PubMed Health⌕ Search

Biomedical subjects

M Andre

Publications and source records attributed to M Andre.

At least 19 recordsLinked to original sources
PubMed1992

[The long-term therapy of familial hypercholesterolemia with heparin-induced extracorporeal LDL precipitation].

The long-term tolerance to and effectiveness of heparin-induced extracorporeal LDL precipitation (HELP) in combination with lipid reducing drugs and diet was tested in six patient (5 males, 1 female; mean age 48 +/- 4 years). Follow-up period was over 50 months, in one patient over 24 months, while one man had a sudden cardiac death 57 weeks after starting treatment. The study was divided into three phases. In phase I (24 months) treatment consisted of HELP and conventional lipid-reducing drugs; in phase II (12 months) of lovastatin (80 mg daily) and cholestyramine (12-24 g daily); and phase III (14 months) of HELP, lovastatin and cholestyramine. In phase I it was possible to lower the pre-treatment level of LDL-cholesterol from 306 +/- 18 mg/dl to 173 +/- 13 mg/dl (43.5%). A similar effect (from 307 +/- 21 mg/dl to 155 +/- 17 mg/dl [-49.5%]) was obtained in phase II. The resumption of HELP reduced the pre-treatment LDL concentration to 136 +/- 9 mg/dl (-55.7%). The various treatment regimens were well tolerated. Biochemical data remained unchanged except for iron loss requiring substitution. Thus combined HELP, lovastatin and ion exchange offer for the first time an effective and reliable means in familial hypercholesterolaemia of clearly reducing long-term the mean LDL cholesterol level below the atherosclerosis threshold of 120 mg/dl.

Anticholesteremic Agents↗
PubMed1992

Performance of an immunoradiometric assay of erythropoietin and results for specimens from anemic and polycythemic patients.

We evaluated a new commercially available two-site immunoradiometric assay (IRMA; BioMérieux 125I-EPO CoatRIA) for erythropoietin (EPO) in human serum. The precision (CV) was 4.1% intra-assay and 8% interassay for a serum pool with an EPO concentration of 17 int. units/L; the detection limit was 0.5 int. unit/L, one order of magnitude lower than by classical radioimmunoassay (RIA), although standardization of IRMA and RIA were similar. Results by both IRMA and RIA are compared for normal subjects, patients with nonrenal noninflammatory anemias, patients with beta-thalassemia major, hemodialysis patients, and patients with primary or secondary polycythemia. Values by IRMA compared well with those by RIA in the upper area of the range; IRMA and RIA values for EPO show parallel expected variations with the degree of anemia. However, because of its greater sensitivity and specificity, we consider the IRMA more appropriate than RIA for investigating patients with sub-normal EPO concentrations.

Adolescent↗
PubMed1991

Gastric lipase: evidence of an adaptive response to dietary fat in the rabbit.

In the rabbit, the stomach is the only source of preduodenal lipase, and in humans, it is quantitatively the most important. Thus, the adaptive response of gastric and pancreatic lipases to dietary fat was studied in the adult rabbit. Effect of duration was studied by feeding rabbits 12% dietary fat for 1, 2, or 4 weeks or 2.7% for 2 weeks (control). To study the effects of the amount of fat, rabbits were fed the control diet (2.7% fat) or 6% and 12% dietary fat for 2 weeks. The influence of sunflower oil and butter was compared by feeding rabbits 12% dietary fat for 2 weeks. Approximately doubling (6% vs. 2.7%) the usual amount of dietary fat was sufficient to induce a maximum increase in gastric lipase activity in the fundus [+ 66.3% (units per gram tissue) or + 85.2% (units per milligram protein)] and the total stomach mucosa [+ 84.5% (units per mucosa)], whereas pancreatic lipase activity only significantly increased when rabbits were fed 12% dietary fat. A full adaptive response was observed for both gastric and pancreatic lipases after 2 weeks of diet. Triglyceride composition did not noticeably change the adaptive response of both lipolytic enzymes. The present results agree closely with those concerning lingual lipase in the rat and evidence that gastric lipase shows an adaptive response to moderate fat intake. The implications of these findings concerning humans are discussed.

