Search PubMed⌕ Search

Biomedical subjects

Jean-Louis Schlienger

Publications and source records attributed to Jean-Louis Schlienger.

18 recordsLinked to original sources
PubMed2006

Diet and physical activity profiles in French preadolescents.

Dietary patterns have been identified in adults, but less is known about children and adolescents. For the first time, we have investigated lifestyle patterns combining diet and physical activity in 12-year-old French preadolescents and examined their association with sociodemographic factors. Physical activity, sedentary activities and dietary habits were assessed by questionnaires given to 2724 students in 2001. Family income tax and parents' educational level, as indicators of socio-economic status, and the size of the residence commune were obtained from parents. After adjusting for socio-economic status, physical activity was positively associated with a consumption of fruit/vegetables/fruit juice on more than four occasions in the previous 24 h (P<0.001). Sedentary activities were positively associated with the consumption of French fries or potato chips (P<0.001), with sweetened drink as the most usual drink (P<0.001) and with nibbling while watching television (P<0.001), and inversely associated with a high consumption of fruit/vegetables/fruit juice (P=0.04). Multiple correspondence analysis identified two independent axes and specific combinations of behaviour: one axis characterised by sedentary activity, sweetened drink as the most usual drink, the consumption of French fries or potato chips and nibbling while watching television; a second one associating physical activity and the consumption of fruit/vegetables/fruit juice. Both socio-economic proxies were associated with the former axis (P<0.001). The size of the residence commune was associated with the latter (P<0.1). Combinations of diet and physical activity habits were identified in adolescents, indicating that prevention programmes targeting both behaviours may have an enhanced outcome.

Beverages↗
PubMed2005

Food-cobalamin malabsorption in elderly patients: clinical manifestations and treatment.

PURPOSE: Approximately 15% of people aged more than 60 years old have a cobalamin (vitamin B12) deficiency, mainly in relation with food-cobalamin malabsorption (FCM). To date, no study has documented this disorder in the elderly. There is also little information on clinical consequences. SUBJECTS AND METHODS: We studied 92 elderly patients with well-established FCM who were extracted from an observational cohort study (1995-2004) of 172 consecutive elderly patients with documented cobalamin deficiency. RESULTS: The median patient age was 76 +/- 8 years; 60 patients were women. The most common clinical manifestations were neurologic or psychologic: mild sensory polyneuropathy (44.6%), confusion or impaired mental functioning (22.8%), and physical asthenia (20.7%). Hematologic abnormalities were reported in at least one third of the patients: anemia (21%), leukopenia (10.9%), thrombopenia (8.7%), and pancytopenia (6.5%). All patients had low serum vitamin B12 levels (<200 pg/mL), with a mean value (+/- standard deviation) of 131 +/- 38 pg/mL and total serum homocysteine level of 22.1 +/- 9.3 micromol/L. The mean hemoglobin level was 10.9 +/- 2.5 g/dL and the mean erythrocyte cell volume 95.7 +/- 12.7 fL. Correction of the serum vitamin B12 levels and hematologic abnormalities was achieved equally well in patients treated with either intramuscular or oral crystalline cyanocobalamin. CONCLUSIONS: This study suggests that in elderly patients, FCM may be associated with significant neurologic, psychologic, and hematologic abnormalities, which seem to respond equally well to either oral or parenteral vitamin B12 therapy.

Aged↗
PubMed2005

Interactions between traditional regional determinants and socio-economic status on dietary patterns in a sample of French men.

