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Biomedical subjects

M Roulet

Publications and source records attributed to M Roulet.

At least 19 recordsLinked to original sources
PubMed2006

[Short bowel syndrome: nutritional guidelines for the adult patient].

The short bowel is defined by the extended resection of the small intestine, leaving a maximum of 100 cm of healthy organ beyond the ligament of Treitz, with or without preservation of the colon. Nutritional management must be quick in order to optimize adaptation of the remaining intestine, therefore avoiding intestinal insufficiency. Consequent nutrition support such as long term enteral or parental nutrition is some times indispensable. Home enteral nutrition is relatively comfortable. Home parental nutrition somewhat complex, necessitates the creation of a strong home support group. This article addresses practitioners unfamiliar with clinical nutrition, directly faced with problems due to the short bowel in hospital (short and mean term phases) and in home settings (mean and long term phases).

Gastrointestinal Agents↗
PubMed2006

[Chronic renal failure: what diet?].

A low protein diet has been traditionally advocated in patients with chronic renal failure (CRF), in order to slow its progression. However, CRF is often associated with malnutrition, aggravating its prognosis, especially in elderly patients. In severe CRF, the spontaneous reduction of appetite coupled with additional restrictions regarding sodium, potassium and phophates may further impact on nutrition status. The potential benefit of a low protein diet is therefore questionable. We only recommend a moderately restricted protein diet (0,8 g/kg/day) in selected patients with no sign of malnutrition. This strategy, if applied, must be supported by a multidisciplinary approach involving a nephrologist and a specialised dietician. Additional dietary restrictions are not justified, except in particular situations.

Diet, Protein-Restricted↗
PubMed2006

[Malnutrition on dialysis: the end of a fatality].

Protein-energy malnutrition in patients treated with haemodialysis (HD) is a complex, multifactorial and prevalent problem, starting well ahead of the dialysis program. It is associated with an increased morbidity and mortality. Uraemic patients are relatively resistant to nutrients because of metabolism abnormalities. Prevention of malnutrition is therefore more efficient than treatment per se. Classical supplementation including oral nutritional supplements, intradialytic parenteral nutrition and enteral nutrition remain efficient, if applied for a sufficient time. A global approach coupling supplementation and strategies designed to optimise metabolism abnormalities should increase treatment efficacy and improve the outcome and quality of life of these patients.

Humans↗
PubMed2005

A validated liquid chromatography-mass spectrometry method for the determination of leukotrienes B4 and B5 produced by stimulated human polymorphonuclear leukocytes.

A validated high-performance liquid chromatography (HPLC)-mass spectrometry method has been developed for the simultaneous assay of leukotrienes (LTs) B4 and B5, derived from omega-6 arachidonic acid and omega-3 polyunsaturated fatty acids (PUFA), respectively, produced by human polymorphonuclear leukocytes (PMNLs) stimulated with calcium ionophore A23187. The HPLC separation of PMNL ether extracts was performed on a reversed-phase column using a gradient elution program of 15 mM ammonium acetate and MeOH. Detection was performed by electrospray ionization-single quadripole mass spectrometry using single ion reaction monitoring in the negative mode at m/z 333.3 [M-H](-) and m/z 335.2 for prostaglandin B2/LTB5 and LTB4, respectively. The calibration curves for LTB4 and LTB5 were linear over the ranges 165-990 and 0.825-13.2 ng/ml, respectively. The lower limit of quantification for LTB5 was 0.66 ng/ml. The mean absolute recoveries for LTB4 and LTB5 were 81+/-4.8% and 82+/-5.9%, respectively. The method is precise with mean interday CVs for LTB4 and LTB5 within 7.1-10.7, and 3.8-9.4%, respectively, and accurate (range of interday deviations for LTB4 and LTB5 were -7.8 to 1, and -5 to 9% , respectively). The method has been validated and is being applied to the simultaneous quantification of the leukotrienes B4 and B5 in stimulated PMNLs in a clinical protocol studying the influence of a diet enriched in omega-3 PUFA on various surrogate markers of inflammation in young cystic fibrosis patients.

Calibration↗
PubMed2005

[Detection and management of early Pseudomonas aeruginosa infection in patients with cystic fibrosis].

