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Gauthier H, Zedet M, Wahab A, Baldé S, Bapst B, Lafont C, Créange A. Metabolic syndrome and the phenotype of multiple sclerosis. Rev Neurol (Paris) 2024:S0035-3787(24)00502-2. [PMID: 38729781 DOI: 10.1016/j.neurol.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Comorbidities, particularly vascular comorbidities, have been shown to exacerbate the progression of disability in multiple sclerosis (MS). Metabolic syndrome (MetS) is a cluster of conditions including abdominal obesity, insulin resistance, atherogenic dyslipidemia, and vascular dysfunction, which contribute to vascular morbidity and chronic inflammation. OBJECTIVE To describe the characteristics of MetS in a cohort of MS patients and evaluate its relationship with the MS phenotype. METHODS A monocentric cohort study was conducted on MS patients, collecting demographic, clinical, radiological, and therapeutic data, as well as metabolic data including waist circumference, blood pressure, serum triglycerides, high-density lipoprotein cholesterol, and fasting blood glucose. RESULTS Among the 84 patients included in the study, 27% were diagnosed with MetS. MetS was found to be associated with secondary progressive MS (SPMS). Patients with SPMS had a higher prevalence of MetS compared to those with relapsing-remitting MS (RRMS), even after adjusting for disease duration. While MetS was associated with Expanded Disability Status Scale (EDSS) progression in the 3-year period according to univariate analysis, it did not show a significant association with disease activity. CONCLUSION This study provides evidence supporting the connection between MetS and the progression of disability in MS, independent of disease relapse activity.
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Affiliation(s)
- H Gauthier
- Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France
| | - M Zedet
- Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France; EA4391, université Paris-Est, Créteil, France
| | - A Wahab
- Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France; EA4391, université Paris-Est, Créteil, France
| | - S Baldé
- CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France
| | - B Bapst
- EA4391, université Paris-Est, Créteil, France; Service de neuroradiologie, hôpital Henri-Mondor, AP-HP, Créteil, France
| | - C Lafont
- IMRB, Inserm, université Paris-Est-Créteil, 94010 Créteil, France; Service de santé publique, hôpital Henri-Mondor, AP-HP, 94010 Créteil, France
| | - A Créange
- Service de neurologie, hôpital Henri-Mondor, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; CRC SEP Grand-Paris-Est, hôpital Henri-Mondor, AP-HP, Créteil, France; EA4391, université Paris-Est, Créteil, France.
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Miran C, Bonnet É, Lafont C, Baseilhac P, Clippe S, El Hedi Zouai M, Langrand-Escure J, Bosset M, Fleury B, Guy JB. Plexite radique : épidémiologie, diagnostic, facteurs de risque et prise en charge. Cancer Radiother 2023. [DOI: 10.1016/j.canrad.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Halimi F, Sabouret P, Huberman JP, Cohen S, Ouazana L, Hoffman O, Assouline S, Guedj-Meynier D, Schwartz J, Weiss P, Lafont C, Lellouche N. Atrial fibrillation diagnosis by a systematic 14-day continuous ECG-Holter in patients with high cardiovascular risk and clinical palpitation: the prospective AFTER study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial Fibrillation (AF) is asymptomatic in 20–30% of cases. New technologic tools for continuous ECG monitoring have been developed to detect and potentially treat AF in specific population with high cardiovascular risk.
Purpose
We aimed to evaluate the prevalence and the management of AF diagnosed in patients with no previous documented AF but with a high cardiovascular risk and clinical palpitation undergoing systematic 14-day continuous ECG-Holter monitoring and associated characteristics.
Methods
Patients were prospectively enrolled from December 2019 to December 2021 in this multicentered study, sponsored by the French National College of Cardiology. Patients needed to meet the following criteria: CHA2DS2VASc score ≥3 in women >2 in men associated with clinical palpitation without previous documented arrhythmia, particularly AF. Exclusion criteria were: previous documented AF, participation to another study that could interfere with the current study, pregnancy, previous skin intolerance to ECG-Holter electrodes. Included patients underwent a 14-day monitoring Holter-ECG to detect cardiac arrhythmia, particularly AF. Patients' characteristics, type of arrythmias and management of detected AF were described.
Results
Among the 336 included patients, 39% were men, median age was 73 [64.5–78] years, 71.5% had hypertension and 46.5% had a previous history of stroke. AF was detected in 14% of patients, among which 23.4% in the first 24 hours monitoring. In univariate analyses, older age (p=0.045) was significantly associated with AF, and a trend was observed regarding male gender (p=0.067) and less antiplatelet therapy (p=0.058). Patients with diagnosed AF had a prescription of anticoagulation therapy in 90% of cases consisting in apixaban and rivaroxaban for 72% and 28% respectively. Antiarrhythmic drugs were administered in 90% of AF patients and 13% underwent AF ablation.
