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Biomedical subjects

H Milon

Publications and source records attributed to H Milon.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Primary prevention of hypertension in the general population. The Lyon Action for the Prevention of Hypertension and Atherosclerosis].

UNLABELLED: The aim of ALPHA (1976-1982) was to realize an action of cardiovascular prevention in a professional population, by combining a) an education of the general population and b) an individual managing of the high risk people. The "Study" (S) population originated from Lyon; the "Reference" (R) population originated from two smaller cities. There was no randomization. The plan of the study included: A baseline cross study, dealing respectively with 9,598 and 9,558 subjects in S and R; The educational intervention, aiming chiefly at reducing caloric and sodium intakes, and at increasing the potassium intake; The evaluation was done after five years, by re-examining the subjects seen at the baseline study and still present in the enterprises. Mainly because of the economic crisis, the re-examination rates were only about 45%. RESULTS: at the baseline, BP's were not significantly different: 137/77 S vs 132/75 R for men, and 129/74 S vs 126/73 R for women. The final comparisons about primary prevention of hypertension were computed after adjustment for age and sex, after exclusion of the subjects who were hypertensive at baseline. The knowledges about hygiene were significantly but moderately better in S. The urinary Na/K and Na/Creatinine ratios did not differ significantly. The alcohol intake was lower in S (p less than 0.001). The incidence of HT was greater in S (p less than 0.001). The means of the individual variations of systolic and diastolic BP were computed: the adjusted differences S-R were respectively + 1.53 and 2.19 mmHg for systolic and diastolic (p less than 0.001 for both). CONCLUSION: the feasibility of the intervention was moderate. The failure to demonstrate any prevention of HT might indicate that the hypothesis was wrong, and/or that the methodology was inadequate.

France↗
PubMed1990

Effect of in vivo modulation of membrane docosahexaenoic acid levels on the dopamine-dependent adenylate cyclase activity in the rat retina.

We have studied the effect of a dietary deprivation of n-3 fatty acids on the activity of the dopamine (DA)-dependent adenylate cyclase in the rat retina. Experiments were conducted in 6-month-old rats raised on semipurified diets containing either safflower oil (n-3 deficient diet) or soybean oil (control diet). The levels of docosahexaenoic acid [22:6 (n-3)] in retinal phospholipids were significantly decreased in n-3 deficient rats (35-42% of control levels). This was compensated by a rise in 22:5 (n-6), the total content of polyunsaturated fatty acids (PUFA) remaining approximately constant. Adenylate cyclase activity was measured in retinal membrane preparations from dark-adapted or light-exposed rats. The enzyme activity was stimulated by DA and SKF 38393 in a light-dependent fashion. The activation was lower in rats exposed to light than in dark-adapted animals, suggesting a down-regulation of the D1 DA receptors by light. The activation by guanine nucleotides and forskolin was also decreased in light-exposed rats. There was no significant effect of the dietary regimen on the various adenylate cyclase activities and their response to light. Furthermore, the guanine nucleotide- and DA-dependent adenylate cyclase activities of retinal membranes were found to be relatively resistant to changes in membrane fluidity induced in vitro by benzyl alcohol. The results indicate that in the absence of changes in total PUFA content, a decreased ratio of n-3 to n-6 fatty acids in membrane phospholipids does not significantly affect the properties of adenylate cyclase in the rat retina.

Adenylyl Cyclases↗
PubMed1990

[Association of cutaneous myxoma, recurrent cardiac myxoma and Cushing's syndrome (Carney's complex). Description of a case and review of the literature].

The authors report the case of a rare clinical syndrome which has recently been called Carney's complex or "myxomas, spotty pigmentation and endocrine overactivity". Three components of this complex are described: cutaneous myxomas, Cushing's syndrome of unpredictable evolution treated by bilateral adrenalectomy for multiple adrenal adenoma and left atrial myxoma which recurred twice. The authors review the literature and discuss the practical implications of this new syndrome which may be familial. The role of echocardiography, the key investigation for the detection of the myxoma and follow-up of these patients who have a high risk of recurrence, is underlined.

Adrenal Glands↗
PubMed1990

[Myocardial infarction after coronary bypass surgery. Associated factors and prognosis].

