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Biomedical subjects

F Lamisse

Publications and source records attributed to F Lamisse.

At least 19 recordsLinked to original sources

Protein-energy malnutrition in elderly medical patients.

STUDY OBJECTIVE: To evaluate (1) the prevalence of protein-energy malnutrition in elderly patients; (2) the changes in nutritional status during the hospital stay; and (3) (main objective) the relationship between simple nutritional parameters and short-term in-hospital mortality. DESIGN: Prospective time series at admission and on the 15th day of hospitalization. SETTING: Medical care unit in a teaching hospital. PARTICIPANTS: Consecutive sample of 324 hospitalized patients greater than or equal to 70 years (86.4% of eligible patients). Norms of measurements were obtained from a referred sample of healthy control subjects (26 males and 36 females). MAIN OUTCOME MEASURES: Mid-arm circumference, triceps skinfold thickness, serum albumin, prealbumin, and retinol-binding protein levels were measured in patients at admission and on the 15th day. RESULTS: (1) Prevalence of PEM was 30% in male and 41% in female patients. (2) Both mid-arm circumference and serum albumin level decreased over the first 15 days of hospital stay (53 patients, paired t test, P less than 0.05). Triceps skinfold thickness did not change. (3) A step-wise discriminant-function analysis determined the utility of the parameters at admission as predictors of in-hospital mortality before the 15th day. Mid-arm circumference, triceps skinfold thickness, albumin, and prealbumin levels, as well as age, are predictors of in-hospital mortality, with 73% sensitivity, 69% specificity, and 70% of correctly classified patients of both sexes. CONCLUSIONS: Parameters used are predictors for short-term in-hospital mortality of elderly patients hospitalized in an acute medical unit. The lean body mass is preferentially mobilized for energy during hospitalization.

Aged

Age-related insulin resistance: a review.

Impaired glucose tolerance occurs with age. This impairment is multifactorial including a decrease in insulin-mediated glucose uptake by peripheral tissues and a delay in insulin-induced suppression of hepatic glucose output. A post-binding defect in insulin action such as a reduced capacity to transcribe more glucose transporter mRNA and/or a reduced translocation of preformed glucose transporters to plasma membrane is incriminated. However, insulin resistance with age is not a constant finding and other mechanism(s) has (have) to be involved in old individuals with impaired glucose tolerance and normal tissue insulin sensitivity.

Aging

Essential fatty acid composition of human colostrum triglycerides: its relationship with adipose tissue composition.

The relationships between essential fatty acid (EFA) composition of colostrum and white adipose tissue (WAT) were examined on day 5 after delivery in 69 healthy women. Fatty acid composition was assessed by capillary gas chromatography, and 33 fatty acids were detected in colostrum and in WAT. Total polyunsaturated fatty acid (PUFA) content was similar in colostrum and in WAT (15.7 +/- 3.1% and 16.1 +/- 3.8%, respectively), but long-chain PUFA content was higher in colostrum than in WAT (2.9 +/- 0.6% and 1 +/- 0.2%, respectively; P less than 0.001). The concentrations of linoleic acid were significantly correlated between colostrum and WAT (r = 0.77, P less than 0.0001). No correlation was found for alpha-linolenic acid. The relationships between long-chain PUFA composition of colostrum and WAT suggested that individual factors along with tissue specificity of the mammary gland are involved in either the capacity of desaturating and chain-elongating pathways and/or incorporation of long-chain PUFAs into colostrum.

Adipose Tissue

[Increase of serum gamma-glutamyl transferase activity in diabetic patients is not linked to diabetes itself].

