The decision-making process in nutritional surveillance in Europe.
Explore the source record for details and available documents.
Diet↗
Biomedical subjects
C Leclercq
Publications and source records attributed to C Leclercq.
Total and domestic consumption of salt and their determinants in three regions of Italy.
Total and domestic (discretionary) consumption of salt was assessed in a sample of 91 households, which were randomly selected in three areas of Italy characterized by different dietary habits. Total salt intake was estimated by the mean urinary sodium in four 24 h collections. Discretionary salt, added during the preparation of the meals or at the table, was assessed using a simplified protocol of the lithium marker technique. Total sodium excretion was 191 mmol/d, 160 mmol/d and 132 mmol/d in adult males, adult females and children respectively. Dietary sodium density was 15 mmol per MJ of energy in children and 19 mmol/MJ in adults. It was significantly lower in the area where the traditional consumption of unsalted bread persists. Discretionary sodium intake was 67 mmol/d in adult males and females and 43 mmol/d in children; equivalent respectively to 36 per cent, 39 per cent and 34 per cent of total sodium intake. No difference was found between urban and rural environments, whereas discretionary use of salt was higher in the lower social class. These findings have important nutrition policy implications for the lowering of salt intake in the general population.
Adolescent↗
An augmented escape of beta-endorphins to suppression by dexamethasone in severely depressed patients.
Baseline beta-endorphin and cortisol levels and their responses to 1 mg dexamethasone were measured in 11 healthy controls and in 35 depressed patients, categorized according to the DSM-III. Dexamethasone significantly suppressed beta-endorphin levels. Depressed patients with melancholia/psychotic features exhibited significantly increased post-dexamethasone beta-endorphin levels compared with healthy controls, minor and simple major depressives; the baseline beta-endorphin levels did not differ between those study samples. Post-dexamethasone beta-endorphin and cortisol values were found to be significantly and positively correlated. Accordingly, cortisol non-suppressors showed significantly higher post-dexamethasone beta-endorphin levels. Post-dexamethasone beta-endorphin may be the most sensitive and specific reflection of the disorder in negative feedback exerted by dexamethasone in depression.
Adult↗
Thumb duplication: surgical treatment and analysis of sequels.
Between 1978 and 1988, 50 thumb duplications were operated upon at either the orthopedic department of Hôpital Trousseau (Paris) or at l'Institut Français de la Main (Paris). Following Wassel's classification, we observed a large incidence of types IV, II and VII (in that order). There was a 30% incidence of associated anomalies. The average age at operation was 15 months. We were able to review 30 patients (31 thumbs) with a mean follow-up of 30.9 months. We divided our series into two groups depending on the operative protocol. Group A: 19 patients (20 thumbs), operated on between 1978 and 1982 and reviewed at 33 months on average. Group B: 11 patients (11 hands) operated on between 1983 and 1988 and reviewed with a mean follow-up of 28.5 months. All of the children were evaluated following Wassel's and Tuch's criteria. In groupe A, only five thumbs could be considered normal, or near normal upon this reexamination. All the others were affected by various sequels, which were essentially esthetic. Only two thumbs had a functional deficit, due to instability of the MP joint in one case, and stiffness of the two joints of the thumb in the other. These poor objective results were, however, not shared by the children and their parents, since 16 of them declared themselves satisfied with the appearance and the function of the thumb. 6 patients required further surgery with an average of 2.5 operations per patient. These secondary operations gave imperfect results: out of 6 such patients, we obtained 3 fair results, and three remained poor. This relatively high proportion of sequels in our patients in group A led us to change our treatment protocol in 1983. Our revised attitude was to treat all deformities at once, and especially axial deviation with a corrective osteotomy if soft tissue surgery alone did not afford perfect realignment of the thumb. Thus, among the 11 reviewed patients of group B, 6 results could be considered to be good, 4 suffered from slight sequels, and one patient required a secondary surgery (tenolysis of the extensor apparatus) to correct an inadequate active extension of the IP joint. This result was functionally good on review. The optimal age for operation is between 12 and 18 months. Il seems to us that bad results are apparent early, after 6 to 12 months, because they are mainly due to inadequate treatment. Conversely, good short-term results seem to persist with growth, but there is an overall paucity of studies in this field.
