Ruptured abdominal aortic aneurysms.
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Adult↗
Biomedical subjects
P Martin
Publications and source records attributed to P Martin.
Immobilized phenylboronic acids for the selective extraction of beta-blocking drugs from aqueous solution and plasma.
The use of phenylboronic acid (PBA) solid-phase extraction cartridges for the extraction of a range of beta-blockers from aqueous buffer and plasma has been investigated and compared with other phases commonly used for solid-phase extraction. PBA was found to provide an efficient means for the extraction of this class of compound from simple aqueous buffer systems. Extraction from buffers was pH-dependent and gave optimum results at approximately pH 8. Extraction from plasma was less efficient for some of the test compounds; this matrix effect was probably due to protein binding. Chromatography showed that plasma extracts were free of major sources of interference.
Adrenergic beta-Antagonists↗
Urinary excretion of albumin, alpha-1-microglobulin, and N-acetyl-B-D-glucosaminidase in relation to smoking habits in diabetic and nondiabetic subjects.
Smoking may be a risk factor for the development of diabetic nephropathy. Therefore, the urinary excretion of albumin, alpha-1-microglobulin, and N-acetyl-BD glucosaminidase was studied in 24 young adult diabetic patients who smoked. None of these patients had urine samples positive for albumin as determined by the Albustix method (i.e., a urinary concentration of albumin of less than 0.5 g in 24 hr). Control groups were nonsmoking diabetic patients (matched for age and duration of diabetes) and nondiabetic subjects (smokers and nonsmokers). Expired breath carbon monoxide and the urinary nicotine metabolite cotinine were measured as objective markers of smoking load. No significant differences in concentrations of urinary proteins were found among any of the four groups. Therefore, smoking is not associated with the development of an increased urinary excretion of albumin within the "microalbuminuria" range. However, further studies are required to determine whether smoking is a risk factor for the progression of established microalbuminuria to Albustix positive proteinuria in diabetic patients.
Adult↗
[Psychotropic drugs induced weight gain: a review of the literature concerning epidemiological data, mechanisms and management].
Weight gain is associated with the use of many psychotropic medications, including antidepressants, mood stabilizers, antipsychotic drugs, and may have serious long term consequences: it can increase health risks, specifically from overweight (BMI = 25-29.9 kg/m2) to obesity (BMI > or =30 kg/m2), according to Body Mass Index (BMI), and the morbidity associated therewith in a substantial part of patients (hypertension, coronary heart desease, ischemic stroke, impaired glucose tolerance, diabetes mellitus, dyslipidemia, respiratory problems, osteoarthritis, cancer); according to patients, psychosocial consequences such as a sense of demoralization, physical discomfort and being the target of substantial social stigma are so intolerable that they may discontinue the treatment even if it is effective. The paper reviews actual epidemiological data concerning drug induced weight gain and associated health problems in psychiatric patients : there is a high risk of overweight, obesity, impaired glucose tolerance, diabetes mellitus, premature death, in patients with schizophrenia or bipolar disorder; and the effects of specific drugs on body weight: Tricyclic Antidepressants (TCA) induced weight gain correlated positively with dosage and duration of treatment, more pronounced with amitriptyline ; Selective Serotonin Reuptake Inhibitors (SSRI) decrease transiently bodyweight during the first few weeks of treatment and may then increase bodyweight; weight gain appears to be most prominent with some mood stabilizers (lithium, valproate); atypical antipsychotics tend to cause more weight gain than conventional ones and weight gain, diabetes, dyslipidemia, seem to be most severe with clozapine and olanzapine. Conceming the underlying mechanisms of drug induced weight gain, medications might interfere with central nervous functions regulating energy balance; patients report about: increase of appetite for sweet and fatty foods or "food craving" (antidepressants, mood stabilizers, antipsychotic drugs) and weight gain despite reduced appetite which can be explained by an altered resting metabolic rate (TCA, SSRI, Monoaminoxidase Inhibitors MAO I). According to current concepts, appetite and feeding are regulated by a complex of neurotransmitters, neuromodulators, cytokines and hormones interacting with the hypothalamus, including the leptin and the tumor necrosis factor system. The pharmacologic mechanisms underlying weight gain are presently poorly understood: maybe the different activities at some receptor systems may induce it, but also genetic predisposition. Understanding of the metabolic consequences of psychotropic drugs (weight gain, diabetes, dyslipidemia) is essential: the insulin-like effect of lithium is known; treatment with antipsychotic medications increases the risk of impaired glucose tolerance and diabetes mellitus. Several management options of weight gain are available from choosing or switching to another drug, dietary advices, increasing physical activities, behavioural treatment, but the best approach seems to attempt to prevent the weight gain : patients beginning maintenance therapy should be informed of that risk, and nutritional assessment and counselling should be a routine part of treatment management, associated with monitoring of weight, BMI, blood pressure, biological parameters (baseline and three months monitoring of fasting glucose level, fasting cholesterol and triglyceride levels, glycosylated haemoglobin). Psychiatrics must pay attention to concomitant medications and individual factors underlying overweight and obesity. Weight gain has been described since the discovery and the use of the firstpsychotropic drugs, but seems to intensify with especially some of the second generation antipsychotic medications ; understanding of the side effects of psychotropic drugs, including their metabolic consequences (weight gain, diabetes, dyslipidemia) is essential for the psychiatrics to avoid on the one hand a risk of lack of compliance, a discontinuation of the pharmacological medication and also a risk of relapse and rehospitalization, and on the other hand to avoid acute life threatening events (diabetic ketoacidocetosis and non ketotic hyperosmolar coma, long term risk complications of diabetes and overweight).
