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Biomedical subjects

F Mimouni

Publications and source records attributed to F Mimouni.

At least 109 records · Page 6Linked to original sources
PubMed1987

[Effects of propofol on intraocular pressure during the induction of anesthesia].

A study of variations in intraocular pressure during anaesthetic induction with propofol was carried out in 20 patients. There were compared with the effects caused by thiopentone. The intraocular pressure fell by 50%; this was very significant. Besides, a more important fall in blood pressure was seen with propofol (congruent to 15%) than with thiopentone (less than 10%). Complete recovery was faster after an anaesthesia with propofol. This drug seemed to be particularly interesting in ophthalmologic anaesthesia in elderly people.

Aged↗
PubMed1987

Management of the insulin-dependent diabetic during labor and delivery. Influences on neonatal outcome.

Infants of insulin-dependent diabetic mothers are at risk for neonatal polycythemia, hyperbilirubinemia, respiratory distress syndrome (RDS), and hypoglycemia. The purpose of this study was to determine whether labor and delivery management of diabetes may influence the rate of these complications. We hypothesized a priori that: infants of diabetic mothers delivered by cesarean section have a lower rate of neonatal polycythemia and hyperbilirubinemia, but a higher rate of RDS, than infants of diabetic mothers delivered by vaginal route, and poor glycemic control during labor increases the rate of neonatal hypoglycemia. We therefore prospectively studied 122 pregnancies in 100 well-controlled insulin-dependent diabetic mothers. Intravenous glucose and/or insulin was infused during labor to maintain capillary glucose concentration between 70 and 100 mg/dl. Fifty-six pregnancies were concluded by primary or elective cesarean section (group 1), 36 by cesarean section following spontaneous or induced labor (group 2), and 30 by spontaneous or induced vaginal delivery (group 3). Hemoglobin A1, birthweight, and gestational age were similar in all three groups. The rate of neonatal polycythemia was significantly lower in the cesarean section subjects, groups 1 and 2, as compared to group 3 (P less than 0.04). The rate of neonatal hyperbilirubinemia was significantly lower in group 1 (P less than 0.05) as compared to groups 2 and 3. The rate of RDS was higher in group 1 (versus groups 2 or 3), but did not reach significance on initial analysis (P = 0.06); however, group 1 was associated with a significant risk for RDS when corrected for the confounding variables of gestational age and neonatal asphyxia as defined by Apgar scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Amniotic fluid osteocalcin concentrations in pregnancies uncomplicated by fetal bone disease.

Osteocalcin is the major noncollagenous bone protein. Serum osteocalcin concentrations increase in conditions when bone turnover is increased, reflecting enhanced osteoblastic activity. The presence of osteocalcin in amniotic fluid (AF) has not been reported. We undertook this study to determine if osteocalcin is present in AF and to establish standards for AF osteocalcin concentrations, to be used in pregnancies at risk for diseases with increased fetal bone turnover. One hundred and thirty-one samples of AF from 15 to 43 weeks gestation were analyzed for osteocalcin by a radioimmunoassay detecting greater than or equal to 0.1 ng/ml, with a coefficient of variation of 6%. Osteocalcin measured in AF had the same gel-filtration characteristics as serum osteocalcin and the standard curves for serum and AF osteocalcin were parallel. Indications for amniocentesis were genetic study (n = 15) and fetal lung maturation (n = 116). None of the pregnancies studied produced an infant with bone mineral disorder. In 67% of the AF samples, osteocalcin was undetected; in 95% of the samples the concentration was less than 2.4 ng/ml. Concentrations of AF osteocalcin did not correlate with gestational age or birthweight, and were lower than the reported concentrations in cord serum or maternal serum. Thus normal amniotic fluid osteocalcin concentrations are less than 2.4 ng/ml; we speculate that its elevation in fetal bone disorders may provide a genetic counselling tool.

Amniotic Fluid↗
PubMed1987

The role of magnesium in neonatal calcium homeostasis: effects of magnesium infusion on calciotropic hormones and calcium.