Classification↗
Simplifying the lithium-marker technique used to assess the dietary intake of discretionary sodium in population studies.
1. Lithium has been used by Sanchez-Castillo et al. (Clin. Sci. 1987; 72, 81-6) for tracking sodium in order to monitor the domestic use of salt. The present study was designed to simplify the original protocol, which is too cumbersome for epidemiological studies. 2. A preliminary study conducted on nine volunteers showed that sharp modifications of lithium intake are detected within 24 h in urinary excretion. The average intake over a 5-day period could be predicted by the mean excretion of the last 3 days. Lithium recovery established from 1 baseline day and 3 plateau days was 95 +/- 6% (mean +/- SD), not significantly different from the recovery obtained by the integrated excretion curve over 12 days. 3. A simplified protocol was therefore developed, reducing to 4 the 12 days of urine collection originally required. 4. This simplified protocol was tested on five households (14 adults and five children). All domestic salt was substituted with lithium-tagged salt. Urine samples were collected on 1 baseline day and on 3 plateau days. The lithium/sodium ratio of all urine collections (both complete and incomplete) could be used to estimate the proportion of discretionary sodium. In our sample it was about 29% of total sodium intake. 5. The simplified protocol can thus be proposed for population studies.
Adult↗
Usefulness of red cell distribution width in association with biological parameters in an epidemiological survey of iron deficiency in children.
The diagnostic usefulness of red cell distribution width (RDW) in association with usual biochemical and haematological parameters in detection of iron deficiency has been studied in a representative sample population of 384 children aged six months to six years in Reunion. Traditional parameters measured included serum ferritin (Fri), total iron binding capacity (TIBC), serum iron (SI), transferrin saturation (TSat), free erythrocyte protoporphyrin (FEP), mean corpuscular haemoglobin concentration (MCHC), mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and haemoglobin concentration (Hb). RDW is an index of the variation in red cell size (anisocytosis). This recently derived parameter is measured by some models of electronic cell counter. It is not usually used in epidemiological investigations. Of the children studied, 13.6% had Hb less than 11 g/dl. The Pearson correlation coefficients between circulating iron parameters (SI, TSat, TIBC) or iron storage parameters (Fri) and RDW, MCV, MCH and FEP were greater than with Hb. The best correlations were observed for RDW, MCV and MCH with all other parameters. In this study, the upper limit value of RDW was defined as 18% using a Technicon model H-6000 counter. Other iron deficiency criteria were also defined and found to be in agreement with the international reference values for children aged six months to six years; MCV less than 70 fl, MCH less than 22 pg, MCHC less than 32%, FEP greater than 35 micrograms/dl whole blood, SI less than 6 mumols/l, TIBC greater than 85 mumols/l, TSat less than 10% and Fri less than 12 micrograms/l. The combination of sensitivity and specificity was best for RDW and worst for MCHC.(ABSTRACT TRUNCATED AT 250 WORDS)
Anemia, Hypochromic↗
Suppressant effects of dexamethasone on the availability of plasma L-tryptophan and tyrosine in healthy controls and in depressed patients.
Formation in the brain of serotonin from L-tryptophan (L-TRP) and noradrenaline from tyrosine are pathways related to the pathophysiology of major depression and to the regulation of the hypothalamic-pituitary-adrenal (HPA) axis. In the past, decrements in L-TRP availability and disorders in the HPA axis have repeatedly been observed in major depressed patients; both factors were shown to be inversely correlated. In order to investigate the relationships between glucocorticosteroid activity and the availability of L-TRP and tyrosine, the authors measured L-TRP, tyrosine, valine, leucine, isoleucine and phenylalanine in baseline conditions and after treatment with 1 mg dexamethasone in 16 healthy controls and in 50 depressed patients. The ratios between L-TRP and tyrosine and the sums of the amino acids known to compete with them during transport across the blood-brain barrier were computed as an index of (respectively) the serotonin and noradrenaline synthesis in the brain. We found significantly decreased plasma L-TRP and tyrosine levels after treatment with dexamethasone compared with basal levels. Accordingly, the plasma ratios between L-TRP and tyrosine and the sum of the competing amino acids were significantly reduced by dexamethasone administration. It was hypothesized that through these actions of dexamethasone on peripheral amino acids, the central noradrenaline and serotonin control over the HPA-axis could be altered.
