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Biomedical subjects

E Renard

Publications and source records attributed to E Renard.

68 records · Page 4Linked to original sources
PubMed1991

DNA restriction polymorphisms of the apolipoprotein AI-CIII-AIV gene cluster: a genetic determinant of atherosclerosis in type 2 (non-insulin-dependent) diabetes mellitus.

The presence of polymorphic restriction sites (S2, M2, P2) of the apolipoprotein AI-CIII-AIV gene cluster for the respective Sst1, Msp1, and Pst1 enzymes was assessed after hybridization with a radiolabelled apolipoprotein AI gene probe in 64 Type 2 diabetic patients and 67 healthy control subjects, all Europids. Twenty-two diabetic patients showed evidence of ischaemic heart disease or macrovascular arteriopathy and forty-two were free of cardiovascular complications. Control subjects were selected for the absence of personal or familial metabolic or cardiovascular diseases. The frequencies of polymorphic alleles were in agreement with previous studies in the control group: S2 6.3 (95% confidence interval (CI) 2.3-10.3) %, M2 5.5 (1.6-9.4) %, P2 6.3 (2.3-10.3) % and did not differ in the whole diabetic group: S2 4.2 (0.7-7.7) %, M2 6.5 (2.0-11.0) %, P2 6.6 (2.3-10.9) %. The relative prevalences of S2, M2, and P2 alleles were, respectively: 3.32, 1.54, and 2.00 (Woolf's ratio) in the macroangiopathic group but allele distribution frequencies were not statistically different from non-macroangiopathic patients. The allelic associations S2M2P1 and S1M1P2 showed a relative prevalence of 2.86 and 2.00 in the presence of cardiovascular complications but the difference was not significant in terms of polyallelic distribution frequencies in the absence of atherosclerosis. No serum lipid abnormalities could be related to the presence of any polymorphic allele or allelic association. These results suggest a genetic influence on the development of atherosclerosis in Type 2 diabetes, but the mechanism remains unclear.

Apolipoprotein A-I↗
PubMed1990

[New techniques of thyroid medical imaging. Value and limitations in the exploration of isolated thyroid nodules].

The exploration of thyroid nodules deals mainly with the problem of detection of malignancy. Except in the cases of characteristic clinical situations which suggest at once malignancy, classical investigations offer mostly an insufficient approach including erroneous conclusions. Scintigraphy, whose morphological definition remains limited, can miss non- or hypofixing lesions. Pharmacological tests of nodule reduction by suppression of thyreostimulin do not provide specific informations. Fine needle- biopsy cannot absolutely exclude malignancy, depending too much of the sites of punction and of the difficulties of cytological analysis. Echography brings an important progress in the precision of thyroid volume, nodules counting and gross connections. The liquid or solid characterization is an important echographic information as well. Tomodensitometry provides useful data in the retrosternal and retrotracheal areas. The connections with aerodigestive tract are more clearly pointed out and the presence of metastatic nodes as well. Magnetic resonance imaging gives further information because of the ability of multiple longitudinal slices, and of the trial of a tissular characterization from signal analysis and ultrastructural macroanatomic study. Additive precisions will be likely in the future by a more accurate determination of criteria of malignancy. The complementarity of magnetic resonance imagery and fine needle-biopsy should lead to a more frequent use of these investigations before the decision of surgical removal.

Diagnostic Imaging↗
PubMed1989

[Variations in the metabolism of lipoproteins as a function of thyroid hormones].

Like the demonstrated action of thyroid hormones on low density lipoproteins receptors and lipoproteins metabolism enzymes, plasma lipoprotein assays provide an insight into the classical variations of cholesterol blood levels observed in thyroid gland pathology. Thyroid hormones seem to play an important part in the regulation of lipid metabolism by accelerating the endogenous production of cholesterol as well as its penetration into cells. However, their most original effect consists of stimulation of tissue cholesterol removal, which may confer these hormones an anti-atherogenic property. The exact underlying mechanisms, notably their effect on the quantitative and qualitative distribution of apoproteins among lipoproteins, remain to be explored. Measurements of the cholesterol flows entering and leaving peripheral cells seem to provide a more accurate index than lipoprotein concentration to evaluate the actions of thyroid hormones, particularly those on atherogenesis.

Cholesterol↗
PubMed1987

[Long-term remission in fresh acute diabetes mellitus].

Among 28 patients with acute diabetes mellitus of recent onset, long-term remission (25-48 months) was obtained in 14 and medium-term remission (10-24 months) in the other 14. At the onset of the disease these two groups were very similar: remissions were longer in the older patients and shorter in the leaner ones. In patients seen at an early stage, there is no hormonal or immunological data to differentiate between those who will be in remission and those who will not. In our series, insulin secretion was the same in all patients at the onset of diabetes and at the end of the remission period. Further explorations suggested some degree of resistance to insulin, but this was easily overcome by the initial intravenous insulin treatment and by the conventional subcutaneous insulin treatment after the remission had ceased. Our data show the weakness of arguments which separate insulin-dependent from non insulin-dependent patients in acute diabetes mellitus of recent onset.

Acute Disease↗
PubMedDate not supplied

Effect of Miglitol (Bay m1099), a new alpha-glucosidase inhibitor, on glucose, insulin, C-peptide and GIP responses to an oral sucrose load in patients with post-prandial hypoglycaemic symptoms.

