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Biomedical subjects

L Papoz

Publications and source records attributed to L Papoz.

At least 73 records · Page 4Linked to original sources
PubMed1991

The frequency of alcoholisation among young people injured in accidents in France.

In a nation-wide epidemiological survey carried out in France in 1982-1983, blood alcohol concentration was systematically measured in 1423 young casualties (aged 15-24 years) on their arrival in the emergency room. Traffic accidents accounted for almost half of the admissions, and they were the most severe, with over 10% requiring hospitalisation with vital risk. A quarter of the admissions was female; on average, their blood alcohol concentration was low and not statistically related to age. Conversely, among young male casualties, 1 out of 5 had a blood alcohol concentration of at least 0.50 g/l (11 mmol/l) and 1 out of 15 was classified as a chronic heavy drinker. It is of note that alcohol was implicated in 43% of the car/truck accidents of the young men and that blood alcohol concentration as well as the proportion of chronic drinkers were strongly related to age. Alcohol consumption may begin as early as 15 years; in the young men 15-24 years, only 7% were chronic drinkers whereas in men over 24, 37% were chronic drinkers. On this basis, it is appropriate to focus education about alcohol consumption on adolescents, particularly men.

Accidents↗
PubMed1991

[Incidence of insulin-dependent diabetes occurring before 20 years of age in France].

Incidence rates of insulin dependent diabetes mellitus (IDDM) are distributed over Europe along a North to South gradient where the values observed in Finland are 7-fold greater than in the South. According to previous data, France represented the bottom of this gradient. A survey in 1988 and 1989 was conducted in order to record all newly diagnosed diabetic children under 20 years of age, in 4 French regions: Aquitaine, Lorraine, lower Normandie, upper Normandie. The mean annual incidence rate was 7.3/10(5), without any significant geographical variation. Age-specific incidence rates indicated two peaks: one in the younger age group and the other around puberty, already described in most incidence studies. The study confirms that France is a country with one of the lowest incidence rate in Europe. It also suggests that incidence has increased over the past decades as in other countries.

Adolescent↗
PubMed1991

[Dietary intake of a representative sample of the population of Val-de-Marne: I. Contribution of diet to energy supply].

Dietary intakes and its nutritional value were assessed during a nutritional survey performed in a population living in a district in the Paris area (Val-de-Marne). Data were obtained from 1108 subjects, aged 6 months to 97 years, randomly selected from the telephone directories of 12 of 47 towns and cities in the district. Dietary intake was evaluated in individual home interviews conducted by specialized dietitians, using the dietary history method. Age appears to be an important determining factor in variations in nutritional intake. Large differences exist between men and women for most types of food consumption. But the relative contribution of the main groups of food groups to the structure of energy intake is very similar in both sexes and virtually constant in the different age groups after the age of 6.

Adolescent↗
PubMed1991

[Dietary intake of a representative sample of the population of Val-de-Marne; III. Mineral and vitamin intake].

Mineral and vitamin intakes were assessed among 1108 subjects, aged 6 months to 97 years in 12 of 47 towns and cities in the district of Val-de-Marne (Paris area), using the telephone directory as random sampling base. Micronutrients intake was evaluated by individual interviews at home by specialized dietitians (dietary history method). Mineral and vitamin intake was found to vary widely with age. In absolute value, overall mineral and vitamin dietary intakes was higher in men than in women (except for vitamin C). Conversely, the dietary density for mineral and vitamins was higher in females. For a large part of the studied population, it would appear difficult to satisfy recommended dietary allowances for many micronutrients (iron, zinc, vit. B1, B6, C, A et E). These results bring to light possible difficulties in covering certain mineral and vitamin requirements in the French population.

Adolescent↗
PubMed1990

Incidence of juvenile type 1 (insulin-dependent) diabetes mellitus in France.