Adaptation, Physiological↗
PubMed1991

Ambulatory blood pressure monitoring: is it cost-effective?

The detection and treatment of hypertension can prevent cerebrovascular disease and, to some extent, coronary heart disease. For mild hypertension this process is not efficient because many patients must be treated with antihypertensive medication to benefit only a few. The costs of identification, diagnosis and drug treatment of mild hypertension are significant. These costs have increased recently, in part due to changing patterns of drug selection favoring newer agents. Primary and secondary screening for hypertension has relied on casual blood pressure measurement which has high sensitivity, but low specificity, i.e. many false-positives can be expected. Incorporation of ambulatory blood pressure monitoring into secondary screening has potential for greater specificity by excluding from treatment 20-40% of those initially identified as having mild hypertension. Computer analysis of simulated populations selected for treatment by either casual blood pressure or by use of ambulatory blood pressure monitoring with echocardiography (for borderline cases) demonstrates no difference in calculated life expectancy for the two groups. However, the former strategy selected 23% of the subjects for treatment, while the latter selected 6%. These results imply that appropriate use of ambulatory blood pressure monitoring in secondary screening of mild hypertension may have a significant impact on cost-effectiveness.

Ambulatory Care↗
PubMed1990

Neurophysins as markers of vasopressin and oxytocin release. A study in carcinoma of the lung.

Vasopressin-neurophysin (hNpI), oxytocin-neurophysin (hNpII) and blood osmolality were assayed before any treatment in basal conditions in 35 patients suffering from lung carcinoma (20 oat cell, 6 undifferentiated and 9 well-differentiated epidermoid cell carcinomas). Plasma vasopressin (antidiuretic hormone, ADH) was also assayed in 7 of the 20 patients suffering from oat cell carcinoma. We found a close correlation (r = 0.98) between plasma ADH and hNpI levels in the 7 patients. Further, hNpI was elevated in 13 out of the 20 oat cell carcinoma patients and in none of the epidermoid-cell carcinoma group; however, searching for an abnormality of ADH secretion as reflected by a detectable plasma hNpI level together with subnormal plasma osmolality revealed 2 additional positive results in the oat cell carcinoma group, and 2 out of the 6 in the undifferentiated-cell carcinoma group. hNpII was increased together with an increase in hNpI in 6 oat cell carcinoma patients; it was specifically increased without hNpI increment in 2 additional oat cell carcinoma patients and in 2 patients of the undifferentiated-cell carcinoma group (different from the 2 positive for the hNpI-osmolality ratio). hNpI and hNpII were normal in the majority of undifferentiated and all of the differentiated epidermoid-cell carcinoma group. Hence, our results show that simultaneous measurements of hNpI, hNpII, and blood osmolality could detect abnormalities in 17 out of 20 oat cell carcinoma patients, in 4 of the 9 undifferentiated-cell carcinoma patients, but in none of the differentiated epidermoid-cell carcinoma patients, suggesting that the neurophysin assay can be used for the early detection of oat cell- and possibly other neuroendocrine-derived carcinomas.

Biomarkers, Tumor↗
PubMed1990

Inverse modifications of heart and liver alpha-tocopherol status by various dietary n-6/n-3 polyunsaturated fatty acid ratios.