Magnesium (Mg) deficiency is a possible etiologic factor contributing to neonatal hypocalcemia. In adults, parathyroid hormone (PTH) secretion is negatively feedback regulated by acute changes in serum Mg concentration, but paradoxically Mg deficiency may lead to functional hypoparathyroidism and hypocalcemia. We hypothesized that in neonates, Mg administration will cause changes in PTH secretion and serum Ca concentration that will be inversely related to serum Mg status. We also hypothesized that Mg administration will result in increased calcitonin (CT) secretion. Thirty-nine newborn infants with birth weights greater than 1500 g were studied on day 3 of life. Ten received placebo, and 29 intravenous magnesium sulfate (MgSO4), 6 mg elemental Mg/kg body weight, over 1 h. Serum Mg, Ca, PTH, and CT were measured at time 0 (baseline, preinfusion) and 1, 2, 6, 12, 24, and 48 h postinfusion. In both groups combined, baseline PTH correlated with baseline Mg (r = 0.72, p less than 0.005), and with baseline Ca (r = 0.68, p less than 0.005). In the control group there was no change in serum Mg, Ca, PTH, and CT during the study period. In magnesium sulfate-infused infants: 1) serum Mg concentration rose from 1.80 +/- 0.06 to 2.82 +/- 0.07 mg/dl (mean +/- SEM, p less than 0.001); 2) the change from baseline in serum PTH at 1, 6, and 12 h postinfusion correlated inversely with baseline Mg (p less than 0.05); 3) the change from baseline in serum Ca at 1, 2, and 24 h postinfusion correlated inversely with baseline Mg (p less than 0.005); 4) serum CT remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcitonin↗
PubMed1987

Decreased maternal serum magnesium concentration and adverse fetal outcome in insulin-dependent diabetic women.

Insulin-dependent diabetic pregnant women are at risk for magnesium deficiency, predominantly because of increased urinary magnesium losses. They also have a high incidence of spontaneous abortion, possibly related to major lethal malformations. We tested the hypothesis that adverse fetal outcome (fetal loss before 20 weeks' gestation and/or congenital major malformations) is related to magnesium status (as assessed by determining serum magnesium levels) in insulin-dependent diabetic pregnant women, even after sonographic documentation of fetal viability. Eighty-four insulin-dependent diabetic women (class B to RT) with 96 pregnancies were recruited prospectively in a program project. Serum magnesium and blood glycohemoglobin were measured at about nine weeks' gestation. Blood glycohemoglobin was higher (P = .039) and serum magnesium concentration lower (P = .05) in the 21 pregnancies that ended in adverse fetal outcome, compared with the other (75) successful pregnancies. When compared with the "successful pregnancy" group, blood glycohemoglobin was higher (P = .012) and serum magnesium lower (P = .037) in the subgroup of nine pregnancies with fetal cardiac activity present by ten weeks and ending in adverse fetal outcome, compared with the 64 equivalent pregnancies in the "successful" group. We speculate that decreased magnesium status may contribute to the high spontaneous abortion and malformation rate in insulin-dependent diabetic pregnant women.

Abortion, Spontaneous↗
PubMed1987

Surfactant associated protein (SAP-35) in amniotic fluid from diabetic and nondiabetic pregnancies.

We have recently shown that, with the current management of insulin-dependent diabetes during pregnancy, infants of diabetic mothers are at no greater risk of respiratory distress syndrome (RDS) than an appropriately matched control population. A previous study suggested a selective inhibition of surfactant associated protein of 35,000 daltons (SAP-35) in the amniotic fluid of diabetic pregnancies. In order to determine whether a selective inhibition of SAP-35 occurs in well controlled, insulin-dependent diabetic pregnancies, we compared SAP-35 concentration and lecithin/sphingomyelin (L/S) ratios in amniotic fluid from 30 well controlled, insulin-dependent women with 30 nondiabetic pregnant women pair-matched for gestational age, race, and indication for amniocentesis. Gestational ages ranged from 30-43 weeks, with a mean of 36.5 +/- 2.5 weeks, in both groups. Surfactant associated protein-35 was measured by an enzyme-linked capture immunoassay specific for SAP-35 and its oligomers. Mean +/- SEM SAP-35 was 3.7 +/- 0.4 micrograms/mL (N = 30) in the diabetic group, not significantly different from 5.0 +/- 1.1 micrograms/mL (N = 30) in the control group (P greater than .05). Mean L/S ratios were also not different: 2.4 +/- 0.1 (diabetic) compared with 2.3 +/- 0.1 (control); P greater than .05. The rate of RDS was similar in both groups. We conclude that in well controlled diabetic pregnancies, fetal lung maturation, as assessed by the L/S ratio, SAP-35 concentration, and outcome, is not adversely affected.

Amniotic Fluid↗
PubMed1987

Decreased amniotic fluid magnesium concentration in diabetic pregnancy.

