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P Minaire

Publications and source records attributed to P Minaire.

At least 19 recordsLinked to original sources
PubMed1995

[Epidemiology and psycho-social consequences of urinary incontinence].

Previous studies about urinary incontinence epidemiology are disparate. Incontinence affects about 7% of children between 5 and 14, without predominance of sex. Among adults, prevalence is higher for female. In male patients incontinence percentage varies between 1.4% and 2.9% according to the age, with a low increase in prevalence after the age of 40. In female population, the percentage varies between 4 and 57% according to age after 45, and menopause status. The menopause occurrence is not unanimous admitted as causal factor. Obstetrical traumatism, pelvic surgery, child enuresis, postpartum urinary incontinence increase the risk of urinary incontinence. Overall in France, we estimate that 39% of adult women have micturition disorder: 24% with urgency, 25% with pollakiurie and 21% with incontinence. A lot of studies underline that incontinence exists in young nullipara woman. Over the age of 65, prevalence of urinary incontinence is estimated between 14 and 55% (average 30%). Incontinence rate is higher in institution than at home.

Adolescent↗
PubMed1995

Effects of tiludronate on bone loss in paraplegic patients.

Immobilization secondary to spinal cord injury is associated with a marked and rapid atrophy of trabecular bone (disuse osteoporosis). This is due to an early increase of osteoclastic bone resorption associated with a pronounced decreased osteoblastic bone formation. Bisphosphonates are antiosteoclastic compounds and they have been effective in preventing disuse osteoporosis. However, some of them also depress osteoblastic activity and may impair the mineralization process. Tiludronate was shown effective in reducing bone resorption in several metabolic bone diseases without inducing mineralization defects. Twenty paraplegic patients (6 females and 14 males) were randomly assigned to three groups: 6 patients entered the placebo group; 7 patients received tiludronate 200 mg/day; and 7 received 400 mg/day. Histomorphometric analysis was performed on transiliac bone biopsies before and after 3 months treatment. An insignificant decrease of bone volume was observed in the placebo group and the 200 mg group. In patients receiving 400 mg/day, a slight increase was noted. Osteoid parameters changed nonsignificantly in three groups although the 400 mg group exhibited a slight tendency to decrease osteoid volume and thickness. Eroded surfaces increased in all groups. The number of osteoclasts (identified histochemically by TRAP staining) increased in the placebo group but decreased in groups receiving tiludronate. Tiludronate appears effective in reducing bone resorption without impairing bone formation in a manner that preserved bone mass and bone cell coupling.

Adolescent↗
PubMed1995

Cross-sectional study of muscle strength and bone mineral density in a population of 106 women between the ages of 44 and 87 years: relationship with age and menopause.

This study examined the correlations between isokinetic muscle strength of knee and elbow flexors and extensors with vertebral and femoral bone mineral density in a population of 106 women between the ages of 44 and 87 years. The absolute value of muscle strength correlated significantly with bone mineral density; muscle strength of the upper limb appeared to be more closely correlated with bone mass, while muscle strength in the lower limb was more specific for femoral mineral bone density. The most important finding that these results demonstrated was a concomitant decline in muscle strength of the upper limb and bone mineral density between the 5th and 6th decades. In contrast, they also showed a decline in muscle strength of the lower limbs after the 6th decade, occurring before the decline in bone mineral density observed between the 7th and 8th decades. From these results it would appear that other studies are required to examine the relationship between the essentially hormonal role in postmenopausal decline in muscle strength and the decline in physical activity during the senile period. These elements are important because they must be taken into account in physical exercise programmes designed to prevent osteoporosis.

Adult↗
PubMed1992

A comparative study of the muscle strength and mass of the arm flexors and extensors in paraplegic and in non paraplegic basketball players.