Initial Pseudomonas aeruginosa infection in patients with cystic fibrosis is a key step in pulmonary evolution of the disease. This first infection is most of the time early in life and gives some practical problems to the clinicians. It is important to look for colonisation with Pseudomonas aeruginosa as often as possible, at least every 3 month, by sputum culture when the child is able to or with induced sputum by hypertonic saline nebulisation. Treatment with inhalation of an antibiotic, preferably tobramycin for a 28 days course. Efficacy of the treatment as to be assessed by new culture.

Anti-Bacterial Agents↗
PubMed2001

Sequential analysis of hair mercury levels in relation to fish diet of an Amazonian population, Brazil.

Several studies in the Amazonian Basin have shown that riverine populations are exposed to methylmercury through fish consumption. It has been suggested that seasonal variations in hair mercury observed through sequential analyses may be related to the changes in fish species ingested by the local communities. The aim of the present study was to investigate the relationship between fish-eating practices and seasonal variation in mercury exposure. A group of 36 women from a village located on the banks of the Tapajós River, a major tributary of the Amazon, comprised the present study population. An interview-administered questionnaire was used to gather information on socio-demographic characteristics, fish-eating practices and other relevant information. The women also provided hair samples of at least 24 cm in length for mercury analysis. Hair total and inorganic mercury concentration was measured using a cold vapor atomic absorption analytical method. Trigonometric regression analysis was done to assess the seasonal variation of total mercury levels. Variations in inorganic mercury were examined by repeated measures analysis of variance, and analysis of contrast variable with a polynomial transformation. The results showed that hair mercury levels varied with the season. Higher levels were observed in months corresponding to the dry season, with lower levels in the rainy season. Herbivorous fish predominated the diet for 47.2% of the women during the dry season, but this rose to 72.2% during the rainy season. Those who reported eating fish daily had higher mercury levels in hair compared to those who only ate fish a few times per week. Retrospective mercury analyses, evaluated by the quantity of mercury present in each centimeter of hair, indicate that mean mercury level of the population decreased over the 2 years prior to the study. The percentage of inorganic mercury over the total mercury in hair increased towards the extremities of the hair strand. Higher percentages of inorganic mercury were found for the group who ate more fish (on a daily consumption basis). These results support the assumption that there are seasonal variations in methylmercury exposure and also a relationship between type of fish species consumed and the resulting hair mercury levels.

Adolescent↗
PubMed2000

Methylmercury in water, seston, and epiphyton of an Amazonian river and its floodplain, Tapajós River, Brazil.

Levels and accumulation of MeHg were characterized in filtered water, suspended organo-mineral matter, phytoplankton, zooplankton and epiphyton during the dry season and the wet season. In open water of the lentic and lotic ecosystems, the MeHg in filtered water (< 0.2 microm) was near or below the detection limit (< 0.02-0.03 ng/l). These concentrations represent < 5% of the Hgtot. content in filtered water. Inundated forests (Igapó) and macrophyte floating mats were the only sites where MeHg was significantly detected (0.07-0.24 ng/l), representing 3-22% of the Hgtot. in filtered water. MeHg concentrations in organo-mineral suspended matter (2-26 ng/g dry wt. representing 0.6-7.3% of Hgtot.) were correlated with the N content but not with the C content. Data suggest that MeHg enrichment of suspended matter is strongly influenced by the presence of degraded planktonic remains relatively rich in N and MeHg. In zooplankton, MeHg concentrations (20-140 ng/g dry wt.) increased from the dry season to the end of the wet season. This increase was followed by higher proportions of MeHg during the wet season in comparison to the dry season (15-40 to 50-70% of the Hgtot.). The epiphytic material collected from the roots of macrophyte floating mats contained 2-8.5 ng/g dry wt. of MeHg. The proportion of MeHg to Hgtot. in epiphyton (1.5-8.3%) correlated with its C and N contents. The data suggest a greater bioavailability of MeHg in the Tapaj6s River ecosystems due to the seasonal increase in water level and the consequent inundation of the floodplain. Inundation favours the development of large macrophyte floating mats which increases the bioavailability of epiphyton to herbivorous/detritivorous fish. The root zone of floating macrophytes and the flooded organic horizon of the Igapó forest are the only sites along the Tapajós River where significant MeHg can be detected in the water column and sediment. This new study supports the hypothesis that MeHg production and transfer to the first link of the food chain in Amazonian river systems is closely related to organic matter biogeochemistry in the floodplain environment.

