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Biomedical subjects

D Brun

Publications and source records attributed to D Brun.

At least 37 records · Page 2Linked to original sources
PubMed1989

Hypertriglyceridemia and lower LDL cholesterol concentration in relation to apolipoprotein E phenotypes in myotonic dystrophy.

Plasma lipid, lipoprotein levels and apolipoprotein apo E phenotypes were determined in 70 patients with myotonic dystrophy (MyD) and 81 controls. Marked differences were noticed in the apo E phenotype frequencies between the two groups. Plasma triglycerides and VLDL cholesterol were higher in MyD than controls, but only the latter was related to differences in the apo E phenotypes between two groups. Accordingly, the ratio of VLDL cholesterol/plasma triglycerides was increased significantly in MyD, suggesting accumulation of intermediary density particles due to lower affinity of E2 containing lipoproteins for lipoprotein cell receptors. The LDL cholesterol concentration was lower in MyD than controls and was related to differences in the apo E phenotype frequencies between the two groups. These results indicate increased removal of LDL particles in the apo E2 phenotypes, perhaps due to upregulation of LDL (B, E) receptor activity. Plasma cholesterol and HDL cholesterol concentrations were similar in both groups. Another feature of the study was lower levels of plasma cholesterol, triglycerides, VLDL and LDL cholesterol in the homozygous E4:E4 phenotype. These results suggest increased clearance rate of both VLDL and LDL particles and support the concept that apo E4-containing lipoproteins have higher in vivo affinity for ape E and/or B, E receptors.

Adolescent↗
PubMed1988

Changes in plasma lipoproteins during various androgen suppression therapies in men with prostatic carcinoma: effects of orchiectomy, estrogen, and combination treatment with luteinizing hormone-releasing hormone agonist and flutamide.

Cardiovascular complications are a well recognized side-effect of antihormonal therapy in men with prostatic carcinoma. We studied changes in plasma lipoproteins in patients with prostate cancer during treatment with several androgen suppression therapies. Estrogen, orchiectomy, and a combination of LHRH agonist and antiandrogen (flutamide) reduced plasma testosterone concentrations (89-92%) and plasma estradiol decreased by 85%, 44%, and 54%, respectively. Estrogen induced hypertriglyceridemia and elevation of plasma HDL cholesterol, phospholipid, and apolipoprotein A-I and A-II concentrations. Low density lipoprotein (LDL) cholesterol decreased but LDL apolipoprotein B did not. These results suggest that the cardiovascular complications that occur during estrogen administration are not mediated through changes in lipoprotein profile, other than the hypertriglyceridemic effect. Orchiectomy caused hypercholesterolemia and an increase in both total and LDL apolipoprotein B, all of which are strong determinants of cardiovascular disease. The high density lipoprotein (HDL) concentration was not affected despite a reduction in plasma testosterone, perhaps due to a simultaneous decrease in estradiol. Combination therapy had no effect on plasma lipid and apolipoprotein B concentrations, but very low density lipoprotein (VLDL) apolipoprotein B decreased, and LDL apolipoprotein B increased. The HDL cholesterol and apolipoprotein A-I concentrations increased but A-II and phospholipids did not. These results suggest enhanced lipoprotein lipase activity, consistent with the reciprocal changes in VLDL and LDL apolipoprotein B levels, apolipoprotein B enrichment of LDL particles, and increase in HDL cholesterol. The higher apolipoprotein A-I to A-II ratio indicates an increase in HDL2 subfraction due to inhibition of endothelial hepatic lipase, increased secretion of apolipoprotein A-I, or both. These effects are attributed to estradiol, which decreased less than after orchiectomy, and to additional adrenal androgen inhibition by flutamide. We conclude that estradiol plays an important role in determining plasma lipoprotein concentrations in men, and androgens exert an antagonist effect. The lipoprotein profile resulting from the combination treatment is more beneficial than that resulting from orchiectomy or estrogen administration.

Aged↗
PubMed1987

Increase in plasma high-density lipoprotein concentration following complete androgen blockage in men with prostatic carcinoma.

There is evidence that endogenous estrogens have a positive effect on plasma high density lipoprotein (HDL) concentration, whereas the relation between HDL and male sex hormones is unclear, since both positive and negative effects have been reported. This study examined the effects of LHRH agonist in combination with an antiandrogen on plasma lipids and lipoproteins in 17 elderly men with prostatic carcinoma. Subjects were examined prior to and after therapy at 4-week intervals up to 16 weeks. Prior to therapy, their lipid and lipoprotein profiles were not significantly different from a control group composed of individuals of similar age and living in the same community area. Following therapy plasma levels of testosterone and dihydrotestosterone were markedly decreased (above 90%) and their residual activity neutralized through effective use of an antiandrogen. Plasma estradiol decreased between 65% and 85% and the concentration of cortisol was unaffected. The very low density lipoprotein (VLDL) apo-B decreased and low density lipoprotein (LDL) apo-B increased; thus, no change was observed in the total plasma apo-B levels. Total plasma cholesterol increased by 6% (baseline v peak values, mg/dL, mean +/- SEM; 219 +/- 9 v 233 +/- 9, P less than 0.05) due to a significant rise in HDL cholesterol concentration (45.5 +/- 2.8 v 56.5 +/- 3.6, P less than 0.01). Both VLDL and LDL cholesterol levels remained unchanged. The mean elevation of 21% in HDL cholesterol was accompanied by a significant rise in HDL apo-A concentration (161 +/- 6 v 193 +/- 10, P less than 0.01), thus suggesting an increase in HDL mass and/or particle number.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1986

Plasma triglycerides related decrease in high-density lipoprotein cholesterol and its association with myocardial infarction in heterozygous familial hypercholesterolemia.