Conclusions
The systematic AF screening of selected patients based on CHA2DS2VASc score ≥3 in women >2 in men associated with palpitations allows to diagnose AF in 14% of the population with a 14-day continuous ECG-Holter. This strategy seems efficient as it induced the prescription of anticoagulation and antiarrhythmic therapy in 90% of individuals.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): NATIONAL COLLEGE OF FRENCH CARDIOLOGISTS
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Affiliation(s)
- F Halimi
- Private Hopital of Parly II, Rythmology , Le Chesnay , France
| | - P Sabouret
- Hospital Pitie-Salpetriere , Paris , France
| | - J P Huberman
- National College of French Cardiologists, Cardiology , Paris , France
| | - S Cohen
- National College of French Cardiologists, Cardiology , Paris , France
| | - L Ouazana
- National College of French Cardiologists, Cardiology , Paris , France
| | - O Hoffman
- National College of French Cardiologists, Cardiology , Paris , France
| | - S Assouline
- National College of French Cardiologists, Cardiology , Paris , France
| | - D Guedj-Meynier
- National College of French Cardiologists, Cardiology , Paris , France
| | - J Schwartz
- National College of French Cardiologists, Cardiology , Paris , France
| | - P Weiss
- National College of French Cardiologists, Cardiology , Paris , France
| | - C Lafont
- University Hospital Henri Mondor, Public Health , Creteil , France
| | - N Lellouche
- University Hospital Henri Mondor, Rythmology Department , Creteil , France
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Halimi F, Sabouret P, Huberman JP, Ouazana L, Guedj D, Djouadi K, Dhanjal TS, Goette A, Lafont C, Lellouche N. Atrial fibrillation detection with long-term continuous Holter ECG recording in patients with high cardiovascular risk and clinical palpitations: the prospective after study. Clin Res Cardiol 2022:10.1007/s00392-022-02109-9. [PMID: 36169720 DOI: 10.1007/s00392-022-02109-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022]
Abstract
AIM New technologic tools for continuous ECG monitoring have been developed to detect and treat atrial fibrillation (AF) in specific populations with high cardiovascular risk. We evaluated the prevalence and the management of AF diagnosed in patients with high cardiovascular risk and non-documented clinical palpitation undergoing systematic 14-day continuous ECG-Holter monitoring. METHODS Patients were prospectively enrolled from December 2019 to December 2021 in this multicentre study, sponsored by the French National College of Cardiology. Patients met the following criteria: CHA2DS2VASc score ≥ 2 in males and ≥ 3 in females and clinical palpitations without previously documented arrhythmia. Enrolled patients underwent a continuous 14-day Holter-ECG monitoring for arrhythmia detection. RESULTS Among the 336 included patients, 39% were male, 75% were greater than 65 years of age and 46.5% had suffered a prior stroke. AF was detected in 14% of patients, among which 23.4% were detected in the first 24 h of monitoring. Finally, age ≥ 65 years (p = 0.037) was significantly associated with AF, as well as male gender (p = 0.023) and a lower rate of antiplatelet therapy (p = 0.018). Patients with diagnosed AF had a prescription of anticoagulation therapy in 90%. Antiarrhythmic drugs were administered in 90% of AF patients and 13% underwent AF ablation. CONCLUSIONS The systematic AF screening of patients with palpitations and high cardiovascular risk resulted in a diagnostic yield of AF in 14% of the population with a 14-day continuous ECG-Holter monitor. This strategy resulted in the prescription of anticoagulation and antiarrhythmic therapy in 90% of the AF detected population.
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Affiliation(s)
- F Halimi
- Hôpital Privé, Parly 2, 21 rue Moxouris, 78150, Le Chesnay, France
| | - P Sabouret
- Department of Cardiology, AP-HP, University Hospital Pitié-Salpétrière, Creteil, France
| | - J P Huberman
- French College of Cardiology, 75014, Paris, France
| | - L Ouazana
- French College of Cardiology, 75014, Paris, France
| | - D Guedj
- French College of Cardiology, 75014, Paris, France
| | - K Djouadi
- Department of Cardiology, AP-HP, University Hospital Henri Mondor, 51, Avenue du Maréchal de Lattre de Tassigny, 94000, Creteil, France
| | - T S Dhanjal
- Department of Cardiac Electrophysiology, University of Warwick, Gibbet Hill, Coventry, UK
| | - A Goette
- Department of Cardiac Electrophysiology, St Vincenz Kliniken, Paderborn, Germany
| | - C Lafont
- Univ Paris Est Creteil, INSERM, IMRB, 94010, Creteil, France.,Service de Santé Publique, AP-HP, Hôpital Henri-Mondor, 94010, Créteil, France
| | - Nicolas Lellouche
- Department of Cardiology, AP-HP, University Hospital Henri Mondor, 51, Avenue du Maréchal de Lattre de Tassigny, 94000, Creteil, France.
