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Biomedical subjects

P Drouin

Publications and source records attributed to P Drouin.

At least 109 records · Page 6Linked to original sources

Effect of simvastatin on plasma lipids, apolipoproteins and lipoprotein particles in patients with primary hypercholesterolaemia.

The effect of treatment with simvastatin, a new HMG-CoA reductase inhibitor, has been investigated in 27 patients with primary hypercholesterolaemia. It produced a significant decrease of cholesterol and phospholipids in plasma, LDL and apolipoprotein B-containing lipoproteins. Plasma apolipoproteins B, C-III and E were also significantly lowered. The concentration of lipoprotein particles recognized by monoclonal antibodies (BL3, BL5 and BL7), associated with atherosclerotic disease, was also lowered by the treatment. Lipoproteins LpA-II:A-I were not changed, while LpA-I, which has been suggested to be the protective fraction of the apo A-I-containing lipoproteins, was slightly and inconsistently increased.

Adolescent↗

Metabolic effects of a single administration of growth hormone on lipid and carbohydrate metabolism in normal-weight and obese subjects.

The effects on lipid metabolism of a single intramuscular dose of SR 29001 (0.15 U/kg body wt), a biosynthetic human growth hormone (hGH), were explored in a double-blind randomized crossover vs a placebo study of six normal-weight and six obese subjects (Quetelet Index greater than 120%). Circulating hGH concentrations reached means of 35 and 28 ng/mL in the normal-weight and obese subjects, respectively. Free fatty acids increased in both groups (p less than 0.05); increases in beta-hydroxybutyrate and acetoacetate concentrations were more moderate (NS). Plasma glucose increased significantly despite a significant increase in insulin (p less than 0.002). The lipolytic effect persisted after a standardized 950-kcal meal eaten 5 h after hGH administration. A delayed increase in somatomedin-C and decreases in blood urea and total cholesterol were also observed (p less than 0.05). Despite increased insulin secretion, biosynthetic hGH produced a significant increase of lipolysis in both groups, which was only partially suppressed by food.

3-Hydroxybutyric Acid↗

Reliability of self-monitoring of blood glucose by CSII-treated patients with type I diabetes.

The reliability of patient-generated data from self-monitoring of blood glucose (SMBG) was studied in 14 patients with type I (insulin-dependent) diabetes mellitus treated by continuous subcutaneous insulin infusion (CSII) (7 women, 7 men). The reflectance meters (Glucometer I, Ames, Elkhart, IN) used by the patients were replaced for a period of 21 days by memory-reflectance meters; patients were unaware of the memory capacity of the new meters and were instructed to continue their practice of recording the meter readings in their logbook. This study compares the data recorded in the memory-reflectance meters with those reported in the logbook. The number of SMBG measurements was different in 11 patients (differences ranging from 2 to 66). Mean glycemia was similar (8.23 +/- 0.36 mM in logbook vs. 8.49 +/- 0.48 mM in memory-reflectance meters), but both the M value and mean amplitude of glycemic excursions (MAGE) index were lower when calculated from logbook data (38 +/- 5 vs. 48 +/- 7 mM, P less than .05 and 6.91 +/- 0.43 vs. 7.72 +/- 0.52 mM, respectively; P less than .05). Overreporting (addition of phantom values in logbook) and underreporting (omission of SMBG measurements from logbook) indexes were 19 +/- 7 and 12 +/- 3%, respectively. Precision (percent of identical values in logbook and in memory-reflectance meters at the corresponding time) was 77 +/- 6.8%. The number of SMBG measurements recorded in the memory-reflectance meter was negatively correlated with glycosylated hemoglobin [HbA1c; (r = -.85, P less than .001)], whereas overreporting was positively correlated with HbA1c (r = .76, P less than .01).

Adult↗

Visual evoked potentials in diabetic patients.

