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Biomedical subjects

P Metais

Publications and source records attributed to P Metais.

At least 19 recordsLinked to original sources
PubMed2005

[Diagnosis of psychological and behavioural disorders in Alzheimer's disease].

Although Alzheimer's disease has long been considered mainly a cognitive disorder, behavioral and psychological symptoms are present from its onset and at all the stages of the disease in most patients. They must be identified from the beginning because they orient the diagnosis. They include affective and emotional disorders, delusions and hallucinations, disorders of instinctual behavior and behavioral problems. The best tool for assessing them is the Neuropsychiatric Inventory (NPI). They are generally related to neurobiological aspects of the disease but may, especially when acute, have multiple etiologies: somatic, iatrogenic, psychological and environmental. They condition the course of the disease. As a source of suffering and reduced quality of the life and as the primary cause of distress for the caregivers and hence of hospitalization and institutionalization, they increase the costs of care. The challenge today is to learn more about them and thus improve their treatment and especially their prevention.

Affective Symptoms↗
PubMed2005

[Treatment of the psychological and behavioural disorders of Alzheimer's disease].

When psychological and behavioral disorders of Alzheimer's disease appear suddenly, somatic, iatrogenic and reactive or relational psychological causes must be ruled out or treated before concluding that the cause is lesional. Non-pharmacological interventions should be privileged for the prevention and management of behavioral manifestations of mild to moderate intensity: psychological support of the patient (short therapies), training the caregiver, work on daily habits, reorganization of the home, behavioral measures against apathy and especially agitation, rehabilitation strategies, and therapy involving music, light, aromas, etc. Pharmacological therapies are only moderately effective in these disorders. They must be targeted and follow a sequence of prescription that maximizes tolerance and distinguishes treatment of acute and chronic states. Anticholinesterase agents may be useful in this domain to prevent or ease some symptoms (especially apathy). The efficacy of memantine must be confirmed by additional data. Some selective serotonin reuptake inhibitors agents may be useful not only in depression but also anxiety, emotional disturbances, irritability and compulsiveness. Atypical neuroleptics are better tolerated than the classic ones. They are most effective in this context but must be reserved for specific indications and limited in time because of the increased risk of stroke. Other psychotropics (benzodiazepines, carbamates, antiepileptics) should be used cautiously in this context.

Activities of Daily Living↗
PubMed2002

[A new locking nail for proximal humerus fractures: the Telegraph nail, technique and preliminary results].

We present a new nail, the telegraph nail, designed for the treatment of proximal fractures of the humerus. This nail has a new locking system providing a self-stabilization of the cancelous screws inserted in small fragments. We discuss the surgical technique and present preliminary results. The anterolateral approach and nail insertion through the medial and well vascularized part of the cuff is described for simple fractures. With the cup and ball technique, this nail can also be used for complex fractures of the proximal humerus with three or four fragments and major displacement. With this method, the nail is inserted before reduction and locked in the distal humerus before fixation of the head and tuberosities around the head once the targeting device removed. We report results for the first 64 nails inserted in our unit during the first year (1998-1999). Outcome was assessed at 11 months mean follow-up using the Constant score. Outcome was favorable, including in patients with complex fractures involving 3 or 4 separate displaced fragments. Besides providing an anatomically stable reconstruction, the telegraph nail has the advantage of allowing early mobilization of the shoulder joint. This method is a useful alternative to prosthetic reconstruction for traumatic fractures of the proximal humerus.

Adolescent↗
PubMed1993

[Dietetic prevention in elderly in France].

Beside effects of dietetic recommendations on cellular or tissular ageing, dietetic prevention in elderly aims, at avoiding nutritional deficiencies in healthy old individuals and thus, the occurrence of induced diseases. Requirements of healthy housebound elderly are not different from those of adults but, more than in adults, diet's quality and palatability are important to insure maintenance of intakes. Beyond these advises, dietetic prevention in geriatrics requires screening of physical, psychical and social handicaps frequently observed in very old persons. Their additional effects could deeply modify dietary balance, especially during an acute intercurrent disease or following modifications of the environment. The practitioner's part is essential in preventing malnutrition in an old person impaired by chronic diseases: preventing the outcome of a denutrition to an irreversible state may avoid a medical and social decompensation leading to institutionalisation.

Aged↗
PubMed1985

[Microanalysis on dry reactive supports].

Among actual technological developments in clinical chemistry, the use of dry reagents fixed on a solid support is particularly advantageous for assays in emergency. Reflectometry is used for the measurement and was analysed in terms of principles and measurement devices. To day, only one apparatus Seralyser is furnished by Ames and we have evaluated its performances. However, other apparatus are in evaluating. Thus, Ektachem Kodak 400, 700 or DT 60 employs multilayer slides. Reflotron from Boehringer allows the direct use of blood samples. Stratus with a fluorimetrie measurement is adapted to drug assays. This new technology some permits interesting applications derived from basic research but arises some problems for the realisation of the as well as the role of the clinical chemist.

Blood Chemical Analysis↗
PubMed1983

[Value of blood lipase determination in pancreatic diseases. Comparison with blood amylase assay].

