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Biomedical subjects

J M André

Publications and source records attributed to J M André.

At least 19 recordsLinked to original sources
PubMed2006

Violence to and maltreatment of people with disabilities: a short review.

OBJECTIVE: Violence to disabled persons constitutes a major ethical problem. The European Academy of Rehabilitation Medicine has debated the matter; it presents this short report to alert a wider audience to the problem, with the aim of provoking debate and facilitating prevention. DESIGN: The Academy has produced a full report on the literature. The present short report summarizes the essential features of this and significant references to violence. This is defined, types described, and risk factors and signs identified with the aim of informing rehabilitation practitioners. CONCLUSION: Violence may take many forms, often being subtle, insidious and difficult to recognize. However, the members of the rehabilitation team may be able to provide significant help and act preventively as they work towards the better social integration of the disabled individual helping them gain more control of their lives. European legislation may help us in this task; we are reminded that our roles are set within the context of our civic duties of respect for and tolerance of all.

Adult↗
PubMed2006

Increasing shoe instep improves gait dynamics in patients with a tibiotalar arthrodesis.

Degenerative osteoarthritis in subtalar and midtarsal joints occurring after tibiotalar arthrodesis may be related to biomechanical factors. For patients with tibiotalar arthrodesis walking with their everyday shoes, the ground reaction force is posterior at heel-off and the maximal foot-tibia dorsiflexion is at its upper limit. We hypothesized that increasing the instep of the shoes would improve these abnormalities. Three-dimensional gait analysis was done in nine patients with ankle arthrodesis fused in the neutral position and for 10 control subjects. Four conditions of walking were tested: barefoot, wearing everyday shoes, wearing everyday shoes with the instep increased by 1 cm, and wearing everyday shoes with the instep increased by 2 cm. In the arthrodesis group, the two modified delayed heel-off shoe conditions shifted the ground reaction force closer to the metatarsal heads at heel-off to a normal range, and reduced the maximal foot and tibia dorsiflexion angle. Based on these results, patients with a tibiotalar arthrodesis in the neutral sagittal position may be advised to choose shoes with an instep of approximately 25 mm.

Analysis of Variance↗
PubMed2005

Effects of dietary fructose on liver steatosis in overfed mule ducks.

Overfeeding of some waterfowl species results in obesity, which is mainly characterized by a dramatic hepatic steatosis induced by strong accumulation of lipids synthesized from dietary glucose in the liver. In mammals, fructose is known to be able to raise plasma triacylglycerol concentrations significantly; consequently, this may induce obesity. The aim of this study was to assess the effect of partial replacement of dietary glucose provided by corn starch with fructose on metabolism and fatty liver production in the Mule ducks. On the basis of 9.5 kg maize (132,920 kJ) given twice a day for 14 days, a supplementation of 9,800 kJ was provided in form of glucose, sucrose or high fructose corn syrup (HFCS: 50 % glucose, 42 % fructose and 8 % other saccharides). Fatty liver weight in ducks fed with glucose supplementation was 499 +/- 21 g. Sucrose or HFCS supplementation brought about a significant increase in liver weight (+ 18.7 % and + 16.3 % vs. glucose supplementation respectively, p < 0.05). These results suggest that the dietary fructose favors the liver steatosis by increasing hepatic lipogenesis. Postprandial plasma insulin concentrations were similar in ducks fed diets with or without fructose, suggesting that the effect of fructose on liver steatosis is not mediated by insulin.

Adipose Tissue↗
PubMed2004

Mirror asomatognosia in right lesions stroke victims.

