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Biomedical subjects

M Dramaix

Publications and source records attributed to M Dramaix.

At least 109 records · Page 6Linked to original sources

Transepidermal water loss during sleep in infants.

Transepidermal water evaporation rate (ER) was measured in 207 infants with a mean postnatal age of 12.7 +/- 10.6 weeks. Measurements were made from the forehead with the use of an Evaporimeter during polygraphic sleep recordings performed under standard conditions. ER values were computed in g/m2 X h. Evaporation rates were significantly lower during rapid eye movement (REM) sleep (8.5 +/- 4.4 g/m2 X h), compared to values measured during quiet wakefulness (11.6 +/- 7.4) or non-REM (NREM) sleep (11.2 +/- 7.6). The differences were not related to age, sex, weight, or rectal temperature, as shown by a covariance analysis. These data, recorded in normal infants, indicate the need to consider the state of sleep or wakefulness of the subjects when comparing results of water evaporation studies.

Humans↗

Continuous transepidermal water loss measurement in sleeping infants.

Transepidermal water evaporation rate was measured continuously in 8 infants with the use of an evaporimeter during one night of polygraphic sleep recording. Evaporation rates were significantly lower during REM than during NREM sleep. In both sleep stages it decreased during the night with the lowest values between 02.00 and 04.00 h. Evaporation values showed cyclic changes which were studied by measuring minute-by-minute differences between the maximum and the minimum values (the "amplitude variability") and the number of evaporation peaks per minute (the "peak density"). Both the "amplitude variability" and the "peak density" were smaller in REM than in NREM sleep. The "amplitude variability" decreased during the night with lowest values seen between 02.00 and 04.00 h. These changes in evaporation rates could reflect autonomic nervous system activity as well as basal metabolic activity and should be taken into account whenever such measurements are performed in sleeping infants.

Female↗

Transepidermal water loss during sleep in infants at risk for sudden death.

To search for excessive sweating during sleep in infants considered at risk for sudden infant death syndrome (SIDS), we studied 258 infants during one night. There were 134 normal infants (controls), 85 siblings of SIDS victims (siblings), and 39 infants who survived an apparent life-threatening event (ALTE) with no cause found for the incident. Mean postnatal ages were between 10 and 16 weeks. Transepidermal water evaporation rate was measured from the forehead using an evaporimeter during one night's polygraphic sleep recording. Measurements were made before feedings, during the first part of the night, and evaporation rate values were expressed as grams per square meter of body surface area per hour. In the three groups of patients evaporation rates were significantly lower during rapid eye movement (REM) sleep, compared with values measured during quiet wakefulness or nonrapid eye movement (NREM) sleep. Infants with an ALTE had significantly higher evaporation rate values during NREM sleep than the two other groups (20.1 +/- 1.93, 11.3 +/- 0.68, and 11.5 +/- 0.98 for the ALTE, control, and sibling infants, respectively). The differences were not related to age, sex, weight, or rectal temperature. During NREM sleep, evaporation rate values greater than 25 mg/m2/h were seen in 10/190 (5.3%) of the asymptomatic infants and in 11/36 (30.6%) of the infants with an ALTE. The results are in agreement with reports in the literature of repeated night sweating in infants who eventually died of SIDS. Although we are unable to conclude why evaporation rate values are higher in the ALTE group than in the two other groups, we cannot exclude that it reflects differences in autonomous system activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

Serum lipids and apoproteins in students whose parents suffered prematurely from a myocardial infarction.

Lipids and apoproteins as well as other coronary risk factors were measured in offspring of patients who suffered from a myocardial infarction before the age of 50 years; the results are compared with the results of a control group matched for age and sex. Significant differences were observed in the apoprotein A1 level, in the protein/fat ratios of high- and low-density lipoproteins, and in smoking habits. In a multivariate analysis, the offspring group was found to be different from the control group in nonhigh-density lipoprotein cholesterol/apoprotein B ratio, high-density lipoprotein cholesterol/apoprotein A1 ratio, smoking habits, apoprotein A1, and apoprotein A2. By means of these variables a total of 85% of all subjects could be correctly classified. We conclude that as early as age 21 years the offspring of patients with premature coronary heart disease differ from matched control subjects in lipoprotein measurements and in smoking habits.