Visual evoked potentials (VEPs) were assessed in 50 adult type I (insulin-dependent) and 19 type II (noninsulin-dependent) diabetes mellitus patients and in 54 controls. P100 wave latency was significantly longer in diabetic patients (P less than .001). Twenty-eight percent of diabetic patients had P100 wave latencies above the normal range. There was no correlation between P100 latency and type or duration of diabetes mellitus, quality of metabolic control, or presence of degenerative complications. The significance of VEP abnormalities in diabetes mellitus remains speculative.

Adult↗

[Diet therapy of hypercholesterolemia. From theory to practice].

Hypercholesterolemia, quite frequent in industrialized countries is a major risk factor of atherosclerosis, especially in the coronary arteries. Consensus conferences, in the United States as well as Europe, have established a practical approach to this field. The dietetic treatment, from a population standpoint, remains the corner-stone of the treatment of primary dyslipoproteinemias. The quality and quantity of lipids in the food, play a definite role. In order to lower cholesterolemia, the intake of total lipids and cholesterol must be lowered and the consumption of polyunsaturated or mono-unsaturated fatty acids must be increased. The advantage of fish (omega 3 fatty acid), soy-bean and food fibers, are discussed.

Dietary Carbohydrates↗

[Classification of primary dyslipoproteinemias].

The prevention of atherosclerosis implies a better knowledge of dyslipoproteinemias. The metabolic disease must first be defined before considering its treatment and evaluate the atherogenic risk. The clinician must take advantage of two different classifications. The WHO classification (WHO: World Health Organization) permits to consider six phenotypes (I, IIa, IIb, III, IV, V), according to the serum levels of cholesterol and triglycerides. The genetic classification permits to relate one or several genetic anomaly to these phenotypes. The main clinical and biological characteristics of primary dyslipoproteinemias are summarily reported.

Humans↗

[Holter erectometry. A new approach to erectile disorders].

A Holter-type portable computerised electronic system for measurement of the apparent volume of the penis, eye movements and heart rate over 12 hours, enables investigation of erectile disorders by the patient himself, under more physiological conditions at home. Data processing and ease of use will permit scientific use on a large scale.

Adult↗

[Impotence in the diabetic].

Two-hundred-and-two impotent diabetic patients gave their consent to be investigated. Impotence is linked to diabetes mellitus in 58.9% of patients so all the other etiologies have to be systematically eliminated. Neuropathy or arteriopathy, when isolated, are found with the same frequency, but these 2 etiologies are often associated (47 patients). No statistical difference between IDDM and NIDDM was found. Mercury strain gauge plethysmography and venous occlusion coupled to ECG allows detection of arterial lesions in diabetic impotence. Patients agreed to submit to all of the various therapeutic possibilities. Combination of alpha-blockade and good glycemic control induced the best results.

Adult↗

[Study of the HLA system and glyoxalase in 31 insulin-dependent diabetics free from micro and macro-angiopathies after more than a 20-year development].

Insulin-dependent diabetics are not equal as concerns vascular complications. Many factors have been incriminated. The object of this study was to determine if a genetic factor protected the insulin-dependent diabetic from vascular complications. The population included 31 unrelated, white insulin-dependent diabetic subjects (18 females and 13 males), with diabetes of over 20 years' duration (21 to 43 years, m +/- SD 27.82 +/- 6.03 years; age at diagnosis: 2 to 57 years, m +/- SD 22.7 +/- 15.19 years). The absence of vascular lesions was checked for by the following investigations: visual acuity, fundoscopic examination, retinal fluorescein angiography (Canon F 60 Z), systolic pressure on the thigh and ankle, Doppler velocimetry, plethysmography of the lower limbs, serum creatinine level, urinary protein. The study of the HLA A, B, DR specificities was carried out using the Tersaki microlymphocytotoxicity assay, those of C4 by high voltage gel electrophoresis followed by hemolytic detection, those of B1 using Alper's method and those of glyoxalase by gel electrophoresis followed by a glutathione redox reaction in order to test for a marker for a possible protective genetic factor against complications. The antigen frequencies found were compared with: 1) Those in the general Caucasian reference population (9th Histocompatibility Workshop, 1984). The study group presented the HLA characteristics known to occur in insulin-dependent diabetes: increase in A30, B8, B18, D6, DR3, DR4, BfF1 and decrease in A3, B7, DR2. Furthermore an increase in the frequency of DRw53, DQw2 and DQw3 alleles was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Prognostic significance of endometrial extension in carcinoma of the cervix.