The objectives of this prospective study were: to search for mirror-induced disorders of the body image in right hemisphere stroke victims using a description task of the contralateral upper limb, to analyze their clinical features, and to discuss possible mechanisms. Sixteen consecutive patients with documented unilateral right hemisphere stroke were examined for asomatognosia at the acute phase of stroke, then at least 2 months after stroke under three test conditions: without a mirror, with a conventional mirror, with an inverted mirror. Video recordings of the tests were analyzed to assess performance. The diagnosis of asomatognosia was retained if the subject reported at least one of three sensations: limb transformation, limb strangeness, and/or limb alienation. During the acute phase, 14/16 patients presented manifestations of asomatognosia. All of these spontaneous manifestations had disappeared 2 months later, but were reactivated in 12 patients when exposed to mirror images. The mirror tests revealed four situations: no disorder (n = 4), asomatognosia with both mirrors (n = 5), asomatognosia with the conventional or inverted mirrors (n = 1 and 5), and asomatognosia with the inverted mirror (n = 1). These manifestations were designated as mirror-asomatognosia, a disorder resulting from adaptations of the procedures leading to reorganization of the internal representations of the body image. These findings suggest there are several such internal representations of the body image and that direct body image and mirror body image would be two specific ones. These clinical manifestations and their evolution over time are an expression of the progressive nature of the underlying compensatory mechanisms made possible by brain plasticity.

Adult↗
PubMed2003

[Comparative study of effort training in deconditioned patients with and without pain. A preliminary study].

INTRODUCTION: The deconditioning or disuse syndrome is a recent nosological entity, based on medical, professional, social and psychological arguments. The aim of the study was to measure the physical condition in deconditioning situation and to evaluate the effectivity of a training program on five chronic painful patients and five painless subjects. METHODS: After determining the physical aspects of the deconditioning syndrome using three tests and evaluating pain, this prospective study evaluated the benefits of a six weeks effort training period called "interval training" in subjects with and without chronic pain. The inclusion criteria were the patient's consent, the absence of etiological treatment of the pain and the absence cardiotropic medication. The data were compared using the t-test of Student. After the training protocol, people were satisfied. A significant increase of Maximum Oxygen Uptake, Maximum Tolerance Power duration of recovery and cardiac adaptation of effort were observed. Pain didn't seem to be a limited factor to cardiac effort training and decreased actively after the program. CONCLUSION: A training effort protocol can help to reduce the deconditioning syndrome whether people are painful or not. The improvements of physical parameters seem to be reinforced by a better self assurance.

Adult↗
PubMed2003

Pancreatic hormonal and metabolic responses in overfed ducks.

When overfed at their maximum (intensive overfeeding) or at only 80% (moderate overfeeding) of food intake capacity, Mule ducks developed strong liver steatosis, whereas Pekin ducks showed very marked extrahepatic fattening. During overfeeding, evolution of plasma glucose and triacylglycerol concentrations suggested a very strong increase in the hepatic lipogenesis as well as genotype- and diet-independent lipoprotein secretion. In contrast, lipoprotein-lipase activity was dependent on alimentary status (the intensive overfeeding induces the highest activities), and Pekin ducks showed higher lipoprotein-lipase activity than Mule ducks, which could favor extrahepatic fattening to the detriment of hepatic steatosis. In Pekin ducks, plasma pancreatic hormone concentrations are related to diet levels and blood sugar. With similar food intake, Mule ducks (moderately overfed) showed global blood insulin lower than that of Pekin ducks (intensively overfed) despite similar blood sugar levels, suggesting a trend towards reduced pancreas response to glucose in Mule ducks. This may result from their lower lipoprotein-lipase activity as previously shown in these two ducks overfed at only 60% of their maximal food intake capacity (unpublished results). These results suggest that high plasma insulin concentrations may be necessary to induce an optimum lipoprotein-lipase activity in overfed ducks.

Animals↗
PubMed2002

Charge-transfer transitions in triarylamine mixed-valence systems: a joint density functional theory and vibronic coupling study.

A theoretical model is developed to describe the intramolecular transfer in organic mixed-valence systems. It is applied to rationalize the intervalence charge-transfer transitions in triarylamine mixed-valence compounds. The electronic coupling parameter is evaluated at the density functional theory (DFT) and time-dependent density functional theory (TD-DFT) levels. The shapes of the charge-transfer absorption bands are analyzed in the framework of a dynamic vibronic model. The influence on the optical properties of diagonal and nondiagonal vibronic couplings is discussed. Our results are compared to recent experimental data.

Amines↗
PubMed2002

Functional asymmetries of the lower limbs. A comparison between clinical assessment of laterality, isokinetic evaluation and electrogoniometric monitoring of knees during walking.

