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Biomedical subjects

A Laffitte

Publications and source records attributed to A Laffitte.

18 recordsLinked to original sources
PubMed2006

[Twin pregnancies in southern Reunion Island: a three-year cross-sectional study of risk factors and complications].

OBJECTIVES: To describe characteristics of multiples pregnancies in southern Reunion Island. MATERIAL AND METHODS: A three-year [corrected] cross-sectional observational study aimed at describing risk factors, events and [corrcected] complications and associated with twin pregnancies from 22 weeks gestation onward, within a tertiary care hospital centre, the Groupe Hospitalier Sud-Réunion. RESULTS: The study included 241 multiple pregnancies out of 15 837 pregnant women. The regional incidence of multiple pregnancies was 1.5%. Indicators of eligible twin pregnancies (n=234) were mother age up or equal to 35 years (63% of women, OR 8.4; CI95% 6.3-11.1), infertility treatments (15%): ovarian stimulations (OR: 50.2; CI95% 24.7-102) and in vitro-fertilisations (OR: 44.3; CI95% 22.6-86.3). A low maternal corpulence before pregnancy (BMI<20) and celibacy were negatively associated with twin pregnancies. Prenatal cares for twin pregnancies were globally adequate. The need for hospitalisation was 50% (30% of whom for preterm delivery threats). Twin pregnancies increased risks for pre eclampsia (OR: 3.0; CI95% 1.6-5.7) and gestational diabetes (OR: 1.9; CI95% 1.2-2.8). Caesareans and instrumental delivery rates were 50% and 12% (vs 16% and 7%), respectively. Twin infants were preterm for 62% and very preterm for 18%. Last, they were more likely to die than singletons (perinatal mortality: 78 per thousand for monochorionic twins, 57 per thousand for bichorionic twins vs 17 per thousand, p<0.0001, respectively). CONCLUSION: In Reunion Island, the incidence of multiple pregnancies is similar to that seen in Europe, but seems less due to assisted reproduction techniques. In return, they are associated with higher morbidity and mortality rates.

Adolescent↗
PubMed2005

[Congenital varicella: limits of prenatal diagnosis].

INTRODUCTION: Primary varicella infection during pregnancy is uncommon. Fetal varicella syndrome is unusual when varicella occurs after 20 weeks of gestation. CASE REPORT: A mother contracted chicken pox at 21 weeks and 3 days of gestation. Monthly monitoring was assured by the center for prenatal diagnosis, starting from 23 weeks. At 36 weeks, foetal echography detected liver calcifications, without other lesions. At 38 weeks, the patient went into spontaneous labour and delivered a male baby. The baby presented cicatricial skin lesions all over the body and scalp. The cerebral scan detected calcifications and a bilateral chorioretinitis was noticed. At 12 months, the infant had delayed psychomotor acquisitions, a cerebral cortical atrophy and blindness. CONCLUSION: The presence of fetal liver calcifications after chicken pox in the mother is a seldom reported sign. In our observation, liver calcifications were the single sign of a severe fetal damage.

Brain Diseases↗
PubMed2004

[Post mortem brain MRI: an alternative for pathology examination in Bourneville tuberous sclerosis of the fetus?].

Antenatal discovery of cardiac rhabdomyomes evokes the diagnosis of Bourneville's disease. Antenatal brain exploration with ultrasonography and magnetic resonance imaging (MRI) can highlight cerebral localizations. In the event of termination of pregnancy, confirmation of the cerebral lesions can be achieved with post mortem MRI as well as pathology examination. MRI can be usefully employed in the event pathology examination is not feasible.

Adult↗
PubMed2004

[Pregnancy beyond age 40 in 382 women: a retrospective study in Reunion Island].

OBJECTIVE: To examine obstetrical and neonatal outcomes among women age 40 years and older. MATERIAL AND METHODS: There was a retrospective study including 382 pregnant women at least 40 years of age and 7786 controls aged 20-34, stratified according to parity. Associations between maternal age and pregnancy outcomes were assessed using Pearson's chi(2) test, Fischer exact test, Student test or Mann and Whitney test, as appropriate. RESULTS: Maternal age 40 and over was associated with an increased risk for gestational diabetes (multiparas: OR 3.2, 95%CI 2.2-4.8; grandmultiparas: 2.8, 1.6-5.0), chronic diabetes (multiparas: 3.5, 1.04-10.6), chronic hypertension (multiparas: 3.1, 1.5-6.1; grandmultiparas: 12.1, 3.3-53.2), pregnancy-induced hypertension (nulliparas: 4.6, 1.01-17.3; multiparas: 2.6, 1.3-5.4) and preclampsia (multiparas: 2.9, 1.1-7.2). The risk for cesarean section was 2-fold higher in older multiparas and grandmultiparas. The same was true for the rate of operative vaginal delivery. The rate of fetal chromosomal abnormalities was 7-fold higher in older gravidas. Rates of fetal death were significantly increased in the cohort of older pregnant women (nulliparas: 11.2, 2.9-44.0; multiparas: 3.9, 1.4-10.9). CONCLUSION: Pregnancy at age 40 and over is associated with high rates of obstetrical complications, cesarean sections and operative vaginal deliveries, emphasizing the importance of rigorous antenatal care.

Adult↗
PubMed2003

[Severe cytomegalic inclusions disease in the fetus of a woman immunized before pregnancy].

After detection of a fetal microcephaly at 24 weeks gestation, we performed an amniocentesis at 29 weeks with chromosomal and polymerase chain reaction (PCR) search for viral contamination. Cytomegalovirus (CMV) infection was confirmed by PCR although the mother had previously been tested as immunized for CMV prior to conception. Abortion was induced; the fetus presented clinical CMV injuries confirmed by positive tissue culture (liver, brain and lungs). Recent publications have reported similar observations with variable viral strains. These findings point out the importance attentive search for ultrasonographic signs suggestive of fetal CMV infection.

