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Biomedical subjects

P Valensi

Publications and source records attributed to P Valensi.

155 records · Page 9Linked to original sources
PubMedDate not supplied

A low-salt medical water reduces irritancy of retinoic acid in facial acne.

Although effective medications are available for the treatment of acne, tolerance problems may preclude adequate treatment regimens such as topical retinoic acid, and reduce patient compliance. The present study was conducted to evaluate whether a medical water (Avène) in conjunction with retinoic acid may improve local tolerance in acne. A controlled, open, randomised, multicentric study was completed after 28 days of treatment in 69 acne patients, 34 applying a retinoic acid preparation alone, and 35 applying retinoic acid in association with the water spray used ad libitum. Topical retinoic acid treatment induced prominent signs of irritation in both groups. However, a statistically significant reduction between the two treatment groups could be demonstrated on scaling at all assessment visits (p< or =0.02, Wilcoxon test). No significant water effect on erythema, burning and itching was shown during the treatment period. The overall tolerance assessed by the investigator was significantly improved with the water (p = 0.04, Wilcoxon). Taken together, water with a low mineral content appears to be a promising adjunctive treatment for improving the tolerance of topical retinoids in acne.

Acne Vulgaris↗
PubMedDate not supplied

[Role of vagosympathetic balance in obesity-induced hypertension].

A sympathetic hyperactivity is a common feature in hypertension, type 2 diabetes (T2D), ageing and obesity-induced hypertension. This increase in sympathetic activity may lead to an elevation of arterial rigidity. By contrast, cardiac parasympathetic impairment is observed in these pathologies. Recently we showed in a model of rats with massive obesity (ventromedial hypothalamic lesions) that an enhanced vagal activity may be protective against hypertension. The aim of the present study was to evaluate the influence of an increase in sympathetic activity and a change in vagal activity on arterial rigidity and hypertension in T2D patients. Fourteen hypertensive T2D patients aged 54 +/- 2 years were compared to 22 elderly normotensive subjects (75 +/- 1 years: 11 controls and 11 T2D) and 34 middle aged normotensive subjects (43 +/- 1 years; 17 controls and 17 T2D). Cardiovascular vagosympathetic activity was investigated by spectral analysis of heart rate (HR) and blood pressure (BP) (Finapres) during 6 min at a controlled breathing rate (12 cycles/min). BP and the low frequencies of systolic BP (LF-SBP) were significantly (p<0.01) higher in hypertensive T2D and elderly patients. Pulse pressure (PP) and the high frequencies of HR (HF-HR) were lower in hypertensive T2D patients. PP was positively correlated to LF-SBP (r=0.58; p=0.03) only in hypertensive T2D patients. Diastolic BP was negatively correlated to HF-HR in elderly control subjects (r=-0.63; p=0.03) but not in hypertensive T2D patients. The present results suggest that: sympathetic nervous system activity is enhanced in subjects over 70 years without any aggravating effect of T2D and in middle-aged hypertensive patients with type 2 diabetes; the increase in pulse pressure, an index of arterial rigidity, in elderly subjects may result from sympathetic override; the decrease in the cardiac sympathovagal balance, mainly due to a high vagal activity, may be protective against the occurrence of hypertension in patients with type 2 diabetes.

Age Factors↗
PubMedDate not supplied

[Silent coronary artery disease in diabetic patients. New guidelines].

More than half of diabetic individuals will die from a coronary event. Coronary artery disease often presents an atypical form among diabetic subjects. Silent myocardial ischaemia may be detected in 20 to 35% of diabetic patients with associated cardiovascular risk factors. When a coronarography is performed in patients with silent myocardial ischaemia, it demonstrates significant coronary stenosis in one to two thirds of patients. The prognosis of diabetic patients with silent myocardial ischaemia is associated with a higher incidence of cardiac events in the next three years, especially when silent ischaemia is associated with angiographically coronary stenosis. French guidelines jointly published in 2004 by the ALFEDIAM and the French Society of Cardiology propose the search for silent myocardial ischaemia--in diabetic patients with peripheral arteriopathy or overt nephropathy with proteinuria,--in diabetic patients with microalbuminuria and two other classical cardiovascular risk factors,--in a sedentary diabetic patient who wants to begin a physical activity,--in type I diabetic patients above 45 years or with a disease lasting for more than 15 years and in type 2 diabetic patients above 60 years or with a known disease lasting for more than 10 years, when at least two other traditional cardiovascular risk factors are present. Besides the standard annual electrocardiogram, these high risk patients should benefit first from an exercise test or when the latter is impossible, under-maximal or doubtful, from a myocardial scintigraphy combined with dipyridamole injection or from a stress echocardiography. The demonstration of a silent myocardial ischaemia should lead to a coronarography when the general status of the patient and the absence of severe comorbidities allow considering a coronary revascularisation procedure in these diabetic patients.

