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Biomedical subjects

M Blanchard

Publications and source records attributed to M Blanchard.

At least 37 records · Page 2Linked to original sources
PubMed1997

Is there a specific trauma precipitating anorexia nervosa?

BACKGROUND: The aims of this study were to explore the role of life events and difficulties in the onset of anorexia nervosa and bulimia nervosa and to find out whether events and difficulties with a specific meaning, i.e. those of a certain sexual nature, are important in the onset of anorexia nervosa. METHODS: Seventy-two patients with anorexia nervosa (AN) and 29 with bulimia nervosa (BN) were assessed with the life events and difficulties schedule (Brown & Harris, 1978), the year before onset was studied. A new dimension to measure specific meaning of life events and difficulties called 'pudicity' was developed. Subjects from two community cohorts were used as comparison groups (Brown & Harris, 1978; Andrews et al. 1990). RESULTS: Anorexic patients, bulimic patients and community controls did not differ in proportion of patients with at least one severe event; however, significantly more AN and BN patients than community controls had experienced a major difficulty. Sixty-seven per cent of anorexics and 76% of bulimia nervosa patients had either a severe event or a marked difficulty during the year before onset. In AN and BN the most common serious life stresses before onset concerned close relationships with family and friends with BN patients being significantly more often than AN patients directly involved in the problem (interpersonal events). Patients with anorexia nervosa had significantly more pudicity events before onset than BN patients or community controls. CONCLUSION: While serious life stresses commonly precede the onset of anorexia nervosa and bulimia nervosa, problems with sexuality seem to be specific in triggering the onset of anorexia nervosa.

Adolescent↗
PubMed1996

Partition of metallic and organochlorinated pollutants and monoorthosubstituted PCB pattern in the trophic web from different areas of the river Seine.

The partition of metals and organochlorines was studied along the trophic web at two different pollution level areas of the river Seine. The metal results along the trophic web were: (1) High concentration processes by the sediment (Kb from 0.7 x 10(2) to 32 x 10(2) according to metal). (2) Bioconcentration processes by the plants from the water and the sediment for all metals (Kb from 0.5 10(3) to 13.2 x 10(3)); (3) The mussel (benthic and fossorial) exhibited the highest metal levels; (4) the bream (benthic and detritivorous) had higher metal levels than the roach and the perch. No biomagnification was shown for the metals along the trophic web. The organochlorine results were: (1) High concentration in the sediment with Kb-values about 10(3). (2) A relationship between lipid and PCB levels in plants. (3) No rise in organochlorines along the trophic web at the slightly polluted areas. (4) Occurrence of organochlorine biomagnification in the highly polluted area. For the PCB pattern: (1) The profiles are similar in plants and the water. (2) Sediment and animals exhibited a rise in the more chlorinated congeners accompanied by an impoverishment of the less chlorinated and monoorthosubstituted ones with rising position in the trophic web.

Animals↗
PubMed1994

Community psychiatric nurses for the elderly: well tolerated, few side-effects and effective in the treatment of depression.

Depression in elderly people is a common yet treatable psychiatric problem. The Gospel Oak depression study researched this much overlooked group and has shown that a community psychiatric nurse (CPN) was able significantly to improve the mental state of depressed elderly people. A multifaceted package of care was co-ordinated and delivered by one CPN over a study period of 3 months. A detailed account is given of those interventions implemented, highlighting those which were of most benefit for the patient. Outcome was assessed independently and it was found that those patients allocated to CPN care improved significantly compared to the non-intervention control group. Ways in which nurses can enhance care given to patients in the community are discussed.

Age Factors↗
PubMed1994

[Surgical therapy of ulcus cruris. Significance of extension of the damage to deep veins for incidence of ulcus cruris recurrence].

