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Biomedical subjects

R François

Publications and source records attributed to R François.

At least 19 recordsLinked to original sources
PubMed1997

Ivermectin in onchocerciasis control in the forest zone of Cote d'Ivoire.

Ivermectin (Mectizan MK-933) is an efficient microfilaricidal drug used for mass treatment by the Onchocerciasis Control Programme (OCP) in the savanna zones of West Africa. Some populations of the forest zone of Côte d'Ivoire have very high microfilarial loads, so it was decided to treat some of these populations with ivermectin, in order to avoid an eventual reinfestation of the protected savanna areas. A pilot campaign was carried out in a small stream catchment area where onchocerciasis transmission is usually high. The whole population was treated orally with ivermectin (200 micrograms/kg of body weight), with the exception of children under 5 years of age, pregnant women and people who were ill. The results showed a very high efficiency of ivermectin in the treatment of onchocerciasis in the forest zone. The prevalence rate of microfilaria dropped from 60.1 to 33.2%. The community microfilarial load was reduced from 29.7 to 5.6 microfilariae per skin snip. To maintain this effect, the authors recommend regular treatment of all new comers into the area.

Adolescent↗
PubMed1991

Autoantibodies and genetic factors associated with the development of type 1 (insulin-dependent) diabetes mellitus in first degree relatives of diabetic patients.

Factors associated with diabetes onset were analysed for their predictive value in 708 first-degree relatives of Type 1 (insulin-dependent) diabetic patients including 374 parents and 308 siblings of Type 1 diabetic patients. Relatives were prospectively followed for 2,304 subject years with blood samples for specific autoantibody evaluation. Islet cell cytoplasmic autoantibody titres were quantified in Juvenile Diabetes Foundation units with a threshold of positivity of 5 units. Insulin autoantibodies were determined using Tyr-A14 iodinated human insulin. HLA typing was performed in 92% of the relatives. During the time of study, 17 of 646 (2.6%) relatives showed islet cell antibodies. During follow-up, eight relatives developed diabetes, including six with high islet cell antibody titre. Taking titres above 20 units increased the positive predictive value from 35% to 75% whereas the presence of insulin autoantibodies did not increase the positive predictive value for the disease. Analysis of metabolic profiles months before the onset of diabetes by either oral or intravenous glucose loads, indicated a considerable level of heterogeneity with relatives with a high islet cell antibody titre who rapidly developed insulin-dependent diabetes, whereas other remained insulin-independent during the same observation period despite comparable titres. This study clearly indicates that initial islet cell antibody titre is not sufficient to predict individual outcome. Follow-up samples are clearly needed to monitor progression of the disease. Few relatives with persistent immunologic positivity progress to clinical Type 1 diabetes, suggesting that non-progressive and sub-clinical Beta-cell dysfunction is common.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[The socio-professional outlook of children and adolescents with diabetes].

Intensive medical education programs started in France in 1950 have allowed French patients with diabetes mellitus to assume responsibility for their own management. Obstacles to school attendance and vocational education have been gradually overcome, in large part as a result of the efforts of non-profit organizations such as Assistance to Young Diabetics. At present, diabetics have nearly equal professional opportunities with normal children. However, some professions, such as "security jobs", remain justifiably prohibited; jobs where previous military service is required also remain out-of-bounds for diabetics, although the grounds for this restriction may be questionable. For other government agencies and private corporations, the decision to accept a subject with diabetes mellitus rests with occupational physicians, who are without doubt better informed now than before. Surveys on the long-term social outcome in subjects with diabetes mellitus since childhood have shown that the distribution of occupations is comparable to that seen in the population at large with, however, a higher prevalence of crafts persons, intellectual occupations and health care professionals.

Adolescent↗
PubMed1990

[Virilizing ovarian tumor in an adolescent].

This clinical case describes a 13 year-old pubertal girl suffering from secondary virilization, amenorrhea, and abdominal mass. Plasma testosterone and androstenedione levels were markedly elevated. Upon surgery, an ovarian tumor containing 5 l of liquid was removed. The histologic examination revealed a macrocystic granulosa cell type tumor of non-juvenile type. After removal of the tumor, which included ipsilateral ovariectomy, the contralateral ovary developed polycystic changes. The role of the tumoral hyperandrogeny in inducing this contralateral polycystic ovary is discussed.

Adolescent↗
PubMed1990

[Study of the dimensions of the penis from birth to adult age and as a function of testicular volume].

Year to year mean +/- 2 standard deviation values of the length and circumference of the penis from birth to 18 years have been determined on a population of white French children and adolescents of European origin. In addition, curves relating the length and the circumference of the penis with the testicular volume are reported. These curves appear to be useful for an appropriate evaluation of the size of the penis in the adolescents where large variations of the pubertal development are observed.

Adolescent↗
PubMed1989

[Hypothalamic dysfunction. 2 cases: the contribution of nuclear magnetic resonance, therapeutic trial of naltrexone].

Two cases of idiopathic hypothalamic dysfunction (one boy and one girl) are reported. Symptoms of hypothalamic dysfunction were noted by the age of 2 years: initial polyphagia and obesity with subsequent anorexia and emaciation were observed in one patient. Thermoregulation and thirst disorders, recurrent accesses of hypernatremia, acrocyanosis and profuse sweating were present. Impaired growth and delayed puberty in one case, and in the other hypogonadism, absence of growth hormone and gonadotrophins release in response to provocative stimuli were observed as well as abnormal thyroid stimulating hormone response to thyrotropin releasing hormone with hyperprolactinemia. Magnetic resonance imaging showed structural lesion in the lateral part of the lentiform nucleus in one case. Treatment with naltrexone, an opiate antagonist, had little if any effect.

