesterol levels and can help evaluate cardiovascular risk.

Adult↗
PubMed1990

Analytical and clinical evaluation of a new one-step non-analogue radioimmunoassay for serum-free thyroxine.

We evaluated analytically and clinically the new one-step non-analogue free thyroxine (FT4) assay (Amerlex-MAB from Amersham), using a labelled monoclonal thyroxine-specific antibody as tracer, in comparison with the Gammacoat two-step FT4 kit (Baxter). Analytical performances of the new kit were excellent: within and between run coefficients of variation were less than 5% in the working range. Clinical sensitivities for hypo- and hyperthyroidism were comparable for both kits (FT4 Amerlex-MAB 95% confidence interval: 12-25 pM). When serum was supplemented with albumin we observed a slight decrease in FT4 values measured by both kits. When oleate was added to serum we noted a moderate increase with the Amerlex-MAB kit up to 10 mM oleate added and a much more marked increase with the two-step kit. Results obtained with patients from particular euthyroid populations, known to have low albumin or high free fatty acids concentrations or to have perturbed FT4 results when measured by an analogue-based method, agreed with those of the in vitro studies. With these patients the specificity of the Amerlex-MAB FT4 results was good but slightly decreased compared with the two-step FT4 method, except for heparin-treated patients who were all classified according to their euthyroidal status (17/17 instead of 13/17 with the two-step kit).

Antibodies, Monoclonal↗
PubMed1990

Comparison of dietary patterns between population samples in the three French MONICA nutritional surveys.

A nutritional survey was carried out from 1985 to 1987 in three French areas covered by the ischaemic heart disease registers: Bas-Rhin (BR), Haute-Garonne (HG) and the Urban Community of Lille (UCL). 1,128 men aged 45-64 were included in a survey, using the 3-day record method. The results, after adjustment for age, socio-economic status, residence and prescribed diet, showed differences, sometimes significant, between the three samples. Fat represented 37% of the total energy intake in BR, 36% in UCL, and 34% in HG. The P:S ratio ranged from 0.50 in HG, to 0.47 in BR, and 0.40 in UCL. These differences were due to a higher intake of vegetable fat and a lower intake of animal fat in HG. In spite of a very important alcohol intake, with no big differences between the centres (33 to 36 g/day), we noticed that HG drank mainly wine, whereas BR and UCL drank wine and beer in about the same proportions.

Alcoholic Beverages↗
PubMed1990

Blood pressure and dietary intake in a French population sample from three regions.

In order to determine the possible relationship between nutritional factors and blood pressure (BP), a sample of 1128 men of the population living in the three French MONICA centres, Bas-Rhin (BR), Haute-Garonne (HG) and the Urban Community of Lille (UCL), was included in a nutritional survey. Of the sample, 16.2% were taking antihypertensive drugs and 34.1% of the remainder had high BP. Prevalence of high BP was greater in BR and UCL than in HG, the differences persisting after adjustment for body mass index (BMI) and age. BMI and geographic location were the best predictors of high systolic BP (SBP) and diastolic BP (DBP). Age was positively correlated with SBP, but not with DBP. Alcohol intake was the dietary component which had the most consistent relationship with SBP and DBP. However, greater intakes of total fat and of cholesterol were also associated with higher DBP and SBP respectively. A small but significant contribution of sodium chloride to SBP and DBP was also found, whereas no influence of the intake of calcium or of any diary product was observed.

Age Factors↗
PubMed1990

In vitro and in vivo effects of increased concentrations of free fatty acids on free thyroxin measurements as determined by five assays.

To compare in vitro and in vivo effects of increased concentrations of free fatty acids (FFA) on free thyroxin (FT4) values, we measured FT4 in three pooled sera supplemented with oleate and in serum from 18 euthyroid patients before and after an infusion of fat emulsion (Intralipid). We used five FT4 RIA kits: two two-step methods [Gammacoat, Baxter (GC); Ria-gnost, Behring (RG)], two analog RIAs [Amerlex-M, Amersham (AM); Coat-Ria, BioMérieux (CR)], and one kit with labeled antibodies [Amerlex-MAB*, Amersham (AA)]. In vitro, at the maximum oleate addition of 5 mmol/L, FT4 increased when measured by the GC and RG kits, decreased by the AM kit, and showed no significant change by the CR and AA kits. In vivo, post-Intralipid, FFA concentrations rose significantly and the FT4 changes agreed with the results of the in vitro experiments, except for the RG kit, for which FT4 increased in only nine patients. We conclude that in vitro oleate addition is useful to predict the in vivo effect of increased FFA on FT4 values; moreover, in serum from euthyroid subjects with high concentrations of FFA, FT4 analyzed with the CR or AA kits should better agree with normal results for thyrotropin than FT4 values measured with the other kits.

Chromatography, Gas↗