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Biomedical subjects

T Constans

Publications and source records attributed to T Constans.

At least 19 recordsLinked to original sources
PubMed1997

Comparison of subcutaneous and intravenous administration of a solution of amino acids in older patients.

OBJECTIVE: To compare the plasma amino acid (AA) concentrations obtained by the infusion of an AA solution (660 mOsm/L, pH 7) using the subcutaneous (SC) with that using the intravenous (i.v.) route in older patients. DESIGN: A prospective, randomized, cross-over study. SETTING: A hospital geriatric ward. PARTICIPANTS: Six patients with a mean age of 84 years. MEASUREMENTS: The infusion of the AA solution (IV or SC) lasted 6 hours. Blood was sampled at 0, 2, 4, 6, 8, 10, 14, 18, and 24 hours from the start of the infusion to determine plasma AA level by the phenyl-isothiocyanate method. RESULTS: Compared with baseline values, plasma AA concentrations increased to a significantly higher level from the second to the tenth hour and from the second to the fourteenth hour during i.v. and SC infusions, respectively. Plasma AA levels did not differ between the two routes. SC infusion was well tolerated. CONCLUSION: Assuming that nutritional sufficiency is the desired result of plasma AA infusion, we conclude the SC route is well tolerated and offers the possibility of nitrogen supplementation for older patients over short periods of time, when oral protein intake is transiently insufficient or impossible, as a way to limit, but not to treat, protein-energy malnutrition.

Aged↗
PubMed1995

Outcome of elderly patients requiring ventilatory support in intensive care.

The objectives of the study were: 1) to evaluate mortality in elderly patients requiring ventilatory support in Intensive Care Unit (ICU) and at 6, 12 and 18 months after discharge from ICU; 2) (main objective) to determine predictors of mortality in ICU and after discharge; and 3) to assess the life-style of survivors. One hundred and ten consecutive hospitalized patients > or = 70 years were included in this retrospective study. Follow-up evaluation was conducted by telephone interview. Mortality in ICU and after discharge was the outcome variable. Fifteen parameters were recorded at admission and during hospitalization. Residence, health status, and self-sufficiency were evaluated after discharge. 1) Mortality in ICU and at 6, 12 and 18 months after discharge was 38%, 60%, 63% and 67% respectively. 2) The predictors of mortality in ICU were admission in shock, and use of major therapeutic interventions. Predictors of mortality at 6 months were admission in shock, previous impaired health status and marital status. 3) Eighteen months after discharge 92% of the surviving patients (N = 33) had the same residence, 75% had the same health status, and 78% had the same autonomy compared with pre-admission status. We concluded that shock and previous health status but not age are predictors of short- and long-term prognoses in elderly patients hospitalized in ICU for mechanical ventilation.

Aged↗
PubMed1995

Metabolic and hormonal changes induced by hypodermoclysis of glucose-saline solution in elderly patients.

BACKGROUND: Hypodermoclysis, i.e., infusion of solutions into the subcutaneous tissues, is an alternative method for hydration. The aim of our study was to describe the metabolic changes induced by hypodermoclysis of a glucose-saline solution in elderly patients. METHODS: Twelve experiments were conducted in a random cross-over study, intravenous infusion (IV) vs subcutaneous infusion (SC), in 6 hospitalized patients (81.5 +/- 9.8 years). The solution (1000 mL of 5% glucose solution containing 4 g NaCl) was infused over 6 hours in fasted patients who remained in bed. Blood was sampled at -10, 0, 30, 60, 90, 120, 180, 240, 300, and 360 minutes for measurement of plasma concentrations of glucose, insulin, free fatty acids, and beta-hydroxybutyrate. Plasma concentration of cortisol was analyzed only at T-10, T0, T180, and T360. RESULTS: The increases in glucose and insulin and the decrease in plasma concentrations of free fatty acids were lower with SC infusion than with IV infusion. The decrease in beta-hydroxybutyrate plasma concentration was lower at T300 with SC infusion than with IV infusion. The decrease in cortisol did not differ with the route. Plasma concentrations of all compounds were similar at T360. CONCLUSION: We conclude that hypodermoclysis of glucose-saline solution induced similar but smaller metabolic and hormonal changes than the IV infusion.

