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Biomedical subjects

F Mimouni

Publications and source records attributed to F Mimouni.

At least 91 records · Page 5Linked to original sources
PubMed1988

Bone mineral content of infants fed soy-based formula.

We compared the results of two studies that measured the bone mineral content (BMC) of 57 infants fed soy-based formula and 27 infants fed human milk or cow milk-based formula at various ages from 2 weeks to 1 year. In a study by Chan et al., the BMC of 40 white infants fed soy-based formula and 10 infants (of unstated race) fed human milk was measured at 2 weeks and at 2 and 4 months of age. The infants fed soy-based formula also had BMC measured at 6 and 12 months; the BMC of these infants was compared to the BMC of human milk-fed historical control subjects. The BMC was similar at 2 weeks in both groups but was lower in infants fed soy-based formula than in human milk-fed infants at 2 and 4 months. The BMC was similar in historical control subjects fed human milk and in soy formula-fed infants at 6 and 12 months. In the Steichen-Tsang study, the BMC of 17 soy formula-fed infants and of 17 white infants fed cow milk-based formula was measured at 6 weeks and at 3, 6, and 12 months of age. The BMC was similar at 6 weeks in both groups but was lower in infants fed soy-based formula than in those fed cow milk-based formula at 3, 6, and 12 months. The BMC of the historical control group fed human milk and of the soy formula-fed infants was also similar. In the first year of life, the BMC of infants fed soy formula and those fed human milk appears to be similar, especially after 6 months of age. However, the BMC of infants so fed may be lower than that of infants fed cow milk-based formula.

Animals↗
PubMed1988

Rate of spontaneous abortion after first trimester sonographic demonstration of fetal cardiac activity.

The incidence of spontaneous abortion once embryonic development has reached the stage of sonographically demonstrable cardiac activity has not been precisely determined in a large population. This retrospective study was designed to determine the risk of pregnancy loss after first trimester sonographic confirmation of fetal cardiac activity. A total of 840 patients were referred for ultrasound examination to the Perinatal Center, University of Cincinnati, between January 1, 1979 and December 31, 1985 who fulfilled the criteria of singleton pregnancy with sonographically visible fetal cardiac activity and crown-rump length consistent with gestational age less than or equal to 12 weeks. Patients were grouped into two categories based on the absence (control) or presence of vaginal bleeding (bleeding) prior to or at the time of the ultrasound examination. The abortion rates for the two groups were 5.2 and 16.4%, respectively (P less than 0.001). The relative risk of abortion in patients with vaginal bleeding was nearly four-fold greater than the control population. In the control group there was a significantly greater incidence of pregnancy loss in the greater than or equal to 34 years age group compared to less than 34 years age patients (4.4 versus 11.1%, P less than 0.05). Although there was no significant effect of race on abortion rates, low socioeconomic status almost doubled the relative risk of miscarriage. We conclude that the presence of visible fetal cardiac activity in the first trimester predicts a decreased risk for spontaneous abortion compared to generally reported rates. The significant risk factors for increased chance of abortion are vaginal bleeding, advanced maternal age, and low socioeconomic status.

Abortion, Spontaneous↗
PubMed1988

Review of fetal cardiovascular and metabolic responses to diabetic insults in the pregnant ewe.

Studies with pregnant sheep are reviewed, which were designed to investigate whether short-term episodes of maternal hyperglycemia or hyperketonemia were detrimental to the fetus, whether ketones can cross the ovine placenta, and whether the combination of maternal hyperglycemia and hyperketonemia would contribute to an increased risk of fetal morbidity. It is concluded that acute increases in maternal ketones appear to be more detrimental to the fetus than acute increases in maternal glucose, as assessed by fetal cardiovascular, metabolic, and blood gas changes.

Animals↗
PubMed1988

Serum unconjugated estriols in insulin-dependent diabetic pregnancies: normative data and clinical relevance.