Body Height↗
PubMed1988

Dawn phenomenon in type 1 (insulin-dependent) diabetic adolescents: influence of nocturnal growth hormone secretion.

In order to reassess the role of growth hormone in the dawn phenomenon, we studied eight C-peptide negative diabetic adolescents, who are likely to exhibit important nocturnal growth hormone surges. The insulin infusion rate necessary to maintain euglycaemia was predetermined in each patient from 22.00 hours to 01.00 hours, and then kept constant until 08.00 hours resulting in stable free insulin levels. Blood glucose rose from 4.3 +/- 0.7 mmol/l at 01.00 hours to 7.1 +/- 1.1 mmol/l at 08.00 hours (p less than 0.01) secondary to an increased hepatic glucose production. All the subjects presented an important growth hormone secretion, ranging from 20 to 66 ng/ml (peak values) and from 3619 to 8621 ng.min.ml-1 (areas under the curve). The insulin infusion rate selected for each patient was positively correlated with the nocturnal growth hormone secretion (area under the curve) (r = 0.87, p less than 0.01). On the other hand, there was no relationship between the nocturnal growth hormone secretion and the magnitude of the early morning blood glucose rise (r = -0.48, p greater than 0.2). We conclude that, in Type 1 (insulin-dependent) diabetic adolescents, the dawn phenomenon exists but is moderate despite important growth hormone surges; the nocturnal growth hormone secretion influences the nocturnal insulin requirements but not the dawn phenomenon itself, if insulinisation is adequate.

Adolescent↗
PubMed1988

Islet cell and insulin autoantibodies in subjects at high risk for development of type 1 (insulin-dependent) diabetes mellitus: the Lyon family study.

Genetic determination as well as prospective analysis of islet cell autoantibodies and autoantibodies to insulin were conducted in a population of 479 first degree relatives of 174 Type 1 (insulin-dependent) diabetic patients. Analysis of HLA haplotypes within families illustrated the high frequency of DR3 and DR4 alleles with preferential transmission from parent to both affected and unaffected offspring. DR4 was preferentially associated with DQw3.2 (TA10-) in 60/73 (82.2%) patients and 101/127 (79.5%) relatives. Relatives have been followed for a period of 800 subject-years. Twenty-two out of 430 relatives (5.1%) were found islet cell antibodies (ICA-IgG) positive. Seven sera with low titres became negative 6 months later at two different determinations. Fifteen sera ICA-IgG and ICA-protein A positive with high titres remained positive thereafter. Half of the ICA positive relatives were also found insulin autoantibodies (IAA) positive. All but 3 ICA negative relatives did not have IAA in their sera. Analysis of IAA specificity with competition experiments indicated that most antibodies recognised epitopes shared between human and pork insulins while four were specific for human insulin determinants. Analysis of class I and class II HLA antigen distribution indicated no particular allelic restriction in antibody positive individuals. Metabolic status of antibody positive relatives was determined with oral and intravenous charge of glucose. Two haplo-identical DR3-DQw2 brothers became diabetic during the study. One child and one mother both with DR4-DQw3.2 became intolerant to glucose. Each of these relatives had high titre ICA prior to metabolic deterioration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Undescended testis: comparison of two protocols of treatment with human chorionic gonadotropin. Effect on testicular descent and hormonal response.

A randomized study of two protocols of human chorionic gonadotropin (hCG) treatment was performed in 183 prepubertal boys between 7 months and 12 years of age: protocol I, in which the boys were given 7 injections of 1,500 IU every other day, and protocol II consisting of 4 injections of 100 IU/kg at 4- to 5-day intervals. In both protocols, by the end of the test, testosterone had risen significantly to values within the normal adult male range. However, the amplitude of the rise was slightly but significantly lower using protocol II (4.08 +/- 2.07 ng/ml) than protocol I (5.16 +/- 2.73 ng/ml). It would thus appear that repetition of the hCG injection at intervals of less than 4 days is unnecessary, and that a total stimulation period of 2-3 weeks is sufficient. Although not correlated with testosterone levels, the success rates for treatment were similar in both protocols and comparable to rates reported in the literature.

Adolescent↗
PubMed1988

[Dwarfism and delayed puberty in a child with insulin-dependent diabetes mellitus].

A 17-year-old boy who had been treated for insulin-dependent diabetes since age 2, and for coeliac disease since age 6, presented a major growth retardation (-6 SD), a delayed puberty and a hepatomegaly with excessive glycogen storage (Mauriac's syndrome). Improved metabolic control resulted in normal pubertal development and growth catch-up.

Celiac Disease↗
PubMed1987

[Scriver type autosomal hypophosphatemic rachitis: a family case].

A familial observation of hypophosphatemic rickets with unusual inheritance and evolution, different from that of X linked hypophosphatemia, is reported. The mode of inheritance was autosomal dominant, a father and his son being affected. Severe early signs of rickets and delayed growth were present in both cases. Plasma 1,25 dihydroxyvitamin D and PTH levels were normal. There was no hypercalciuria. Complete cure of rickets and catch-up growth were obtained with the only treatment of vitamin D (40,000 U/day) in the father and of 1 alpha hydroxyvitamin D (1 microgram/day) in the son. This observation is quite similar to the 'autosomal hypophosphatemic bone disease' described by Scriver et al. It illustrates the heterogeneity of familial hypophosphatemia which presently includes 4 different physiopathological entities.

Genes, Dominant↗
PubMed1987

[Statural growth of Moghrabin children living in France].

In order to compare the statural growth of French and Maghrebian children living in France, the authors measured the height of 1,243 children aged between one month and 16 years. The study showed no significant difference at any age between the two ethnic groups. It is therefore possible, in daily medical practice, to use the same age charts for French and maghrebian children living in France.

Adolescent↗