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Biomedical subjects

M F Doré

Publications and source records attributed to M F Doré.

15 recordsLinked to original sources
PubMed2000

[Body composition in chronic obstructive lung patients. Comparison of bioelectric impedance and anthropometry].

Malnutrition is associated with poor prognosis in patients with chronic obstructive pulmonary disease (COPD). Body weight is not a reliable evaluation criterium. Body composition which is more useful can be determined routinely using 2 techniques: skinfold thickness anthropometry (Ant) and bioelectrical impedance analysis (BIA). The validity of this last technique has not been demonstrated in patients with COPD. Fat-free mass (FFM) in 58 patients (51 men, 7 women) with stable COPD (FEV1 < 50% of predicted value) was assessed using the 4-skinfold-thickness method (Ant) and BIA (Imp). Statistical analysis included correlation analysis, intraclass correlation coefficient, and the Bland and Altman analysis. Imp-FFM and Ant-FFM correlated well (r = 0.920; p < 0.0001). Intraclass correlation coefficient was high (rI = 0.9065). However, the values were scattered and there was a systematic bias (significant linear regression between the difference in estimates obtained by the 2 methods and the means). As anthropometric measurements are not reliable in the elderly patients, our results suggest that BIA could be a useful tool to determine FFM in patients with COPD. Its validity still has to be tested against a reference method.

Adipose Tissue↗
PubMed1999

[Methods of nutritional assessment in chronic obstructive lung diseases].

A poor nutritional state is often encountered in the course of chronic obstructive lung disease (COLD) and worsens the prognosis. The methods used to assess nutritional status proposed in the literature vary greatly. We detail here the methods used in clinical practice and in research, describing results obtained in patients with COLD. Appropriate routine tests are discussed. Body weight should be followed in this population, but weight loss may be masked by sodium-water retention. Bioelectric impedancemetry or biphotonic absorptiometry are used to define body composition in patients with COLD. Lean mass can be measured with the creatinine/height index but is difficult in the ambulatory patient. Plasma levels of visceral proteins are often normal and do not appear to be useful markers in these patients. Immunology tests (delayed hypersensitivity, total lymphocyte counts) are not sensitive screening tests. An evaluation of skeletal muscle function using the walking test or an exercise test is recommended before starting a renutrition program and to evaluate its efficacy.

Absorptiometry, Photon↗
PubMed1997

Role of the thermic effect of food in malnutrition of patients with chronic obstructive pulmonary disease.

Malnutrition in patients with chronic obstructive pulmonary disease (COPD) is classically ascribed to an increased resting energy expenditure (REE) secondary to high cost of breathing. However, malnutrition correlates only weakly with the severity of respiratory dysfunction, which suggests other mechanisms. The aim of the present study was to determine the possible role of diet-induced thermogenesis (DIT). Therefore, we evaluated the relationship between DIT and nutritional status, in particular fat-free mass (FFM) estimated by bioelectrical impedance analysis in 26 patients with stable COPD (mean FEV1 +/- SEM = 36.5 +/- 3.8% of predicted). Ten patients were undernourished (weight < 90% of ideal body weight [IBW] and/or FFM < 69% of IBW), and 16 were normally nourished. Diet-induced thermogenesis was determined by comparing postprandial energy expenditure and REE, the latter being measured after an overnight fast and the former over 4 h after a mixed test meal of 0.4 times REE load. No statistical difference in DIT was found between undernourished and eutrophic patients. There was no relationship between DIT and nutritional or functional parameters, notably FFM. These results suggest that malnutrition is not a consequence of an increased DIT.

Body Composition↗
PubMed1997

[Forced expiration. Various current concepts, 50 years after Robert Tiffeneau].

One hundred and fifty years after the original description of spirometry by Hutchinson and 50 years after the definition of his famous ratio by Tiffeneau, a certain number of physiological advances have enabled a better understanding of the determinants of the forced expired manoeuvre and to mitigate some of its inconveniences. This review focuses on three of these advances. The first is the influence of an inspiratory manoeuvre which precedes a forced expiration, on the expiratory flow. This influence is probably a consequence of viscoelastic phenomena and impose some strains on standardisation in current practice. The second is the possibility of detecting in a reproducible and simple fashion, without the need for co-operation on the part of the subject, a limitation in expiratory flow by the application of a negative expiratory pressure at the opening of the airways (NEP for negative expiratory pressure). The third is the possibility to verify in a simple fashion the quality of the expiratory performance achieved by the patient and thus to detect an insufficient effort in the force of a falling expiratory flow.

Dyspnea↗
PubMed1996

Bronchial hyperresponsiveness following acute severe asthma.

OBJECTIVE: To evaluate bronchial hyperresponsiveness (BHR) early after recovery from acute severe asthma (ASA). DESIGN: Prospective study including all patients admitted to the intensive care unit (ICU) for ASA over a 12-month period. SETTING: University teaching ICU and pneumonology department. PATIENTS: 41 consecutive patients admitted to the ICU for ASA. Results were compared with those of a control group with stable asthma and no history of ASA or steroid therapy, matched for sex and age. MEASUREMENT AND RESULTS: Of the 41 patients, 40 completed respiratory function tests 10 days after ICU admission, and the minimal dose of acetylcholine inducing a fall in forced expiratory volume in 1 s (FEV1) of 20% or more (PD AC) could be determined safely by a novel method in 26 patients with an FEV1 above 60% predicted. PD AC (micrograms) was found to be significantly lower in ASA than in control patients. Very severe BHR (PD AC < or = 100 micrograms) was found in 18 ASA patients, but not in the control patients; 5 ASA versus 12 control patients had marked BHR (100 > PD AC < or = 500 micrograms); and 3 ASA versus 14 control patients had moderate BHR (> 500 micrograms). A similar level of BHR was found in ASA patients with progressive or acute worsening. No correlation was found between PD AC and admission PaCO2 value, admission peak expiratory flow (PEF) value, delay in improvement of PEF, delay in PD AC determination, or prechallenge FEV1 value. CONCLUSION: BHR measurement is safe soon after an episode of ASA if done with caution. At this time, patients who are free of clinical symptoms and have no significant objective bronchial obstruction appear to have severe bronchial hyper-responsiveness.