OBJECTIVES: to study the changes in the strength of the elbow flexors and extensors in paraplegic subjects, and the agonist/antagonist mass and strength ratio in paraplegic wheelchair users. METHOD: 10 paraplegic wheelchair basketball players were compared with 10 healthy basketball players. The 20 subjects underwent a clinical and dynamometric isokinetic assessment, and a CT scan measurement of the muscle cross-sectional surface area of the flexor and extensor muscles of the elbows. RESULTS: there was an increase in muscle strength in paraplegic subjects. There was no significant difference in the agonist/antagonist ratio between the dominant and non dominant upper limb in paraplegics whereas such a difference was found in healthy subjects. The muscle mass was increased in the paraplegics, but a correlation between muscle mass and strength was only found in the healthy subjects.

Adult↗
PubMed1992

Disease, illness and health: theoretical models of the disablement process.

Handicap is the result of a process of disablement whose origin is a pathological condition (disease). According to some definitions of health (e.g., a state of complete physical, mental and social well-being), the classical biomedical concept is too restrictive to cover all the consequences of disease. New models have been proposed: the impairment-disability-handicap model presented by WHO, the situational handicap model, and the quality-of-life model. A unifying schema of the disablement process includes these concepts and provides a useful way of analysing the consequences of disease. Factors that modify the disablement process can be identified by their respective impacts, and provide operational guidelines for public health interventions.

Disability Evaluation↗
PubMed1992

[The prevalence of female urinary incontinence in general practice].

To determine the prevalence of urinary incontinence, a questionnaire was administered to 2,911 women by 60 general practitioners, in April and May 1989. The first 50 women seen by the physician in his practice were included in the study. 1,075 women out of 2,911 (37%) declared the presence of episodes of incontinence. Among these 1,075 women, 77% had genuine stress incontinence, 60% urge incontinence, 35% spontaneous leakage. One out of five had these three conditions together. 12% of women with incontinence were less than 31 years of age, 36% were between 31 and 51 years, 20% between 51 and 70 years, and 31% above 70 years. Incontinent women were more frequently post-menopausal; 83% had children (74% for those without incontinence), but the parity was comparable in the two groups. Perineal tears, use of forceps for delivery, high-birth-weight children (above 3,500 g) were more frequently found in incontinent women; but not episiotomy. Incontinent women had more urinary infections, were more often obese, were slightly older at their first childbirth. Post-partum incontinence was found more frequently in incontinent women. A positive association is found with the presence of diabetes, neurological diseases, and chronic bronchitis and cough. Incontinent women more frequently underwent a gynecological surgical procedure, particularly hysterectomies. Incontinence had been present for more than 5 years in 34% of cases, one year in 77% of cases. Only 47 women out of 2,911 (1.6%) consulted specifically for their incontinence.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1991

Cortical osteoclasts are less sensitive to etidronate than trabecular osteoclasts.

Acute osteoporosis after spinal cord injury is related to an early increase in osteoclastic resorption. Healthy subjects subjected to bed rest similarly increase their osteoclast number in trabecular bone. Bisphosphonates possess a highly antiosteoclastic activity. The effects of a 120 day bed rest period, with or without etidronate therapy on cortical bone were measured in 15 subjects. Cortical thickness and cortical porosity were measured on transiliac bone biopsies taken before and after the bed rest period. Osteoclasts were detected histochemically and were counted with a semiautomatic image analyzer. Cortical thickness, cortical porosity, and cortical osteoclast number were not significantly modified in subjects submitted to bed rest alone. In the etidronate-treated patients, cortical bone mass parameters were also found to be unaffected, but the most striking feature was that the osteoclast number was unchanged. Trabecular osteoclasts, on the contrary, were increased in the untreated subjects (+95.2%) but decreased in the treated subjects (-78%). Bone cells may have heterogeneous responses according to their trabecular or cortical location. Cortical osteoclasts seem to be unaffected by etidronate therapy.

Adult↗
PubMed1989

Immobilization osteoporosis: a review.