This paper studies the factors associated with perioperative myocardial infarction after coronary bypass surgery and assesses the medium-term prognosis of these patients. Four hundred and seventy patients underwent coronary bypass surgery between January 1983 and December 1986. The appearance and persistence of pathological Q waves, absent on the preoperative ECG, was the unique criterion of perioperative infarction. This complication was observed in 36 patients (7.65%). A comparison of these patients with a random group of 144 of teh 434 patients without perioperative infarction showed that they had a higher incidence of crescendo angina (55% vs 21%; p less than 0.001), ST-T wave changes on the resting ECG (78% vs 46%; p less than 0.001) and poor distal left anterior descending network (33% vs 13%; p less than 0.001): in addition, the group with infarction had a lower left ventricular ejection fraction (0.58 vs 0.64, p less than 0.01), incomplete myocardial revascularisation procedures (58% vs 32%; p less than 0.01), longer cardiopulmonary bypass times (86 mn vs 69 mn; p less than 0.001) and longer aortic clamping times (44.5 mn vs 37.4 mn p less than 0.05). The acute phase of the perioperative infarct was characterised by a higher incidence of major cardiac complications such as low output states (30.5% vs 2.02%; p less than 0.001). The hospital mortality was higher in the infarct group (8.3% vs 2.01%) but this was not statistically significant. After an average follow-up of 44 +/- 3 months, the 5 year survival rate was 95.4 +/- 2.1 per cent in patients without infarction and 76.5 +/- 6.9 per cent in those with perioperative infarction (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1989

[The link between cholesterol and atherosclerosis: intervention trials].

Intervention trials aimed at influencing the course of atherosclerosis by reducing blood cholesterol levels of two types: some of them evaluate the clinical consequences of atherosclerosis, while the others study the disease itself by means of arteriography. Several trials of the first type have convincingly shown that the incidence of coronary disease decreases after at least 5 years of medicinal treatment. As for direct visualization trials, they seem to indicate that the development of atheromatous lesions can really be delayed, which would confirm the principal mechanism of the benefits observed in the former trials. Other studies, and notably those on secondary prevention, have not yielded positive results, probably because of belated intervention on the course of atherosclerosis and insufficient reduction of blood cholesterol levels. In clinical practice, the implementation of the corresponding measures remains controversial since in these trials the overall mortality rate did not decrease owing to overmortality from non-cardiovascular causes. Nevertheless, the experimental results strongly support the pathogenic role of atherosclerosis, already well documented by numerous studies of other type.

Adult↗
PubMed1989

"Non-Q wave," alias "nontransmural," myocardial infarction: a specific entity.

Although Q wave and non-Q wave MI are often referred to as "transmural" and "nontransmural," there is no anatomic evidence to justify this distinction. Nevertheless, a distinction is important, because the two entities have a different prognosis. At the present time, between 25% and 35% of MIs are non-Q wave. They are frequently observed in patients with previous coronary events. They occur in a relatively older population and involve a slightly higher proportion of women than do Q wave MIs. The degree of cardiac damage is less, reflected by a smaller rise in enzyme level and less impairment of left ventricular ejection fraction; early reperfusion may occur, after spontaneous thrombolysis or resolution of coronary spasm. The immediate mortality rate is half that of Q wave MI but identical in the long term. Reinfarction and angina are more frequent because of a peri-infarction zone of ischemia maintained by a high-grade coronary stenosis and inadequate collateral circulation. Early characterization of those MIs likely to progress is important. Diltiazem seems effective in this context if given between 24 and 72 hours of the onset of the event. Other therapeutic approaches need further assessment.

Electrocardiography↗
PubMed1989

[Estimate of the frequency of excessive diagnosis and treatment of hypertension].

The ALPHA program aimed at testing the feasibility and the efficiency of a multifactorial, primary preventive intervention for cardiovascular diseases. It dealt with two occupational populations: intervention and control (without any randomization), each amounting to about 12,000 people. Largely because of the economic crisis, only 9,598 and 9,558 people were seen at the 1976 initial examination, and only 43 per cent of these were re-examined at the 1981-82 final examination. In 1976, there were some significative differences between the two populations (more smokers, and less anti-hypertensive treatments in the intervention group). The same differences were found in 1981-82. So the intervention was not proved efficient, and the two populations could be pooled for the present analysis restricted to the french people (to diminish the risk of misunderstanding), aged 20-59 at the initial 1976 examination. We used the following (arbitrary) criteria of hypertension: being treated for hypertension, and/or two BP readings at 160 and/or 94 mmHg at a few minutes interval. 1) In 1981-82, 659 men and 492 women answered that they were still treated for hypertension, and/or had been previously said that they had hypertension or too much blood pressure. At this 1981-82 examination, 298 of these men (45 per cent) and 294 of these women (58 per cent) did not meet the criteria of hypertension. 2) In 1976, 3,114 men and 2,429 women did not meet the criteria of hypertension. At the 1981-82 examination, they were asked whether they had had any antihypertensive treatment previously given. 139 were still under antihypertensive treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Relation of alcohol consumption and blood lipids and apolipoproteins--a study of a population of 3,897 wage-earners from the Lyon region].