Acetylcholine↗
PubMed1995

Longitudinal observations of serum IgE and skin prick test response.

The objective of the study was to assess skin prick test and IgE changes in a working population surveyed 5 yr apart and to determine whether age and smoking habits modify these changes. SPTs were performed on 223 subjects by the same method and common allergens (a mixture of grass pollens and a mixture of 95% house dust and 5% house dust mite). IgE measurements were done in duplicate by the same technique at each survey. A SPT-positive response at the first survey was highly predictive of a positive value at the second survey. The prevalence of positive SPT significantly increased in 5 yr (from 17.5 to 24.7%). A strong correlation was observed between IgE levels 5 yr apart (r = 0.92), and the IgE level appeared very stable. The initial IgE level was significantly greater among the converters than in consistently negative subjects (92.3 versus 30.1 IU/ml). Conversely, the initial IgE level was lower for the reverters than in consistently positive subjects (36.8 versus 97.0 IU/ml). In SPT negatives, non- and exsmokers had a greater decrease in IgE than current smokers (p = 0.06). IgE level appears to be a good predictor of SPT changes for both conversion and reversion. The IgE level appears very stable in midadulthood, which suggests that the adult environment may play a small effect in IgE level.

Adult↗
PubMed1990

[Respiratory function abnormalities and pneumonia in HIV-positive patients. A prospective study of 112 patients].

Pulmonary function studies are often limited to the alone measurement of transfer lung factor for CO (TLCO) in screening for pneumonia in patients with Human Immunodeficiency Virus (HIV) infection. We prospectively measured pulmonary function tests (PFT) in 112 HIV seropositive patients. The population consisted of two groups: on one hand, a group free of clinical and radiological abnormalities, on the other hand, one with respiratory symptoms and/or abnormal chest X-Ray, with or without overt pneumonitis. For this latter group, a fiberoptic bronchoscopy with bronchoalveolar lavage was routinely performed in addition to PFT. In case of pneumonitis, PFT showed a restrictive disease and a reduced TLCO. The specificity of this functional pattern was however weaker in the subgroup of drug abusers than in the non-drug addicts. This difference was above all linked to a low TLCO value in the subgroup of drug addicts without pulmonary complications. Multivariate statistical analysis, including discriminant analysis, maintained the same sensibility and improved specificity of PFT in diagnosis of pneumonia, especially if the analysis takes the existence of drug abuse into account. Moreover, initial PFT, performed before any lung disease, improved the sensibility of the screening. The results are discussed in relation to new tests proposed for the screening of pneumonitis in HIV positive patients. At the present time, PFT seems to be useful and enables one to understand natural functional evolution.

Adult↗
PubMed1988

Relation of perceived nasal and bronchial hyperresponsiveness to FEV1, basophil counts, and methacholine response.

Perceived nasal and bronchial hyperresponsiveness to tobacco smoke and cold air were assessed in 912 working men in the Paris area. Baseline lung function measurements and peripheral leucocyte counts with standard differential counts were performed. At least one perceived nasal or bronchial hyperresponsiveness symptom was reported by 15.7%. Current smoking was significantly less frequent among those with cough induced by tobacco smoke. Rhinitis induced by cold air was associated with lower FEV1 (p less than 0.01) and the association remained after adjustment for smoking, asthma, and wheezing (p = 0.06). Symptoms induced by cold air were related to circulating basophils. Neither perceived nasal nor perceived bronchial hyperresponsiveness was significantly related to the airway response to methacholine in a sample of the group (n = 324) surveyed again five years later. The result suggest that the symptom of rhinitis provoked by cold air is a possible "new" risk factor or marker for chronic airflow limitation.

Adult↗
PubMed1986

[The forced expiration test from the pulmonary capacity usable in effort to the transit time].

Since Tiffeneau's days the forced expiration test used qualitatively and quantitatively has undergone numerous changes. FEV1 remains useful to diagnose bronchial obstruction, but other, more sensitive parameters have been introduced for epidemiological purposes. Following a review of the data provided by flow-volume curves, the authors discuss the pros and cons of its statistical analysis by the moment method, as expressed in the literature.

Bronchospirometry↗
PubMedDate not supplied

[Typologic analysis of comparative effects of tobacco and Pi phenotype on the respiratory function].

Seven hundred and fourty-eight subjects from the general population were included in a transversal epidemiologic survey. The aim was the determination of a possible relationship between functional profile and Pi phenotype. Seric levels of alpha 1-antitrypsin (alpha 1 AT) and phenotypes were determined in all subjects. All underwent clinical examination, chest X-ray and functional tests (flow-volume curves and single breath nitrogen test). Distribution of the various phenotypes appeared similar to those described in other studies. No homozygote Z was found. Typologic analysis allowed identification of 7 functional profiles, among which 3 were normal and 4 had various levels of obstruction. The comparison between functional impairment and the phenotypes or smoking habits showed that smoking played the major part in the onset of obstructive disease. Mean age of the population surveyed was however rather low, which led to questions about rapidity of onset of chronic obstructive lung disease. This survey thus will lead to a longitudinal study.

Closing Volume↗