The aim of the present study was to assess the respective contributions of regional and socio-economic factors to dietary pattern. We used the data from the final MONICA (MONItoring of trends and determinants in Cardiovascular disease) population survey conducted in the three French centres in 1995-7 among a representative sample of 976 men aged 45-64 years. Dietary intake was assessed using a 3-d record method. Dietary patterns were identified by a factor analysis, based on fifteen food items. An analysis of variance was then used to study their relationship with regional and socio-economic determinants. Two major dietary patterns were identified: a 'Western diet', characterized by high intakes of sugar and sweets, grains, butter, added fats, eggs, potatoes and cheese; a 'prudent diet', mainly distinguished by high intakes of fruit, vegetables, olive oil and fish and low intakes of alcohol, high-fat meat and potatoes. Strong associations were mostly observed with the 'prudent diet' pattern, with a significant relationship with region, educational and income-tax levels, leisure-time physical activity and smoking status. There was also a statistically significant interaction between region and educational level (P=0.05), and between region and income-tax level (P=0.03), indicating that the influence of socio-economic factors is different among regions. In conclusion, these results indicate large regional and socio-economic differences in the dietary patterns of this French male population. When considering the 'prudent diet' pattern, they also suggest that traditional regional influences may now be overcome by socio-economic determinants.

Aged↗
PubMed2005

Plasma fatty acid composition is associated with the metabolic syndrome and low-grade inflammation in overweight adolescents.

BACKGROUND: Together with adiposity, plasma fatty acid (FA) composition can modulate the development of the metabolic syndrome (MS). OBJECTIVE: Our aim was to investigate the relations of FA composition in plasma phospholipids and cholesterol esters (CEs) with weight status, MS, and inflammation in adolescents. DESIGN: Plasma FA composition was measured by gas-liquid chromatography in 120 (60 normal-weight and 60 overweight) 12-y-old adolescents. We also measured the presence of MS, insulin resistance with the homeostasis model assessment, and interleukin 6 and C-reactive protein concentrations in the adolescents. RESULTS: MS was present in 25% of the overweight adolescents but in none of the normal-weight adolescents. Compared with overweight adolescents, normal-weight adolescents had lower saturated FAs (SFAs) in both phospholipids (P < 0.001) and CEs (P < 0.01) and higher docosahexaenoic acid in phospholipids (P < 0.001). In overweight subjects, FA composition was associated with MS features independent of body fat. The odds ratios of MS for a 0.1 increase in the ratio of polyunsaturated FAs (PUFA) to SFAs (PUFA:SFA) were 0.91 in phospholipids (P = 0.03) and 0.90 in CEs (P = 0.06). In phospholipids, PUFA:SFA and linoleic acid were associated positively with HDL cholesterol (P < 0.01 for both). PUFA:SFA in phospholipids and CEs were associated inversely with interleukin 6 (P < 0.05 for both). Eicosapentaenoic acid in phospholipids (P = 0.06) and CEs (P < 0.05) and linolenic acid in CEs (P < 0.05) were inversely related to C-reactive protein. These relations remained significant after adjustment for the waist-to-hip ratio. No significant relation between FA composition and the homeostasis model assessment was observed. CONCLUSIONS: Plasma FA composition is associated with weight status in healthy adolescents. High intake of long-chain PUFAs, especially n-3 PUFAs, may protect obese subjects against MS and low-grade inflammation as early as adolescence.

Body Weight↗
PubMed2004

Vitamin B12 (cobalamin) deficiency in elderly patients.

Vitamin B12 or cobalamin deficiency occurs frequently (> 20%) among elderly people, but it is often unrecognized because the clinical manifestations are subtle; they are also potentially serious, particularly from a neuropsychiatric and hematological perspective. Causes of the deficiency include, most frequently, food-cobalamin malabsorption syndrome (> 60% of all cases), pernicious anemia (15%-20% of all cases), insufficient dietary intake and malabsorption. Food-cobalamin malabsorption, which has only recently been identified as a significant cause of cobalamin deficiency among elderly people, is characterized by the inability to release cobalamin from food or a deficiency of intestinal cobalamin transport proteins or both. We review the epidemiology and causes of cobalamin deficiency in elderly people, with an emphasis on food-cobalamin malabsorption syndrome. We also review diagnostic and management strategies for cobalamin deficiency.

Aged↗
PubMed2004

Glibenclamide-induced acute haemolytic anaemia revealing a G6PD-deficiency.