Between June 1982, and September 1984, a survey was conducted among 3,897 employees in the Region of Lyon to study the relationship between alcohol consumption and serum concentrations of total cholesterol and triglycerides. In 400 randomly selected men, the following data were also obtained: concentrations of the cholesterol of the high density lipoproteins (HDL) and of their subfractions, and concentrations of the apoproteins A-I, A-II and B. All these biochemical concentrations increased, more or less, with alcohol consumption. Relative to non drinkers, the concentrations increased among males who declared drinking more than 80 grams of alcohol per day: for total cholesterol, by 10.0%; for triglycerides, by 24.7%; for HDL-cholesterol, by 26.7%; for HDL2-cholesterol, by 76.0%; for HDL3-cholesterol, by 15.0%; for apoprotein A-I, by 30.0%; for apoprotein A-II, by 52.2%; for apoprotein B, by 5.1%. These results, with the limitations inherent in a cross-sectional study, suggest that regular consumption of alcohol raises the concentrations of blood lipid components, both atherogenic and non-atherogenic.

Adult↗
PubMed1988

Analysis of mutagenic heterocyclic amines in cooked beef products by high-performance liquid chromatography in combination with mass spectrometry.

Mutagenic activity detected in beef extracts and in fried beef heated for varying periods of time was purified and then analysed by high-performance liquid chromatography in combination with mass spectrometry (LC-MS). The major mutagenic component found in all of the beef products was identified as 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) followed by lesser amounts of 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (4,8-DiMeIQx). Identification and quantification of mutagens were achieved by the use of deuterium-labelled analogues. Measured levels of MeIQx and 4,8-DiMeIQx in different batches of beef extract were in the range 11.7-52.2 and 0-11.2 ng/g, respectively, and in beef heated at 275 degrees C for 5-15 min the values of MeIQx and 4,8-DiMeIQx were in the range 2.7-12.3 and 0-3.9 ng/g, respectively. The levels of IQ found in beef extracts were 0-36.8 ng/g and in fried beef the amounts were estimated at 0.3-1.9 ng/g. The method of purification is rapid, requiring only XAD-2 adsorption followed by an acid-base liquid partition against ethyl acetate and blue cotton treatment (trisulpho-copper-phthalocyanine) prior to LC-MS analysis. Because of the sensitivity of LC-MS, mutagens present in cooked beef can be detected at the low parts-per-billion-level and as little as 10 g of cooked beef was required for analysis.

Animals↗
PubMed1988

Infective endocarditis on stenotic aortic valves.

Charts were reviewed of 42 adult patients (27 men, 15 women, mean age 55 years, with 17 older than 60) hospitalized and/or autopsied between 1970 and 1986 with diagnosis of definite or highly probable infective endocarditis (IE) on pure aortic stenosis (AS). Ring and/or septal abscesses were found in 18/37 patients who were operated upon and/or autopsied. IE was recognized in 32 patients, undiagnosed in 10 (revealed at autopsy in seven, at operation in three). Infecting organisms were identified in 26 patients (Str. viridans, 16; Str. D, three; Staphylo., four; other, three). Twenty-seven patients were treated in our institution, 14 of them more than four weeks after the beginning of the symptoms. Echocardiograms were recorded in 17, with vegetations in only six. Severe cardiac failure was present in 17 cases. One patient was lost to follow-up. Fourteen patients died (mean delay between IE and death 22.4 months): eight of the 13 non-operated patients (cardiac failure, four; myocardial infarction, two; neurological complications, two) and six of the 14 operated patients (peri-operative death, four; late sudden death, two). Twelve patients are alive (mean follow-up 51.6 months), eight of them in NYHA class 1. IE on pure AS is rare, difficult to recognize echocardiographically, and of poor prognosis. It usually requires rapid aortic valve replacement.

Adult↗
PubMed1988

[Prognostic value of serum creatinine in treated hypertensives. A case-controlled study].

UNLABELLED: The aim of the study was to assess the prognostic value of serum creatinine (SC), in treated hypertensive subjects (HT). In a clinical population of 2738 HT consecutively examined between october 1969 and december 1982, as in-patients (n = 1599) or out-patients (n = 1139): 152 had a moderate elevation (ME) of SC: below 178 USI but above the "normal limit" (124 USI in men, 106 USI in women); 95 had a severe elevation (SE) of SC: above 17 USI. Whenever possible, each of these cases was matched to a control, belonging to the same population: same sex, same age (+/- 5 years), same group (in-patient or out-patient), same date of initial examination (+/- 6 months), but normal SC. 119 ME and 63 SE could be matched. The response rate of the mortality survey (november 1985) was 100 per cent. The mean follow-up period was 10 years (range 3 to 16 years). RESULTS: At initial examination, ME and SE cases differed significantly from their controls in several variables (mainly: more frequent T or J-ST ECG abnormalities and stage III-IV retinal changes); The life-table survival rate was moderately and non significantly reduced in ME cases (57 per cent at 10 years vs 66 per cent in controls); this decrease was only observed and significant (p less than 0.001) in subjects aged 60 to 79 years. In SE cases, survival rate was markedly reduced (43 per cent at 10 years vs 73 per cent in controls, p less than 0.001) and this reduction is observed at least since the age 40.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Effects of interventions on community awareness and treatment of hypertension: results of a WHO study.