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Lafont C, Paillaud E, Bertolus C, Baron M, Caillet P, Bouvard E, Laurent M, Salvan D, Chaumette L, De Decker Lemarcis L, Piot B, Barry B, Raynaud-Simon A, Sauvaget E, Minard A, Anota A, Panjo H, Brugel L, Canouï-Poitrine F. 657MO Effectiveness of geriatric assessment-driven interventions on quality of life for 2 years in older patients with head and neck cancer: Results from the EGeSOR trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Pouchelon C, Lafont C, Lafarge A, comont T, Riviere E, Boutboul D, Dossier A, Hamidou M, Graveleau J, Bonnard G, Audia S, Gobert D, Ruivard M, Vaidie J, Godeau B, Michel M. Caractéristiques et évolution des patients adultes atteints d’anémie hémolytique auto-immune sévère admis en réanimation : résultats d’une étude française observationnelle multicentrique. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Engels C, Ségaux L, Lafont C, Canouï-Poitrine F. Older adults’ daily activities during lockdown in France, spring 2020: a cross sectional survey. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The 2020 COVID-19 pandemic prompted many countries to go into lockdown for varying periods. The French population was limited to 1km around their house, with the need to have a travel declaration when going out. According to the World Federation of Occupational Therapists (2020), “populations around the world have been required to adjust and make compensations to usual routines in order to participate in ongoing or newly acquired activities that are necessary for daily life.” AIMS. In this context, we aimed to describe changes in daily activities, social contacts, and mental health and wellbeing of older adults (i.e. aged 60 or more) living in France.
Methods
We performed an online cross-sectional survey, based on the Canadian Occupational Performance Measure (COPM) for restriction of and satisfaction with daily activities, and the Cantril's ladder for mental health and wellbeing. RESULTS. Of the 512 respondents, 9% did not feel restricted at all in their daily activities, and 13% reported no change. About one third (31%) reported to have less diverse activities than usual but to be satisfied with it. Regarding social contacts, 72% of the respondents reported to have a lot more contacts than usual with their relatives. Concerning the type of activities, 2477 restricted activities could be identified, but also 2190 that were done more often during the lockdown. Most restricted ones concerned leisure (83%), especially active leisure, the most mentioned being walking. The more engaged activities also concerned leisure (73%), especially quiet recreation, the most mentioned reading. The median value of Cantril's ladder was 5 [4;7].
Conclusions
Lockdown measures led to some activity restrictions for older adults, but also offered opportunities for new engagements. Remarkably was the increase in social contacts with relatives, probably related to the use of new technologies.
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Affiliation(s)
- C Engels
- INSERM, University Paris Est Créteil, Créteil, France
- Faculty of Health, University Paris Est Créteil, Créteil, France
| | - L Ségaux
- INSERM, University Paris Est Créteil, Créteil, France
- Public Health Service, Henri Mondor Hospital, Créteil, France
| | - C Lafont
- INSERM, University Paris Est Créteil, Créteil, France
- Public Health Service, Henri Mondor Hospital, Créteil, France
| | - F Canouï-Poitrine
- INSERM, University Paris Est Créteil, Créteil, France
- Public Health Service, Henri Mondor Hospital, Créteil, France
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Tavassoli N, Piau A, Berbon C, De Kerimel J, Lafont C, De Souto Barreto P, Guyonnet S, Takeda C, Carrie I, Angioni D, Paris F, Mathieu C, Ousset P, Balardy L, Voisin T, Sourdet S, Delrieu J, Bezombes V, Pons-Pretre V, Andrieu S, Nourhashemi F, Rolland Y, Soto M, Beard J, Sumi Y, Araujo Carvalho I, Vellas B. Framework Implementation of the INSPIRE ICOPE-CARE program in collaboration with the World Health Organization (WHO) in the Occitania region. J Frailty Aging 2020; 10:103-109. [DOI: 10.14283/jfa.2020.26] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: Limiting the number of dependent older people in coming years will be a major economic and human challenge. In response, the World Health Organization (WHO) has developed the «Integrated Care for Older People (ICOPE)» approach. The aim of the ICOPE program is to enable as many people as possible to age in good health. To reach this objective, the WHO proposes to follow the trajectory of an individual’s intrinsic capacity, which is the composite of all their physical and mental capacities and comprised of multiple domains including mobility, cognition, vitality / nutrition, psychological state, vision, hearing. Objective: The main objective of the INSPIRE ICOPE-CARE program is to implement, in