Animals↗
PubMed2000

Mercury methylation along a lake-forest transect in the Tapajós river floodplain, Brazilian Amazon: seasonal and vertical variations.

The seasonal and spatial variations of net methylmercury production in sediments, soils and other sites were evaluated by assays with 203Hg at different depths and locations along a lake-forest transect at lake Enseada Grande, Tapajós river. Soil and sediment samples were taken at the surface and at different depths up to 9 cm. Fresh samples and acidified controls (1-3 g dry wt.) were slurried with local water and incubated in the dark at 25-28 degrees C for 3 days with 0.5-1.6 microg Hg g(-1) (dry wt.) added as 203HgCl2. CH3 203Hg was extracted and measured in scintillation cocktail after acid leaching. Methylmercury production varied by orders of magnitude among sites and among sediment or soil layers. Seasonal variations were smaller than those with sample depth and location. In both seasons, MeHg formation in sediment and soil or flooded soil decreased with depth and was, in the top layers, one order of magnitude higher in the C-rich littoral macrophyte zone (2.3-8.9%) and flooded forest (3.2-4.5%) than in the center of the lake (0.2-0.56%). Similar MeHg production was found in slurried dry soils (dry season) and in soils already flooded for months. In the macrophyte zone soil (dry season), methylation was mainly associated with the thin Paspalum sp. rootlet layer. In the forest site, vertical variation in methylation was less pronounced in flooded than in dry soils and during the inundation the higher methylation rate was found in the flocculent sediment settled over the litter layer. The roots of floating Paspalum sp. were an important Hg methylation site, particularly those heavily colonized with periphyton (3.4-5.4%). Methylation in surface or near-bottom water was undetectable (< 3 x 10(-2)%) at all sites. Flooded forests and macrophyte mats are specific features of the Amazon and are important links between Hg inputs from natural and manmade sources and MeHg exposure of local populations through fish intake.

Brazil↗
PubMed2000

Mercury net methylation in five tropical flood plain regions of Brazil: high in the root zone of floating macrophyte mats but low in surface sediments and flooded soils.

In aquatic systems, bottom sediments have often been considered as the main methylmercury (MeHg) production site. In tropical floodplain areas, however, floating meadows and flooded forests extend over large areas and can be important Hg methylating sites. We present here a cross-system comparison of the Hg net methylation capacity in surface sediments, flooded soils and roots of floating aquatic macrophytes, assayed by in situ incubation with 203Hg and extraction of formed Me203 Hg by acid leaching and toluene. The presence of mono-MeHg was confirmed by thin layer chromatography and other techniques. Study areas included floodplain lakes in the Amazon basin (Tapajós, Negro and Amazon rivers), the Pantanal floodplain (Paraguay river basin), freshwater coastal lagoons in Rio de Janeiro and oxbow lakes in the Mogi-Guaçú river, São Paulo state. Different Hg levels were added in assays performed in 1994-1998, but great care was taken to standardise all other test parameters, to allow data comparisons. Net MeHg production was one order of magnitude higher (mean 13.8%, range 0.28-35) in the living or decomposing roots of floating or rooted macrophyte mats (Eichhornia azurea, E. crassipes, Paspalum sp., Eleocharis sellowiana, Salvinia sp., S. rotundifolia and Scirpus cubensis) than in the surface layer of underlying lake sediments (mean 0.6%, range 0.022-2.5). Methylation in flooded soils presented a wide range and was in some cases similar to the one found in macrophyte roots but usually much lower. In a Tapajós floodplain lake, natural concentrations of MeHg in soil and sediment cores taken along a lake-forest transect agreed well with data on net methylation potentials in the same samples. E. azurea, E. crassipes and Salvinia presented the highest methylation potentials, up to 113 times higher than in sediments. Methylation in E. azurea from six lakes of the Paraguay and Cuiabá rivers, high Pantanal, was determined in the 1998 dry and wet seasons and ranged from 1.8 to 35%. Methylation was lower in washed roots than in untreated roots of E. azurea and methylation in solids isolated from the roots, was higher than in sediments but lower than in untreated roots. This indicates that the methylation in roots zones occurs mainly in the root-associated solids. Floating meadows are sites of intense production of biomass and of highly bioavailable MeHg and appear to be an essential link of the MeHg cycle in tropical aquatic systems.