Abortion, Induced↗
PubMed1996

Chronic consumption of short-chain fructooligosaccharides by healthy subjects decreased basal hepatic glucose production but had no effect on insulin-stimulated glucose metabolism.

We aimed to study the effects of chronic ingestion of short-chain fructooligosaccharides (FOS), an indigestible carbohydrate, on hepatic glucose production, insulin-mediated glucose metabolism, erythrocyte insulin binding, and blood lipids in healthy subjects. Twelve healthy volunteers received either 20 g FOS/d or sucrose for 4 wk in a double-blind crossover design. FOS did not modify fasting plasma glucose and insulin concentrations. Mean (+/- SEM) basal hepatic glucose production was lower after FOS than after sucrose consumption (2.18 +/- 0.10 compared with 2.32 +/- 0.09 mg.kg-1, min-1, respectively; P < 0.02, paired Student's t test). However, neither insulin suppression of hepatic glucose production nor insulin stimulation of glucose uptake measured by hyperinsulinemic clamp was significantly different between the two dietary periods. Erythrocyte insulin binding was also comparable. Serum triacylglycerols, total and high-density- lipoprotein cholesterol, apolipoproteins A-I and B, and lipoprotein(a) were not modified by FOS. To try to understand why FOS did not increase serum lipids, the in vitro production of short-chain fatty acids from FOS was evaluated by using human fecal inoculum and compared with that from lactulose, which was found to increase serum lipids. FOS produced an acetate-propionate ratio two times lower than that of lactulose. We conclude that 4 wk of 20 g FOS/d decreased basal hepatic glucose production but had no detectable effect on insulin-stimulated glucose metabolism in healthy subjects. The colonic fermentation pattern of undigestible carbohydrates may be relevant to predicting their metabolic effects.

Adult↗
PubMed1995

Low-fat (41%) butter consumption decreases total energy and lipid intake in diabetic patients under acute conditions.

Decreasing fat intake in subjects at risk of cardiovascular diseases and particularly diabetics is a major issue. To investigate whether low-fat (41%) butter (LFB) is of any benefit compared to regular butter (RB), 97 hospitalized diabetics (41 insulin-dependent) were studied on four consecutive days. Breakfast (bread, butter and drink) was served at 0830 hrs, on successive mornings. LFB and RB were presented ad libitum, on alternate days. Satiety was assessed at 10 and 12 h, using line rating scales. At 1230 hrs lunch was served, with large servings corresponding to 130% of the recommended lunch intake, so that carry-over effects from the breakfast manipulation could be measured. At breakfast, LFB was consumed in higher amounts, 27 vs. 21 g, F(1,96) = 33.24, p < 0.0001, than RB; however, the energy intake was significantly lower (by about -38%) on LFB days, F(1,96) = 158.3, p = 0.0001. Hunger at 10 h but not at 12 h was affected by breakfast conditions. Lunch intake was comparable following LFB and RB breakfasts. In conclusion, LFB utilization under acute conditions seems to benefit diabetics by reducing caloric and fat intake.

Adult↗
PubMed1995

Low-fat (41%) butter use decreases butter lipid intake over 4-week trials in healthy persons.

All members of 18 families (n = 75; ages from 1 to 65 years) participated in a cross-over study of butter usage. Two types of butter were compared: regular (82%) fat) and low-fat (41%) butter. Butter was supplied to the families by the laboratory for use in raw (spread) form over two successive periods of 5 weeks (first week served as training). No other butter was allowed. The number of consumers (75) remained constant throughout the study. Over four consecutive weeks, the families consumed as much low-fat as regular butter (10.70 +/- 1 g versus 10.06 +/- 1.17 g per day per person). However, lipid intake from butter was significantly reduced during the low-fat butter period as compared to the regular butter period (4.39 +/- 0.41 g versus 8.25 +/- 0.96 g per day per person, p = 0.0005). Since previous studies showed that nutrient-specific compensatory intake is unlikely, it is suggested that use of low-fat butter can facilitate a reduction in fat intake over extended periods of time in healthy persons.

Adolescent↗
PubMed1989

[Intraerythrocytic potassium and diuretic therapy].

Diuretic-induced hypokalemia is one of the most common and important disturbances during antihypertensive therapy. However, it has been suggested that determination of serum potassium levels may not reflect significant changes of its intracellular concentration. This study was performed to evaluate whether there is any change of red cell potassium concentration as compared to serum potassium levels, in ten patients receiving chlorthalidone, 25 mg/day, during 4 weeks. Significant antihypertensive effect was achieved and despite serum potassium levels less than 3.5 mEq/1 occurred in four patients, no significant change in intracellular concentration of potassium was observed in this population with essential hypertension.

Adult↗
PubMed1984

[Uremic polyneuropathy: a study of vibratory perception threshold in 19 patients].

A vibratory perception threshold study was done in 19 patients with uremic polyneuropathy, using a palesthesiometer. Three patients were maintained in conservative treatment (controls), 7 patients maintained with hemodialysis and 9 patients with peritoneal dialysis, during a period of 4 to 72 months. Abnormal vibratory perception threshold was found in 94.73% when the first toe was studied, 36.84% with the fifth finger and 52.63% with the second finger. The statistical analysis between the hemodialysis, peritoneal dialysis and control group was non significant. It was not found any correlation between the severity and duration of neuropathy with the low perception threshold. The authors conclude that this is a simple method, easy to be done and very useful in the quantification of the vibratory perception threshold in the uremic patient, but lack specificity regarding severity of the illness.

Adult↗