Amniotic fluid samples from 21 diabetic pregnant women were pair-matched for gestational age with 21 samples obtained from nondiabetic women, and analyzed for magnesium concentration. Mean +/- standard deviation amniotic fluid magnesium concentration (mg/dL) was 0.86 +/- 0.21 in the diabetic group and 1.06 +/- 0.22 in the control group (P less than .001). It is concluded that in the diabetic pregnancy, a state of fetal magnesium deficiency exists. This deficient state may contribute to neonatal hypocalcemia in infants of diabetic mothers.

Amniotic Fluid↗
PubMed1987

Respiratory distress syndrome in infants of diabetic mothers in the 1980s: no direct adverse effect of maternal diabetes with modern management.

The purpose of this study was to test the hypothesis that diabetes in pregnancy in the 1980s no longer represents a direct risk factor for the development of respiratory distress syndrome (RDS) independent of gestational age, race, sex, mode of delivery, and neonatal asphyxia. We pair-matched 127 infants of diabetic mothers (diabetic group) with 127 infants of nondiabetic mothers (controls) for the above factors. Diabetic mothers enrolled before nine weeks' gestation were randomly assigned to one of two groups: I. "strict management," to achieve euglycemic (fasting blood glucose less than 80 mg/dL, 1.5-hour-postprandial blood glucose less than 120 mg/dL); II. "customary management," to provide care "as practiced in the community" (fasting blood glucose 100 mg/dL or less, postprandial blood glucose less than 140 mg/dL). A group enrolled after the first trimester (III) was managed identically to group II. Infants of diabetic mothers had a rate of RDS of 13.4%, not significantly different from the rate of 15% in controls (P greater than .05). When analyzed by gestational age groups of less than 36, or 36 or more weeks' gestation, there was also no difference in frequency of RDS between the diabetic group and controls. By logistic regression analysis, the presence of RDS in infants of diabetic mothers significantly correlated with lower gestational age (P less than .0001), and delivery by cesarean section not preceded by labor (P less than .01)(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMed1986

Polycythemia, hypomagnesemia, and hypocalcemia in infants of diabetic mothers.

Hypomagnesemia (serum magnesium concentration, less than 1.5 mg/dL [0.62 mmol/L]) and hypocalcemia (serum calcium concentration, less than 8 mg/dL [2.00 mmol/L]) have been reported in polycythemic infants, as well as in infants of diabetic mothers (IDMs). These latter infants are at risk for neonatal polycythemia (venous hematocrit, greater than or equal to 65% [0.65]). We tested the hypothesis that neonatal polycythemia in IDMs is associated with increased serum calcitonin concentration, hypomagnesemia, and hypocalcemia. Serum magnesium and calcium concentrations were measured at 24 and 72 hours of age in 76 IDMs; serum calcitonin concentration was measured at 24 hours of age. Peripheral venous spun hematocrit was measured between 2 and 4 hours of age. The rates of hypomagnesemia and hypocalcemia were similar in polycythemic and nonpolycythemic IDMs (0% vs 9% and 56% vs 49%, respectively). The serum calcitonin concentration was similar in both groups. There was no correlation between hematocrit and the serum magnesium or calcium concentration; a significant association existed between hypocalcemia and hypomagnesemia.

Female↗
PubMed1986

Glycemic control and spontaneous abortion in insulin-dependent diabetic women.

Insulin-dependent diabetic women without adequate glucose control have a higher spontaneous abortion rate when compared with the general population. The present study examined whether the increased rate of spontaneous abortions in insulin-dependent diabetic women was associated with poor glycemic control in the early postconceptional period or close to the abortive event itself. Measurements of glycohemoglobin A1 at eight to nine weeks' gestation provide retrospective indexes of glucose control during the early postconceptional period, whereas measurement of glycosylated serum albumin and serum protein at the same time reflects short-term glycemic control before the abortive event. This study evaluated 84 consecutive pregnancies occurring in 68 insulin-dependent diabetic women; 66 pregnancies progressed beyond 20 weeks with no malformation or death, and 18 pregnancies terminated in spontaneous abortions before 20 weeks' gestation. The mean glycohemoglobin A1 concentrations of women experiencing spontaneous abortions were significantly greater than that of women who did not abort (P less than .05). In contrast, maternal glycosylated proteins and glycosylated albumin concentrations did not differ between groups. The authors suggest that poor control of diabetes in the early conceptional period, rather than that just before abortion, increases the risk of spontaneous abortion.

Abortion, Incomplete↗
PubMed1986

Neonatal polycythemia in infants of insulin-dependent diabetic mothers.