clinical practice at a large scale, the WHO ICOPE program in the Occitania region, in France, to promote healthy aging and maintain the autonomy of seniors using digital medicine. Method: The target population is independent seniors aged 60 years and over. To follow this population, the 6 domains of intrinsic capacity are systematically monitored with pre-established tools proposed by WHO especially STEP 1 which has been adapted in digital form to make remote and large-scale monitoring possible. Two tools were developed: the ICOPE MONITOR, an application, and the BOTFRAIL, a conversational robot. Both are connected to the Gerontopole frailty database. STEP 1 is performed every 4-6 months by professionals or seniors themselves. If a deterioration in one or more domains of intrinsic capacity is identified, an alert is generated by an algorithm which allows health professionals to quickly intervene. The operational implementation of the INSPIRE ICOPE-CARE program in Occitania is done by the network of Territorial Teams of Aging and Prevention of Dependency (ETVPD) which have more than 2,200 members composed of professionals in the medical, medico-social and social sectors. Targeted actions have started to deploy the use of STEP 1 by healthcare professionals (physicians, nurses, pharmacists,…) or different institutions like French National old age insurance fund (CNAV), complementary pension funds (CEDIP), Departmental Council of Haute Garonne, etc. Perspective: The INSPIRE ICOPE-CARE program draws significantly on numeric tools, e-health and digital medicine to facilitate communication and coordination between professionals and seniors. It seeks to screen and monitor 200,000 older people in Occitania region within 3 to 5 years and promote preventive actions. The French Presidential Plan Grand Age aims to largely implement the WHO ICOPE program in France following the experience of the INSPIRE ICOPE-CARE program in Occitania.
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de Kerimel J, Tavassoli N, Lafont C, Soto M, Pedra M, Nourhashemi F, Lagourdette C, Bouchon L, Chaléon A, Sourdet S, Rolland Y, Cesari M, Vellas B. How to Manage Frail Older Adults in the Community? Proposal of a Health Promotion Program Experienced in a City of 16,638 Inhabitants in France. J Frailty Aging 2019; 7:120-126. [PMID: 29741197 DOI: 10.14283/jfa.2017.47] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Health promotion programs could prevent and delay frailty and functional decline. However, in practice, the planning and establishment of such a program is a challenge for health care providers. We report an experimental model of screening and management for frail elderly conducted in Cugnaux, city of 16,638 inhabitants in France, by the Toulouse Gerontopole and the social care service of the Cugnaux City Hall. METHODS A frailty screening self-administered questionnaire (FiND questionnaire) was sent to community-dwelling residents of 70 years old and over of Cugnaux. The completed questionnaires were analyzed and the subjects were classed into three groups: robust, frail, mobility disability, based on their score. Frail subjects and those with mobility disability invited to undergo a frailty assessment in the premises of the town hall realized by a nurse in order to identify the causes of their frailty and propose them a personalized intervention plan (PIP). RESULTS The FiND questionnaire was sent to the residents of Cugnaux of 70 years old and over (n=2,003). After two mailings, 860 (42.9%) completed questionnaires were received. Mean age of the responders was 79.0 ± 6.2 years and 59.6% women (n= 511). According to the questionnaires analysis, 393 (45.7%) were robust, 212 (24.6%) frail, 240 (27.9%) had a mobility disability and 15 (1.7%) could not be classified due to missing data. 589 (68.5%) subjects accepted to be contacted by the Gerontopole nurse. The assessment by the nurse was proposed to frail subjects and those with mobility disability (n=313). Until 31 December 2016, 136 patients have been evaluated. The mean age was 80.1±5.4 and most patients were women (69.9%). The mean ADL score was 5.8±0.5 and the IADL showed a mean score of 6.9±1.7. According to Fried definition of frailty, 76 patients (55.9%) were pre-frail, and 35 (25.7%) frail. Concerning the frailty domains identified, 75 patients (55.1%) showed the alteration of physical performance, 70 (51.5%) thymic disorders and 46 (33.8%) sensory disorders. Preventive interventions proposed in the PIP were mostly physical interventions (86.8%, n=118) followed by cognitive (61.8%, n=84) and nutritional (39.7%, n=54) interventions. DISCUSSION This project shows the feasibility to implement a care model in the community. It permitted a large identification of frail elderly people in the city population, insuring their assessment and clinical follow up to maintain their capacities and referring them to social services.
