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Biomedical subjects

A Leger

Publications and source records attributed to A Leger.

At least 19 recordsLinked to original sources
PubMed2006

Reproducibility of a task description questionnaire for working pregnant women.

The objective of this study was to evaluate the reproducibility of a Task Description Questionnaire that was designed to investigate exposures to, and influential factors for, problematic tasks experienced by working pregnant women. The questionnaire comprised questions concerning 22 task components (covering working posture, manual material handling, work pace, prolonged postures and others), eight influential factors contributing to problematic tasks, discomfort (measured using a body map) and level of effort to perform the tasks. Reproducibility of the questionnaire was assessed by interviewing participants on two occasions one week apart for interviews at both 20 and 34 weeks of pregnancy. Eleven and 13 problematic tasks were reported by 21 working pregnant women at 20 and 34 weeks of pregnancy, respectively. These tasks were surveyed using the Task Description Questionnaire. Kappa statistics and correlation coefficients (supplemented by paired t-tests) were used to examine the reproducibility of responses to the questionnaire. The results showed that most of the variables were measured with very good or satisfactory reproducibility. The reproducibility of exposure to work posture was higher than that of exposure to manual material handling. There was no significant difference between test and retest means for the discomfort scores measured on the body map, except for the maximum discomfort score for the whole body in the 34 weeks survey. The study suggests that the questionnaire can be reliably used in the study of problematic tasks experienced by pregnant women. But an initial preview of the questions by the subjects and explanation of the questions given to the subjects by the interviewer may help to produce more reliable results.

Female↗
PubMed2001

Fluoxetine modulates motor performance and cerebral activation of patients recovering from stroke.

In order to determine the influence of a single dose of fluoxetine on the cerebral motor activation of lacunar stroke patients in the early phase of recovery, we conducted a prospective, double-blind, crossover, placebo-controlled study on 8 patients with pure motor hemiparesia. Each patient underwent two functional magnetic resonance imaging (fMRI) examinations: one under fluoxetine and one under placebo. The first was performed 2 weeks after stroke onset and the second a week later. During the two fMRI examinations, patients performed an active controlled motor task with the affected hand and a passive one conducted by the examiner with the same hand. Motor performance was evaluated by motor tests under placebo and under fluoxetine immediately before the examinations to investigate the effect of fluoxetine on motor function. Under fluoxetine, during the active motor task, hyperactivation in the ipsilesional primary motor cortex was found. Moreover, fluoxetine significantly improved motor skills of the affected side. We found that a single dose of fluoxetine was enough to modulate cerebral sensory-motor activation in patients. This redistribution of activation toward the motor cortex output activation was associated with an enhancement of motor performance.

Adult↗
PubMed2001

Disagreement between height/weight classifications of underweight, normal weight, and obesity in peritoneal dialysis patients.

Peritoneal dialysis (PD) patients are classified as underweight, normal weight, or obese by height/weight indices including body mass index (BMI) and the body weight/desired weight (W/DW) ratio. We compared these classifications of degree of obesity in 378 women and 555 men on PD. We used these cut-off values: for underweight, BMI < or = 18.5 and W/DW < or = 0.9; for obesity, BMI > or = 30.0 and W/DW > or = 1.2. The W/DW values were calculated assuming first a small frame, then a medium frame, and finally a large frame for all subjects. Regardless of sex or skeletal frame, BMI correlated highly with W/DW (r value between 0.98 and 0.99); however, the range of BMI values corresponding by linear regression to the normal range of W/DW (0.9-1.2) was narrower than the range of "normal" BMI (18.5-30.0). Consequently, regardless of sex or skeletal frame, smaller fractions of the patient population were classified as underweight or obese by BMI standards than by W/DW standards. The degree of agreement of the classifications of subjects as underweight, normal weight, or obese by BMI and W/DW was evaluated by Cohen's kappa ratio. The kappa ratio varied between 0.47 and 0.58, indicating a reasonable--but not high--degree of agreement beyond chance. The highest kappa ratios were obtained assuming a medium skeletal frame for both women and men. Substantial discrepancies are observed in the classification of PD patients as underweight, normal weight, or obese by BMI and W/DW. Further research is needed to identify the height/weight index that has the strongest association both with clinical outcomes and with other, more precise measurements of body fat content.