The incidence rate of juvenile Type 1 (insulin-dependent) diabetes in France was reported as the lowest in Europe 13 years ago, but during the recent years increasing rates have been observed in different European countries. A prospective programme has been designed to study the incidence rate of Type 1 diabetes in patients up to 20 years of age in four regions located in the north and south of France (population less than 20 years = 2.31 million inhabitants; 15% of the French population). All cases were independently identified by four specially trained research assistants through hospital admission files, paediatricians, diabetologists and general practitioners. A specific questionnaire was filled out for each newly diagnosed case. Degree of ascertainment was 96% with the data from Sécurité Sociale, the French National Health Insurance. In 1988, 166 cases of juvenile Type 1 diabetes were identified. The incidence rate was 7.17 cases per 10(5) children (95% confidence interval = 6.1-8.2/10(5). The values were not statistically different among the four regions. Age specific incidence rates were as follows: 0-4 years = 3.8; 5-9 years = 8.0; 10-14 years = 9.7 and 15-19 years = 7.3/10(5). Sex ratio was 1.2 (male/female). These data indicate that incidence of juvenile Type 1 diabetes in France was higher in 1988 than previously reported but remains lower than in Northern Europe. This is consistent with the concept of a north to south gradient of the disease.

Adolescent↗
PubMed1990

Effects of oral contraceptives on carbohydrate and lipid metabolisms in a healthy population: the Telecom study.

In a cross-sectional study that aimed to identify risk factors for diabetes, 1290 consecutive, healthy, nonpregnant women of child-bearing age were examined in a center for preventive medicine. An in-depth interview about menses, use of oral contraceptives, and menopause was performed. Plasma glucose at fasting and 2 hours after a 75 gm glucose load, glycated hemoglobin A1c, fasting plasma insulin, total plasma cholesterol, and triglycerides were measured. Compared with nonusers taking no progestogens, oral contraceptive users (n = 431; 33.4%) were younger (p less than 0.001) and leaner (p less than 0.001). After adjustment for age and body mass index, oral contraceptive users had higher 2-hour plasma glucose (p less than 0.001), higher fasting plasma insulin (p less than 0.01), and higher triglycerides levels (p less than 0.01). Fasting plasma glucose, glycated hemoglobin A1c, and total cholesterol did not significantly differ between the two groups. In relation to dosage and types of steroid components, few differences have been found between high-dose and low-dose oral contraceptives or according to the estrogen-progestogen balance of the preparations. Use of oral contraceptives appears to induce an increase of insulin-resistance markers, which have recently been cited as risk factors for ischemic vascular diseases. These markers should be carefully monitored in oral contraceptive users.

Adult↗
PubMed1990

Oral contraceptives, insulin resistance and ischemic vascular disease.

From a large prospective study on diabetes risks, 1112 professionally active, non-menopausal, non-pregnant, healthy women were cross-sectionally analysed according to their use of oral contraception. After adjustment for age, weight and diabetes risk factors, those taking the pill, compared to those who did not, had significantly higher fasting serum insulin, triglycerides and 2-h 75 g OGTT blood glucose levels. The insulin-resistance markers which have recently been cited as ischemic vascular disease risk factors should be carefully monitored in pill users.

Adult↗
PubMed1989

Epidemiological features of glycated haemoglobin A1c-distribution in a healthy population. The Telecom Study.

HbA1c was measured in 3240 healthy non-diabetic adult individuals in a working population. There was no difference in HbA1c between sexes. The distribution of HbA1c was approximately normal with a slight difference between mean and median values at all ages in both sexes. HbA1c increased with deterioration of glucose tolerance and with all the known risk factors for diabetes (age, obesity, family history of diabetes, history of a large newborn delivery); age but not body mass index appeared as a factor influencing HbA1c independently. In women, HbA1c levels rose particularly at the age of menopause but the use of oral contraceptives or oestrogens made no difference. In both sexes, HbA1c was higher in smokers than in non-smokers. No consistent seasonal variation was observed. Haematologic factors had a negligible influence on HbA1c level. HbA1c was more highly correlated with fasting plasma glucose than with 2 h-plasma/glucose (r = 0.20 vs 0.11). In a stepwise multiple regression analysis, age followed by fasting plasma glucose were the only two significant factors associated with the level of HbA1c. These data indicate that HbA1c is influenced only by factors closely linked to diabetes.

Adult↗
PubMed1988

Diabetes mellitus in Tunisia: description in urban and rural populations.