A WHO-coordinated study of the community control of hypertension in six countries (Cuba, Finland, France, Italy, Mongolia and Portugal) has shown that a comprehensive approach clearly improves the care of hypertensives in various populations. Hypertension control programmes were individually designed in each country and were implemented in defined communities. The intervention strategies varied between countries, the major components being: establishment of hypertension clinics and hypertension registers, involvement of health care personnel, and health education of the entire community. As a result of this programme, the blood pressure in the age group 30-59 years decreased on average by 3/2 mmHg among men and by 6/3.5 mmHg among women; the mean blood pressure level decreased twice as much in hypertensive subjects as in the entire population in the intervention areas of the study.

Adult↗
PubMed1987

[Q fever infectious endocarditis. 3 cases].

An acute infectious disease with predominant pulmonary symptoms, Q fever, may become chronic as hepatitis or, more frequently, endocarditis. We report 3 cases of Q fever endocarditis. In 2 of these patients endocarditis developed on cardiac valve prosthesis. The 3 patients have been under doxycycline for more than a year, and their condition is satisfactory. A review of the literature provides additional data on the epidemiological, aetiological, clinical, biological and therapeutic aspects of this rare type of endocarditis. It is recommended to look for chronic Q fever in all cases of endocarditis with negative blood cultures.

Adult↗
PubMed1987

Thermospray liquid chromatographic-mass spectrometric analysis of mutagenic substances present in tryptophan pyrolysates.

During protein pyrolysis, as can occur when broiling meat or fish, mutagenic substances are formed, as shown by in vitro mutagenicity assays. Some of the most active compounds have been shown to originate from tryptophan (Trp). Hundreds of grams of Trp had to be used previously to study the formation of these compounds by classical separation and detection methods. Studies have been made of the formation of two active heterocyclic amines, 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp-P-1) and 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2), by heating Trp at different temperatures and for different periods at time. Advantage was taken of the high selectivity and sensitivity of thermospray liquid chromatography-mass spectrometry coupling, which permitted the use of much smaller amounts (10 g) of starting material. These conditions permit a more accurate control of the pyrolysis temperature and the method of extraction can be shortened and simplified. The results show that Trp-P-1 and Trp-P-2 were already formed at 250 degrees C. These substances were detectable in the low ppb range, i.e., less than the threshold levels necessary to elicit a positive response in the Ames test under standard conditions.

Animals↗
PubMed1987

Biochemical and radioautographic evidence for dopaminergic afferents of the locus coeruleus originating in the ventral tegmental area.

The dopamine (DA) content of the locus coeruleus (LC) and the uptake of tritiated DA in the presence of desmethylimipramine into fresh vibratome sections of the LC-area were determined in control rats and in rats whose ventral tegmental area (VTA) had been destroyed by local application of 6-hydroxydopamine (6-OHDA). Destruction of the VTA reduced the DA content and the number of dopaminergic fibers visualized by radioautography in the LC area. This indicates that the DA containing afferents of the LC originate, at least partly, in the VTA.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1987

[Prognosis of surgically treated infectious endocarditis].

The prognostic factors in infective endocarditis patients who underwent surgery in the acute stage were evaluated from the records of 189 cases of native valve endocarditis operated upon between 1970 and 1986. Surgery had been performed before June 30, 1982 in 105 patients (group 1) and since July 1, 1982 in 84 patients (group 2). Group 2 only differed from group 1 in that the proportion of negative blood cultures was lower (13.7% vs 35%; p less than 0.01) and that of subjects older than 70 was higher (11.6% vs 5.7%; p less than 0.01). 105 patients (66 in group 1, 39 in group 2) had been operated upon during the first 6 weeks of antibiotic therapy ("early surgery"), while 84 patients (57 in group 1, 27 in group 2) had been operated upon between 7 and 24 weeks from the beginning of antibiotic therapy ("semi-early surgery"). Hospital mortality was 23.6% in group 1 (29/123) as against 10.6% in group 2 (7/66; p less than 0.05). The difference in mortality between the two groups was significant only in early surgery patients (33.3% vs 7.7%; p less than 0.01) and in patients operated upon while the infection was active with presence of pathogens in valve cultures (47.4% vs 7.7%; p less than 0.05). A study of mortality factors showed that the operative prognosis did not depend on the type of valve replacement performed or on the pathogen involved, but solely on the degree of cardiac failure before surgery. The post-hospital course was evaluated in group 1 patients followed up during 61.8 months on average.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