2 retrospective studies illustrate the importance of the extent of damage to the deep venous system governing the recurrence rate of stasis ulcers treated surgically. 1. In patients with recurrent venous stasis ulcerations associated with superficial varicosis of the great or lesser saphenous veins and incompetent perforators operative treatment of the varicose veins resulted in a 100% long-term healing rate of the ulcerations (5-year results). This was the case for 25 legs with venous ulcers in 229 consecutive cases operated for varicose veins. 2. In 76 patients with rebellious ulcers presenting without operable superficial varicose veins the treatment was a localized one consisting of wide and deep excision of the ulcer with ligature of underlying perforators and surrounding varicose veins. The 2-year success rate was 87% in 39 patients with intact deep veins, but only 59% in 37 patients with postphebite damage to the deep veins (p < 0.05). For 1 and 2 level deep vein disease the success rate was still high at 80%, but fell to 20% if damage to the deep veins extended to 3 or 4 levels! Thus, the degree of damage to the deep veins correlates well with the propensity to recurrence of venous ulceration following surgical treatment. Venous hypertension measured by phlebodynometry is the single most powerful predictor of success or failure of surgical treatment. Patients at risk should therefore be encouraged to wear compression stockings or hosiery to offset recurrencies.

Follow-Up Studies↗
PubMed1993

Depression in older people. Some criteria for effective treatment.

Depression at a level requiring clinical attention affects 12-15% of those over 65 in the community. Only a small minority are in contact with specialist mental health services, the majority of these depressed older patients will require detection and treatment in primary care. Although the symptoms of depression, once elicited, are similar to those of younger patients, initial presentation in older people can be misleading, and the onset and outcome of depression in this age group is closely linked with the state of current physical health and social adversity. Pharmacotherapy is effective for treatment, but both the family doctor and older patient may be reluctant to consider and persist with antidepressant medication. A controlled study is described which aims to improve the management of older patients in primary care by evaluating the role of a nurse acting as case manager to work in conjunction with family doctors and community agencies to implement a plan of treatment for depression. Preliminary results indicate that the nurse was effective through her personal work with depressed older patients, despite the fact that the recommended introduction of antidepressant medication was often not possible.

Aged↗
PubMed1991

Propofol and spontaneous movements: an EEG study.

Spontaneous movements during induction of anesthesia with propofol were studied in 21 children aged 6-12 yr. The children were randomly assigned to group A (propofol 3 mg.kg-1), B (propofol 5 mg.kg-1), or C (thiopental 5-7 mg.kg-1). A baseline electroencephalogram (EEG) was recorded during 10 min in children awake, supine with eyes closed and opened, and then from the beginning of induction until 5 min after tracheal intubation. Spontaneous movements were observed in all children in group A but only in 14% in groups B and C. The induction EEG sequences were similar for the three groups: after a mean latency of 12 s, the tracing showed an increase in frequency from 9 to 10 Hz (alpha waves) to more than 14 Hz (beta waves). This transition lasted approximately 2 s, followed by delta waves (2-3 Hz) that continued for 1-2 min. Finally, beta waves reappeared and progressively but incompletely replaced delta waves during the next 5 min. Neither spikes, spike-wave patterns, rhythmic theta waves, nor burst suppressions were observed. Spontaneous movements were recorded on videotape and analyzed after the completion of the study by a neurologist unaware of patient treatment. Videotape analysis of the periinduction period showed spontaneous movements to be dystonic and choreiform with flexion, twisting, or extension movements of all extremities. All movements occurred coincident with the appearance of delta waves on the EEG. Their dystonic nature and the absence of EEG abnormalities suggest a subcortical origin and argue against associated cortical epileptic activity.

Anesthesia↗
PubMed1990

Application of preparative high-performance liquid chromatography to the purification of a fetal ovine insulin-like growth factor II: N-terminal sequence determinations using two different carriers.

A highly efficient procedure for the purification to homogeneity of an ovine fetal insulin-like growth factor II (IGF II) is described. Fetal sheep serum was used as the source material, and the bioactivity was followed throughout purification by an IGF II radioreceptor assay. Ovine IGF II was isolated by a combination of gel permeation, ion-exchange chromatography and reversed-phase high-performance liquid chromatography. The amino-terminal sequence of the first 36 amino acid residues was compared using two supports (polyethylenimine and polybrene) as carrier for protein sequencing. Ovine fetal IGF II was found to differ from human IGF II in three residues of the C-domain, with serine, isoleucine and asparagine substituted for alanine, valine and serine, respectively, at positions 32, 35 and 36. The final yield of highly purified ovine fetal IGF II was 134 micrograms, starting from 450 ml of serum.