Body Mass Index↗
[A new patient focused scale for measuring quality of life in schizophrenic patients: the Schizophrenia Quality of Life Scale (SOL)].
UNLABELLED: RATIONALE/OBJECTIVE: Quality of Life (QOL) has been recognized as an important measure of the outcome of patients by clinicians and policy makers in Mental Health. The emerging consensus in the health field that personal values and the patient's preferences are important in monitoring the quality of medical care outcomes makes it even more important to assess the patient's perspectives. Unfortunately, there is little consensus about what constitutes QOL or how to measure it, particularly in psychotic patients. The objective of this study is to report the stages of development and validation of a QOL questionnaire based on issues pertinent to patients with schizophrenia. METHOD: During a first phase, identical pattern were identified among interviews (conducted by psychologists) of schizophrenic patients (DSM IV, n = 100), mental health staff (n = 20) and families (n = 20). The data gathered in the first phase were discussed and organized, by 25 experts, into a structure that made up the skeleton of the scale (133 items, 17 factors). Based on a prospective epidemiological study conducted with 337 French psychiatrists, a validation analysis of structural and psychometric proprieties was performed. Finally reliability of the scale was assessed by a second test/retest (D0, D7) study (n = 100). RESULTS: A total of 686 schizophrenic, schizophreniform or schizoaffective patients (DSM IV) were included. Internal consistency analysis identified 14 factors (74 items), all with a Cronbach's alpha of at least 0.75: professional life (0.95), affective and sexual life (0.92), illness knowledge (0.90), relationship (0.92), life satisfaction, (0.87), coping with drugs (0.79), drugs impact on the body (0.87), daily life (0.83), family relationship (0.81), future (0.88), security feeling (0.84), leisure (0.87), money management (0.76) and autonomy (0.75). Construct validity was confirmed (Pearson test) using established clinical (Brief Psychiatry Rating Scale and Clinical Global Improvement), social (Psychological Aptitude Rating Scale) and generic quality of life (Functional Status questionnaire) measures, correlation coefficient was significant for all factors but 2 in the BPRS (illness knowledge and coping with drugs) and 3 in the CGI (illness knowledge, coping with drugs and life satisfaction). Lastly, test/retest indicated high reliability for each factor (p < 0.001), the lower correlation coefficient (r) was 0.526. CONCLUSIONS: The Schizophrenia Quality Of Life-scale (SOL), based on a patient's point of view approach, is an efficient, multidimensional instrument designed for the measurement of the consequences of schizophrenia on individuals' lives.
Adolescent↗
Factors determining outcome of liver transplantation for hepatocellular carcinoma associated with hepatitis C cirrhosis.
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Adult↗
Causes of graft loss following liver transplantation for chronic hepatitis C.
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Graft Rejection↗
[Unusual hemolytic-uremic syndrome in an adult].
A 44-year old woman presented with haemolytic-uraemic syndrome due to predominantly arteriolar microangiopathy, with anuria lasting 48 days. The semeiology in this case was unusual: there was no anaemia and only rare schizocytes on admission, blood pressure was normal and anuria was prolonged. The severity of arteriolar thrombosis observed at renal biopsy stood in sharp contrast with the lack of arterial hypertension and the almost total recovery of renal function within three months.
Adult↗
[Malignant hyperthermia during alcohol withdrawal].