Bone mass is not only subject to systemic hormonal homeostatic mechanisms, but also to local mechanical influences. The importance of the mechanical balance of bone has been more recently stressed by the research on the effect of weightlessness on bone, and by the introduction of the concept of "mechanostat" in the pathogenesis of osteoporotic conditions. Immobilization osteoporosis has clinical (fractures, sometimes hypercalcemia, urinary lithiasis) and radiological features. Immobilization has an effect on bone modeling and remodeling, through an increased activation of remodeling loci, and a decrease of the osteoblastic stimulus. This leads directly to a local reduction in bone mass, the increased activation multiplying the effect of the deficit in bone formation. The prevention is based on exercise if the load is applied intermittently for a daily period. It seems also that muscle weight is an important determinant of bone mass. There is a potential for recovery during the active early phase of immobilization osteoporosis that may disappear in the subsequent late (about six months) inactive phase. Permanent losses could be prevented by appropriate measures, pharmacology or exercises, applied during the first months of immobilization. No recovery has been demonstrated after the inactive phase has been reached, whatever the treatment. The cumulative effect of repeated periods of immobilization remains hypothetical.

Animals↗
PubMed1989

Effects of a bisphosphonate (1-hydroxy ethylidene-1,1 bisphosphonic acid) on osteoclast number during prolonged bed rest in healthy humans.

Acute osteoporosis is known to occur after immobilization in spinal cord injured patients and is related to an early increase in osteoclastic bone resorption. Whether osteoporosis develops in healthy immobilized human patients is still a matter of controversy. Furthermore, acute osteoporosis was thought to be a good model to study the effects of weightlessness on the human skeleton and to adapt preventive procedures. A bed rest experiment was developed in the USSR on 15 healthy human volunteers to determine the precise effects on bone structure and cell activities. A preventive protocol, including an anti-osteoclastic drug (1-hydroxyethylidene-1,1 bisphosphonic acid; K salt) was investigated. Two transiliac bone biopsies were performed on the 15 individuals before and at the end of the 120-day bed rest period. Undecalcified bone biopsies were studied with automatic and semi-automatic image analyzers specially devoted to bone histomorphometry. Trabecular bone volume, osteoid amount, and eroded surfaces were measured. Osteoclast number was measured after histochemical identification of tartrate-resistant acid phosphatase. After the bed rest period, an insignificant bone loss was observed in healthy humans while osteoclast number was highly increased. In bisphosphonate-treated subjects, osteoclast number was markedly reduced and so was osteoid amount. Bisphosphonates were shown to present a highly cytotoxic activity on osteoclasts, a finding that has never been demonstrated in normal subjects.

Adult↗
PubMed1989

[Measurement of handicap in the community: a micro survey in a French village].

Handicap is the result of a process initiated by an underlying disease, an accident or an abnormality, which leads to a functional deficit in various situations of everyday life. This definition, derived from the International Classification of Impairments, Disabilities, and Handicaps (ICIDH), reflects the desire of the elderly and the handicapped for social integration. It may also form the conceptual basis for analysis of the capacities of individuals and populations. To this end, a micro-survey was conducted in a homogeneous village community of 532 people aged 1-92 years. This study was of the ergonomic type, accompanied by a questionnaire on perceived restrictions and handicaps, and carried out transversely over a period of one month (94.7% participation). The specific objectives of the study were to obtain a reliable functional representation of the population of the village, comparing self-assessment of functional capacity with observed performance, and analysing the effects of age on capacity. The copious data collected in the areas of locomotion, prehension and communication have provided a detailed functional profile of the population studied. These data may be transposed to particular environments, such as transport, housing, school or work, and may serve as a basis for comparisons. The difficulties encountered by subjects in the tests were closely correlated with the situations simulated by the tests. Subjective estimation of handicap proved to be reliable in comparison with actual performance, especially for tests of mobility and highly demanding situations. Estimation of the presence of a handicap increased with age. The deterioration in performance observed was proportional to age, but can be perceived to begin early, at about 30-40 years. Disability-free life expectancy (DFLE) could be an interesting indicator in so far as it appears to be sensitive to the confrontation of individual functional capacities with the environment. However, it is important that any disability used as a basis for calculation should be measured with maximum precision. A community survey of this kind is thus particularly useful for ergonomic purposes, but is also valuable for the planning of medical and social assistance at the local level in the areas of disability and handicap. The combination of observation and listening to people, with an interview, appears to be fruitful and reliable. Single studies of well-targeted samples of the population, or, alternatively, of larger and more significant populations, would be desirable in public health, since the epidemiological approach to handicap has hitherto been essentially focused on diagnosis and medical evaluation.