Age Factors↗
PubMedDate not supplied

[Insulin analogs in 1991].

Despite multiple injections of soluble insulin, it remains impossible to perfectly simulate physiological post-prandial plasma insulin profile. Moreover, crystal suspensions of very long-acting insulin show wide variations in the kinetics of crystal dissolving and therefore in biological activity. These data have lead to the development of insulin analogues, either very rapid-acting or long-acting, in order to avoid these disadvantages. This study focuses on the in vitro characteristics, the biological effects in animals, and the clinical effects in healthy subjects and in diabetic patients of the analogues having therapeutic potential.

Amino Acid Sequence↗
PubMedDate not supplied

[Diabetes and hemorheology].

Diabetes is associated with several types of rheological abnormalities: 1. macrorheological ones, consisting of increased whole blood viscosity and plasma viscosity; 2. microrheological ones, consisting of a change in erythrocyte deformability, an increase in erythrocyte aggregation and in their adhesiveness to endothelial cells. Microrheological abnormalities in the leukocytes and platelets are associated with these changes and may precede them. Certain of these abnormalities are particularly observed in diabetics with macro and/or microangiopathy and may contribute to a reduction in tissular oxygenation and to the vascular complications of diabetes. The precise mechanisms remain to be clarified as well as the part played by the hypertension often found in diabetes.

Blood Viscosity↗
PubMedDate not supplied

[Beliefs in diabetics about the etiology of their disease. Influence of ethnicity].

The education of diabetics often affects the patient's life-style and habits, and the beliefs of his socio-professional and socio-cultural environment. The patient's knowledge is often satisfactory, while his behavior is inadequate. In this study, a sociologist conducted a semi-structured interview for 40 non-obese diabetic patients: 35 IDD and 5 NIDD, who had a knowledge/behavior gap. Emphasis was placed on the study of their subjective etiological beliefs. Four categories beliefs were found: stress, heredity, food and drink transgression, and fatality. Stress, which can lead to deresponsabilization, was the most frequently mentioned etiology (24 patients). Europeans cited several etiological beliefs. North-Africans, in contrast, cited only one, either stress or fatality, but never heredity or food and drink transgression, probably because genetics and genealogy are not superimposable realities and because of their belief in the symbolic benefits of sugar. In conclusion, the patient's etiological beliefs may contribute to the knowledge/behavior gap. Correct information about a more rational etiology for diabetes could improve patient compliance.

Attitude to Health↗
PubMedDate not supplied

Capillary filtration and lymphatic resorption in diabetes. Application to the pharmacodynamic activity of Daflon 500 mg.

Microcirculatory disorders are often a complication of diabetes. They are associated with an increased capillary permeability which can be assessed by the Landis test using 99mTc-labelled albumin. Labelled albumin retention is measured by external detection (residual radioactivity after removal of venous tourniquet). The Fast Fourier Transform of the radioactivity disappearance graph reflects the lymphatic albumin resorption. Thirteen out-patients with diabetes from 1 to 19 years suffering from evident microcirculatory disorders were treated with a micronized flavonoid fraction: Daflon 500 mg (2 tablets per day) during a month. Antihypertensive and/or antidiabetic treatment were continued during the study if they were given before starting. A test was performed before, and at the end of the treatment. In 10 of the 13 patients, the test was carried out a third time 5.5 +/- 1.0 months later, after treatment withdrawal. Results were as follows: 1) labelled albumin retention was abnormal (greater than or equal to 8%) at the start and became normal in the patients and improved in 1 patient. After treatment withdrawal, the results of the third test were again abnormal, in the patients who had been normalized beforehand; 2) the initially abnormal lymphatic resorption became normal in six of the 13 patients at the end of the treatment and became abnormal again in all patients after treatment withdrawal. In a parallel group of 15 patients with abnormal test lymphatic fluctuations and not being treated with a vasculo-protector agent, the initially abnormal test remained abnormal 5 to 48 months later in all patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Changes in capillary permeability in diabetic patients.

Microangiopathic disorders, characterized by capillary vasodilation and increases in capillary blood flow and permeability, are common in diabetes and can occur before the development of microangiopathic complications. In a study of 163 diabetic patients, capillary permeability, measured by albumin retention (AR), was increased in 39% of patients. AR was increased more frequently in women than in men, and in patients without microangiopathic complications than in patients with complications. Increased AR was significantly associated with insulin-dependent diabetes in male patients. Lymphatic function was abnormal in 72% of patients; this abnormality was often present before AR increased. The pathophysiology of microangiopathy is complex and involves metabolic, haemodynamic, neurological and hormonal factors. Improved control of glycaemia and blood pressure can reduce capillary permeability. In addition, studies with a flavonoid fraction and n-3 polyunsaturated fatty acids suggest that these agents may also be beneficial.

Capillary Permeability↗