Body Constitution↗
PubMed2000

Body mass index in patients with amputations on peritoneal dialysis: error of uncorrected estimates and proposed correction.

UNLABELLED: "Weight-height" indices including percent of ideal weight (%IW) and body mass index (BMI) are used to estimate degree of obesity in populations and are predictors of survival in dialysis patients. Amputation affects the relationship between weight and height independently of the degree of obesity. Corrections of both %IW and BMI for amputation have been published, but a National (U.S.) computer nutrition program used in the authors' institution uses only the correction for %IW. This study had two parts: (1) To test whether the weight-height cut-off values for weight deficit (%IW 90%, BMI 20 kg/m2) and obesity (%IW 120%, BMI 30 kg/m2) are compatible, we performed linear regression of BMI on %IW in peritoneal dialysis (PD) patients without amputations. In 349 men, BMI = 0.834 + 0.226 (%IW), r = 0.979. From this regression, the 95% confidence interval (CI) of BMI is 19.2-23.1 kg/m2 if %IW is 90%, and 26.1-29.9 kg/m2 if %IW is 120%. In 260 women, BMI = 2.194 + 0.184 (%IW), r = 0.974. From this regression, the 95% CI of BMI is 15.7-21.8 kg/m2 if %IW is 90%, and 21.3-27.3 kg/m2 if %IW is 120%. (2) To identify the direction and magnitude of the error of uncorrected BMI (BMIu) in dialysis patients with amputations, we analyzed weight-height indices in two groups of men by the computer nutrition program, which corrects %IW, but not BMI for amputation, and by the corrected BMI (BMIc) formula. In group A (amputation without height loss, n = 11), %IW = 110.2% +/- 16.9%, BMIu = 23.6 +/- 2.7 kg/m2, BMIc = 26.4 +/- 3.8 kg/m2 (p < 0.001, BMIc vs BMIu), and 5 of the 11 BMIu values fell below the 95% confidence band of the regression of BMI on %IW in patients without amputations. In group B (amputation with loss of height, n = 6), %IW = 92.7% +/- 19.9%, BMIu = 33.9 +/- 10.7 kg/m2, BMIc = 22.1 +/- 4.4 kg/m2 (p < 0.005, BMIc vs BMIu), and 5 of the 6 BMIu values fell above the 95% confidence band of the regression of BMI on %IW in patients without amputations. CONCLUSIONS: (1) The weight deficit cut-offs for %IW and BMI are compatible in non amputated men and women. (2) The obesity cut-offs for %IW and BMI are compatible in non amputated men, but not in non amputated women. (3) Amputation without height loss decreases BMIu, while amputation with height loss increases, in general, BMIu. (4) BMI should be corrected in PD patients with amputations.

Amputation, Surgical↗
PubMed1995

[Molecular typing by pulsed field gel electrophoresis of Pseudomonas (Burkholderia) cepacia isolated from a nosocomial infection].

Because of the emergence of Pseudomonas (Burkholderia) cepacia, isolated among patients from an intensive care unit of the Hôpital Pellegrin (Bordeaux), strains were studied in the aim to determine the source and the mode of transmission of the bacteria. The study was performed on 44 isolates of P. cepacia from 21 patients (23 strains) or from the environment (16 isolates from ventilators and five from the distilled water used for these ventilators). Susceptibility to 23 antibiotics of these strains and endonuclease restriction polymorphism on their total DNA were determined. Pulsed field gel electrophoresis was performed after digestion of the genomic DNA, using three restriction enzymes. Results obtained by analysis of genotypic characteristics demonstrated the clonal origin of the P. cepacia epidemy in the different intensive care units, but did not localize the source of the infection.

Aminoglycosides↗
PubMed1994

Rowing performance and selected descriptive, field, and laboratory variables.