Recent studies suggest that decreased levels of high-density lipoprotein (HDL) may contribute to the risk of premature occlusive atherosclerosis in familial hypercholesterolemia (FH). To investigate further, we have analyzed the concentration as well as distribution of HDL cholesterol in relation to plasma triglycerides and their influence on ischaemic heart disease in FH subjects. The study was carried out in 71 men with heterozygous FH and 46 matched controls. FH subjects were relatively young with a mean age of 38 +/- 11 years. Tendon xanthomatas were observed in 57% of the subjects, whereas ischemic heart disease was identified in 33%. Compared to normals, the mean value of HDL cholesterol is significantly reduced by 21% in FH heterozygotes (42 +/- 12 v 33 +/- 9 mg/dL, P less than 0.001). The decrease in HDL cholesterol is highly correlated to the levels of plasma triglycerides (r = -0.50, P less than 0.001) and VLDL cholesterol (r = -0.53, P less than 0.001). Moreover, HDL cholesterol decrease is not associated with elevated levels of LDL cholesterol (r = -0.20, NS), which is the primary characteristic feature of FH subjects. However, HDL cholesterol decrease is weakly related to total plasma cholesterol concentration (r = -0.24, P less than 0.05). The body weight is also contributory to the reduction of HDL cholesterol (r = -0.42, P less than 0.01), probably due to its strong positive correlation to plasma triglycerides (r = +0.54, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Psychoanalysis and psychometric evaluation].

Concerning the quality of life of former cancer patients both psychometric tests and psychoanalysis lead to better knowledge of problems. However neither their effects nor their efficiency can be compared. While psychometric tests are largely used to establish intellectual and affective attitudes, one must not forget that they are intended for diagnosis. The danger of defining profiles which are too acute or too precise has then to be exposed. Several questions must be raised: is the medical offer compatible or not with the patient's demand? This question opens the space of promise for the doctor and of delusion for the patient. Within this space, there is a place for psychoanalysis including the search of truth about oneself. But too whom should psychoanalysis be suggested? For the patient himself or his relatives? Regarding my own experience in a children's cancer ward where I have worked for more than ten years, I shall say that any psychoanalytical work, long or short, with the mother, the father or members belonging to the medical staff, clearly increases the child's quality of life. Why? Because fears of separation such as fantasies enclosed in the feeling of precariousness can be recognized and analyzed. It is not necessary to be a psychoanalyst to be aware of the role of subjectivity and of over-determination within the evolution of an illness like cancer. Precariousness has no place in the subconscious. That is why, not being able to believe in recovery, as it is often the case of parents or former cancer patients themselves, proves the importance of inner movements which have been hidden by medical reality for a long time. The announcement of recovery has, then, to be considered as a turning point where feelings of omnipotence are mixed with the sensation of being impotent. Fascinating is the former cancer patient regarding his victory over death. Becoming aware of this fascination is relevant to psychoanalysis.

Anxiety, Separation↗
PubMed1985

Articular manifestations of familial hypercholesterolaemia.

Familial hypercholesterolaemia is characterised by a decreased removal of low density lipoproteins and premature coronary artery disease. Tendinous xanthomata are a hallmark of the disease. The affected joints may also be the sites of inflammation and pain. Arthropathy has been associated mainly with the homozygous form of familial hypercholesterolaemia, but it is also known to occur in the heterozygous form. We report on the articular manifestations in 73 patients with heterozygous familial hypercholesterolaemia. About 40% of these patients had at least one episode of articular symptoms. The observed articular manifestations may be classified into four types: Achilles pain (18%), Achilles tendinitis (11%), oligoarticular arthritis (7%), polyarticular or rheumatic fever-like arthritis (4%). It is concluded that in heterozygous familial hypercholesterolaemia articular manifestations are frequent, diverse, and may be the first symptom of this metabolic disorder.

Achilles Tendon↗
PubMed1982

Beta blockers and their effects on lipoproteins, phospholipids, apoproteins A and B, in whole plasma and the different fractions.