Amino Acid Sequence↗
PubMed1990

Comparison of pattern recognition methods for computer-assisted classification of spectra of heart sounds in patients with a porcine bioprosthetic valve implanted in the mitral position.

The diagnostic performance of two pattern recognition methods (or classifiers) to detect valvular degeneration was evaluated in 48 patients with a porcine bioprosthetic heart valve inserted in the mitral position. Twenty patients had a normal porcine bioprosthetic valve and 28 patients had a degenerated bioprosthetic valve. One method was based on the Gaussian-Bayes model and the second on the "nearest neighbor" algorithm using three distance measurements. Eighteen diagnostic features were extracted from the sound spectrum of each patient and, for each method, a two-class supervised learning approach was used to determine the most discriminant diagnostic patterns composed of 6 features or less. The probability of error of the classifiers was estimated with the leave-one-out approach. The performance of each method to discriminate between normal and degenerated bioprosthetic valves was verified by clinical evaluation of the valves. The best performance in evaluation of the sound spectrum (98% correct classifications) was obtained with the Bayes classifier and two patterns of six features each. The percentage of false positive classifications of valve degeneration was 0% and the percentage of false negative classifications was 4%. Sensitivity for the detection of valve degeneration was 96%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 95%. The best performance of the nearest neighbor method (94% correct classifications) was obtained by using the Mahalanobis distance and five patterns composed of three, four, five, or six diagnostic features. Using a pattern composed of only three features, the percentage of false positive classifications for degeneration was 10% and the percentage of false negative classifications was 4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Bayes Theorem↗
PubMed1989

[Positive direct Coombs' test in acute leukemias and other hemoblastoses: relation to clavulanic acid-containing antibiotics?].

Alerted by a high incidence of positive autologous controls in pretransfusion compatibility testing for patients with acute leukemia, we retrospectively analysed 59 cases of severe hemoblastoses undergoing myelosuppressive treatment. Seventeen (29%) of these patients had a positive direct antiglobulin test (DAT) with the following characteristics: the test was of the IgG and/or C3d type in all but two cases, which reacted with polyvalent antiglobulin sera only; the reaction was very weak throughout; very high concentrations of monospecific sera were needed to elicit positive reactions; free antibodies were never detected in the patients' serum; the eluates of the patients' red cells were non-reactive against a very large panel of test erythrocytes. All these criteria suggested a non-immunologic absorption of proteins under the influence of drugs such as cephalosporins and clavulanic acid. Timenten (ticarcillin and clavulanic acid) was found to be the only common drug which had been administered to the majority of the patients with a positive DAT: 15 of the 17 patients with a positive DAT (88%) had received Timenten against 19 of 42 patients (45%) with negative DAT. 44% of all the patients receiving Timenten thus had a positive DAT, whereas only 8% of the patients without this drug reacted in this way. These data document the role of clavulanic acid in the development of a positive DAT. The literature and our experience show that this kind of unspecific binding of proteins to the red cell membrane is not associated with increased hemolysis. Knowledge of the phenomenon, however, is important for differential diagnosis of anemias and interpretation of difficulties arising during pretransfusional compatibility testing.

Acute Disease↗
PubMed1989

Instantaneous secretion rate of growth hormone in lambs: relationships with sleep, food intake, and posture.