A prevalence survey of diabetes mellitus was carried out in Tunisia on two random samples of households. The first sample (3826 adult subjects) was drawn from the Gouvernorat of Tunis, the second one (1787 adult subjects), was drawn from a rural area, the Gouvernorat of Siliana. The families were investigated at home and diabetes assessed on the basis of an interview (to determine known cases) and of fasting blood glucose level in subjects having no personal history of diabetes (new cases). Prevalence rates were estimated considering known cases and newly found ones together. Overall, the age-standardized prevalence rate was found to be much higher in the urban sample compared to the rural one, especially for women (4.6% versus 2.3% in men, 3.5% versus 0.6% in women). Diabetes was often associated with obesity, especially in men. Within the urban sample, the prevalence rate was similar in subjects born in Tunis and in those born in the rest of the country, thus mainly of rural extraction. In contrast, a family history of diabetes was more often reported in the former group. The results are consistent with other epidemiological findings, showing that a dramatic increase in diabetes morbidity parallels the rapid westernization of urban centres in developing countries.

Adult↗
PubMed1988

Creatinine clearance evaluation in routine diabetes practice.

Creatinine clearance measurement based on timed urine collection is not reliable in routine practice. Methods for creatinine clearance estimation have already been established and validated in non diabetic patients. In order to ascertain their validity in diabetic patients, creatinine clearance values were determined in 33 diabetic patients (16 men, 17 women) on two consecutive days by direct measurement and by estimation according to the methods of Kampmann et al., Bjornsson et al. and Cockcroft and Gault. A good correlation (r = 0.73-0.75, p less than 0.001) was observed between measured and estimated creatinine clearance values. The correlation coefficients were stronger in men than in women. The day to day coefficient of variation was poor for creatinine clearance direct measurements (28%) and better for creatinine clearance estimation values (about 17%). These results suggest that methods for creatinine clearance estimation are suitable in diabetic patients for routine clinical practice.

Creatinine↗
PubMed1987

Prognostic factors in patients with hepatocellular carcinoma. Attempts for the selection of patients with prolonged survival.

A prognostic study based on 127 untreated patients with hepatocellular carcinoma was undertaken to evaluate their survival time and to find clinical and biologic criteria which allow the selection of patients with a survival time longer than 60 days who could enter a therapeutic trial. Twenty-eight clinical and biologic variables were assessed using univariate and multivariate semiparametric regression (Cox's) models. Ten variables were isolated by univariate analysis. Multivariate analysis found a negative relationship between a survival time longer than 60 days and five of these variables; these variables were in decreasing order: encephalopathy, alcohol consumption, aspartate amino transferase (AST), blood urea nitrogen, and total bilirubin. Prevalence, positive, and negative predictive values of encephalopathy were 20%, 27.5%, and 97% respectively. When three other criteria: ASAT greater than four times the upper limit of the normal (N), blood urea nitrogen greater than N, and total bilirubin greater than 2N were added, their prevalence, positive, and negative predictive values were 72%, 89.7%, and 57.1% respectively. These results suggest that in countries where incidence of hepatocellular carcinoma is low and recruitment of patients difficult, absence of encephalopathy must be the only criterion for selection of patients with hepatocellular carcinoma in therapeutic trials; whereas, in countries with a high incidence of hepatocellular carcinoma the other criteria may be added.

Age Factors↗
PubMed1986

Cyclosporin increases the rate and length of remissions in insulin-dependent diabetes of recent onset. Results of a multicentre double-blind trial.