Activities of Daily Living↗
PubMed1987

Effects of weightlessness on bone mass and osteoclast number in pregnant rats after a five-day spaceflight (COSMOS 1514).

Five pregnant growing rats were orbited for 5 days aboard the Soviet COSMOS 1514 biologic satellite. The bone effects of weightlessness were studied and compared to those of five pregnant rats kept in vivarium and five pregnant conditioned rats. Bone histomorphometric studies were performed to investigate the early effects of weightlessness in loaded (tibia-femur) and unloaded (thoracic and lumbar vertebrae) bones. A short exposure to weightlessness does not induce any change in bone mass and inner structure in either type of bone. In unloaded bones, the number of osteoclasts per square millimeter of the trabecular surface significantly increased when measured after histochemical demonstration of tartrate-resistant acid phosphatase. It is likely that a stimulation of bone resorption activity occurs in the trabeculae of unloaded bones during the early phase of a spaceflight. In tibia, osteoid seam thickness and total osteoclastic resorption surfaces at the endosteal level were not modified.

Acid Phosphatase↗
PubMed1987

The functional aptitude of a natural sample of population. A new approach to handicap (Saint Cyr-sur-le-Rhône, Sept. 1984).

A survey of the total population of a small rural village was undertaken to discern the amount of impairment and disability present, using both questionnaire and examination techniques. It was confirmed that the concept of disability was applicable to such populations and that it was related to age, at both extremes of life. There was a good correlation between self-reporting and examination of locomotor and sensory impairments but it was poor when applied to prehensile or dexterity skills. This survey showed that such techniques can be applied to populations. As yet the handicap code in the International Classification of Impairment, Disability and Handicap has not been related to this population but this is seen as an important next step in the proper understanding of chronic disability in the community.

Adolescent↗
PubMed1987

Effects of clodronate on immobilization bone loss.

Clodronate can be used in animals to prevent the effects of immobilization on bone. For this reason we have studied the effects of this agent on immobilisation bone loss in man. We administered clodronate by mouth to 14 paraplegic patients (400 mg/d, n = 7; 1600 mg/day, n = 7), and compared its effect with a placebo (n = 7). Treatment was given for 100 days, 5-29 days after spinal cord injury. Our results suggest that clodronate, given early after immobilization, prevents the acute bone loss observed in immobilization as judged by its effects on serum and urine calcium and hydroxyproline, bone mineral content, trabecular bone volume, and the number of osteoclasts present in bone. No mineralization defect or other side-effects were observed during or after treatment. In addition, a total of 70 patients, with comparable degrees of immobilization, were studied with a variety of antiosteoclastic drugs comprising controls (n = 16), etidronate (n = 20), salmon calcitonin (n = 20) and clodronate 400 mg/d (n = 7) or 1600 mg/d (n = 7). Clodronate, at the dose of 1600 mg/d appeared the most effective drug on bone resorption, together with calcitonin. Unlike calcitonin, clodronate can be administered orally. The mineralisation defects observed during prolonged treatment with etidronate at high doses were not observed with clodronate. We conclude that clodronate 1600 mg/d is a promising agent for the treatment of bone loss and the resorptive hypercalcaemia and hypercalciuria noted in immobilisation.

Animals↗
PubMed1987

Effects of a 120 day period of bed-rest on bone mass and bone cell activities in man: attempts at countermeasure.