Relationships among sleep, feeding behavior, posture, and GH secretion were investigated in two groups of ruminant lambs in January (n = 6) and May (n = 3). Lambs were placed in individual cages and fed ad libitum. Behavioral features were obtained from continuous polygraphic recording. Blood was collected from undisturbed sheep every 3 min for 24 h via an indwelling catheter connected to a peristaltic pump. One month after the sampling session, ovine GH (oGH) was iv administered to evaluate oGH kinetic parameters. From GH plasma concentrations and oGH kinetic parameters, the instantaneous secretion rate of GH was reconstituted using a numerical deconvolution method. All lambs exhibited normal behavioral patterns. The clearance of oGH was similar for the two groups, and the daily production rates of GH were estimated at 14.60 +/- 7.99 micrograms/kg.24 h in January and 10.57 +/- 5.21 micrograms/kg.24 h in May. Analysis of concentration profiles indicate an episodic pattern of GH secretion into plasma. The mean number of peaks was 16.22 +/- 4.47/24 h, and the mean duration was 47.2 +/- 12.8 min for the nine sheep. When instantaneous secretion rates were taken into account, the number of identified peaks was similar, but the mean duration was reduced (32.9 +/- 9.8 min for the nine sheep). Significant relationships were not found between GH plasma concentration profiles and the state of vigilance, food behavior, or posture. Conversely, when the instantaneous secretion rates were taken into account, the highest GH production rate was detected during rest, i.e. slow wave sleep and rapid eye movement sleep, absence of food intake or rumination, and lying down. It is emphasized that the use of GH instantaneous secretion rate instead of GH concentration is of importance when evaluating the relationships between GH dynamics and short duration events. It is concluded that the influence of vigilance on GH secretion, which has already been demonstrated in humans, is likely to exist in other species.

Animals↗
PubMed1989

Design and preliminary evaluation of a portable instrument for assisting physiotherapists and occupational therapists in the rehabilitation of the hand.

This paper describes a portable instrument designed to monitor progress accomplished by patients participating in a hand rehabilitation program. The instrument is driven by a microcontroller and features signal conditioning circuits to measure and record the strength and duration of hand contractions. An alphanumeric display provides the patient with performance indications to allow biofeedback reinforcement, and clear instructions on how to perform the prescribed exercises. Exercise data acquired by the portable instrument can be transferred to a host computer for analysis and archival storage. Results of a preliminary clinical evaluation in 14 patients are presented.

Biofeedback, Psychology↗
PubMed1988

[Effects of GRF 1-29 in normal and hypotrophic lambs].

Injections of hGRF rapidly stimulated GH secretion in lamb and this response was significantly higher in hypotrophic than in normal lambs. The treatment had an effect on body composition reducing the retention of lipids and the energy level and increasing calcium and phosphorus content. The results showed that GRF affected both metabolism and skeletal growth of ruminants, stimulating specially the production of Sm-C and proliferation of chondrocytes.

Animals↗
PubMed1987

Characteristics of growth hormone response to the administration of growth hormone-releasing hormone (GRF) in the lamb.

Human growth hormone releasing hormone (GRF 1-44 or GRF 1-29) was administered to lambs at two different physiological stages (suckling: 5-6 week-old and weaned: 14-15 week-old) when growth hormone (GH) secretory patterns were different: suckling lambs exhibited flat basal GH profiles (5-10 ng/ml) while the weaned lambs had frequent spontaneous episodes of GH release (15-65 ng/ml). The iv injection of GRF evoked an immediate release of GH. In each case, plasma GH levels reached a maximum 1-4 min after the injection. The secretory spike was multiphasic and lasted 30-60 min. Administration of GRF (0.1 microgram/kg) in weaned lambs induced GH pulses with an amplitude comparable to that of endogenous peaks. The induction of a GH peak occurred even when a spontaneous peak immediately preceded the GRF injection. Also, spontaneous peaks were observed during the hour following a GRF-induced GH peak. In suckling lambs, GRF injected intravenously as a single bolus in a range of 0.01 to 0.5 microgram/kg (2 to 100 pmoles/kg) stimulated GH release in a dose-dependent manner. Chronic administration of GRF (0.75 nmole GRF 1-44 or GRF 1-29 per kg twice daily for 21 days) in newborn lambs increased significantly (p less than 0.001) the acute response to GRF during the course of the treatment. GH response to GRF 1-44 and GRF 1-29 was the same. These data show that lambs are highly responsive to GRF action during both suckling and weaning and suggest that there is no in vivo desensitization of the pituitary gland after acute or chronic GRF administration.

Animals↗