A 58-year-old woman was admitted at diagnosis of type 2 diabetes without keto-acidosis. Blood glucose was normalized initially with insulin. Whilst taking glibenclamide, she developed acute haemolysis. She was homozygous for glucose-6-phosphate dehydrogenase (G6PD) deficiency and had no other factors predisposing haemolysis. We reviewed the literature and discuss the relationship between glibenclamide and haemolytic crisis and between G6PD-deficiency and diabetes.

Anemia, Hemolytic↗
PubMed2004

Free thyroxine measured with equilibrium dialysis and nine immunoassays decreases in late pregnancy.

We measured free thyroxine in sera from 29 women in the ninth month of pregnancy. We used the reference method, equilibrium dialysis, and nine immunoassays. The bias between immunoassay and dialysis results was insignificant or modest. With all methods, the results were in the lower part of the non-pregnant female reference interval or below the lower limit of this interval: 10 results with the equilibrium dialysis assay and from 4 to 18 results with the nine immunoassays. Method-specific reference intervals should be determined during pregnancy to be in a position to quantify not only hypothyroidism but also hyperthyroidism and to adjust an appropriate T4 treatment.

Adult↗
PubMed2003

[Homocysteine and alcohol consumption. An ambiguous relationship and a new paradox].

HOMOCYSTEINEMIA AND ITS VARIATIONS: The increase in plasma concentrations of homocysteine (Hcy) is a factor of cardiovascular risk. Its determinants are multifactorial, genetic and environmental. Out of the ingestion of dietary supplements containing vitamin B6, folates and B12, other substances such as coffee or alcohol contribute in the increase in Hcy. THE EFFECTS OF ALCOHOL: The alcohol-Hcy interaction is complex and ambiguous. Although chronic alcoholism clearly increases Hcy concentration, the effects of moderate and regular consumption of alcohol are debated in epidemiological studies. Following adjustment of various parameters, it is now admitted that alcohol moderately increases Hcy levels. This is paradoxical since the coronary protective effects of alcoholic beverages has been well established. THE PARTICULAR CASE OF BEER: However, a negative correlation between Hcy and alcoholic beverages has been described in some studies, more especially in beer-drinkers. The hypothesis of a reduction in Hcy induced by the beer contents has been described in an interventional study. The vitamins contained in beer, particularly B6, may well be at the origin of this beneficial effect.

Alcohol Drinking↗
PubMed2003

Increased sensitivity of a new assay for anti-thyroglobulin antibody detection in patients with autoimmune thyroid disease.

OBJECTIVES: To verify the cut-off values and to determine the clinical sensitivity of antithyroglobulin (TgAb) determinations using our routine RIA and the new electrochemiluminescent Elecsys assay. DESIGN AND METHODS: We used the DYNOtest anti-Tgn manual RIA from BRAHMS and the new automated Elecsys electrochemiluminescent immunoassay from Roche Diagnostics. We analyzed 452 sera from the following subjects: 193 euthyroid controls, 163 with treated and untreated autoimmune thyroid diseases (AITD) (108 Graves' disease and 55 thyroiditis), 50 with differentiated thyroid carcinoma, 13 with nonautoimmune thyroid disease and 33 with type 1 diabetes mellitus. RESULTS: As expected, using the proposed thresholds (BRAHMS 60 kIU/L, Elecsys 115 kIU/L) approximately 6% of the control subjects were positive for TgAb with both methods. In AITD patients, the sensitivity of TgAb determination was significantly higher with the Elecsys assay (51.5%) than with the BRAHMS assay (39.3%). This difference was not observed in the other patient groups. CONCLUSION: The Elecsys assay can be preferred not only because it is automated and rapid, but also because of its better clinical performance in AITD patients.

Adult↗
PubMed2003

Actigraphic assessment of the circadian rest-activity rhythm in elderly patients hospitalized in an acute care unit.