Sixteen patients suffering from symptoms suggestive of idiopathic reactive hypoglycaemia and reproducible during an oral glucose tolerance test when plasma glucose was less than or equal to 2.8 mM, were included in an acute, double-blind and cross-over study to test the efficacy of Miglitol (Bay m1099), a new alpha-glucosidase inhibitor versus placebo. Patients were randomized to ingest 100 mg Miglitol or placebo together with a sucrose solution (45 g/m2 body surface), one week apart. During four hours, plasma glucose levels were continuously monitored and plasma insulin and gastric inhibitory polypeptide (GIP) levels were measured at 30-minute intervals; serum C-peptide concentration was determined at 0, 30, 60 minutes and then every hour. The post-load rise in plasma glucose was significantly blunted by Miglitol, as shown by the reduced plasma glucose peak, the diminished early (0-120 min) area under the glycaemic curve and the decreased rate of plasma glucose rise. Thereafter, plasma glucose nadir was significantly raised and rate of plasma glucose fall was slowed by Miglitol with a concomitant improvement in the hypoglycaemic index. Insulin secretion was dampened as indicated by parallel reduction of plasma insulin and serum C-peptide peaks; morever, early area under the insulin curve and total (0-240 min) area under the C-peptide curve were significantly reduced. Decrease of plasma GIP peak and total area under the GIP curve were also significant. During sucrose tolerance test with Miglitol, hypoglycaemic symptoms were significantly alleviated but intestinal side-effects were common. Blunting the insulin response to glucose directly by delaying glucose absorption and indirectly through reducing GIP secretion, may be a valuable therapeutic approach in reactive hypoglycemia; nevertheless, long-term study with Miglitol are needed, due to the poor intestinal tolerance of this drug in the present acute study.

1-Deoxynojirimycin↗
PubMedDate not supplied

[Evaluation of a quick screening test of microalbuminuria in diabetology].

Disclosure of microalbuminuria gives a hope to improve renal and perhaps cardiovascular outcome of diabetes mellitus by the mean of an early treatment. We studied in 30 diabetic patients for each sex, consecutively admitted to hospital the efficacy of a colorimetric tablet-test for quick screening of microalbuminuria. The results obtained from a 24 hours-urine collection are compared to those observed with a reference radio-immunologic method. In this population whose prevalence for microalbuminuria over 15 micrograms/mn is 30%, the test shows a sensibility and a negative predictive value of 100%, but a specificity and a positive predictive value of about 40%. Else, intensity of positivity follows systolic blood pressure and creatininemia increase. If the good and cheap screening value of the test can be acknowledged, its positivity needs however a precise evaluation by a reference assay before therapeutic decision.

Adult↗
PubMedDate not supplied

Increased prevalence of soft tissue hand lesions in type 1 and type 2 diabetes mellitus: various entities and associated significance.

Sixty Type 1 (insulin dependent) and sixty Type 2 (non insulin dependent) diabetic patients attending a diabetology unit were examined in search of limited joint mobility, Dupuytren's disease, flexor tenosynovitis and carpal tunnel syndrome, in comparison with two populations of 60 non diabetic controls matched for sex and age with the Type 1 and the Type 2 diabetic patients. Microangiopathic and neuropathic complications, glycaemic control, blood pressure and tobacco consumption were simultaneously assessed in 39 of the 60 type 1 and in all the type 2 diabetic patients. The prevalence of the various soft tissue hand lesions was higher in both diabetic populations (respectively Type 1 and Type 2) than in their control populations: Limited joint mobility: 33.3 and 26.7% vs 5.0 and 8.3% (both p < 0.01); Dupuytren's disease: 35.0 and 30.0% vs 6.7 and 10.0% (both p < 0.01); flexor tenosynovitis: 23.3 and 16.7% vs 0.0 and 3.3% (p < 0.01 and p < 0.05); carpal tunnel syndrome: 26.7 and 15.0% vs 3.3 and 5% (p < 0.01 and NS). The prevalence of limited joint mobility in Type 1 diabetes was independently associated with increasing age (p < 0.05) and to lower extent with increasing duration of diabetes (p = 0.05), whereas the prevalence of Dupuytren's disease only correlated with increasing age in both types of diabetes (p < 0.05). In Type 2 diabetes, the prevalence of flexor tenosynovitis also increased independently with age (p < 0.05), and the prevalence of limited joint mobility increased in the opposite way to the body mass index after adjustment on age, duration of diabetes and sex (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Experience with intraperitoneal insulin infusion from implantable programmable systems in type 1 (insulin-dependent) diabetes mellitus previously treated by external pumps.

The feasibility of the continuous intraperitoneal insulin infusion from implantable programmable systems was evaluated in 17 Type 1 (insulin-dependent) diabetic patients currently treated by external pumps. Eight subjects were using a continuous subcutaneous insulin infusion (cumulated experience: 7.4 patients x years) and nine subjects had a cumulated experience of 61.4 patients x years of continuous intra peritoneal insulin delivery by external pumps. The two studied implantable systems (A and B) were delivering the same pH neutral surfactant-stabilized semi-synthetic human insulin, but at the respective concentrations of 400 units per ml in group A (n = 12) and of 100 units per ml in group B (n = 5), via a peritoneal catheter. The pump was implanted in a subcutaneous pocket created in the abdominal wall under general anesthesia. The reported trial of implantable programmable systems is 21 patient x years with an individual experience of 1.2 +/- 0.4 years (mean +/- SD). A sustained and stable glycaemic control was obtained, as indicated by the haemoglobin A1c: 7.4 +/- 1.3% (normal range: 4.3-6.1%), the mean blood glucose: 7.4 +/- 2.1 mM.l-1, the standard deviation of blood glucose values: 3.4 +/- 0.4 mM.l-1 and the percentages of 13.1 +/- 4.5% and 6.1 +/- 6.1% of blood glucose values respectively over 11 mM.l-1 and under 2.8 mM.l-1 after one year. The only metabolic event to occur was one episode of ketoacidosis secondary to a catheter obstruction. No hypoglycaemic coma occurred contrasting with incidences of 0.54 and 0.05 per patient x year during subcutaneous external and intraperitoneal pumps respectively (p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