A retrospective analysis of 343 consecutive patients with histologically proven carcinoma of the cervix, treated at the Ottawa General Hospital, was undertaken to evaluate the prognostic significance of endometrial extension. All these patient had a D + C as part of their work-up. Sixty-seven patients had a (+) D + C: 34/150 (23%) in Stage IB, 21/106 (20%) in Stage II, and 12/87 (14%) in Stage III. Survival was closely related to the D + C findings in early stages. In Stage IB, the 5-year survival of D + C (-) patients was 90% vs 50% in D + C (+) patients (P less than 0.003) and in Stage II, the 5-year survival was 77% and 55%, respectively (P = 0.089). There was, however, no difference in survival in Stage III patients (35% vs 29%). Pelvic failures were similar in both groups, stage for stage, but those with a (+) D + C had a higher incidence of distant metastasis. In Stage IB, distant metastases were found in 8.5% (10/116) of D + C (-) patients compared to 38% (13/34) in D + C (+) patients (P less than 0.001) and in Stage II, in 18.5% (16/85 and 33% (7/21) of the patients (P = 0.126), respectively. There was no difference in Stage III patients (28% vs 25%). This study suggests that endometrial extension is a significant prognostic factor in early stages and is associated with a higher risk of distant metastases. Management of these high risk patients is discussed.

Dilatation and Curettage↗

Efficacy of sequential cyclical hormonal therapy in endometrial cancer and its correlation with steroid hormone receptor status.

Forty-six eligible women with metastatic endometrial cancer were randomly allocated to receive monthly cycles of either CAF (cyclophosphamide, adriamycin, 5-fluorouracil) or CAF plus Provera 200 mg daily for 3 weeks followed cyclically by Tamoxifen 20 mg daily for 3 weeks. Overall response rates of 15 and 43% were seen with CAF and CAF plus hormonal therapy. Using a multivariate analysis of the results, this difference is significant (P value 0.05). In 8 patients with operable endometrial cancer, negative estrogen receptor concentration (ER less than 15 fmole/mg protein) and Grade 3 disease, the clinical course was aggressive in 4 patients with systemic and local relapse. In 10 other similar patients (negative ER and Grade 3) who received adjuvant cyclical hormonal therapy only 1 relapsed and the other 9 are disease-free for an average of more than 31 months. Sequential cyclical hormonal therapy with ER and progesterone receptor analysis has a place in the management of endometrial carcinoma.

Adenocarcinoma↗

Circadian and ultradian rhythms in blood glucose and plasma insulin of healthy adults.

The circadian and ultradian variations of blood glucose and plasma insulin have been characterized individually and as a group phenomenon in five healthy young adults studied while adhering as closely as possible to their usual routine of sleep, activity, meal content and timing. Three complementary methods were used to analyze the data: displaying raw data as a function of time; cosinor method according to Nelson and Halberg; and time series analyses as proposed by De Prins and Malbecq. The subjects were studied in the laboratory and their life routine were controlled, but very close to that of their habitual routine. They had mainly ultradian rhythms of blood glucose (mainly about 6 hr) and circadian rhythms of immunoreactive insulin (I.R.I.). Blood glucose ultradian rhythms seem to be mainly but not exclusively mealtime dependent, while I.R.I. circadian rhythms appear to be primarily endogenous in origin. Therefore, the role played by insulin in the control of blood glucose levels seems to be programmed on a circadian basis rather than by a time independent feedback phenomenon as postulated by the conventional homeostatic hypothesis. The advantage of this chronophysiologic approach is to consider circadian rhythms of both I.R.I. and insulin effectiveness as an adaptive phenomenon able to maintain blood sugar changes in the ultradian domain of rhythms.

Activity Cycles↗