We used bilateral electrogoniometric gait monitoring of the knees to demonstrate the existence of an angular asymmetry between the two legs in healthy subjects. We also searched for correlations between this asymmetry and handedness, footedness and ocular laterality and isokinetic strength of the flexor-extensor muscles of the two knees. Among the 40 subjects studied, 25 (62.5%) showed an asymmetric maximal knee flexion: the difference being superior or equal to 5 degrees between the knees. There was no correlation between this asymmetry and the lateralities studied. We termed this type of asymmetry 'angular preponderance' to differentiate it from the laterality defined by clinical tests. Isokinetic strength of the knee flexors and extensors was correlated with the gender and speed, but not with side or laterality. Appropriate interpretation of lower limb examination should take into consideration angular gait asymmetry in the healthy subject.

Adult↗
PubMed2002

Nottingham Health Profile: reliability in a sample of 542 subjects with major amputation of one or several limbs.

The reliability of a generic health-related quality of life measure was assessed for subjects with major amputation of one or several limbs. The Nottingham Health Profile was sent a first time to 1011 limb amputees, and a second time to the 542 respondents to the first inquiry. The intraclass correlation coefficient (ICC) between the answers to each survey was highest for the categories of distress caused by pain (ICC = 0.83), emotional reactions (ICC = 0.83) and mobility (ICC = 0.81). It was found satisfactory for energy level (ICC = 0.75), sleep (ICC = 0.75) and social isolation (ICC = 0.64). It is concluded that the NHP is a reliable health related quality of life measure for amputees.

Adult↗
PubMed2001

Mirror images and unilateral spatial neglect.

Responding correctly to a mirror image requires the creation of a rather peculiar form of dual representation. Mirror agnosia and mirror ataxia, i.e. a deficit in reaching an object reflected in a mirror, have been reported to be associated with parietal lobe lesions. This prospective study was conducted to investigate the capacity of subjects with neglect to identify the mirror image nature of visual information. Four consecutive brain-damaged patients with neglect, selected on the basis of specific criteria, and four control subjects performed grasping and object displacement tests under two response conditions (normal mirror and inverted mirror). Video recordings of the tests were analyzed to assess performance using the following criteria: (i) direction of the arm movement during the initial phase of movement, (ii) number of corrections of the hand position before grasping. The control subjects successfully grasped the objects in both experimental conditions. The patients (1) neglected the contralesional space, grasping objects correctly in the ipsilesional space (normal mirror condition) and (2) neglected the ipsilesional space, grasping correctly objects in the contralesional space (inverted mirror). Controls used real object-centered correction clues to modify the position and direction of their hand movement. The patients only produced horizontal displacements of the upper limb in the "healthy" and neglected space. These results suggest that patients with neglect do not use the same clues and do not modify their procedures as they cannot recalibrate their spatial representations. These differences concerned non-mirror-image clues and directional and positional as well as attentional vectors. Theoretical and rehabilitative implications are discussed.

Adult↗
PubMed2001

[Classification and mechanisms of body perceptions in the amputees].

OBJECTIVE: Amputees can experience several types of physical illusions and phantom limb phenomenon. The objective was to establish a synthetic classification of theses perceptions. METHOD: Prospective study in 75 amputees (group 1: amputation (n = 60), group 2: congenital defect). The subjects were asked first to report their perceptions spontaneously and then to detail the perception, if exist, of the missing limb: form recognition, posture, movement, reminiscence of a lost limb. RESULTS: Different types of perception were described besides the perception of the real state : normal, deformed or commemorative phantom limb and illusion of a normal body. DISCUSSION: Whatever the model (i.e.: neuro-matrix) which support the construction of the scheme and the body image, the representations related to identified perceptions, use various innate, autobiographic and identity frames of references as well as instantaneous peripheral information, treated by reorganized cerebral structures. Each type of perception is related to a particular representation pattern. CONCLUSION: This approach, in accordance with the literature, offers a better understanding of the differences between amelic and amputated subjects and of their perception of any prosthetic equipment.

Amputees↗
PubMed2001

[MRI and leg stump neuroma].