Heat shock is the consequence of malignant hyperthermia triggered by general anaesthesia, the use of neuroleptic drugs, or strenuous muscular exercise. Chronic alcoholism could be a contributing factor by facilitating the triggering of malignant hyperthermia. We describe two cases of malignant hyperthermia which occurred during the summer in undernourished chronic alcoholics showing withdrawal syndrome during their stay in hospital. General anaesthesia and neuroleptics were excluded as the origin of their malignant hyperthermia, and we looked for new mechanisms to explain the heat shock, other than shivering associated with the withdrawal syndrome or the high temperature of the season. These two patients were considered deficient in thiamine on admission, their plasma pyruvic acid level being sharply increased (185 mumol/l and 304 mumol/l respectively; normal range: 45.6-91.2 mumol/l). This deficiency can lead to disregulation of thermal centres. Other metabolic disorders, frequently observed in alcoholics, could facilitate heat release during withdrawal syndrome shivering. The risk of heat shock during abrupt alcohol withdrawal should not be underestimated.
Adult↗
[Economic aspects of conformal radiotherapy].
The significantly higher human and material costs induced by the development of conformal radiotherapy cannot be ignored. In France, the present criteria for medical reimbursements underestimate the costs related to treatment preparation and evaluation, slowing down the implementation of new equipment and therapeutic practices. To fit the legitimate concerns regarding health cost containment, conformal radiotherapy should be submitted to appropriate economic analyses. These analyses are based on rigorous methods aimed at weighing the actual costs of conformal treatment by the benefits achieved in terms of tumor control, normal tissue complication and the patients' quality of life. The conclusions from the few studies published to date are rather in favour of conformal radiotherapy when compared to alternative therapeutic procedures. These early results need to be confirmed in order to support more rational reimbursement modalities to promote innovative treatments.
Cost Control↗
[Stereotactic radiotherapy: nomenclature of acts].
Acts of neurosurgery, neuroradiology and radiation therapy are not always identified in the French "nomenclature générale des actes professionnels" (NGAP) (general nomenclature of professional acts). Project of a new "nomenclature commune des actes professionnels" (NCAP) (communal nomenclature of professional acts) is described and discussed.
Magnetic Resonance Imaging↗
Induction of proliferation or transformation of neuroretina cells by the mil and myc viral oncogenes.
The genome of the avian retrovirus MH2 contains, in addition to the v-myc oncogene shared with three other avian retroviruses (MC29, CMII and OK-10), a second cell-derived oncogene, v-mil (refs 1-3). Like the three other viruses, which contain only v-myc, MH2 induces mainly liver and kidney carcinomas in fowl and transforms fibroblasts and macrophages in vitro. However, MH2 and MC29 differ in their biological properties when assayed on cultures of chicken embryo neuroretina (NR) cells. Indeed, NR cells, which normally do not multiply in vitro, are induced to proliferate and become transformed upon infection with MH2, whereas infection with MC29 has no apparent effect on these cells. To analyse the functions of the two oncogenes of MH2, we isolated spontaneous and in vitro-constructed mutants of this virus and investigated their effects on NR cell multiplication and transformation. We report here that expression of v-mil is sufficient to induce NR cell proliferation, although it does not result in cell transformation. In addition, viruses expressing only the v-myc oncogene fail to induce any detectable change in NR cells. However, cooperation of the two oncogenes is required to achieve transformation of NR cells by MH2.
Animals↗
Messenger RNAs encoding lipoprotein lipase, fatty acid synthase and hormone-sensitive lipase in the adipose tissue of underfed-refed ewes and cows.
The mechanisms involved in the nutritional regulation of genes encoding lipogenic (lipoprotein lipase (LPL) and fatty acid synthase (FAS)) and lipolytic (hormone-sensitive lipase (HSL)) enzymes were investigated by comparing the levels of the corresponding mRNAs in the adipose tissue (AT) of underfed or underfed-refed ewes and cows. Refeeding sharply increased LPL and FAS activities (19-25- and 6-8-fold, respectively) and moderately increased (2-4 fold) the activities of glucose-6-phosphate dehydrogenase (G6PDH), malic enzyme (ME) and glycerol-3-phosphate dehydrogenase (G3PDH). Northern blot analysis revealed three LPL transcripts and a single FAS transcript in cow and ewe AT. A single HSL mRNA was detected in cow AT and two transcripts in ewe AT. Refeeding sharply increased LPL and FAS mRNA levels, while restriction slightly increased (cows) or had no effect (ewes) on the HSL mRNA levels. This suggests that nutritional factors regulate sharply the expression of LPL and FAS genes by pretranslational mechanisms, but less clearly that of HSL gene.
Adipose Tissue↗
Effects of photoperiod and feeding level on perirenal adipose tissue metabolic activity and leptin synthesis in the ovariectomized ewe.