Hospitalization for acute illness is a major risk factor of rest-activity rhythm disturbance among elderly subjects. The rest-activity rhythm is disturbed by the acute illness, aging and hospital environment. The purpose of this study is to assess the rest-activity rhythm and light exposure (using a wrist worn actigraph) of 10 patients (mean age 81 years, seven females) admitted on an acute care unit, suffering from cardiac, respiratory or renal acute disease. A non-parametric method was used to analyze activity data. With an improvement of the underlying diseases, the mean relative amplitude of rhythm increased from 0.31 +/- 0.19 for the first 5-day period after admission to 0.54 +/- 0.21 for the second period before discharge (P < 0.05). The amount of time at night spent above a lighting threshold of 50 lux decreased from 31.4 to 12.3 min between the two periods. The rhythm of elderly subjects hospitalized in the acute care unit is severely altered during the initial period and is progressively resynchronized following clinical improvement. Under the acute underlying disease and/or aging, environmental conditions (light, noise) should be considered to maintain regular rest-activity rhythm.

Acute Disease↗
PubMed2002

Effects of thyroid-stimulating hormone suppression with levothyroxine in reducing the volume of solitary thyroid nodules and improving extranodular nonpalpable changes: a randomized, double-blind, placebo-controlled trial by the French Thyroid Research Group.

The efficacy of suppressing TSH secretion with levothyroxine (L-T(4)) in reducing solitary thyroid nodule growth is still controversial. In this prospective multicenter, randomized, double-blind, placebo-controlled trial, 123 patients with a single palpable benign nodule were included and randomly allocated to an 18-month treatment with L-T(4) or placebo. Individual dose was adjusted to allow a serum TSH level below 0.3 mIU/liter. Clinical and ultrasonographic nodule characteristics were assessed before treatment and 3, 6, 12, and 18 months thereafter. The largest mean nodule size assessed on palpation and largest volume, assessed by ultrasonography, decreased in the L-T(4) group and increased slightly in the placebo group [size, -3.5 +/- 7 mm vs. +0.5 +/- 6 mm (P = 0.006); volume, -0.36 +/- 1.71 ml vs. +0.62 +/- 3.67 ml (P = 0.01), respectively]. The proportion of clinically relevant volume reduction (> or =50%) rose significantly in the L-T(4) group [26.6% vs. 16.9% (P = 0.04)]. The proportion of patients with a reduced number of infraclinical additional nodules was significantly higher in the L-T(4) group [9.4% vs. 0 (P = 0.04)]. It is concluded from this study that suppressive L-T(4) therapy is effective in reducing solitary thyroid nodule volume and improving infraclinical extranodular changes.

Adult↗
PubMedDate not supplied

Retrospective monocentric study of 17 patients with adult Still's disease, with special focus on liver abnormalities.

BACKGROUND/AIMS: Adult Still's disease is one of the febrile disorders of unknown etiology, characterized by high fever, transient cutaneous rash and leukocytosis. Liver dysfunction in adult Still's disease has been described in some case reports. The objective of this study was to analyze the pattern and the frequency of liver abnormalities in a monocenter series of adult Still's disease patients. METHODOLOGY: Data of 17 patients with adult Still's disease (fulfilling Yamaguchi's diagnostic criteria) were retrospectively reviewed. These patients were followed in an Internal Medicine Department over a period of 7 years. RESULTS: The median age was 27 years with a sex ratio M/F of 1.4. Fever was present in 100% of the cases and hepatomegaly occurred in 47% of the cases. Abnormalities in liver biochemistry, apparent in 76% of the subjects were characterized from moderate (elevation of transaminases between 2 and 5 N) (65%) to severe cytolysis (level of transaminases > 5 N) (12%), cholestasis (elevation of gamma GT and/or PAL) (65%), and increase in the level of LDH (35%). All of these symptoms disappeared either spontaneously or under treatment (83%), within a median period of 18 days. CONCLUSIONS: This study confirms the high frequency of liver dysfunction in adult Still's disease patients. Although it is moderate and asymptomatic in most cases, severe cytolytic hepatitis has been described. This study especially puts forward the need for exploring the possibility of adult Still's disease in the presence of a fever and hepatic cytolysis.

Adult↗