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Affiliation(s)
- J de Kerimel
- Justine de Kerimel, E-mail address: , Postal address : La Cité de la Santé - Gérontopôle de Toulouse - Équipe Régionale Vieillissement et Prévention de la Dépendance 20 rue du Pont Saint Pierre - TSA 60033 - 31059 Toulouse Cedex 9 - France, Phone number: 05 61 77 70 12 Fax number: 05 61 77 64 75
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Cazejust J, Lafont C, Raynal M, Azizi L, Tourabi AC, Menu Y. Internal hernia through the omental foramen. Answer to the e-quid "Epigastric pain with sudden onset". Diagn Interv Imaging 2014; 94:663-6. [PMID: 23731500 DOI: 10.1016/j.diii.2012.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- J Cazejust
- Department of Radiology, Hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
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Cazejust J, Lafont C, Raynal M, Azizi L, Tourabi A, Menu Y. Epigastric pain with sudden onset. Diagn Interv Imaging 2013. [DOI: 10.1016/j.diii.2012.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lafont C, Castex A. Dressings. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lafont C, Castex A. Les pansements. Ann Phys Rehabil Med 2012. [DOI: 10.1016/j.rehab.2012.07.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Le Tissier PR, Hodson DJ, Lafont C, Fontanaud P, Schaeffer M, Mollard P. Anterior pituitary cell networks. Front Neuroendocrinol 2012; 33:252-66. [PMID: 22981652 DOI: 10.1016/j.yfrne.2012.08.002] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 08/17/2012] [Accepted: 08/18/2012] [Indexed: 12/17/2022]
Abstract
Both endocrine and non-endocrine cells of the pituitary gland are organized into structural and functional networks which are formed during embryonic development but which may be modified throughout life. Structural mapping of the various endocrine cell types has highlighted the existence of distinct network motifs and relationships with the vasculature which may relate to temporal differences in their output. Functional characterization of the network activity of growth hormone and prolactin cells has revealed a role for cell organization in gene regulation, the plasticity of pituitary hormone output and remarkably the ability to memorize altered demand. As such, the description of these endocrine cell networks alters the concept of the pituitary from a gland which simply responds to external regulation to that of an oscillator which may memorize information and constantly adapt its coordinated networks' responses to the flow of hypothalamic inputs.
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Affiliation(s)
- P R Le Tissier
- Division of Molecular Neuroendocrinology, MRC National Institute for Medical Research, The Ridgeway, Mill Hill, London NW7 1AA, United Kingdom;
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Abstract
BACKGROUND Hospitalization is the first cause of functional decline in the elderly: 30 to 60% of elderly patients lose some independence in basic activities of daily living (ADL) during a stay in hospital. This loss of independence results from the acute condition that led to admission, but is also related to the mode of management. OBJECTIVE This paper is a review of the literature on functional decline in elderly hospitalized patients. It is the first stage in a project aiming to prevent dependence that is induced during the course of care. METHODS During a 2-day workshop in Monaco, a task force of 20 international experts discussed and defined the concept of "iatrogenic disability". RESULTS 1- "Iatrogenic disability" was defined by the task force as the avoidable dependence which often occurs during the course of care. It involves three components that interact and have a cumulative effect: a) the patient's pre-existing frailty, b) the severity of the disorder that led to the patient's admission, and lastly c) the hospital structure and the process of care. 2- The prevention of "iatrogenic disability" involves successive stages. - becoming aware that hospitalization may induce dependence. Epidemiological studies have identified at-risk populations by the use of composite scores (HARP, ISAR, SHERPA, COMPRI, etc). - considering that functional decline is not a fatality. Quality references have already been defined. Interventions to prevent dependence in targeted populations have been set up: simple geriatric consultation teams, single-factor interventions (aimed for example at mobility, delirium, iatrogenic disorders) or multidomain interventions (such as GEM and ACE units, HELP, Fast Track, NICHE). These interventions are essentially centered on the patient's frailty and have limited results, as they take little account of the way the institution functions, which is not aimed at prevention of functional decline. The process of care reveals shortcomings: lack of geriatric knowledge, inadequate evaluation and management of functional status. The group suggests that interventions must not only identify at-risk patients so that they may benefit from specialized management, but they must also target the hospital structure and the process of care. This requires a graded "quality approach" and rethinking of the organization of the hospital around the elderly person.
