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Biomedical subjects

P Calmels

Publications and source records attributed to P Calmels.

35 records · Page 2Linked to original sources
PubMed1998

Femoral fracture and iatrogenic hyperthyroidism in spinal cord injury.

Analysis of the clinical case of a male aged 30 years, presenting with T6 complete paraplegia in 1991, demonstrated the existence of aggravating factors for disuse osteoporosis of spinal cord injury, possibly leading to bone density values below the fracture threshold with the risk of spontaneous fractures. This patient was admitted to hospital for multiple pressure sores requiring prolonged local dressings before and after plastic surgery performed in July 1995. In January 1996, following exercise, he developed a fracture of the femoral diaphysis with a cystic demineralized appearance of the bone. The etiologic work-up demonstrated hyperthyroidism due to iatrogenic iodine overload secondary to Betadine. A review of the literature revealed numerous cases of thyroid dysfunction secondary to iatrogenic iodine saturation. This case justifies regular surveillance of thyroid function tests during prolonged treatment with Betadine and identification of patients with a clinical predisposition.

Administration, Topical↗
PubMed1998

Relation between locomotion impairment, functional independence in retirement, and occupational strain resulting from work carried out during working life. Study of a sample population of 350 miners in the Loire valley in France.

STUDY OBJECTIVES: To analyse long term effects of working conditions experienced at an advanced age, and after retirement by quantifying occupational strain, impairment, and disability to establish their interrelation. DESIGN: Retrospective study. PARTICIPANTS: Retired miners from The French Coal Board who had worked in the coal fields of the Loire valley. From a potential population of 507 retired miners, 350 were completely evaluated. MEASUREMENT: The study examines the occupational strain experienced by each subject, measured using both auto-evaluation and evaluation by experts and the locomotion impairment and the functional independence. MAIN RESULTS: A significant relation between the evaluation of occupational strain and functional independence and locomotion impairment of the low back was found and also a significant relation between locomotion impairment of the low back and the length of time spent working at the coal face. CONCLUSIONS: This study confirms other studies as regards the effects of occupation on health status and on the aging process, but it goes further to show the consequences of this relation on functional independence.

Activities of Daily Living↗
PubMed1996

Quality of life of the spouses of stroke patients: a preliminary study.

To study the global quality of life (QOL) of spouses of chronic stroke patients, and to determine its most pertinent factors, we assessed nine stroke patients and their spouses, using the Barthel index, the Functional Independence Measure (FIM), the Montgomery and Asberg Depression Rating Scale (MADRS), the Reintegration to Normal Living Index (RNLI), and a 10-cm visual analogue scale (VAS) to evaluate spouses' QOL. Correlation analysis was performed with the Spearman rank correlation analysis. Mean age of spouses was 53.6 +/- 11.3 years (male:female ratio, 8:1). The mean interval from stroke was 17.6 +/- 10.6 months. The spouses' median QOL score was 4.9, with a significant correlation between spouses' QOL scores and patients Barthel index scores, FIM global scores, and FIM locomotion scores. Spouses complained of the physical burden, but psychological, social, economic and marital consequences of the stroke were also reported. This study confirms the constant impact of stroke on the QOL of the spouses, and demonstrates the role of patients' physical disability. However, the VAS allows only a global approach. A self-administered composite index, exploring the consequences of the stroke on the spouses' daily life, would be a useful complement.

Activities of Daily Living↗
PubMed1996

An update on orthotic devices for the lumbar spine based on a review of the literature.

Orthoses are often used to treat lumbar spine disorders, although their indications have rarely been evaluated in clinical trials. We reviewed the literature for data on the effects of lumbar spine orthoses. Apart from bermuda corsets, restriction of intervertebral mobility seems limited at the most distal levels (L4-L5 and L5-S1). Restriction of extreme gross spinal motions can be achieved and is more marked for lateral bending than for forward bending or extension. Stiff corsets provide greater motion restriction than flexible corsets, although there are wide interindividual variations. Stiff orthoses are associated with decreased intradiscal pressure and increased intraabdominal pressure. Studies of the electrical activity of trunk muscles have produced conflicting data as a result of marked interindividual variability. In most studies, use of orthotic devices did not induce muscle wasting. Although lumbar spine orthoses are often prescribed with the goal of inducing analgesic, proprioceptive and preventive effects in the workplace, whether such effects are actually obtained, has not been adequately evaluated. Based on our literature review, we have drawn a list of the main indications for orthotic devices according to the desired effects in various disorders of the lumbar spine.