The rate of neonatal polycythemia was determined prospectively in 34 infants of diabetic mothers pair-matched to 34 infants of nondiabetic mothers (control group) for site of sampling, time of sampling, time of cord clamping, gestational age, mode of delivery, and one- and five-minute Apgar scores. Polycythemia (venous hematocrit greater than or equal to 65%) was present in 29.4% of infants of diabetic mothers and 5.9% of control subjects (P less than .03). Mean nucleated red blood cell counts were significantly higher in infants of diabetic mothers than in controls. Polycythemia did not correlate with higher maternal hemoglobin A1 concentration or with increased infant weight percentile, but did correlate with neonatal hypoglycemia. The authors speculate that increased erythropoiesis exists in infants of diabetic mothers and might be subsequent to fetal hypoxemia due to fetal hyperglycemia, hyperinsulinism, and hyperketonemia.

Birth Weight↗
PubMed1986

Multiple hamartomas associated with intracranial malformation.

We examined a newborn infant with multiple hamartomas, including an epidermal nevus syndrome and a giant pigmented congenital nevocellular nevus, associated with other structural developmental abnormalities such as nevus flammeus, vascular malformation, cutis aplasia congenita of the scalp, cartilage hamartoma, and a lipodermoid of the conjunctiva. This child had a significant brain malformation, diagnosed by sonography and computerized tomography, consisting of a significant enlargement of the left hemisphere not associated with asymmetry of the skull or facial bones. We suggest a careful investigation of the intracranial structures by computerized tomography and/or ultrasonography in case of either extensive linear nevus sebaceous sequence and/or giant pigmented nevocellular nevus.

Adult↗
PubMed1986

Differential leukocyte count in infants of diabetic mothers. Increased band count associated with macrosomia.

The differential leukocyte count was studied within the first 24 hours of life in 115 infants of diabetic mothers (IDMs) appropriate for gestational age (AGA), 16 IDMs large for gestational age (LGA), 104 infants of non-diabetic mothers (INM's) AGA, and 22 INMs-LGA. A significant "shift to the left" was found in IDM's-LGA only. The usual cause of "shift to the left" such as maternal hypertension or fever, respiratory distress syndrome, meconium aspiration, neonatal asphyxia, sepsis, convulsions, or hypoglycemia could not explain this finding. It is hypothesized that increased glucocorticoid secretion may possibly play a role.

Adult↗
PubMed1986

Calcium-regulating hormones and minerals from birth to 18 months of age: a cross-sectional study. I. Effects of sex, race, age, season, and diet on vitamin D status.

The influence of sex, race, age, season, and diet (cow's milk formula v human milk) on the vitamin D and vitamin D-binding protein status in infants less than 18 months of age was investigated in this cross-sectional, prospective study of 198 infants. No differences by sex were observed in serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D, or vitamin D-binding protein concentrations. By race, black infants had significantly elevated serum 1,25-dihydroxyvitamin D levels relative to white infants. By age, vitamin D-binding protein concentrations increased with increasing age. By season, serum 25-hydroxyvitamin D concentrations were low in winter, whereas 1,25-dihydroxyvitamin D and vitamin D-binding protein were high in winter compared with summer. By diet, formula-fed infants had higher serum concentrations of all measured vitamin D metabolites and vitamin D-binding protein than human milk-fed infants. Thus, race, age, season, and diet exert, individually or in combination, different and significant effects on vitamin D metabolites; these should be considered in assessing infant vitamin D status.

24,25-Dihydroxyvitamin D 3↗
PubMed1986

Calcium-regulating hormones and minerals from birth to 18 months of age: a cross-sectional study. II. Effects of sex, race, age, season, and diet on serum minerals, parathyroid hormone, and calcitonin.

The influence of sex, race, age, season, and diet (cow's milk formula v human milk) on serum minerals and calcium-regulating hormones in infants less than 18 months of age is described in this study of 198 infants. No sex differences were observed in calcium, magnesium, phosphorus, parathyroid hormone, or calcitonin concentrations. Black infants had decreased serum phosphorus concentrations compared with white infants. There was a decrease in serum ionized calcium and phosphorus levels with age. During winter, there were significant increases in serum calcium and magnesium and decreases in serum phosphorus, parathyroid hormone, and calcitonin levels. Formula-fed infants had increased serum phosphorus and decreased ionized calcium concentrations compared with infants fed human milk. Thus, race, age, season, and diet appear to exert significant effects on serum minerals and calcium-regulating hormones in infancy. Interpretation of these mineral and hormone concentrations in normal or diseased states should be based on normative data specific to race, age, season, and diet.

Age Factors↗