The effect of dietary n-6/n-3 fatty acid ratio on alpha-tocopherol homeostasis was investigated in rats. Animals were fed diets containing fat (17% w/w) in which the n-6/n-3 ratio varied from 50 to 0.8. This was achieved by combining corn oil, fish oil, and lard. The polyunsaturated to saturated ratio and total alpha-tocopherol remained constant in all diets. Results showed that enrichment of n-3 polyunsaturated fatty acids in the diet, even at a low amount (3.9% w/w), resulted in a dramatic reduction of blood alpha-tocopherol concentration, which, in fact, is the result of a decrease in plasma lipids, since the alpha-tocopherol to total lipids ratio was not significantly altered. The most striking effect observed was a considerable alpha-tocopherol enrichment (x 4) of the heart as its membranes became enriched with n-3 polyunsaturated fatty acids. This process appeared even with a low amount of fish oil (3.9% w/w) added to the diet. Accordingly, a strong positive correlation was found between heart alpha-tocopherol and docosahexaenoic acid (r = 0.86) or docosahexaenoic acid plus eicosapentaenoic acid levels (r = 0.84). Conversely, the liver alpha-tocopherol level dropped dramatically when n-3 polyunsaturated fatty acids were gradually added to the diet. It is concluded that fish oil intake dramatically alters the alpha-tocopherol homeostasis in rats.

Animals↗
PubMed1989

Perfusion lung scan in patients operated for transposition of the great arteries.

Fifty perfusion lung scans were performed with Tc-99m albumin microspheres in 42 patients, 15 days to 12 years after corrective surgery for transposition of the great arteries. The scan was entirely normal in nine of 42 patients. Absence of left lung perfusion was observed in three patients and hypoperfusion of the left lung in 19 patients. Segmentary zones of hypoperfusion was visualized in 13 patients either in the right or left lung. A moderate right to left shunt was observed in eight cases. The absence or decrease in left lung perfusion was due to pulmonary vein occlusion in four patients, left pulmonary artery stenosis in two patients, and preferential right blood flow in one patient. Right to left shunt was due to dehiscence of the atrial patch in four patients.

Adolescent↗
PubMed1989

[Post-transfusion cytomegalovirus infection in premature infants weighing less than 1,500 g].

The incidence of cytomegalovirus (CMV) infection among 107 low birth weight transfused infants (birth weight less than or equal to 1,500 g) admitted to an intensive care nursery over an 18 month period was evaluated. The diagnosis of CMV infection was based on specific serologic tests (presence of IgM, increased IgG by ELISA technic) and identification of the virus in the urine. During the first 8 months, the infants received untested blood and CMV disease occurred in 8 infants out of 44 (18.2%). During the following 10 months, all transfusions performed in 63 infants were supposed to be CMV negative. However, 32 infants received untested blood due to emergency, and 5 of them developed a CMV infection (15.6%). Finally, only 31 infants received CMV negative blood without any case of CMV infection. These data clearly demonstrate that, considering the severity of the CMV disease in the premature infants, transfusions should be performed with CMV negative blood products.

Cytomegalovirus↗
PubMed1988

Neonatal seizures--recent aspects.

This study reports the neonatal aspects and prognosis of seizures observed in 71 neonates from 1.3. 1980 to 30.6 1981. Forty-five were full-term, 26 preterm babies. Twenty-one children had status epilepticus (SE), 50 isolated crises (IC). An etiology was found in 68 cases. Acute fetal distress (AFD) was observed in half of the cases. AFD and intracranial hemorrhages represented 62% of the etiologies in term babies, 42% in preterm. Fifteen children died in the neonatal period. The outcome of the 56 survivors was followed until at least two years of age. Forty-one children were neurologically normal; 15 were not: 9 had a cerebral palsy, 12 a mental retardation, 1 was deaf, 4 were epileptic. Sequelae occurred in 24.3% of term, 31.6% of preterm survivors (p less than or equal to 0.01). The outcome was normal in 8 out of 15 living children with SE (53%), in 32 out of 41 (78%) with IC (p less than or equal to 0.01). The prognosis of hypoxic-ischemic seizures was good if crises lasted less than two days. Treatment was discontinued as soon as possible, during the days following the end of the crises and the recovery from the initial disease, without adverse effects. Convulsions following obstetrical abnormalities were less frequent, and the prognosis was better in premature babies than in previous studies.