OBJECTIVE: To describe RMI aspects of leg stump neuroma and to evaluate RMI scan interest for neuroma diagnosis and management. POPULATION AND METHOD: During a 2 years period, 224 amputated patients consulting for pain or prostetics problems were studied. In 10 cases, a characteristic pain leads to neurona diagnosis. This is described as a sensation of ascending or descending electric shock induced by the stimulation of an identified point with a reproducible topography. In all these cases, RMI scans were performed. In thirty two other cases, a RMI scan was performed to confirm a pathology (bursitis, bone abnormality) or in order to establish an etiologic diagnosis. Twelve neuromas were diagnosed. RESULTS: RMI scan showed a neuroma in the ten cases with a clinical suspicion and two asymptomatic neuromas were diagnosed out of the 32 patients without clinical suspicion. Medium delay between amputation and neuroma diagnosis is 11,6 year. In six cases, staking was modified and in six other cases, surgery was necessary. In aIl cases, clinical manifestations disappeared. Vanous RMI aspects ofneuromas are described and illustrated. Neuroma is observed on the extremity of a nerve that have a wavy aspect on its top. The neuroma is an oblong structure, with clear limits. There is an hyposignal with Ti sequence and variable signal with T2 and after gadolinium injection. DISCUSSION: RMI scan is a good way to diagnose amputee neuroma. It makes it possible to demonstrate the pathological character of the neuroma. It has to be performed when a neuroma is suspected. It enables to confirm the diagnosis and establish the exact topography and anatomic connection. Mechanical strains role as a factor of discovering the neuroma is discussed because of the concomitant evolution of associated lesions (bursitis, bone edema). Surgical repair takes place after correcting abnormal mechanical strains.

Amputation, Surgical↗
PubMed2001

[Early surgery management of pelvic region pressure ulcers versus directed cicatrization in a population of spinal cord injured patients].

OBJECTIVE: To estimate the benefit brought by an early surgery management of pelvis region pressure ulcers compared to medical processing in a population of subjects spinal cord disabled. MATERIAL AND METHOD: The studied population consist of 53 patients (62 pressure ulcers) divided into two groups: the group 1 includes 30 patients (34 pressure ulcers) presenting pressure ulcers stage III or IV (NPUAP scale) with early surgery management, included consecutively during a period of 2 years; the group 2 includes 23 patients (28 escarres) included in a retrospective way, with medical processing by the same team of care. The criteria of judgment are the delay of healing and the delay of delivery of the station sat in the armchair. RESULTS: In the group 1, the average delay of healing is of 42 days and the average delay of delivery for the armchair of 39 days. In the group 2 healing can be obtained only in 13 cases and in an average delay of 180 days. Differences are significant (p < 0.05). DISCUSSION - CONCLUSION: The originality of this study results in the comparison of two processing within two groups of patients having close demographic characteristics. It clearly shows the interest of the early surgery of the pelvic pressure ulcers comparing to medical processing and illustrates the requirement for a close cooperation between teams specialized in plastic surgery and teams specialized physical medicine.

Adult↗
PubMed2001

[Rehabilitation protocols after repairs of zone 2 of the flexor tendon of the hand: presentation and indications].

We report the results of a retrospective study of 47 adult patients corresponding to 54 fingers, operated on in the emergency room at Nancy University Hospital between December 1996 and October 1998. These patients were managed using three different postoperative therapy protocols: passive mobilisation according to the Duran technique, active-passive mobilisation according to the Kleinert technique and immediate active mobilisation as described by Strickland. Patients were evaluated in three different ways; active range of movement obtained according to the Strickland scale, the "400 points" flexor function test and the delay in returning to work. Combining all three evaluations showed a 65% rate of satisfactory results, 22% fair and bad results and 13% ruptures. Analysis according to the re-education technique showed a strong superiority of the Strickland protocol. This now needs to be confirmed by a more extensive prospective study. Delay before return to work is not affected by the type or re-education technique chosen, but side-effects are less frequent with the Strickland method. A result in terms of range of active movement alone did not fully evaluate the result of a flexor tendon repair: functional testing was better at this end and the global "400" points test score gave more useful information than each of its component tests taken individually (Purdue pegboard, Minnesota test, Box and Block). Functional testing seemed more helpful in guiding the medical team in its treatment strategy.