In order to assess the relationship between increase of gamma-glutamyl transferase and diabetes, we measured serum gamma-glutamyl transferase in 48 male and 43 female insulin-dependent diabetics aged 20-60 years, 49 male and 41 female non insulin dependent diabetics aged 30-60 years, and in 114 male and 124 female controls (blood donors) aged 20-60 years. A1C haemoglobin was assayed in 124 diabetics. There is no increase of serum gamma-glutamyl transferase activity in insulin dependent diabetics of both sexes when compared with the controls. There is an increase of serum gamma-glutamyl transferase activity in non insulin dependent diabetics when compared either with controls (men p less than 0.02, women p less than 0.02) or with insulin dependent diabetics (men p less than 0.05, women p less than 0.02). There is no correlation between serum gamma-glutamyl transferase activity and fasting blood sugar (148 diabetics). In non insulin dependent diabetics of both sexes there is no correlation between A1C haemoglobin and serum gamma-glutamyl transferase activity. These results suggest that the increase observed in diabetics is not caused by diabetes itself, ie, by hyperglycemia, but by diabetes associated pathologies.

Adult

Chronic subdural hematoma presenting as ataxic hemiparesis.

A 57-year-old man was admitted for a typical left ataxic hemiparesis syndrome. He presented no vascular risk factor, with normal blood pressure. CT scan showed a frontoparietal right subdural hematoma. After surgery, the symptomatology disappeared completely. This observation reveals that subdural hematoma must be considered as a possible etiology of ataxic hemiparesis syndrome. The physiopathology is discussed.

Ataxia

[Acute fatty liver of pregnancy].

The authors analyse 115 cases of acute fatty liver of pregnancy, proven histologically. Characteristics of the condition is the finding of central nuclei in the hepatocytes containing microvesicular droplets. The disease occurs more frequently in primiparous women (54 per cent) and usually occurs in the third trimester of the pregnancy. A pre-icteric phase usually precedes the jaundice and during that time there is usually vomiting and/or nausa with abdominal pain or anarexia. In 92 per cent of case there is transient loss of consciousness with hepatic encephalopathy. Further tests show that there is more defective liver function than would be expected from the extent of cell lysis; and there is defective renal function. The worst complications are intestinal haemorrhages (48 per cent of cases)--genital bleeding (43 per cent of cases)--shock--diffuse intravascular coagulation and complications associated with coma. Maternal mortality at present runs at 25 per cent and fetal mortality at 60 per cent. The condition does not recur. Early evacuation of the uterus is recommended by most authors and does probably improve the outlook. The various hypotheses concerning the aetiology are discussed.

Acute Disease

[Anthropometric and biological evaluation of 44 patients with protein-calorie malnutrition].

In industrial countries protein-calorie malnutrition (PCM) is a frequent cause of hospital morbidity and mortality. In this study, 88 hospital patients were evaluated: 44 (25 men and 19 women) aged from 20 to 80 years) with PCM, and 44 without malnutrition; the two groups were matched with regard to sex, age and height. The following parameters were determined: arm muscle surface, whole-body muscle mass, proportion of body fat, serum albumin (Alb), prealbumin (PA), retinol-binding protein (RBP), transferrin, thyroxine-binding protein, thyroxine, triiodothyronine, reverse triiodothyronine and total complement. Anthropometric measurements were validated by planimetry of a computerized tomographic section of the arm in 60 patients. There were significant differences between the two sexes in anthropometric values. Alb, PA and RBP values were different in men and RBP only in women; all other biochemical parameters were the same in both sexes. Thus, the group with PCM could be distinguished from the control group by anthropometric values and RBP values. Anthropometric parameters have been reported as being more specific of PCM than biochemical parameters, but since the latter are considered more sensitive, both complement each other and must be taken into account.

Adult

[Endocrine aspects of Steinert's disease].

The authors report a case of Steinert's disease in a woman and discuss the endocrine profile of this disease after giving an account of the criteria of diagnosis. Disorders of gonad function are mild in women, primary testicular atrophy is very frequent in man with reduction in 17-ketosteroids and testosterone. Thyroid function was normal but, in a few cases, a low fixation curve was found (our case) corrected by TSH stimulation. The frequency of cataract emphasizes the interest of this sign for detection. Diabetes, associated with hyperinsulinism, seemed more frequent than in a population without Steinert's disease. The pathogenesis of these endocrine disorders appears secondary and is ill explained if one considers it as a single disease. Better knowledge, no doubt linked to progress in biochemistry of normal and myopathic muscle, will help to explain the pathogenesis.

17-Hydroxycorticosteroids