Plasma levels of cholesterol (C), triglycerides (TG), phospholipids (PL) (in total plasma, very low density [VLDL], low density (LDL), and high density [HDL] lipoproteins) and of two apolipoproteins (apo-B and apo-A) were studied in 13 hyperlipidemic patients suffering from hypertension and/or stable angina and treated by metoprolol or propranolol. Propranolol reduced the low density and high density lipoprotein phospholipids by 26% and 11%, respectively, and increased the very low density phospholipids by 24%. Metoprolol had only a transient effect on high density lipoprotein phospholipids. VLDL apolipoprotein-B was markedly increased by propranolol (67%), whereas apolipoprotein-A was slightly (8%) increased during metoprolol treatment. The reduced low density lipoprotein phospholipids and the increased high density lipoprotein apo-A correlated with the plasma concentration of propranolol and metoprolol, respectively. These results suggest that the comparative effects of beta-adrenoreceptor blocking agents on lipoprotein metabolism should be considered in their long-term use in patients with risk factors for hypertension and myocardial infarction.

Adrenergic beta-Antagonists↗
PubMed1980

Removal of cholesterol from blood by affinity binding to heparin-agarose: evaluation on treatment in homozygous familial hypercholesterolemia.

Extracorporeal removal of cholesterol from blood with heparin-agarose conjugates was studied as a means of reducing the plasma cholesterol concentration in two patients with homozygous familial hypercholesterolemia. Both patients were treated in an outpatient clinic. Patient 1 underwent two separate courses of treatment; during the first course of eight treatments, the plasma cholesterol concentration decreased by a maximum of 54% (from 811-370 mg/dl). The six treatments in the second course resulted in a 35% reduction of plasma cholesterol (from 939--632 mg/dl). In patient two, 12 consecutive treatments resulted in a 56% decrease in the concentration of plasma cholesterol (from 768--298 mg/dl). Repetitive treatments in both patients resulted in a new "steady state" with circulating cholesterol levels lower than the pretreatment baseline value. The decrease in plasma cholesterol is mainly due to the removal of low density lipoproteins. The circulating level of high density lipoproteins is unaffected by the treatment. The treatment has no effect on the chemical composition of both low and high density lipoproteins. The extracorporeal treatment of blood with heparin-agarose was well tolerated by both patients and there were no undesirable effects. The effectiveness and simplicity of the present approach makes it attractive as a possible mode of therapy for homozygous familial hypercholesterolemia.

Adolescent↗
PubMed1977

A new infusion flow stabilizer.

A new intravenous flow stabilizer (IFS) for keeping constant infusion rates was evaluated and found to be precise and easy to use. The IFS enables precise intravenous treatment while relieving the nursing staff of the frequent checking and readjustment that are required with the intravenous sets in current use.

Humans↗
PubMed1977

Effect of hyperchylomicronemia on the measurement of hemoglobin.

The effects of plasma triglyceride levels on the measurement of hemoglobin and other erythrocyte indices have been studied in blood samples from ten healthy controls, 11 patients with type IV hyperlipoproteinemia, and five patients with hyperchylomicronemia (type I or V). Measurements were made using erythrocytes in their own plasmas and repeated after resuspension of the cells in physiologic saline solution. Hemoglobin, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration were decreased by removal of plasma in erythrocytes from three patients with hyperchylomicronemia. It is concluded that the triglyceride contained in very-low-density lipoprotein does not affect hemoglobin measurement, while triglyceride contained in chylomicrons increased hemoglobin readings linearly.

Cholesterol↗
PubMed1977

Hypolipidemic effect of tibric acid. A comparison with clofibrate and placebo in type IV hyperlipoproteinemia.

The effects of tibric acid, clofibrate, and placebo were compared in type IV hyperlipidemic patients for a 6-month period. The patients were divided into two pathological level groups according to their baseline triglyceride levels. Compared to the placebo, both tibric acid and clofibrate reduced the mean serum triglyceride concentration in the high pathological level group; however, clofibrate was also effective in the low pathological level group. The effects on total cholesterol were less pronounced with the two drugs. No effect was observed on esterified cholesterol, phospholipids, free fatty acids, and fasting blood sugar. After a 6-week follow-up period under placebo, no rebound of the triglyceride and cholesterol levels could be observed after discontinuation of the two active drugs. The other biochemical changes observed after each active treatment are discussed in relation to the different degree of activity of each active drug and to the different baseline levels of triglycerides.

Adult↗
PubMed1975

Dose-response to tibric acid: a new hypolipidemic drug in type IV hyperlipoproteinemia.

This double-blind study compares the effects of tibric acid at four different doses to that of placebo in type IV hyperlipidemic patients. Fifty patients, divided at random in five groups of 10 patients each, received one of the following treatments: placebo, tibric acid 500 mg, 750 mg, 1,000 mg, or 1,250 mg per 24 hr. The data suggest that the 1,000 mg and the 1,250 mg doses are effective in lowering the serum triglyceride levels after 6 wk of treatment; the effect on total cholesterol is less pronouced. No effect is observed on the concentration of serum esterified cholesterol, phospholipids, and free fatty acids. It is also shown that in the dose range studied, the best fitting curve defining the four mean values of triglycerides and total cholesterol obtained with the four active treatments did not deviate significantly from linearity. Due to lack of toxicity, tibric acid may be useful in the treatment of type IV hyperlipoproteinemia.

Adult↗