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Affiliation(s)
- C Lafont
- Gérontopôle, Department of Geriatric Medicine, CHU Toulouse, France
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Capron J, Lafont C, Grateau G, Steichen O. Diagnostic non invasif d’une tuberculose péritonéale. Rev Med Interne 2010; 31:e10-1. [DOI: 10.1016/j.revmed.2009.10.441] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2009] [Revised: 09/14/2009] [Accepted: 10/03/2009] [Indexed: 11/25/2022]
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Bazot M, Lafont C, Roussel A, Jarboui L, Nassar-Slaba J, Thomassin-Naggara I. Caractérisation tissulaire IRM du pelvis féminin. ACTA ACUST UNITED AC 2010; 91:453-64. [DOI: 10.1016/s0221-0363(10)70060-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Molinier F, Laffosse JM, Tricoire JL, Lafont C, Dubrana F, Chauveaux D, Levai JP, Leclercq S, Laffargue P, Deroche P, Laroche M, Charrier J, Puget J. [Wich total hip prosthesis for patients older than 75 years?]. Rev Chir Orthop Reparatrice Appar Mot 2008; 94 Suppl:S211-S214. [PMID: 18928817 DOI: 10.1016/j.rco.2008.07.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- F Molinier
- CHU de Rangueil, avenue Jean-Poulhes, TSA 5032, 31059 Toulouse cedex 09, France
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Benoit M, Arbus C, Blanchard F, Camus V, Cerase V, Clement JP, Fremont P, Guerin O, Hazif Thomas C, Jeanblanc F, Lafont C, Moreaud O, Pedra M, Poncet M, Richard Harston S, Rigaud AS, Sotto Martin ME, Touchon J, Vellas B, Fitten LJ, Robert PH. Professional consensus on the treatment of agitation, aggressive behaviour, oppositional behaviour and psychotic disturbances in dementia. J Nutr Health Aging 2006; 10:410-5. [PMID: 17066213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- M Benoit
- CM2R, CHU de Nice, Nice, France.
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Soubeyrand M, Oberlin C, Dumontier C, Belkheyar Z, Lafont C, Degeorges R. Ligamentoplasty of the forearm interosseous membrane using the semitendinosus tendon: anatomical study and surgical procedure. Surg Radiol Anat 2006; 28:300-7. [PMID: 16474924 DOI: 10.1007/s00276-006-0086-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Accepted: 01/16/2006] [Indexed: 11/25/2022]
Abstract
Total longitudinal disruptions of the interosseous membrane can allow proximal radius migration and are seen in Essex-Lopresti lesions. We propose an original technique of ligamentoplasty using the semitendinosus tendon. The graft corresponds to the forearm rotation axis for an optimized isometry and longitudinal stabilization. Our ligamentoplasty technique was performed on ten fresh frozen right forearms. We successively assessed the innocuousness, efficiency and resistance of the ligamentoplasty. The ligamentoplasty induced neither passive limitation of pronation-supination nor neurovascular lesions. It prevented from radius proximal migration. The mean load to failure was 28 kg at both ulnar and radial sides of the graft. Our technique is original for the type and position of the graft. It seems safe, efficient and resistant enough for in vivo procedures. This technique decreases longitudinal loads on the radius. It should be indicated in patients with Essex-Lopresti syndrome, in association with radial head internal fixation or arthroplasty.
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Affiliation(s)
- M Soubeyrand
- Service d'Orthopédie et Traumatologie, Hôpital Bichat Claude Bernard, 46, rue Henri Huchard, 75018, Paris, France
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Gaultier E, Bonnafous L, Bougrat L, Lafont C, Pageat P. Comparison of the efficacy of a synthetic dog-appeasing pheromone with clomipramine for the treatment of separation-related disorders in dogs. Vet Rec 2005; 156:533-8. [PMID: 15849342 DOI: 10.1136/vr.156.17.533] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Sixty-seven dogs that showed signs of distress when separated from their owners (destructiveness, excessive vocalisation and house soiling) and hyperattachment were used in a randomised, blind trial to assess the potential value of a dog-appeasing pheromone in reducing the unacceptable behaviours. For ethical reasons, there was no placebo group and the effects of the pheromone were compared with the effects of clomipramine which is regularly used to treat this type of problem. The undesirable behaviours decreased in both groups, but the overall assessment by the owners indicated that there was no significant difference between the two treatments, although there were fewer undesirable events in the dogs treated with the pheromone, and the administration of the pheromone appeared to be more convenient.