Electroencephalography↗
PubMed1988

Three-dimensional quantitative CT of the proximal femur: relationship to vertebral trabecular bone density in postmenopausal women.

Dual-photon absorptiometry (DPA) of the proximal femur cannot independently measure cortical and high-turnover cancellous bone. In this investigation, integrated cancellous, cortical, and total bone densities in the femoral neck and intertrochanteric region were measured bilaterally in 22 women aged 42-75 years. Contiguous section data were analyzed with two different protocols by means of three-dimensional histogram software. Single-section quantitative computed tomography (CT) was used to determine mean mineral equivalent values for vertebral cancellous bone from T-11 to L-3 in each woman. Significant correlation was found between cancellous bone density at the two sites, as well as between total femoral and vertebral measurements. Femoral cortical bone density was predicted less well by means of the vertebral cancellous data. Cortical, cancellous, and total proximal femoral density values tended to exhibit bilateral symmetry. Quantitative three-dimensional volumetric CT affords comprehensive evaluation of proximal femoral mineral status because of its capability for selective measurement of cortical, cancellous, and total bone density.

Absorptiometry, Photon↗
PubMed1987

Vertebral mineral status: assessment with single- versus multi-section CT.

A volumetric approach to quantitative single-energy computed tomography (CT) of the spine for trabecular bone evaluation was compared with the accepted single-section method in 32 thoracic and lumbar vertebral bodies from six cadaveric specimens. Both 5-mm and 10-mm contiguous section sequences afforded greater sample volumes, mean mineral equivalent values, and precision than did the single midplane section technique. These findings can be explained by inhomogeneous trabecular distribution, differential bone resorption rates for various cancellous regions, and nonuniform deposition of marrow fat. Scoliosis may modify the net influence of these factors owing to altered biomechanical forces. Although the single-section method affords optimal sensitivity to early or subtle alterations in vertebral trabecular bone density, it may misrepresent the status of the total cancellous volume. Because three-dimensional histographic analysis includes structurally important peripheral trabeculae in determinations of mean mineral equivalent values, it may more accurately reflect vertebral body strength and risk of compression fracture.

Biomechanical Phenomena↗
PubMed1987

[Complications of inguinal hernia in children].

From 1978 to 1985, 679 boys were operated for an inguinal hernia. 3 groups of patients must be considered. The bilateral inguinal hernias group (119 children) 73 patients were operated on both sides. 46 presented signs of hernia on the opposite side after the first operation and were operated again. In this group, there is a more important frequency of premature. But the classical notion that bilateral hernia are more common when the presenting hernia is on the left side, is not noticed. As a matter of fact, among the 46, there were 33 children operated at first on the right side. If a systematic bilateral exploration had been realised, it would here been useless in 82 per cent of the cases. The incarcerated inguinal hernia group 177 (26%) children were hospitalised for an incarcerated inguinal hernia diagnosis. 23 infants required emergency operation. Mostly, it was the first episode of a right hernia in a child under 3 months of age. 8 times a testicular infarction was noticed. The incidence of testicular lesion following incarceration of inguinal hernia is more important that the testicular atrophy after primary hernioplasty. This justify the surgical treatment for children of any age. The premature group 126 children were premature infants. In this group, a more important frequency of bilateral and incarcerated hernias are noted. 24 among these patients presented recurrent apnea episodes. To 8 of those children, the intervention was probably a benefit for the evolution of their apneas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

A comparative study of the clinical results obtained with plastipore and ceramic ossicular prostheses in otologic surgery.

We describe our experience with clinical tolerance to total and partial ossicular prostheses using ceramic and plastipore and the functional results obtained. We have found that ceramic is well tolerated (with a 4% incidence of rejection) in contrast to plastipore (which had a 19% incidence of rejection). The ceramic partial and total prostheses give satisfactory function results, and 63% and 62% of our patients, respectively, were found to have postoperative air-bone gaps of less than 20 dB, and average air-bone gap gains of 16 and 21 dB.

Biocompatible Materials↗