Adult↗

Ischemic heart disease and regional variations of socio-cultural characteristics in Belgium.

Ischemic heart disease (IHD) can be considered as a 'cultural disease'. It is surprising to see how IHD is differentially distributed in Belgium on both sides of the linguistic frontier, with higher prevalence, incidence and mortality rates in the South as compared to the North. Therefore, various socio-cultural characteristics have been under investigation in two samples of middle-aged men, in order to determine the most discriminative ones, according to the subjects' cultural belonging. The largest differences are found in the professional activities area, suggesting that stress related to profession might be responsible for the geographical distribution of the disease.

Age Factors↗

Predictors of early death after acute myocardial infarction: two months follow-up.

Clinical variables and the results of non-invasive tests (exercise test, echocardiogram, gated equilibrium radionuclide ventriculography and 24 h ECG) were recorded in a series of 202 patients who left the hospital alive after an acute myocardial infarction. The short term (two months) predictive value of all these data was prospectively assessed by uni- and multi-variate analysis. The best correlation with early death was observed with the variables related to the extent of infarction and left ventricular dysfunction, namely: early clinical signs of heart failure, high peak CK-MB level, complete bundle branch block, increased cardiothoracic ratio on chest X-Ray, number of Mets reached during the stress test, echocardiographic dyskinesia index, and decreased left ventricular ejection fraction as measured by radionuclide ventriculography. Using multi-variate stepwise discriminant analysis, the following independent prognostic factors appeared by order of entry: early clinical signs of heart failure, peak CK-MB level and cardiothoracic ratio on chest X-Ray. These results highlight the short-term predictive value of the data related to left ventricular dysfunction and especially of simple clinical data for patients surviving an acute myocardial infarction.

Acute Disease↗

[Prenatal care and occupational activity].

We studied the gestational age at the first prenatal visit and the number of prenatal visits by occupational activity among 1,573 women who delivered in 32 maternity units of the Belgium's French speaking region. The comparison with non working women showed that working women consulted significantly (p less than 0.01) earlier, whatever their professional activity, their parity and their social class. They consulted significantly (p less than 0.05) more frequently in terms of reaching the expected number of consultations calculated as a function of gestational age at the first visit. This difference disappeared when parity and social class were taken into account.

Belgium↗

Effective extraction of diagnostic ECG waveform information using orthonormal basis functions derived from body surface potential maps.

A common basis of orthogonal waveform functions was derived from 128 lead body surface potential maps of 405 subjects. Twelve such orthogonal functions or frames were adequate for reconstruction of original ECGs from the beginning of QRS to the end of T. A larger number of frames (18) was required when basis functions were derived separately for QRS (10) and ST-T segments (8). Diagnostic information content of the coefficients of the orthogonal basis functions was evaluated in comparison with Minnesota Code criteria for myocardial infarction and with a more advanced multivariate ECG analysis program (Pipberger Program). This was done by deriving a linear discriminant function for separating normals from ECGs of patients with myocardial infarction and testing the discriminant in a different test population of infarcts and normals. The diagnostic accuracy of orthogonal basis functions was as good as that of Pipberger's program and considerably better than that of the Minnesota Code. The classification method described is insensitive to noise and errors in detecting QRS and T wave onsets and offsets or in selecting proper baseline for amplitude measurements. The robustness and enhanced classification stability with respect to noise and minor wave detection errors is a potential advantage particularly in serial ECG comparison.

Adult↗

Episiotomy and third-degree tears.