Adult↗
PubMed2001

Vestibular caloric stimulation evokes phantom limb illusions in patients with paraplegia.

STUDY DESIGN: Prospective study. OBJECTIVES: To determine the mechanisms of body illusions in paraplegia patients as compared with the amputee phantom phenomena. METHODS: A vestibular caloric stimulation was performed in 10 consecutive patients with complete section of the spinal cord. Perception of body, before and after stimulation, was classed as illusion of a normal body (lower limbs with normal morphological, postural and kinetic characteristics perceived as before spinal injury), normal phantom (overly vivid perception of all or part of the lower limbs), deformed phantom (perception of all or part of the limbs below the injury level as abnormal in shape, posture, movement or even number), or painful phantom. RESULTS: After vestibular caloric stimulation, nine out of 10 patients stated their perception of body segments below the injury level had changed to normal phantoms or to deformed phantoms (morphological, postural or kinetic changes). Among the four patients who initially had painful limbs, two stated the stimulation greatly relieved their pain. CONCLUSION: The normal or deformed phantom evoked by vestibular stimulation would result from use of identity data or instantaneous data as is observed in amputees. Cerebral remapping following deafferentation could be the origin of the deformed phantoms. Illusions corresponding to phenomena perceived at the time of the accident corresponding to autobiographical engrammes do not appear to be evoked by vestibular stimulation, as is also the case in amputees.

Adult↗
PubMed2001

Elevated C-reactive protein constitutes an independent predictor of advanced carotid plaques in dyslipidemic subjects.

Inflammation plays a key role in the physiopathology of atherosclerosis. C-reactive protein (CRP) has been found to predict cardiac events in healthy subjects and in patients with coronary heart disease. However, the relationship between CRP and subclinical atherosclerosis is not well established. We examined the potential relationship between CRP and common carotid artery intima-media thickness and carotid plaques in dyslipidemic subjects. Dyslipidemic patients (n=1051) were recruited for the study. All patients had a complete clinical examination and systematically underwent ultrasonographic evaluation of the extracranial carotid arteries on a duplex system. The serum concentration of CRP was measured by using a sensitive immunoradiometric assay. In a univariate model, a strong positive relationship was found between CRP and the severity of carotid stenosis (P<0.0001). In multivariate analysis, the association between CRP and the degree of carotid atherosclerosis remained significant for advanced plaques (P=0.0007) in male subjects only. Significant correlations were found between CRP and body mass index (P<0.0001) and between CRP and other markers associated with the metabolic syndrome. In this large dyslipidemic population, elevated CRP is an independent predictor of advanced carotid plaques in male subjects. Body mass index and other markers of the metabolic syndrome (HDL cholesterol, triglycerides, diabetes, and high blood pressure) are significant determinants of CRP levels in this population.

Arteriosclerosis↗
PubMed2001

[Georges Gilles of Tourette, pioneer of gait analysis in the nervous system diseases].

Georges Gilles de la Tourette's contribution to neurology goes beyond the description of the neurological disorder named after him. On December 28, 1885, he defended his doctoral thesis devoted to "gait in the diseases of the nervous system, studied by the method of imprints". In collaboration with Albert Londe, he worked for two years in Charcot's department on "a simple method applicable to both healthy and unhealthy patients", establishing the scientific and modern basis of functional exploration of human gait. The purpose was to "record the modifications of the gait and to fix them permanently, using suitable devises to guarantee not only rigorous comparison, but also to prevent observers, making use of the same method, from disputing or canceling the results completely independent of the experimenter himself". Georges Gilles de la Tourette defined the various characteristic parameters and provided the normal reference values in males and females, determining the physiological asymmetry of steps. He described spastic gait, shaking palsy, and locomotor ataxia. He distinguished between disorders of nervous control and related joint diseases. He also classified gait disorders occurring during hemiplegia. Modern development of kinetic, kinematic and biomechanical studies is a good illustration of the current relevancy of Gilles de la Tourette's contribution.

France↗