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Biomedical subjects

L Genton

Publications and source records attributed to L Genton.

26 records · Page 2Linked to original sources

[Nutrition and HIV infection].

The HIV infection leads to many nutritional problems. For a long time, the Wasting Syndrome was one of the most frequent inaugural features of AIDS and still concerns many patients. The weight loss worsens the prognosis of the disease. The reduced dietary intakes, the increased digestive losses and energetic expenditure result in severe malnutrition. Therefore, the nutritional support and its association with orexigenes, anabolic agents and physical activity has to be carefully selected. The adverse events of new antiretroviral drugs influence the nutritional state and the patient's compliance towards their treatments. For lipodystrophy, whose etiology is still unknown, no treatment has yet been found. Metabolic disorders (dyslipidemia, glucose intolerance, diabetes, etc.) in this presently chronic disease require particular attention since they increase cardiovascular risks. In general they are sensitive to a dietary approach.

HIV Infections↗

[Value of prokinetics in enteral nutrition intolerance].

Malnutrition is associated with an increase in morbidity and mortality and therefore a raise in hospitalization's costs. Nevertheless, an early nutritional support can reverse this trend. Gastrointestinal dysfunctions (gastroparesis, abdominal distension, high gastric residues) in patient on enteral nutrition, may appear and very likely generate an increasing risk of regurgitations, pulmonary aspiration and infection. These symptoms represent the main factors limiting dosage in administering enteral nutrition. Prokinectics agents (metoclopramid, cisaprid and erythromycin) which improve gastric motility are often used in order to maintain enteral nutrition and to cover the energetic needs of patients. This revenue shows some way of using prokinectics in case of enteral nutrition intolerance and propose a step-by-step guideline on how to start and increase progressively enteral nutrition.

Clinical Trials as Topic↗

[Assessment of nutritional status].

Malnutrition is an important factor which influences both the morbidity and the recovery. Assessment of the initial nutritional status, then its evolution during the disease and/or treatment, plays an important role for tailoring the nutritional support. This assessment allows to specify the nutritional needs and body reserves, as well as the metabolic and immunologic functions. The global nutritional assessment is aimed at defining if the patient is: well nourished, slightly or severely malnourished, and if the aetiologies of the existing malnutrition will disappear, increase or decrease. This conclusion correlates the nutritional assessment to the dynamic of the pathology and highlights if the nutritional support has to be immediate or delayed, maximal or partial. No single method allows to detect PCM, except in very severe cases. The diagnosis of PCM results of various clinical, biological and functional informations. This review describes the main methods and suggests practical modalities for nutritional assessment.

Absorptiometry, Photon↗

Fat-free and fat mass percentiles in 5225 healthy subjects aged 15 to 98 years.

OBJECTIVES: Fat-free mass (FFM) and fat mass (FM) are important in the evaluation of nutritional status. Bioelectrical impedance analysis (BIA) is a simple, reproducible method used to determine FFM and FM. Because normal values for FFM and FM have not yet been established in adults aged 15 to 98 y, its use is limited in the evaluation of nutritional status. The aims of this study were to determine reference values for FFM, FM, and percentage of FM by BIA in a white population of healthy adults, observe their differences with age, and develop percentile distributions for these parameters between ages 15 and 98 y. METHODS: Whole-body resistance and reactance of 2735 healthy white men and 2490 healthy white women, aged 15 to 98 y, was determined by 50-kHz BIA, with four skin electrodes on the right hand and foot. FFM and FM were calculated by a previously validated, single BIA formula and analyzed for age decades. RESULTS: Mean FFM peaked in 35- to 44-y-old men and 45- to 54-y-old women and declined thereafter. Mean FFM was 8.9 kg or 14.8% lower in men older than 85 y than in men 35 to 44 y old and 6.2 kg or 14.3% lower in women older than 85 y than in women 45 to 54 y old. Mean FM and percentage of FM increased progressively in men and women between ages 15 and 98 y. The results suggested that the greater weight noted in older subjects is due to larger FM. CONCLUSIONS: The percentile data presented serve as reference to evaluate deviations from normal values of FFM and FM in healthy adult men and women at a given age.

Adipose Tissue↗

Comparison of four bioelectrical impedance analysis formulas in healthy elderly subjects.

BACKGROUND: Changes of body composition occur with aging and influence health status. Thus accurate methods for measuring fat-free mass (FFM) in the elderly are essential. OBJECTIVE: The purpose of this study was to compare FFM obtained by three bioelectrical impedance analysis (BIA) published formulas specific for the elderly and one equation intended for all age groups, with FFM derived from dual-energy X-ray absorptiometry (FFM(DXA)), in healthy elderly subjects. METHODS: Healthy Caucasian subjects over 65 years (106 women, age 75 +/- 6.2, body mass index 25.2 +/- 4.1 and 100 men, age 74.6 +/- 6.6, body mass index 25.8 +/- 3.0) were measured by DXA (Hologic QDR-4500) and BIA (Xitron, 50 kHz). FFM(BIA) was calculated by the published formulas of Deurenberg, Baumgartner, Roubenoff and Kyle and compared to FFM(DXA) by a Bland-Altman analysis. RESULTS: The Deurenberg and Roubenoff BIA formulas underestimated FFM compared to DXA by -7.1 and -2.9 kg in women and -6.7 and -2.3 kg in men, respectively. The Baumgartner formula overestimated FFM by 4.3 kg in women and 1.4 kg in men. The Kyle formula showed differences of 0.0 kg in women and 0.2 kg in men, and the limits of agreement of FFM(BIA (Kyle)) relative to FFM(DXA) were -3.3 and +3.3 kg for women and -3.8 and +4.3 kg for men. CONCLUSION: The Kyle BIA formula accurately predicts FFM in elderly Swiss subjects between 65 and 94 years, with a body mass index of 17 to 34.9 kg/m(2). The other BIA formulas developed especially for the elderly are not valid in this population.

Age Factors↗

Reliable bioelectrical impedance analysis estimate of fat-free mass in liver, lung, and heart transplant patients.

BACKGROUND: Bioelectrical impedance analysis (BIA) can be valuable in evaluating the fat-free (FFM) and fat masses (FM) in patients, provided that the BIA equation is valid in the subjects studied. The purpose of the clinical evaluation was to evaluate the applicability of a single BIA equation to predict FFM in pre- and posttransplant patients and to compare FFM and FM in transplant patients with healthy controls. METHODS: Pre- and posttransplant liver, lung, and heart patients (159 men, 86 women) were measured by two methods-50-kHz BIA-derived FFM (FFM(BIA)) by Xitron instrument and DXA-derived FFM (FFM(DXA)) by Hologic QDR-4500 instrument-and compared with healthy controls (196 men, 129 women), aged 20 to 79 years. RESULTS: The high correlation coefficient (r = .974), small bias (0.3 +/- 2.3 kg), and small SEE (2.3 kg) suggest that BIA using the GENEVA equation is able to predict FFM in pre- and posttransplant patients. The study shows that the lower weight seen in transplant men and women than in controls was due to lower FFM, which was partially offset by higher FM in men but not in women. Furthermore, the higher weights in posttransplant than in pretransplant patients were due to higher FM and % FM that was confirmed by lower FFM/FM ratio in posttransplant patients. CONCLUSIONS: Single 50-kHz frequency BIA permits measurement of FFM in pre- and posttransplant patients.

Absorptiometry, Photon↗