The relation of episiotomy to third-degree perineal tears was investigated in 21 278 singleton deliveries. The incidence of episiotomy was 28.4% (n = 6041). Third-degree tears occurred in 1.4% (85) of the deliveries with episiotomy and in 0.9% (132) of the deliveries without episiotomy (P less than 0.01). To avoid the effect of confounding factors, we analysed a sub-sample that included only vertex presentations with spontaneous occipitoanterior vaginal deliveries. After stratification for birthweight and parity, no relation between episiotomy and third-degree tear was found.

Birth Weight↗

Prevention of coronary heart disease: health knowledge, health attitude and fat consumption in a random sample of Belgian physicians.

Health knowledge, health attitude and fat consumption has been explored in a random sample of 2150 Belgian physicians below age 71; the response rate was 60.7%. Health knowledge, health attitude and fat consumption are significantly intercorrelated. Comparing general practitioners (G.Ps) to specialists, non significant differences were observed in terms of health knowledge whereas health attitude was more positive in G.Ps who, on the other hand, had a lower saturated fat intake score. Dutch speaking physicians had a higher health knowledge score whereas their fat intake score was significantly lower (less saturated fats) compared to their French counterparts. Differences in eating patterns between the French and Dutch speaking Belgian population are also observed in Belgian physicians.

Adult↗

[Physical activity, physical fitness and coronary disease].

The relationship between physical activity on and off the job, physical fitness and coronary artery disease was investigated in a prospective study involving 2 363 men, 40 to 55 years old. Sudden death and myocardial infarction occurred in 31 subjects during a 5-year follow-up. Preliminary data are reported. There was no significant correlation between quartiles of physical activity on and off the job and incidence of coronary events. Physical fitness was significantly inversely correlated with incidence of coronary events (p less than 0.05) and was significantly lower in the 31 new cases (p less than 0.03). Multivariate analysis showed that HDL-cholesterol, smoking and physical fitness significantly and independently discriminate between coronary prone patients and healthy subjects. We conclude that physical fitness is an independent, inverse risk indicator of new coronary events.

Adult↗

Endemic infantile hypothyroidism in a severe endemic goitre area of central Africa.

Thyroid function and exposure to dietary goitrogenic factors (iodine deficiency and thiocyanate overload) were studied at birth and from birth to 7 years in 200 neonates and 347 children living in the severe endemic goitre area of Ubangi, Northern Zaire. Serum T4 was at the lower limit of normal at birth (104 +/- 4 nmol/l) and stayed at that level during the first year of life (123 +/- 9) (NS), but decreased to 75 +/- 8 (P less than 0.001) at 2-4 years and to 62 +/- 6 (P less than 0.001) at 5-7 years of age. Mean serum FT4 decreased from 10.4 +/- 0.9 pmol/l during the first year to 8.2 +/- 1.0 (NS) at 2-4 years (NS) and to 7.7 +/- 0.9 (P less than 0.05) at 5-7 years. Mean serum TSH was 10.4 (8.4-12.9) mU/l (geometric mean +/- 1 SEM) during the first year, 10.1 (7.5-13.7) (NS) at 2-4 years and 24.3 (18.5-31.9) (P less than 0.05) at 5-7 years. Mean serum T3 was 3.23 +/- 0.12 nmol/l during the first year and remained stable thereafter. The frequencies of low T4 (T4 less than 77 nmol/l), high TSH TSH (TSH greater than 50 mU/l), and low T4 and T3 (T3 less than 1.69 nmol/l) were twice as high at 5-7 years as in the first year (respectively 65%, 42% and 15%). The urinary iodide concentration of the children was stable and low throughout the study period. By contrast, serum thiocyanate concentration which was high at birth (129 +/- 5 mumol/l) decreased to normal values between 3 and 12 months of age and increased again during and after weaning (1 to 3 years of age) to reach a value of 138 mumol/l which was comparable to that observed in adults in the same area. Thiocyanate concentration was high (133 +/- 7 mumol/l) in the mothers' serum but low in the mothers' milk (57 +/- 3 mumol/l) (P less than 0.001). Multivariate analysis showed that both iodine deficiency and thiocyanate overload were explanatory factors of the serum levels of T4, FT4 and TSH in children. In conclusion, our results show that infantile hypothyroidism is much more frequent at 5-7 years of age than at birth or during the first year of life. The deterioration in thyroid function during and after weaning is linked to persistent iodine deficiency accompanied by an increase in thiocyanate overload. The variability in the age of onset, the severity, and the duration of infantile hypothyroidism might explain the wide range of psychomotor and physical abnormalities observed in a large proportion of subjects in this area.