Brazil↗
PubMed2000

Chronic ethanol ingestion increases efficiency of oxidative phosphorylation in rat liver mitochondria.

The efficiency of oxidative phosphorylation was compared between rats chronically fed with ethanol and controls. (i) Results showed that the liver mitochondria state 4 respiratory rate was strongly inhibited, while the corresponding proton-motive force was not affected; (ii) the cytochrome oxidase content and activity were decreased and (iii) the oxidative-phosphorylation yield was increased in the ethanol exposed group. Furthermore, oxidative phosphorylation at coupling site II was not affected by ethanol. Cytochrome oxidase inhibition by sodium-azide mimicked the effects of ethanol intoxication in control mitochondria. This indicates that the decrease in cytochrome oxidase activity induced by ethanol intoxication directly increases the efficiency of oxidative phosphorylation.

Alcohol Drinking↗
PubMed2000

Continuous infusion of ceftazidime with a portable pump is as effective as thrice-a-day bolus in cystic fibrosis children.

UNLABELLED: Continuous infusion (CI) of beta-lactam antibiotics provides a stable concentration which may result in a better activity against gram-negative bacteria if exceeding the minimum inhibitory concentration (MIC). Treatment outcome after 24 h CI of ceftazidime (CAZ) in cystic fibrosis (CF) children was compared with the bolus administration regimen. Fourteen CF children with chronic Pseudomonas aeruginosa pulmonary infection were treated during 14 days with the conventional CAZ thrice-a-day bolus infusion (regimen A), and few months later with 24 h Cl of CAZ (regimen B) using a portable pump. Amikacin was added to both regimens. Clinical efficacy of treatment was assessed using pulmonary, inflammatory and nutritional variables. Bacteriological analyses and CAZ concentrations in serum and sputum were also measured. All patients improved clinically with both regimens. Among the parameters used to compare both regimens, only prealbumin values improved (regimen A: + 0.08 g/l versus regimen B: +0.11 g/l P = 0.015). No clinically significant side-effects were noted. In regimen A, the mean predose (trough level) CAZ concentration in serum was highly variable (range 2.2-45.4 gg/ml) with some values (32% of samples) below the MIC of P. aeruginosa isolates found in the sputum of the patients. In regimen B, the serum CAZ level achieved was 28.5+/-8.4 microg/ml without any value below the MIC. The mean sputum levels were comparable in both regimens. No CAZ resistant strains of P. aerugino.sa appeared between and directly after the treatments. CONCLUSION: The clinical outcome of children with cystic fibrosis treated with 24 h continuous infusion of ceftazidime was no different from that achieved with the conventional bolus infusion regimen. Continuous infusion provided a sustained serum ceftazidime level well above the P. aeruginosa minimum inhibitory concentration. Continuous infusion was well tolerated and appreciated by the children and this may promote home therapy for cystic fibrosis children.

Adolescent↗
PubMed1999

Effect of elective antibiotic therapy on resting energy expenditure and inflammation in cystic fibrosis.

Cystic fibrosis (CF) patients often present with malnutrition which may partly be due to increased resting energy expenditure (REE) secondary to inflammation. Both REE and tumour necrosis factor-alpha (TNF-alpha), as other markers of inflammation, are elevated during respiratory exacerbations and decrease after antibiotic treatment. However, the effect of antibiotic therapy on REE and inflammation in patients without respiratory exacerbation is not known. The aim of our study was to determine the effect of such an elective antibiotic therapy on REE, TNF-alpha, and other serum markers of inflammation. Twelve CF patients 5F/7M, age 15.9 +/- 6.1 years, weight for height ratio 89 +/- 8% without clinically obvious exacerbation and treated by intravenous antibiotics were studied. Both before (D0) and after (D14) treatment, pulmonary function tests were performed. REE was measured by indirect calorimetry and blood taken to measure inflammation parameters. Body weight increased by 1.1 kg from D0 to D14 (P < 0.001), composed of 0.3 kg fat mass and 0.8 kg fat-free mass (FFM). The forced expiratory volume at 1 s increased from 43 +/- 15% of predicted at D0 to 51 +/- 15% of predicted at D14 (P < 0.01). Mean REE was 41.1 +/- 7.6 kcal/kg FFM per day at D0 and did not change significantly at D14 (40.6 +/- 8.5 kcal/kg FFM per day). Serum markers of inflammation decreased from D0 to D14: C-reactive protein 17 +/- 17 mg/l to 4 +/- 7 mg/l (P < 0.05), elastase 62 +/- 29 microg/l to 45 +/- 18 microg/l (P < 0.02), orosomucoid acid 1.25 +/- 0.11 g/l to 0.80 +/- 0.15 g/l (P < 0.001), and TNF-alpha 37 +/- 14 pg/ml to 29 +/- 6 pg/ml (P = 0.05). Individual values showed a correlation between changes in REE and in TNF-alpha (P < 0.02). The contribution of inflammation to energy expenditure is possible but appears to be minimal in cystic fibrosis patients treated by antibiotics on a regular basis in the absence of clinically obvious exacerbation.