Biomechanical Phenomena↗
PubMed1995

The relations between physical ability and bone mass in women aged over 65 years.

In this cross-sectional study of 55 women (mean age 73.54 +/- 5.87), the magnitude of the relation between different indices of physical ability and confounding factors to bone density were determined. Physical fitness was assessed by direct measurement of maximal oxygen consumption (VO2 max), isokinetic muscle strength, and quadriceps and psoas muscle surfaces and densities using computed tomography. Anthropometry, chronological and gynecological ages, and dietary calcium intake were also recorded. The bone mineral density (BMD) was evaluated at the axial level (lumbar spine and proximal femur) and at the peripheral level (radius and tibia, cancellous and cortical compartments). Parameters related to physical ability proved to be the best predictors of BMD in radial and tibial cancellous compartments, spine, femoral neck, and trochanter, accounting for 15-27.5% of the total variance. The VO2 max was a major determinant of the femoral mineral density and one of the predictors of radial and tibial cancellous compartments. Psoas parameters were strongly related to spine mineral density and also constituted a predictor of radius (cancellous) and tibia mineral densities. The arm muscle strength could predict, though weakly, the BMD of axial skeleton, whereas thigh muscle strength only predicted the BMD of inferior limbs. No correlation was observed between current dietary calcium intake and BMD. Age-postmenopause and fertile life remained predictive of BMD at mostly cancellous sites, whereas anthropometry exerted important effects on radial and tibial cortices. The study suggests distinct sets of relations between physical ability and the BMD variables. Subjects with greater and denser psoas muscles had greater spine BMD, and those with higher VO2 max had greater proximal femur BMD.

Absorptiometry, Photon↗
PubMed1995

Cross-sectional study of muscle strength and bone mineral density in a population of 106 women between the ages of 44 and 87 years: relationship with age and menopause.

This study examined the correlations between isokinetic muscle strength of knee and elbow flexors and extensors with vertebral and femoral bone mineral density in a population of 106 women between the ages of 44 and 87 years. The absolute value of muscle strength correlated significantly with bone mineral density; muscle strength of the upper limb appeared to be more closely correlated with bone mass, while muscle strength in the lower limb was more specific for femoral mineral bone density. The most important finding that these results demonstrated was a concomitant decline in muscle strength of the upper limb and bone mineral density between the 5th and 6th decades. In contrast, they also showed a decline in muscle strength of the lower limbs after the 6th decade, occurring before the decline in bone mineral density observed between the 7th and 8th decades. From these results it would appear that other studies are required to examine the relationship between the essentially hormonal role in postmenopausal decline in muscle strength and the decline in physical activity during the senile period. These elements are important because they must be taken into account in physical exercise programmes designed to prevent osteoporosis.

Adult↗
PubMed1995

Heterotopic ossification and rhabdomyolysis.

Heterotopic ossification and rhabdomyolysis are well described entities but, as far as we know, their association has never been described in the literature. We recently treated a patient who presented with this association. After a suicide attempt, this patient developed rhabdomyolysis of the left upper and lower limbs with peripheral neurological impairment. Two months later radiographs showed ectopic ossification around the left hip. Rhabdomyolysis is underdiagnosed, and is due to local disturbance of the calcium-phosphorus metabolism resulting in soft tissue calcifications. Underlying rhabdomyolysis may be a possible aetiology of heterotopic ossification. Recognition of this may help us to understand the pathophysiology and to improve the management of heterotopic ossification.

Adult↗
PubMed1994

[Functional ability and quality of life in rheumatoid arthritis: use of the Functional Independence Measure and the Reintegration to Normal Living Index].

Functional disability and quality of life were evaluated using the Functional Independence Measure and the Reintegration to Normal Living Index, respectively, in 57 subjects (15 men and 42 women) with a mean disease duration of 15 years. Scores on both these nonspecific scales correlated with those obtained using instruments specifically designed for rheumatoid arthritis (ARA index, Lee index) and with a number of clinical parameters including patient age, disease duration and number of affected joints. Functional ability was correlated with quality of life in this study and in others performed using other evaluation tools. Nonspecific assessment scales are useful for comparing function and quality of life in various diseases.