The purpose of this study was to establish normative reference values for serum unconjugated estriol (E3) concentrations in insulin-dependent diabetic pregnancy. There were 1973 samples analyzed in 63 diabetic pregnancies not complicated by fetal distress and/or neonatal asphyxia. These samples were compared with 867 samples collected in 25 pregnancies complicated by fetal distress and/or neonatal asphyxia and 103 samples collected in seven nondiabetic, uncomplicated pregnancies. E3 values were found to be significantly higher in diabetic compared with nondiabetic healthy gravid women, correlating with infant birthweight. The percent change of daily E3 values from the highest previous 3 days mean (maximum mean) was 1 +/- 27% (mean +/- SD). The 95% confidence limit for this percent change indicates that a decrease of 52% or more is theoretically seen in 2.5% of the observations. Using the traditional decrease of 40% currently used in the literature, there were false-negative and false-positive predictions of fetal distress and/or neonatal asphyxia at rates unacceptable for patient management. The use of E3 determinations in combination with nonstress test-contraction stress test did not improve the predictability of this latter test. Serum E3 determinations are of little clinical value in the management of insulin-dependent diabetic pregnant women.

Asphyxia Neonatorum↗
PubMed1988

Pregnancy outcome in insulin-dependent diabetes: temporal relationships with metabolic control during specific pregnancy periods.

There are specific temporal relationships between metabolic control during different periods of pregnancy and outcome in insulin-dependent diabetic pregnancies. The rate of spontaneous abortions correlates with poor periconceptional glycemic control. Major malformations and decreased infant bone mineral content at birth correlate with poor first trimester glycemic control. Increased rates of preeclampsia and premature labor correlate with poor glycemic control in the second trimester. The development of macrosomia and that of neonatal hypoglycemia correlate with poor third trimester glycemic control. Perinatal asphyxia and neonatal hypoglycemia correlate with hyperglycemia in labor. We suggest that each stage of the pregnancy, if complicated by poor glycemic control, may lead to specific, temporally related complications. Glycemic control from the periconceptional period to the time of delivery appears important in order to minimize complications of the insulin-dependent diabetic pregnancy.

Blood Glucose↗
PubMed1988

Decreased bone mineral content in infants of diabetic mothers.

The present study was conducted to test the hypothesis that infants of diabetic mothers (IDMs) have decreased bone mineral content at birth, and whether or not decreased infant bone mineral content in IDMs correlates with poor control of diabetes during pregnancy, maternal bone mineral content, and the development of neonatal hypocalcemia. Forty-five pregnant diabetic women and their infants were enrolled in a prospective trial. In addition, 55 normal newborn infants of nondiabetic mothers were used as controls. Bone mineral content was measured before delivery in all diabetic pregnant patients and at birth in all infants by photon absorptiometry. Bone mineral content was significantly decreased in infants of diabetic mothers compared with control infants and correlated inversely with mean first trimester maternal capillary blood glucose; it did not correlate with cord serum 1,25-dihydroxyvitamin D concentrations. By stepwise multiple regression analysis, in infants of diabetic mothers, bone mineral content correlated inversely with mean first trimester capillary blood glucose and maternal bone mineral content, but did not correlate with maternal blood glycosylated hemoglobin, infant gestational age, infant birthweight or weight percentile, or development of neonatal hypocalcemia.

Blood Glucose↗
PubMed1988

Impact of pregnancy on complications of insulin-dependent diabetes mellitus.

The effects of pregnancy on acute metabolic complications of diabetes may have important consequences for both mother and fetus. The consequences of pregnancy for chronic complications of diabetes, including retinopathy, nephropathy, neuropathy, and hypertension, are not clear. Recent data are reviewed so that health care providers will be able to provide reasonable advice to insulin-dependent diabetic women contemplating pregnancy both for problems that may potentially arise during gestation and those that may affect long-term health and survival. Diabetic ketoacidosis is an uncommon problem that arises during gestation. Acute alterations in pH and electrolyte concentrations as well as hyperglycemia, however, may have important consequences for mother and fetus, including perinatal asphyxia and reduced fetal oxygen delivery. Hypoglycemia, on the other hand, may result in maternal coma or seizures and, when frequent, has been associated with infant respiratory distress syndrome. Background retinopathy often worsens during gestation, with regression common postpartum. Data suggest that progression of background disease is related to both glycemic control and the acute institution of intensive insulin therapy with those patients with poor control requiring more aggressive therapeutic intervention most adversely affected. The course of proliferative retinopathy is more variable, with both progression and regression reported. Preconception photocoagulation may prevent progression. Preconceptional ophthalmologic evaluation with frequent assessments during pregnancy is advised. Increases in 24-hour protein excretion are common during gestation in patients with preexisting renal disease and resolve in many patients postpartum. Serum creatinine and creatinine clearance increase during the first trimester and generally do not change during the remainder of pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus, Type 1↗
PubMed1988

Periconceptional metabolic status and risk for spontaneous abortion in insulin-dependent diabetic pregnancies.