In a double-blind trial 122 patients aged 15-40 years with insulin-dependent diabetes of recent onset were randomly assigned to cyclosporin 7.5 mg/kg per day or placebo. At the sixth month 25.4% of the cyclosporin group and 18.6% of the placebo group were in complete remission (not a significant difference). Treatment was continued in those patients with complete or partial remission (insulin requirement less than 0.25 U/kg per day) and 106 patients were followed to nine months, at which stage 24.1% of the original cyclosporin group and 5.8% of the original placebo group were in complete remission (p less than 0.01). For those patients whose whole-blood trough cyclosporin levels in the first three months averaged 300 ng/ml or more, the rates of complete remission at six and nine months were 37.5% and 37%. The rates of partial remission were also higher in the cyclosporin group and at six months the rate of complete or partial remission was 46% in the whole cyclosporin group and 65.6% in those with an average blood level exceeding 300 ng/ml in the first three months, versus 28.8% in the placebo group. The principal side-effect of cyclosporin was a modest and reversible increase in plasma creatinine. These results indicate that cyclosporin promotes the remission of type I diabetes and suggest the need for new controlled protocols aimed at evaluating the length of the effect and selecting the best drug regimen.

Administration, Oral↗
PubMed1986

Biological markers of alcohol intake among 4796 subjects injured in accidents.

An epidemiological survey was carried out in France in 1982-3 to study the proportions of occasional and chronic drinkers among people injured in accidents of all kinds. The characteristics of 4796 victims recruited in the emergency units of 21 hospitals were recorded. Systematic blood sampling was performed to determine the blood alcohol concentration and two markers of chronic alcohol consumption--gamma-glutamyltransferase activity and mean corpuscular volume. Alcohol was present in the blood of 35% of the injured people, with concentrations exceeding 17.4 mmol/l (0.8 g/l) in one man out of four and in one woman out of 10. gamma-Glutamyltransferase values and mean corpuscular volume were also much higher than in a reference population of healthy subjects, indicating that most of the intoxicated subjects were probably chronic drinkers. This was confirmed by a discriminant analysis which showed an overall proportion of 30% of chronic drinkers among casualties. In France, therefore, the policy for preventing accidents should focus on chronic as much as on occasional drinking.

Accidents, Traffic↗
PubMed1986

A simple model relevant to toxoplasmosis applied to epidemiologic results in France.

A simple mathematical model was applied to the results of a seroepidemiologic study of toxoplasmosis carried out in France in 1982-1983. An adequate fitting to the prevalence data observed on 7,605 women of childbearing age was obtained. Thus, the data were used to estimate the seroconversion rate, allowing the approach to and discussion of insights gained from the model, such as the risk of Toxoplasma infection during pregnancy, the age-related expected risks of maternal seroconversion, as well as an overall prediction of the yearly number of congenitally infected infants in the total population. In addition, the high prevalence of congenital toxoplasmosis in France and the excess risk encountered by young migrant women from lower prevalence areas were confirmed by the model. The model might therefore be useful for public health purposes in other countries.

Adolescent↗
PubMed1986

[Relation between serum markers of hepatitis B virus and alpha fetoprotein in hepatocellular carcinoma in France].

Prevalences of serum markers of hepatitis B virus and alphafetoprotein levels were investigated in 96 patients with hepatocellular carcinoma. Serum HBs Ag was present in 17 patients (17.5 p. 100), anti-HBc antibody alone in 10 patients (10.5 p. 100), and anti-HBs antibody with or without associated anti-HBc antibody in 32 patients (33.5 p. 100). Serum alphafetoprotein levels were increased (greater than 20 ng/ml) in 71 patients (74 p. 100). Serum alphafetoprotein levels were significantly higher in patients with than in patients without serum HBs Ag. Serum alphafetoprotein levels above 1,000 ng/ml were more frequently found in patients with serum HBs Ag or anti-HBc antibody than in other patients. These results suggest the presence of a link between HBs Ag and alphafetoprotein in hepatocellular carcinoma.

Adult↗
PubMed1986

[Induction of remissions of insulin-dependent diabetes by cyclosporin].

The effect of cyclosporine was evaluated in a double blind placebo controlled trial in 122 recent onset insulin-dependent diabetics. A significantly higher incidence of complete remissions was observed in patients treated with cyclosporine than in those receiving placebo (respectively 24 and 5.8%). The effect was still more clear-cut in patients having presented the highest cyclosporine blood level (37%). These results which have been obtained with modest toxicity demonstrate that cyclosporine induces remission of insulin-dependent diabetes and prompt to set up new controlled trials to evaluate the duration of the effect obtained and the potential risks of the treatment.

Adolescent↗