The purpose of this study was to determine the relationships among measures of rowing performance and selected descriptive, field, and laboratory variables. Rowing performance of 20 intercollegiate oarswomen was assessed using a 2,500-m time test on a Concept II rowing ergometer, the rower's competitive experience, and the coach's ranking of the rowers. The oarswomen also underwent standardized descriptive tests including anthropometric measurements, field tests including 90-s rowing ergometer distance and weight lifting tests, and laboratory tests including VO2max and isokinetic knee extensor strength tests. Rowing ergometer times were highly related to competitive experience (rho = -0.86; p < 0.01) and coach's ranking (rho = 0.87; p < 0.01). VO2max was the only other variable to produce correlations greater than 0.71 with rowing performance. Although most of the correlations observed in the present study were poor to modestly high, they do document and quantify relationships, and suggest that training and testing techniques should be modified to be more rowing specific and that their usefulness with respect to positive transfer and prediction should be examined.

Adult↗
PubMed1993

[Syndrome of resistance to thyroid hormones].

Although rare, thyroid hormone resistance syndrome should be suspected on a biological profile combining high thyroid hormone and non-suppressed TSH plasma levels. Resistance to thyroid hormone can be classified into 3 forms: generalized, pituitary and peripheral, all three showing tissue resistance heterogeneity from one person to another, and from one tissue to another in the same subject. In the generalized and pituitary forms, thyroid hormone levels are high with paradoxically normal or increased TSH levels. The TRH test still stimulates TSH secretion, and only the highest doses of T3 successfully suppress TSH secretion. In the generalized form, euthyroidism is usual, whereas in the pituitary form hyperthyroidism requires treatment in order to lower TSH secretion. In the peripheral form, various symptoms of thyroid hormone deficiency may be observed, contrasting with normal T3, T4 and TSH serum levels, and requiring supraphysiological doses of T3 for correction. In most cases, familial occurrence can be evidenced, with an autosomal dominant or sometimes recessive mode of inheritance. Genetic analysis has identified, in the generalized form, more than 10 mutations of the thyroid hormone receptor beta gene, all resulting in an alteration in the T3 binding domain of the receptor. In the autosomal dominant form, tissue resistance may result from a "dominant inhibitory effect" of the normal receptor function by the mutant receptor. All these thyroid hormone resistance syndromes constitute exceptional models for studying the mechanisms of action of thyroid hormones. Simultaneous observations of the mutated receptors with various clinical and biological phenotypes should further our understanding of thyroid hormone receptor function.

Drug Resistance↗
PubMed1993

Changes in rowing ergometer, weight lifting, vertical jump and isokinetic performance in response to standard and standard plus plyometric training programs.

The purpose of this study was to compare standard (S-weight plus rowing ergometer training) and standard plus plyometric (S+P-weight plus rowing ergometer training, plus plyometric exercises) programs on sport-specific and non sport-specific tests. Twenty-four female rowers completed the weight training or the weight training plus plyometric exercises three times per week and rowing ergometer training four times per week, 1 hr per session for 9 wks. Analysis of variance tests were used to compare S (n = 11; 5 novice and 6 experienced rowers) and S+P (n = 13; 7 novice and 6 experienced rowers) programs on the following sport-specific tests: 1) time to row 2,500 m and 2) distance rowed in 90 s; and on the following non sport-specific tests: 1) leg press, 1 RM, 2) leg press endurance, 3) bench pull 1 RM, 4) bench pull endurance, 5) vertical jump, 6-9) isokinetic knee extensor peak and average power during concentric and eccentric muscle actions and 10) angle of occurrence of peak torque during concentric muscle actions (isokinetic knee extension). Although experienced oarswomen scored significantly higher than did novice oarswomen on eight of 12 tests (p < 0.04), both levels of rower responded similarly to training. No significant differences were observed post-training between the S and S+P training programs (p > 0.05). These results do not discount the value of plyometric exercises, but indicate that the jump exercises used offered no advantages to intercollegiate oarswomen.

Body Weight↗
PubMed1992

Antithyroid hormone antibodies induced by interferon-alpha.