Aged↗
PubMed1994

Anthropometric values in an elderly French population.

We compared anthropometric indices in samples of elderly people aged 65 years and over living in two French areas. The samples were divided into four age-groups (65-69, 70-74, 75-79 and over 80 years). We observed interregional differences in women aged 65-69 years and in men aged 65-74 years. Weight and anthropometric variables related to body fat percentage and to muscle mass showed a decline with age as already reported by others. We established anthropometric percentile values according to sex in pooled subjects when no integrated difference was found. The 50th percentile of arm circumference, muscle arm circumference and triceps skinfold was higher, and the 50th percentile of body mass index was lower than the one reported for the same indices from an elderly Welsh population. Our results show that an interregional difference in anthropometric indices exists in the elderly. The differences which are observed between our results and those reported from a British population emphasize the importance of establishing local values for the elderly population.

Aged↗
PubMed1992

Protein-energy malnutrition in elderly medical patients.

STUDY OBJECTIVE: To evaluate (1) the prevalence of protein-energy malnutrition in elderly patients; (2) the changes in nutritional status during the hospital stay; and (3) (main objective) the relationship between simple nutritional parameters and short-term in-hospital mortality. DESIGN: Prospective time series at admission and on the 15th day of hospitalization. SETTING: Medical care unit in a teaching hospital. PARTICIPANTS: Consecutive sample of 324 hospitalized patients greater than or equal to 70 years (86.4% of eligible patients). Norms of measurements were obtained from a referred sample of healthy control subjects (26 males and 36 females). MAIN OUTCOME MEASURES: Mid-arm circumference, triceps skinfold thickness, serum albumin, prealbumin, and retinol-binding protein levels were measured in patients at admission and on the 15th day. RESULTS: (1) Prevalence of PEM was 30% in male and 41% in female patients. (2) Both mid-arm circumference and serum albumin level decreased over the first 15 days of hospital stay (53 patients, paired t test, P less than 0.05). Triceps skinfold thickness did not change. (3) A step-wise discriminant-function analysis determined the utility of the parameters at admission as predictors of in-hospital mortality before the 15th day. Mid-arm circumference, triceps skinfold thickness, albumin, and prealbumin levels, as well as age, are predictors of in-hospital mortality, with 73% sensitivity, 69% specificity, and 70% of correctly classified patients of both sexes. CONCLUSIONS: Parameters used are predictors for short-term in-hospital mortality of elderly patients hospitalized in an acute medical unit. The lean body mass is preferentially mobilized for energy during hospitalization.

Aged↗
PubMed1992

Age-related insulin resistance: a review.

Impaired glucose tolerance occurs with age. This impairment is multifactorial including a decrease in insulin-mediated glucose uptake by peripheral tissues and a delay in insulin-induced suppression of hepatic glucose output. A post-binding defect in insulin action such as a reduced capacity to transcribe more glucose transporter mRNA and/or a reduced translocation of preformed glucose transporters to plasma membrane is incriminated. However, insulin resistance with age is not a constant finding and other mechanism(s) has (have) to be involved in old individuals with impaired glucose tolerance and normal tissue insulin sensitivity.

Aging↗
PubMed1991

Insulin sensitivity and liver insulin receptor structure in ducks from two genera.

Insulin sensitivity and liver insulin receptor structure were studied in 5-wk-old ducks from two genera (Muscovy and Pekin). In the fasting state, both duck types were equally resistant to exogenous insulin compared with chicken. Despite the low potency of duck insulin, the number of insulin receptors was lower in Muscovy duck and similar in Pekin duck and chicken liver membranes. After 125I-insulin cross-linking, the size of the alpha-subunit of the receptors from the three species was 135,000. Wheat germ agglutinin-purified receptors from the three species were contaminated by an active and unusual adenosinetriphosphatase (ATPase) contaminant (highest activity in Muscovy duck). Sequential purification of solubilized receptor from both duck types on lentil and then wheat germ agglutinin lectins led to a fraction of receptors very poor in ATPase activity that exhibited a beta-subunit size (95,000) and tyrosine kinase activity similar to those of ATPase-free chicken insulin receptors. Therefore the ducks from the two genera exhibit an alpha-beta-structure for liver insulin receptors and a clear difference in the number of liver insulin receptors. Their sensitivity to insulin is, however, similarly decreased compared with chicken.