Activities of Daily Living↗
PubMed1992

A comparative study of the muscle strength and mass of the arm flexors and extensors in paraplegic and in non paraplegic basketball players.

OBJECTIVES: to study the changes in the strength of the elbow flexors and extensors in paraplegic subjects, and the agonist/antagonist mass and strength ratio in paraplegic wheelchair users. METHOD: 10 paraplegic wheelchair basketball players were compared with 10 healthy basketball players. The 20 subjects underwent a clinical and dynamometric isokinetic assessment, and a CT scan measurement of the muscle cross-sectional surface area of the flexor and extensor muscles of the elbows. RESULTS: there was an increase in muscle strength in paraplegic subjects. There was no significant difference in the agonist/antagonist ratio between the dominant and non dominant upper limb in paraplegics whereas such a difference was found in healthy subjects. The muscle mass was increased in the paraplegics, but a correlation between muscle mass and strength was only found in the healthy subjects.

Adult↗
PubMedDate not supplied

Changes in the quality of life of hemiplegic stroke patients with time: a preliminary report.

To evaluate the influence of time on the quality of life of hemiplegic stroke patients living at home, we analyzed a sample of 45 outpatients. The sample was divided into two groups, according to the delay between the discharge time from hospital and the assessment (Group 1, fewer than 6 mo; Group 2, more than 6 mo after discharge). We hypothesized that patients in Group 2 would have a lower level of quality of life than patients in Group 1. Disability was assessed with the Functional Independence Measure, and the quality of life was assessed with the Reintegration to Normal Living Index. Both groups were comparable with regard to demographic and stroke characteristics. There was no statistically significant difference in Functional Independence Measure scores (global and subscales). Reintegration to Normal Living Index-perception of self subscale scores were significantly lower in Group 2. At the item level, quality of life scores were also significantly lower in Group 2 for indoor mobility (Mann-Whitney U test; P = 0.001), self-care needs (P = 0.005), personal relationships (P = 0.02), and the handling of life events (P = 0.05). These results confirm our hypothesis and suggest that quality of life may deteriorate in some domains over time, even when the disability level is unchanged, but these results need to be replicated in prospective studies with larger samples of stroke survivors.

Activities of Daily Living↗
PubMedDate not supplied

Posturographic evaluation of the proprioceptive effect of ankle orthoses in healthy volunteers.

This study analyses the proprioceptive effect of wearing a unilateral and then bilateral ankle orthosis on 34 healthy volunteer subjects by posturography. An elastic orthosis with a ligamentous support band was used, and evaluation was performed by a posturographic statokinesimetric platform. Three tests, one without an orthosis, one with one orthosis, and one with two orthoses, were recorded for each volunteer. The results and statistical analyses demonstrated a significant difference in the antero-posterior measurement between the test without ankle orthosis and the tests with one and with two orthoses. This study provides information about the prophylactic effect of wearing a flexible support; it appears that there are important inter-individual variations in postural equilibrium, and the wearing of prophylactic ankle orthoses should be reserved for subjects after a posturographic examination.

Adult↗
PubMedDate not supplied

Medical activity during an international sporting competition for the physically disabled: Saint-Etienne World Handicapped Sport Championships.

This paper describes the medical activity performed during the 1990 World Games for the Disabled, in Saint-Etienne, France. These Games were attended by 1200 athletes, 229 consultations were performed, and 175 treatments were administered by the medical team. This activity represents a rather high frequency of medical problems, linked either to the disabling disease or to sports injuries. There is a need for specific equipment, for better training of disabled athletes and for improved preparation.

Adolescent↗
PubMedDate not supplied

A review of the role of the agonist/antagonist muscle pairs ratio in rehabilitation.

Based on a review of the literature, this article analyses the application of measurement of the agonist/antagonist ratio of muscular strength in functional rehabilitation. According to many authors this ratio constitutes an element of functional specificity of a joint, but it is subject to numerous factors of variation: the joint considered, dominance, sex, age, physical activity and velocity of movement. Despite these various factors, the ratio may constitute a clinical element in the functional analysis of the joint, providing either an index of the risk of developing certain traumatic sports lesions, or a guide control in the modalities of rehabilitation.

Aging↗