The rate of clinically apparent spontaneous abortions in insulin-dependent diabetic pregnancies has been prospectively determined to be twice as frequent as for the general population (29.5% versus 10 to 15%). In a series of several successive studies, we have shown that spontaneous abortions are associated with poor metabolic control around conception and/or in the early weeks of pregnancy, but not in the 1 to 2 weeks preceding the abortive event itself. There is also a significant relationship between decreased maternal magnesium status (as assessed by maternal serum magnesium concentration) and adverse fetal outcome (spontaneous abortion and/or major congenital malformations) in insulin-dependent diabetic women. We speculate that improvement of glycemic control and of magnesium status before conception and in the very early phases of organogenesis might improve embryonic and fetal survival.

Abortion, Spontaneous↗
PubMed1988

Serial ultraviolet B exposure and serum 25 hydroxyvitamin D response in young adult American blacks and whites: no racial differences.

We tested the hypothesis that repeated whole body suberythemal ultraviolet B (UVB) exposure would result in less increase of serum 25-hydroxyvitamin D (25OHD) concentrations in black compared with white young adults with no significant change or racial differences in serum calciotropic hormones concentrations. Thirteen white and 7 black adults ranging from 22 to 35 years of age were submitted to sequential total body suberythemal doses of UVB (280-315 nm) biweekly for 6 weeks. Initial UVB dose was 5% below the minimal erythemal dose for the most sensitive skin, followed by 10% increase per exposure for 4 weeks. Blood samples were drawn weekly. Baseline 25OHD concentrations were significantly lower in blacks compared to whites, but the increases in serum 25OHD concentrations were similar in both groups; there were no significant differences by sex or age. Serum 24,25-dihydroxyvitamin D [24,25-(OH)2D] concentrations paralleled the serum 250HD response. Mean serum calcium (total and ionized), magnesium, phosphate, alkaline phosphatase, vitamin D binding protein, C-terminal parathyroid hormone, calcitonin, 1,25-dihydroxyvitamin D [1,25-(OH)2D], and osteocalcin concentrations did not differ between blacks and whites at any time. The ratio of the concentration of 1,25-(OH)2D to 25OHD in their serum was initially higher in blacks compared to whites (p less than 0.0001); the ratios decreased to levels similar to whites by the third UVB exposure. We conclude that, in blacks and whites, sequential suberythemal UVB exposure produces similar elevations of serum 25OHD concentrations and unchanged calciotropic hormones concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Changes in intra-ocular pressure in the elderly during anaesthesia with propofol.

Variations in intra-ocular pressure during anaesthesia were studied in two groups of 15 elderly patients selected randomly. The groups were not significantly different with regard to age, sex, weight or ASA classification. The first group received intravenous propofol as a bolus followed by a continuous infusion. The second group received a bolus of thiopentone followed by maintenance with enflurane. Intra-ocular pressure, heart rate and arterial pressure were measured before and after induction, after intubation and at the end of the operation. Overall, compared with baseline values, the results showed a decrease in intra-ocular pressure of 31% in group 1 and 17% in group 2, and a decrease in systolic arterial pressure of 14% in both groups.

Aged↗
PubMed1988

Major malformations in infants of IDDM women. Vasculopathy and early first-trimester poor glycemic control.