Leptin is secreted by adipose tissue and plays a pivotal role in regulating both body energy homeostasis and reproductive function in rodents. Among livestock, sheep is a seasonal breeder whose reproductive period is initiated by short daylength. We show that plasma leptin and leptin gene expression in perirenal adipose tissue were decreased when ovariectomized Lacaune ewes were exposed to short days (8 versus 16 h light/d). This effect of the photoperiod occurred despite the nutritional status, with leptin levels lower in underfed than in refed ewes, and without significant changes in perirenal fat mass and adipocyte size. Plasma prolactin and leptin followed a similar pattern suggesting a relationship between the two hormones. These findings indicate, for the first time, that adipose tissue leptin is modulated by daylength independently of food intake, body fatness and gonadal activity. Furthermore, plasma non-esterified fatty acids of underfed ewes subjected to short days were more elevated than for underfed ewes on long days. On the other hand, refed ewes placed under long daylength tended to have a higher adipose tissue lipogenic activity than refed ewes on short days. We propose that these adaptations of leptin production and lipogenic activity with long photoperiod are of physiological significance for body fat deposition, which naturally occurs during long days when food is abundant. Conversely, a low leptin level during short days may enhance the sensitivity to food deprivation during the natural reproductive season, where any food shortage would decrease plasma leptin under a threshold critical for reproduction. Furthermore, in this situation, the observed enhanced ability to mobilize body fat may be related to the necessity to cope with energy shortage.
Adipose Tissue↗
Mouse lung immune response after acute exposure to flour dust.
To approach the physiopathology of the mucosal immune response in flour-mill and bakery workers, the authors developed a mouse model, which allowed them to study immune responses induced in the deep lung by acute inhalation of flour dust. In situ quantification of T lymphocytes (Thy1-2) and T-cell subsets (CD4 and CD8), macrophages, B lymphocytes, and immunoglobulin A plasma cells in the lungs of all animals revealed significant modifications of these cell compartments as early as 3 d after exposure; within 10 d of exposure, levels returned to baseline. The data suggest that the lung could be a sensitive target for inhaled xenobiotics, which might generate rapid immune local modifications that result in the maintenance of homeostasis.
Administration, Inhalation↗
Psychosocial correlates of subjective health in sexagenarians, octogenarians, and centenarians.
The purpose of this study was to determine if a psychosocial model was a significant improvement over a demographic or a physical health model in predicting subjective health in older adults. Correlates of subjective health in sexagenarians, octogenarians, and centenarians were examined with hierarchical regression analysis. Data were obtained in the first wave of the Georgia Centenarian Study from 1988 to 1992. Psychosocial variables helped explain a significant component of subjective health variance above and beyond the effects of demographic or physical health variables. For centenarians an apprehensive personality and low levels of control over health were additional correlates of poor subjective health. Centenarians were the only cohort to have a unique set of correlates, indicating a uniqueness in the oldest-old, as compared to the young-old and old-old. These findings indicate that a multidimensional perspective of health in older adults is more appropriate than medical models.
Age Factors↗
Cryptococcosis in dogs: a retrospective study of 20 consecutive cases.
The clinical and mycological findings in 20 consecutive cases of cryptococcosis evaluated between 1981 and 1995 were analysed retrospectively. Typically, young adult dogs (median age 2 years) of either sex were affected. Dobermann Pinschers and Great Danes were significantly over-represented in relation to other breeds and crossbred dogs, and there was no trend for cryptococcosis to be acquired at a particular time of year. Cryptococcus neoformans was cultured from 18 dogs, with 16 isolates further characterized. Of these, C. neoformans var. neoformans was isolated from 12 cases, while the remaining four strains were C. neoformans var. gattii. Dogs with C. neoformans var. gattii infections resided in rural (two cases) or suburban (two cases) environments. Ten dogs were presented as a result of infection of structures inside, adjacent to, or contiguous with the nasal cavity. Seven dogs were presented primarily for signs of central nervous system disease, of which at least three also had cryptococcal rhinosinusitis. One dog had cryptococcal pneumonia and also possible mycotic rhinitis, another had disseminated disease with lymph node and skin involvement, while the last dog was presented for vomiting referable to cryptococcal mesenteric lymphadenitis. Treatment consisting of surgery and/or antifungal drug therapy was successful in the majority of animals in which it was attempted, including two of three cases with meningo-encephalitis.
Animals↗
Social and psychological resources in the oldest old.
The purpose of this study was to compare mental health resources, activities of daily living, and social and economic resources in three age groups: centenarians, octogenarians, and sexagenarians. Two hundred and seventy-two older adults were assessed with the Older Americans Resources and Services Survey (OARS). Frequency analyses revealed that centanarians rated lower in social and psychological resources than the other two age groups.
Activities of Daily Living↗