Adolescent↗

Belgian heart disease prevention project: incidence and mortality results.

Results are presented from the Belgian Heart Disease Prevention Project, part of the WHO European Collaborative Trial in the Multifactorial Prevention of Coronary Heart Disease (CHD). 19 409 men aged 40-59 yr took part; they were employed in thirty factories which formed the allocation units for a randomised controlled trial lasting 5-6 yr. The intervention package consisted largely of health education promoting a cholesterol-lowering diet, smoking cessation, weight control, physical activity, and treatment of arterial hypertension. A programme of information was supplemented by face-to-face counselling at the workplace by two physicians attached to the project. The coronary risk profile was reduced in the intervention group, compared with that in the control group, especially during the first 4 yr, by effects on serum cholesterol, number of cigarettes smoked daily, and arterial blood-pressure. Total mortality was 17.5% lower in the intervention group than in the control group (p = 0.038). Coronary mortality was reduced by a non-significant 20.8% whereas CHD incidence (non-fatal myocardial infarction plus fatal myocardial infarction plus sudden deaths) was reduced by 24.5% (p = 0.031). Non-fatal myocardial infarction (not a major end-point) was similarly reduced by 26.1% (p = 0.030).

Adult↗

Behavior, stress, and psychosocial traits as risk factors.

Although psychosocial factors have long been associated with the pathogenesis of heart disease, the independent relation between these variables and coronary heart disease (CHD) is still controversial. However, when experimental, clinical pathological, and epidemiologic studies are taken together, strong evidence is provided that psychosocial and behavioral factors are important in the development and the provocation of clinical CHD manifestations. Heterogeneity in study results is partially due to methodological problems in defining and measuring behavior, stress, and psychosocial traits in population groups as well as in individuals. The difficulties in separating the role of psychosocial factors from the classic risk factors strengthen the importance and need for these factors to be considered in the design of further clinical and epidemiologic studies, not only to explore their independent predictive value but also to study their role in adherence to preventive advice and in the reversibility of risk. In these respects results are presented from a prospective epidemiologic and from a controlled multifactorial intervention study.

Adult↗

Type A in relation to job-stress, social and bioclinical variables: the Belgian Physical Fitness Study.

The present study focuses on the relationship of Type A behavior, a suspected coronary-prone behavior pattern in its overall or specific aspects, to "stress" experienced at work, and to social and coronary bioclinical risk factors. In order to measure Type A behavior and Job-Stress, respectively, the Jenkins Activity Survey Questionnaire (J.A.S. for employed persons, 1969 version) and a self-constructed Job-Stress Questionnaire were administered at a base-line examination to 2,302 men aged 40-50 years. The multivariate analysis shows: A strong Type A behavior-Job-Stress relationship; An important relationship between employment grade, educational attainment and--to a lesser extent--, marital status and, overall Type A behavior, Speed and Impatience and Job-Involvement, A weak relationship between cholesterol and triglycerides (not found in univariate analysis), and, overall Type A behavior; a small weak relationship between smoking habits, and, Speed and Impatience and Hard-Driving. A direct relationship between heavy physical activity during leisure-time and Job-Involvement.

Adult↗