Adult↗
[Myocardial infarction and massive biventricular thrombosis during thrombocytopenia induced by pentosan polysulfate and heparin].
Many cases of immuno-allergic thrombocytopenia complicated by serious thromboembolism induced by heparin or other heparinoids such as pentosan polysulphate have been reported. This case is of interest for two reasons: first of all, it was induced by pentosan polysulphate and then reactivated by secondary administration of heparin; secondly, it was complicated successively by an infero-apical myocardial infarction with probable spontaneous lysis of a coronary thrombosis because coronary arteriography performed one month later was normal, and then by massive biventricular thrombosis requiring surgical thrombectomy under cardiopulmonary bypass. Tests of platelet aggregation were positive to standard heparin and to several low molecular weight fractions. The outcome was favorable when the responsible substances were withdrawn.
Blood Coagulation Tests↗
The treatment of congenital clinodactyly of the hand.
Based on a review of 49 cases (involving 92 digits) of clinodactyly of the hand the authors analyse the cause, associated deformities and amount of time and procedures required for treatment. What emerges in particular is the importance of the age at which corrective surgery is performed.
Age Factors↗
[Cutaneous cover of the lower third of the leg: the distal soleus muscle flap].
Explore the source record for details and available documents.
Humans↗
[Long-term results of aponeurectomy for Dupuytren's disease].
Explore the source record for details and available documents.
Adult↗
[Motivation and orientation to medical studies].
Explore the source record for details and available documents.
Curriculum↗
[In vivo metabolism of rat submaxillary gland phospholipids].
The metabolism of the phospholipids of the submaxillary gland are studied after intraperitoneal injections of [32P]-orthophosphate in several groups of rats. The gland contains mainly phosphatidylcholines and phosphatidylethanolamines and in smaller quantities phosphatidylinositols, phosphatidylserines, sphingomyelins, polyglycerophosphatides, lysophosphatidylcholines and phosphatidic acids. The specific activities of the phospholipids measured in relation to the time (1/2 hour, 1, 2 and 3 hours) show a strong incorporation in the phosphatidylinositols then in the phosphatidylcholines. The other phospholipids have lower activities. The specific activities of the phospholipids measured one hour after injection of different pharmacodynamic agents show the phosphatidylinositols, phosphatidylcholines, sphingomyelins and lysophosphatidylcholines are altered. Acetylcholine increases their turnover, Atropine reduces it, and the addition of atropine counteracts the effect of acetylcholine in all these phospholipids.
Acetylcholine↗
Use of PABA test to check completeness of 24-h urine collections in elderly subjects.
The p-aminobenzoic acid (PABA) test has been successfully used as an indicator of completeness of 24-h urine collection in field studies of the general population. Our study was designed to investigate its validity for elderly people. Urinary excretion of fractionated oral doses of PABA was measured in 21 young control subjects (19-39 yr old) and 356 elderly (60-89 yr old) men and women. PABA excretion over 24 h was lower in elderly than in control subjects. Subjects aged greater than or equal to 70 yr had a lower recovery of the PABA dose than subjects aged 60-69 yr over the first 24 h, followed by a higher recovery over the next 24-48 h. The cumulative 48-h recovery was similar in all age classes of elderly subjects. However, 48% of the elderly subjects had a cumulative PABA recovery below the conventional cutoff for completeness (85%). These subjects also had consistently lower creatinine output and urinary volume. The lower 24-h urinary PABA recovery over 70 yr of age is interpreted to reflect the delayed renal clearance of the marker substance and indicates that the PABA test is unsuitable for this age group. The low 48-h cumulative recoveries found in all age classes of the elderly are thought to be caused by small unreported losses, which are recurrent in free-living populations.
4-Aminobenzoic Acid↗
[Towards humanization of psychiatric hospitals; Similes].
Explore the source record for details and available documents.
Belgium↗
[Symptomatology of dyscalculia in the presence of cortical lesions (author's transl)].
The authors examine the function of calculation in 26 patients presenting lateral local cortical lesions. They analyse the symptomatology of acalculia in relation to the location and lateral position of the lesion, and define the influence of concomitant constructive apraxia or aphasia before proposing a method for the classification of calculating disorders.
Aphasia↗