Adolescent↗
PubMed1998

The geochemistry of mercury in central Amazonian soils developed on the Alter-do-Chão formation of the lower Tapajós River Valley, Pará state, Brazil.

In an oxisol-spodosol system developed on the terrestrial surface of the lower Tapajós Valley, the determination of total mercury (Hg), organic carbon (C), iron and aluminum oxy-hydroxide (Fe(cdb) and Al(cdb)) concentrations in the surface soil horizons are used to characterise the geochemical processes controlling the accumulation of Hg in soils under natural vegetation cover and in deforested and cultivated sites. Oxisols from the plateau have homogeneous and relatively high background Hg contents and burdens constituting an important natural reservoir of Hg for the region (90-210 ng/g dry wt. and 19-33 mg/m2 for the first 20 cm). The Fe(cdb) and Al(cdb) contents associated with the fine fraction (< 63 microns) of the soil suggest that oxy-hydroxides and, particularly Al-substituted Fe oxy-hydroxides, control the Hg concentrations observed in all of the soils of the study region. Consequently, the geochemistry of these minerals along the slopes governs the accumulation or the release of the Hg according to the natural evolution of the soil cover and/or following the degradation of soils by erosion after deforestation and cultivation. These observations have important implications for the interpretation of Hg contamination patterns observed in Amazonian aquatic systems that could be linked to different drainage sources of Hg from the terrestrial surface. The sandification and podzolisation that is characteristic of the evolution of numerous pedological systems in the equatorial Amazon could be responsible for exportation of the naturally accumulated Hg, as for other metals, by acidic complexation and migration to the black waters of the Amazon. In the central Amazon region, as a result of the fragility of the soil cover, deforestation and cultivation, affecting principally the superficial soil, promote the selective erosion of fine particles enriched in oxides and Hg. The erosion of soil could be responsible for an important release of Hg, transported in particulate form by drainage waters.

Aluminum↗
PubMed1997

Essential fatty acid deficiency in well nourished young cystic fibrosis patients.

UNLABELLED: Essential fatty acid deficiency is well known in cystic fibrosis patients, but its pathogenesis remains unclear. It might be related to protein-energy malnutrition which is a common feature of cystic fibrosis or to some specific defects in fatty acid metabolism. To avoid the deleterious effects of protein-energy malnutrition, this study assesses the plasma phospholipid fatty acid pattern in well nourished young cystic fibrosis subjects. Sixteen cystic fibrosis subjects aged 6.6-20.0 years were studied and compared to 16 healthy controls matched for gender, age and nutritional status. Plasma phospholipids were separated by thin layer chromatography and phospholipid fatty acid pattern was determined by gas liquid chromatography. Anthropometry and dual-energy X-ray absorptiometry showed that lean body mass, fat-free mass and fat mass were similar in the two groups. Nutritional inquiry showed higher ingestion of macronutrients by cystic fibrosis subjects than by controls. Plasma phospholipid palmitoleic acid and eicosatrienoic acid were higher, and by contrast linoleic acid and docosahexaenoic acid were lower in cystic fibrosis subjects than in controls. The ratio linoleic acid/arachidonic acid was lower and the ratio eicosatrienoic acid/arachidonic acid was higher in cystic fibrosis subjects than in controls. CONCLUSION: Essential fatty acid deficiency is present in young cystic fibrosis subjects in the absence of protein-energy malnutrition. It means that this deficiency is probably related to specific defects in fatty acid metabolism.

Adolescent↗