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Biomedical subjects

R Doumith

Publications and source records attributed to R Doumith.

27 records · Page 2Linked to original sources
PubMed1980

[An unrecognised cause of hypercalcaemia: hypercalcaemia-hyocalcluria syndrome].

A 32-year-old man with insulin-dependent diabetes secondary to chronic calcifying pancreatitis of alcoholic origin in whom hypocalciuria (22 to 88 mg/24 hours) was discovered by chance, renal function being normal. Plasma phosphate levels were between 25 and 35 mg/l and the level of parathyroid hormone was at the upper limit of normal. Cervicotomy led to the discovery of three parathyroid glands which were removed. Their weight was increased and their histological appearance normal. The fourth parathyroid was not seen. Hypercalcaemia and hypocalciuria were found during the operation and persis 3 years after, with none of the usual causes being found. This patient has a certain number of characteristics reminiscent of familial hypercalcaemia-hypocalciuria syndrome: high plasma calcium levels associated with low calciuria despite normal renal function and a plasma parathyroid level normal in most cases. The physiopathology of this syndrome remains unknown. Its course is benign, without renal complications. Partial parathyroidectomy is ineffective.

Adult↗
PubMed1980

[Dynamic study of the changes in the composition of fatty acids in serum lipid fractions under a diet rich in polyunsaturated fatty acids].

Appropriate adjustment of diet and specially reduction of the saturated fatty acids content is the cornerstone of correcting many hyperlipidemias. What we have tried in our study was first to show the evolution of the changes in the serum's fatty acids composition under a rich polyunsaturated fatty acids diet, second to find an index proving that the diet had correctly been taken. Chromatographic analysis were performed after ultracentrifugal separation of the lipoprotein fractions. Seven volunteers, non fat, and normolipemics were selected. Samples were collected every three or five days before and during the diet. The whole test lasted twenty days. What had been shown is that the linoleic acid content increased but the one of the oleic acid decreased in all lipoprotein fractions. Those changes are bestly illustrated by using the (formula: see text) ratio as a kinetic index. The triglycerid fraction modifications are faster than the phospholipid's one. Concerning the other fatty acids, the modifications are less spectacular : the palmitic acid decrease in every lipids fractions and the palmitoleic acid has a significant decrease only in the esterified cholesterol. And the stearic acid has no variation at least significatively.

Adult↗
PubMed1979

[Discrepancies between TRH test and classical dynamic thyroid tests results in hyperthyroidism. 47 cases (author's transl)].

We have investigated the frequency of discordant results between the TRH test and classic dynamic tests of thyroid function (thyroid suppression and TSH stimulation tests) for patients presenting a diagnostic problem for hyperthyroidism. 12 patients in group I posed the problem of having a relapse of Graves' disease previously treated: a discrepancy between TRH and T3 suppression test results was observed in 17% of the cases. 10 patients in group II demonstrated the ophtalmopathy of Graves' disease without hyperthyroidism: discordance between tests results in this group was present for 20%. Finally, 25 patients in group III had a "hot" thyroid nodul apparent at thyroid scan: in 40% of the cases, the response to TRH did not lead to the same diagnosis that was suggested by the classical dynamic tests of thyroid regulation. The discrepancies observed in this work, between the results of the TRH test and those of classic dynamic tests, demonstrate that this two types of tests are not completely interchangeable, because they do not reflect exactly the same function.

Adult↗
PubMedDate not supplied

[Intolerance to carbohydrates: the seven questions].

The borderline between diabetes and intolerance to carbohydrates has been drawn on the basis of prospective studies which determined a glycaemic threshold marking the risk for microangiopathy. On the other hand, the borderline between intolerance to carbohydrates and normal glucose tolerance remains arbitrary: 25% for subjects who are intolerant to carbohydrates return to normal glucose tolerance within 10 years. This is due to the fact that intolerance to carbohydrates is a heterogeneous entity which should be dismembered according to the severity of insulin deficiency and to the degree of insulin resistance. Alteration of insulin secretion is perhaps the most specific marker of susceptibility to non insulin dependent diabetes, but insulin resistance is certainly the principal factor exhausting insulin secretion and leading to non insulin dependent diabetes. Insulin resistance and the hyperinsulinism it creates seem to facilitate atherogenesis, even when glucose tolerance is still normal, so that the oral glucose tolerance test is not only poorly reproducible but loses a great deal of its value in the early detection of vascular risk. Measurements of fasting and post-prandial glucose levels and of A1C haemoglobin, cholesterol, triglyceride, and HDL cholesterol levels usually make it possible to classify subjects into one of the three following categories: (1) no risk of macro- or microangiopathy; (2) diabetes with a risk of macro- or microangiopathy; (3) intolerance to glucose with risk of atherogenesis but no risk of microangiopathy. The oral glucose tolerance test probably remains useful within a small set of values that are either very slightly above normal or dissociated. Measuring blood insulin levels might be a better way of assessing the risk of atherogenesis, but the clinical use of this test requires evaluation.

Arteriosclerosis↗
PubMedDate not supplied

[Lipoprotein Lp(a): a new risk factor of atherogenesis].

Lp(a) is a lipoprotein present in all individuals in concentrations that are genetically determined. Its structure is characterized by the presence of an apoprotein with a high carbohydrate content called apoprotein a. Since 1972, numerous concordant data have endowed Lp(a) with a high risk of atherogenesis. This risk applies to the coronary and cervico-encephalic arteries. For the latter, Lp(a) even is a lipid parameter regarded as a major risk factor. The origin and metabolism of Lp(a) are little known, by they seem to differ from those of low-density lipoproteins. Its specific apoprotein of Lp(a). At the moment, there is no simple dietetic or medicinal treatment that can lower substantially the serum level of Lp(a).

Arteriosclerosis↗