The effects of immobilization on bone mass and bone remodeling in patients with spinal cord injuries are known to simulate weightlessness-induced bone changes in astronauts. Nevertheless, immobilization has never been investigated using histomorphometric studies in healthy volunteers. Twenty healthy male volunteers participated in a '120 day bed-rest' experiment in the USSR. Bone biopsy cores of iliac crest were taken before and at the end of the period of bed-rest. The subjects were divided into five groups. Five subjects underwent a normal ambulatory life (control subjects); three subjects were placed on continuous bed-rest for 120 days (complete immobilization); four subjects were immobilized and underwent a controlled training program; four subjects were immobilized and received treatment with potassium diphosphonate (ethane-1,hydroxy-1,diphosphonate 900 mg/day, per os); and four subjects were immobilized and received diphosphonate plus physical exercise. Parameters of bone mass and bone cellular activities (osteoblastic formation and osteoclastic resorption) were measured using automatic and semi-automatic image analysis systems. Bone mass remained constant in each group. Cellular activity measurements showed that in completely immobilized men, the mineralization rate was lower than in controls without change in osteoid parameters; in contrast, osteoclastic parameters were increased. In immobilized men given the training program, bone formation was normal and bone resorption was increased. In immobilized men treated with diphosphonate, osteoid parameters and resorption activity were decreased. In immobilized men with diphosphonate plus training, the osteoid parameters and the resorption activity were reduced but to a lesser degree than in immobilized men with diphosphonate alone. Failure of bone loss in normal immobilized subjects differed from results found in paraplegic patients. However, a decrease in mineralization rate and an increase in bone resorption activity were found in both studies. Exercise stimulated bone resorption and diphosphonate inhibited the osteoclastic activity. These data emphasize the difficulties in finding good models to stimulate spaceflight conditions on earth. Comparative studies must be done using bone biopsies to determine more precisely the effects of weightlessness on the human skeleton.

Adult↗
PubMed1987

[Effects of weightlessness on osseous tissue of the rat after a space flight of 5 days (Cosmos 1514)].

Five pregnant female growing rats have been orbited for five days aboard the Cosmos 1514 soviet biological satellite. They were compared to five female rats kept in vivarium and five female conditioned rats in synchronised way. Histomorphometric studies were performed in order to investigate: 1. The early effects of weightlessness on the bone mass in loading (tibiae and femur) and unloading bones (thoracic and lumbar vertebrae). 2. The changes of osteoblastic and osteoclastic activities. A short exposure does not induce changes in the bone mass and the inner structure of loading and unloading bones. These results fit in well with human data available in the literature: they show that weightlessness doesn't change bone mass in the early phase of a spaceflight. However extrapolation of animal results to men is discussed. In unloading bones (vertebrae) osteoblastic activity was not measurable. Osteoclasts detected by histoenzymologic method don't change as far as their number per mm3 of trabecular bone is concerned. However the number per mm2 of trabecular area increases. It seems likely that an increase of the osteoclastic population occurs in trabecular bone. In loading bones, formation activity (appreciated by the measurement of osteoid seam thickness) and total osteoclastic resorption surfaces were not modified. These results are different from those of longer flights.

Animals↗
PubMed1987

[Quantitative histological study of the bone mass and cellular activity after 120-days decubitus. Trial of preventive protocols].

Bone biopsies of iliac crests, performed at the beginning and the end of a decubitus period of 120 days, were studied in 20 healthy volunteers men. The purpose of this experiment is to simulate the bony alterations of astronauts. The bony mass of all bed-ridden patients remained constant. In strictly immobilized patients, the rate of bony mineralization is decreased and the osteoclastic resorption activity is stimulated. In bed-ridden patients subjected to preventive physical exercises, the bony formation and resorption are increased. When prevention is administered with the use of a diphosphonate, the osteoid and osteoclastic parameters are decreased. When both types of prevention are administered, the osteoid parameters and the resorption activity are decreased but less markedly than in patients treated with diphosphonate alone.

Adult↗