From animal and in vitro studies, it has been suggested that high environmental glucose, ketone, or insulin concentrations and low glucose or insulin concentrations may be etiologic factors for congenital malformations (CMs) in infants of diabetic mothers (IDMs). Transplacental passage of antibody-bound insulin has been demonstrated in humans. Controversy exists regarding the pathophysiology of CMs in human insulin-dependent diabetes mellitus (IDDM) pregnancies. We hypothesized that CMs in IDMs are associated with maternal vasculopathy, poor first-trimester glycemic control (i.e., hyper- and/or hypoglycemia), advanced White class, and high insulin requirements. We studied 165 first pregnancies of women with IDDM from 1978 to 1986. The goals of glucose control were a fasting blood glucose of less than 100 mg/dl and a 90-min postprandial blood glucose of less than 140 mg/dl. Insulin requirements, body weight, and pre- and postprandial blood glucose were recorded at weekly clinic visits. Maternal blood HbA1 was measured on entry and every 4 wk to confirm that adequate glycemic control was achieved. Women who enrolled in the project were interviewed during gestation by a geneticist/dysmorphologist who obtained genetic and environmental histories using a standard questionnaire. All live-born infants and stillbirths were examined. Each live-born infant was assessed systematically by two independent examiners, a neonatologist and a geneticist/dysmorphologist; examination with standardized checklists was performed in the newborn nursery as soon after birth as was practical. In first pregnancies in the study, there were 13 IDMs with major CMs (7.9%).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMed1988

High spontaneous premature labor rate in insulin-dependent diabetic pregnant women: an association with poor glycemic control and urogenital infection.

The incidence of spontaneously occurring premature labor in insulin-dependent diabetic pregnancies is unclear, because previous studies have been confounded by a high rate of iatrogenic prematurity. The purpose of this study was to determine, in a large population of insulin-dependent diabetic pregnant women, the rate of spontaneous occurrence of premature labor and the various factors that may affect it. We hypothesized a priori that spontaneously occurring premature labor occurs at a high rate in insulin-dependent diabetic pregnant women, mainly because of poor control of diabetes during pregnancy, and is related to the presence of polyhydramnios and hypomagnesemia. One hundred forty-five insulin-dependent diabetic women undergoing 181 pregnancies were recruited since 1978 in an interdisciplinary prospective study. The goals of glucose control were a fasting blood glucose less than 100 mg/dL and a 90-minute postprandial glucose less than 140 mg/dL. The rate of spontaneous premature labor, 31.1%, was significantly higher (P less than .01) than that in a control population managed by the same obstetricians in similar clinical settings (20.2%). The following variables were not significantly associated with the onset of premature labor: maternal age, parity, gravidity, diabetic class according to White, presence of renal disease or retinopathy, previous elective abortion, chronic hypertension or pregnancy-induced hypertension, cigarette smoking, first-trimester or post-20 weeks' gestation vaginal bleeding, maternal serum magnesium concentration, or polyhydramnios.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Soft intraocular silicone lenses: results after a one-year follow-up].

The main advantage of phacoemulsification is lost when the 3 mm incision has to be enlarged to at least 6 or 7 mm to permit the insertion of a PMMA lens. The major reason for the development of soft IOL is their flexibility which allows them to be folded and introduced through a small incision. We began a clinical study to determine the safety and efficacy of a new silicone lens, which is a single piece, injection molded, flexible implant. 25 patients undergoing extracapsular cataract extraction were included in this study. The silicone lens was inserted flat through the wound and the desired position was sulcus fixation. After a one year follow up period, the results were compared with those of 207 patients implanted with PMMA lenses. The visual results and the mean endothelial cell loss were similar in both groups. Iris capture was seen in 4 cases of soft lenses, probably due to the minimal haptic rigidity. Long term in vivo studies in the unique environment of the eye will be necessary to establish the biocompatibility of new soft intraocular lenses.

Aged↗
PubMed1988

[Scanning microscopy comparison of keratotomies using a diamond or steel knife].

We have compared on 4 cadaver eyes the aspect of keratotomies obtained with a diamond blade or a steel blade. We used the scanning electron microscope for the comparison. The incisions with diamond blade are much thinner than the incisions with steel blade. However the steel blade produced regular and smooth keratotomies. Whatever the blades, the microscopic appearance of the penetration was much better than the exit. The choice between cutting instruments for keratotomy depends upon these results and financial factors.

Humans↗