A 40-yr-old woman known for a multinodular goiter had hyperthyroidism. Treatment with antithyroid drugs and iodine therapy was effective. One year later, she received interferon-alpha for treatment of essential cryoglobulinemia. At that time, the patient was euthyroid. Testing for antithyroglobulin, antimicrosome, anti-TSH receptor, and antithyroid hormone antibodies was negative. After a 1-yr course of interferon-alpha, goiter enlargement was noticed. Apparently elevated free T3 and T4 serum values were measured by RIA, contrasting with clinical euthyroidism and normal TSH values. High serum levels of antithyroid hormone antibodies were found in the patient's serum, using a radiolabeled hormone immunoprecipitation assay. Antithyroglobulin and antimicrosome antibodies titers were also elevated and paralleled antithyroid hormone antibodies. After cessation of interferon-alpha therapy, clinical status and TSH levels remained normal, while thyroid hormone values and antithyroid hormone antibody levels progressively normalized. To our knowledge, this is the first report of antithyroid hormone antibodies induced by interferon-alpha. Since thyroid dysfunction is described in 10-15% of treated patients, the fact that interferon-alpha can induce antithyroid hormone antibodies has important implications: 1) the prevalence or intensity of thyroid dysfunction could be overestimated; and 2) artifactually elevated free T3 and T4 serum values could lead to inappropriate therapy of thyroid disease or cessation of interferon treatment.

Adult↗
PubMed1991

Tracking with a restricted field of view: performance and eye-head coordination aspects.

Vision through a restricted field of view (RFOV) is becoming increasingly common in aviation with the use of helmet mounted displays. Our first experiment investigated the influence of a narrow (20 degrees) binocular RFOV on performance during head-free visuo-manual tracking of a wide range (+/- 85 degrees) horizontally moving target. Second, the effects of two levels of RFOV (20 degrees, 70 degrees) on a similar tracking task presented with various eccentricities were compared to full field of view (FOV). Eye and head movement around the yaw axis were recorded and analyzed versus head-free visual pursuit alone. Tracking performance appeared moderately impaired when RFOV was set to 20 degrees, but did not improve with a 70 degrees field. Discomfort due to unusually large head movements was ruled out as a causal factor. Visuo-manual tracking apparently implies a need for head stability. RFOV degrades this basic requirement which, in turn, could explain performance impairment. Analysis of eye-head coordination characteristics following FOV task conditions supports this hypothesis.

Adult↗
PubMed1988

Detection of myocarditis during the first year after discovery of a dilated cardiomyopathy by endomyocardial biopsy and gallium-67 myocardial scintigraphy: prospective multicentre French study of 91 patients.

The purpose of this study was to assess the frequency of inflammatory lesions in the myocardium of subjects with dilated cardiomyopathy and to determine if there was any correlation between the results of two methods of evaluation, one (endomyocardial biopsy) invasive and the other (gallium-67 scintigraphy) noninvasive. Of 115 subjects recruited in seven centres, 91 met the inclusion criteria (left ventricular dilatation greater than or equal to 100 ml m-2 and ejection fraction less than 55% with normal coronary arteriography) and had endomyocardial biopsy (mean five specimens) and Ga-67 myocardial scintigraphy after several days. Scanning was considered doubtful 19 times and positive 13 times. The histologic count of mononuclear cells in the myocardial interstitium in 20 fields was greater than 5 cells field-1 in only four cases. No correlation was found between the two methods. Subjectivity in the choice of the criterion of positivity of Ga-67 scintigraphy and difficulties in identifying lymphocytes upon pathological examination were the major problems encountered. Despite limitations, both techniques suggest that cellular infiltrates are minimal and quite infrequent in dilated cardiomyopathy.

Adolescent↗
PubMed1986

Multifactorial study of prognostic factors in differentiated thyroid carcinoma and a re-evaluation of the importance of age.

A multivariate analysis of prognostic factors has been carried out with 375 cases of differentiated thyroid cancer (DTC) treated in the same centre by total thyroidectomy and 131I therapy. The patients have been followed for 5 to 23 years. The isolated prognostic roles of age, sex, clinical stage and histology were confirmed, but these factors were found to be strongly interrelated. Multifactorial analysis was conducted following Cox's model. It demonstrated that the prevalent role of clinical staging (nodular versus lobar or massive form) is as important as the initial presence of metastases (P = 0.0001). Histological assessment of differentiation, age and sex were of lesser importance. Thus, the most significant prognostic variable is clinical stage. These data must be taken into account when formulating management protocols for DTC.

Adolescent↗