Animals↗
PubMed1991

Hypodermoclysis in dehydrated elderly patients: local effects with and without hyaluronidase.

Dehydration is frequently encountered in elderly patients and hypodermoclysis is an alternative method of parenteral rehydration. Hyaluronidase is classically added to the solution infused subcutaneously. The local effects of hypodermoclysis with or without hyaluronidase were investigated by using a randomized double-blind study in 12 dehydrated elderly patients. Five hundred millilitres of a 5% glucose saline solution was infused subcutaneously in 2 hours in each thigh, (A) with and (B) without 250 U of hyaluronidase. Circumference and temperature of each thigh were assessed before and after the infusion. Color was evaluated after the infusion. The gain in thigh circumference was less in the presence of hyaluronidase, but the other variables did not differ. The patients were thoroughly questioned about pain: no difference was noted between solutions A and B. We conclude that hyaluronidase adds no comfort that justifies its systematic use in the hypodermoclysis of glucose saline solutions.

Aged↗
PubMed1990

[Validity of a short self-administered dietary questionnaire compared with a dietetic interview].

The dietary intakes of 250 men and women aged from 17 to 60 years were evaluated by means of a self-administered questionnaire. The purpose of this study was to develop and optimise a self-administered questionnaire deliberately reduced to 20 questions. The results were compared with those of a dietetic interview using the diet history method. The correlation coefficients for the main nutrients were determined by multivariate regression analysis and were found to fall in the 0.44-0.80 range (P less than 0.001). It is concluded that the self-administered questionnaire is satisfactory and valid as compared with the diet history method. The degree of validity reached is such that efficient epidemiological studies can be conducted at small cost, and the subjects at risk due to the main dietary errors listed in the contemporary French population can be detected.

Adolescent↗
PubMed1990

Skin acceptance of transcutaneous nitroglycerin patches: a prospective study of 33 patients.

Transdermal nitroglycerin is commonly used and may induce contact dermatitis. The frequency of adverse skin reactions is controversial and may vary from 10% to 75%, according to various authors. 33 patients using transdermal nitroglycerin for more than 7 days were examined and patch tested (nitroglycerin 0.5% aq., 2% pet. and TTS in toto). 5 patients (15%) had adverse reactions. The patch tests were all negative in the 33 patients. Contact dermatitis occurs in many cases, about 15% of the cases with the newly available TTS, and even if patients respect the conditions for using TTS. These contact dermatitides are mainly irritant reactions and do not require transdermal nitroglycerin treatment to be stopped. Nevertheless, since some cases of allergic contact dermatitis have been reported, a contact dermatitis from transdermal nitroglycerin should lead to patch testing.

Administration, Cutaneous↗
PubMed1990

[Increase of serum gamma-glutamyl transferase activity in diabetic patients is not linked to diabetes itself].

In order to assess the relationship between increase of gamma-glutamyl transferase and diabetes, we measured serum gamma-glutamyl transferase in 48 male and 43 female insulin-dependent diabetics aged 20-60 years, 49 male and 41 female non insulin dependent diabetics aged 30-60 years, and in 114 male and 124 female controls (blood donors) aged 20-60 years. A1C haemoglobin was assayed in 124 diabetics. There is no increase of serum gamma-glutamyl transferase activity in insulin dependent diabetics of both sexes when compared with the controls. There is an increase of serum gamma-glutamyl transferase activity in non insulin dependent diabetics when compared either with controls (men p less than 0.02, women p less than 0.02) or with insulin dependent diabetics (men p less than 0.05, women p less than 0.02). There is no correlation between serum gamma-glutamyl transferase activity and fasting blood sugar (148 diabetics). In non insulin dependent diabetics of both sexes there is no correlation between A1C haemoglobin and serum gamma-glutamyl transferase activity. These results suggest that the increase observed in diabetics is not caused by diabetes itself, ie, by hyperglycemia, but by diabetes associated pathologies.

Adult↗