The comparative diagnostic value of plasma lipase and amylase levels was evaluated in 90 patients with various symptoms of pancreatic disease. Comparison with healthy subjects showed that the lipase assay was more sensitive than the amylase assay in patients with acute pancreatitis or post-traumatic pancreatic injury, but not in patients with chronic pancreatitis. On the other hand, acute pancreatitis can be detected earlier by measuring plasma amylase levels, owing to the rapid release of this enzyme. The relative importance of these two laboratory tests is discussed.

Amylases↗
PubMed1983

Multivariate analysis of plasma enzyme profiles in severe head injury.

We followed the changes in the activities of four enzymes (aldolase, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase) in plasma for four days after head injury. The progression of the changes differs significantly between survivors and nonsurvivors. Stepwise discriminant analysis, involving the four enzymes, allowed us to divide 81 to 92% of head-injured patients (n = 280 selected without conscious bias) correctly into the two groups as early as 72 h after trauma. Most of the patients who were misclassified according to our biochemical criteria had received phenobarbital for sedation. Valuable prognostic information in head injury evaluation may thus be obtained by daily determination of enzymatic activities of these four enzymes.

Aspartate Aminotransferases↗
PubMed1982

[Value of C-reactive protein in neonatal bacterial infections].

C reactive protein (CRP) levels were measured in the serum of 2 groups of neonates before and after the 12th hour of life. One group consisted of controls, the other of children with neonatal sepsis. The means (+/- standard error) for CRP serum level were 6 +/- 0.7 mg/l and 7.7 +/- 0.8 mg/l respectively before and after 12 hours of life in controls (n = 100); they were 19.7 +/- 3.4 mg/l and 67.5 +/- 6.6 mg/l in the group of infected neonates (n = 54). For both times of sampling, levels were significantly higher (p less than 0.001) in infected neonates. The low percentage of false-positives and false-negatives suggests that this dosage is almost specific for neonatal sepsis.

Bacterial Infections↗
PubMed1981

[Variations in serum levels of C-reactive protein in severe head injury patients (author's transl)].

The variations of fibrinogen, alpha-antitrypsin, haptoglobin and C-reactive protein (CRP) were compared in sera from patients with a cranial trauma. All these protein concentrations were increased with CRP variation being the most marked and the most rapid. The prognostic and diagnostic value of CRP determination was studied in a series of 88 patients selected according to their clinical evolution. Four typical serum patterns of CRP were obtained according to the evolution of cranial trauma. The validity of this classification was tested in blind on 324 patients. The authors propose to determine daily serum CRP for four days after a trauma in order to survey its evolution. This biochemical information has to be added to the clinical data.

C-Reactive Protein↗
PubMed1977

Studies on intestinal adenosine triphosphatases. II. Stabilitiies in different rat subcellular fractions.

Subcellular fraction (brush border, mitochondria, microsomes and plasma membranes) are isolated from the rat intestinal epithelial cells. A comparison was made between the effect of cold storage, freeze-thawing, heating and of some chemicals (DMSO, DTT, glycerol, sucrose) on the stability of Mg2+ and (Na+-K+) dependent ATPases in these fractions in order to determine possible difference linked to the localization in the enterocyte. Enzymatic activities were found more stable at -20 degrees C than at +4 degrees C. Microsomal (Na+-K+)-ATPase increased in activity until the 8th day, then declined. Brush border (Na+-K+)-ATPase was the least resistant of all fractions. For Mg2+-ATPase, that from mitochondria was that had lost much more activity (84%) in 15 days at +4 degrees C. With freeze-thawing there was a comparable decrease in all activities (20-35%). by heating between 35 and 60 degrees C, Mg2+-ATPase was shown to be more heat resistant than (Na+-K+)-ATPase. The addition of some stabilizing chemicals (DMSO, glycerol, sucrose) improved the heat stability of the two enzymes: better results were obtained with glycerol for Mg2+-ATPase and sucrose for (Na+-K+)-ATPase. These differences might be due to the compositon in membraine lipids or to the nature of the enzymes studied.

Adenosine Triphosphatases↗
PubMed1977

[Practicality of centrifugal analysis].

The practicability of a method or of an apparatus is one of the "figures of merit" which are used by the clinical chemist to choose a method or an apparatus. Joined to the reliability and the efficiency, it has to be evaluated by different tests. Unfortunately, few reflections concern the definition of this criterion, which often is little discussed in the other divisions of the pure and applied chemistry. The clinical chemist is well suited to study and evaluate the practicability. The present paper attempts to define this criterion and to set the discussion of this question.

Autoanalysis↗
PubMed1976

Effect of the fatty acid composition of ingested fats on rat liver intermediary metabolism.

The influence of a single load of medium chain triglycerides (MCT) or long chain triglycerides (LCT) on different intermediary metabolites of the rat liver was studied. Resultes showed that acetyl-CoA increased more after MCT than after LCT. MCT are more ketogenic than LCT. Mitochondrial and cytoplasmic redox state was greatly reduced after MCT. It is particularly interesting to note that MCT produced an increase in malate and citrate levels, whereas LCT had only a minor influence on these substances.

Acetoacetates↗