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Affiliation(s)
- E Gaultier
- Phérosynthèse, Le Rieu Neuf, 84490, Saint-Saturin-les-Apt, France
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Paillard T, Lafont C, Pérès C, Costes-Salon MC, Soulat JM, Montoya R, Dupui P. L’électrostimulation surimposée à la contraction musculaire volontaire présente-t-elle un intérêt physiologique chez les sujets âgés ? ACTA ACUST UNITED AC 2005; 48:20-8. [PMID: 15664680 DOI: 10.1016/j.annrmp.2004.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2004] [Accepted: 08/02/2004] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyze the physiological effects of electrical stimulation with voluntary muscle contraction exercise in postmenopausal women. MATERIALS AND METHODS Thirty-two females aged 62 to 75 years were randomly assigned to three groups to perform four activity sessions for six weeks: group ME (N =11) climbed up and down stairs, group ES (N =11) practised electrostimulation, and group ME + ES (N = 10) undertook both activities. Physiological adaptations of body composition (lean and fat masses and bone mineral density), muscular strength (isometric and dynamic), vertical jump and posturokinetic activities (balance and gait) were analysed. RESULTS For the three groups, the isometric strength at angle 100 degrees (average increase right and left legs, ME: 19 N.m; ES: 4.5 N.m; ME + ES: 11.5 N.m), the dynamic strength at speed 60 degrees.s(-1) (average increase right and left leg, ME: 15 N.m; ES: 14 N.m; ME+ES: 18.5 N.m) and the vertical jump (ME: 23 mm; ES: 16 mm; ME + ES: 34 mm) increased contrary in the body composition and posturokinetic activities. Nevertheless, the group ME + ES adapted differently on some parameters of bone mineral density (P < 0.05) and dynamic strength (P < 0.01) in relation to the groups ES and ME. CONCLUSION Electrostimulation with voluntary muscle contraction exercise could induce different physiologic adaptations compared with electrostimulation or voluntary muscle contraction exercise alone.
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Affiliation(s)
- T Paillard
- Unité d'évaluation de l'équilibre et de la marche, service gérontologie Casselardit, CHU de Purpan, 31500 Toulouse cedex, France.
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Paillard T, Lafont C, Costes-Salon MC, Rivière D, Dupui P. Effects of brisk walking on static and dynamic balance, locomotion, body composition, and aerobic capacity in ageing healthy active men. Int J Sports Med 2005; 25:539-46. [PMID: 15459836 DOI: 10.1055/s-2004-820948] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This work analyses the short-term physiological and neurophysiological effects of a brisk walking programme in ageing, healthy, active men. Twenty-one men 63 to 72 years of age were recruited and separated into 2 groups. One group performed a walking programme (WP) (n = 11) and another served as control (C) group (n = 10). The walking programme lasted for twelve weeks and included five sessions per week. Several parameters were assessed before and after the programme for the WP group. The same tests were performed (separated by twelve weeks) in group C. During each assessment, the subjects were put through static and dynamic balance tests, spatio-temporal gait analysis, body composition measurements and determination of aerobic capacity and bone mineral density. The statistic analysis showed a significant improvement in dynamic balance performance, especially in lateral sway when the subjects kept their eyes open, an increase of VO(2) max and loss of fat mass in the WP group. However, no alterations appeared in spatiotemporal gait characteristics, static balance performance, lean mass or bone mineral density (total body and hip). According to these results, this walking programme may have positive effects on preventing ageing subjects from falling.
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Affiliation(s)
- T Paillard
- Department of Physiology, School of Medicine, 31062 Toulouse, France.
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Paillard T, Lafont C, Soulat JM, Costes-Salon MC, Mario B, Montoya R, Dupui P. Neuromuscular effects of three training methods in ageing women. J Sports Med Phys Fitness 2004; 44:87-91. [PMID: 15181395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
AIM The present study aimed to compare the effects of 3 strength development methods on muscular mass and muscular strength in healthy ageing women. METHODS Thirty-two healthy women, 62 to 75 years old were randomised into 3 groups. The 3 groups performed 4 sessions a week of strength development for 6 weeks. The 1(st) group (SC) climbed up and down 300 stairs per session. The 2(nd) group (ES) followed an electrostimulation programme on the quadriceps muscles. The 3(rd) group (SC+ES) combined stair climbing with electrostimulation. Before and after the 3 programmes, the muscular mass of the leg was assessed using a biphotonic absorptiometry machine. Isometric (angle 20 degrees and 100 degrees ) and isokinetic (60 degrees /s and 240 degrees /s) knee extension torque was measured using an isokinetic dynamometer. RESULTS None of the programmes changed the muscular mass. All 3 groups increased isometric (angle 20 degrees, p<0.001; angle 100 degrees, p<0.003) and isokinetic (60 degrees /s, p<0.0001; 240 degrees /s, p<0.0001) knee extension torque. None of the programmes appeared more efficient than the others for muscular mass or muscular strength. CONCLUSION Six weeks of activity (SC, ES or SC+ES) improved the isometric and dynamic muscular strength in ageing healthy women. However, this period was too short to change the muscular mass. None of the activities presented a real advantage over the others in ageing women.
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Affiliation(s)
- T Paillard
- Department of Physiology, School of Medicine, Rangueil University Hospital, Toulouse, France
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Paillard T, Lafont C, Costes-Salon MC, Dupui P. Comparison between three strength development methods on body composition in healthy elderly women. J Nutr Health Aging 2003; 7:117-9. [PMID: 12679832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The effects of three strength development methods (during 6 weeks) were assessed on the body composition in 32 women, 62 to 75 years old and randomised in 3 groups. The first group (SC) has climbed and come down 300 stairs per session. The second group (ES) followed an electrostimulation programme on quadriceps muscles. The third group (SC+ES) has combined the stairs climbing with electrostimulation. Body composition and bone mineral density (BMD) was assessed using Absorptiometry machine before and after the programmes. None of the programmes has increased significantly BMD. Nevertheless, the SC+ES group BMD enhanced more on the trochanter (p<0,05) and the two legs (p<0,05) than the SC and ES groups BMD (interaction group/time). The combined activity (SC+ES) would deserve to be tested on a longer period.
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Affiliation(s)
- T Paillard
- Department of Medical Physiology, School of Medicine, Toulouse, France.
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Paillard T, Lafont C, Costes-Salon MC, Dupui P, Riviere D, Vellas B. Cholesterol reduction and increased cardiovascular fitness following a 12 weeks brisk walking. J Nutr Health Aging 2002; 6:138-40. [PMID: 12166369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The effects of a walking training programme were assesed on 10 healthy, active men aged 63-69 years. Serum lipids, pulse and blood pressure, maximum oxygen consumption (VO2 max) and anthropometric parameters, were measured before and after this programme. There was a significant fall in LDL (p<0.02) and mean diastolic BP (p<0.005). In spite of the subjects's initial good level of fitness there was still an 8% rise in the mean VO2 max of the group. There was also a significant loss of body fat (P<0.01). These positive physiological effects suggest that brisk walking can be considered as a a useful activity for improving the fitness and general health in this age-range.
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Affiliation(s)
- T Paillard
- Department of Gerontology and Internal Medicine, Purpan University Hospital, Toulouse, France.
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Abstract
The aim of this work was to study the posturokinetic capacities and use of visual information by judoists according to their level of competition. Twenty male judoists aged between 16 and 19 took part. They were separated into two groups: those that competed at regional level and those that competed at national and international level. Static balance was measured on a force platform. No difference was seen between the two groups. However, it seems that visual information is more important to the higher level judoists. Perhaps the level of competition influences the sensory canals involved in balance.
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Affiliation(s)
- T Paillard
- Faculté de Médecine, Laboratoire de Physiologie, 133 route de Narbonne, 31062 Toulouse cedex 4, France.
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Paillard T, Costes-Salon M, Lafont C, Dupui P. Activités posturo-cinétiques et chutes du judoka. Sci Sports 2002. [DOI: 10.1016/s0765-1597(02)00138-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rolland Y, Rival L, Pillard F, Lafont C, Rivére D, Albaréde J, Vellas B. Feasibility [corrected] of regular physical exercise for patients with moderate to severe Alzheimer disease. J Nutr Health Aging 2001; 4:109-13. [PMID: 10842423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND Physical activity delays loss of autonomy in the elderly. In patients with Alzheimer disease (AD), physical activity could be a useful strategy in therapeutic management by delaying loss of functional independence and the usual complications of the disease. OBJECTIVE To determine, using standardized tools, the effects on autonomy (ADL, IADL), cognitive function (MMS), nutritional status (MNA), behavioral problems (NPI) and risk of falls (Tinetti test) of a physical exercise program in patients with AD. DESIGN Twenty-three subjects (13 men and 10 women, aged 71-92 years, mean 78 years) with AD (mean MMS 16, range 1-23) carried out for a mean of 7 weeks (5-12 weeks) a program of endurance exercise (walking, exercise bicycle) adapted to their individual capacities. Standardized gerontological evaluation was performed before and after the study. RESULTS No significant change in autonomy (ADL, IADL) was observed. There was an improvement in the MNA (p<0.001) and the MMS (p<0.001). Risk of falls (p<0.01) and behavioral problems (p<0.05) decreased. These results were obtained without increasing family workload. CONCLUSION We suggest that physical activity is a therapeutic option which can reduce nutritional and behavioral complications and risk of falls in subjects with AD.
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Affiliation(s)
- Y Rolland
- Service de &Mgrave;decine du Sport et d'Exploration Fonctionnelle Respiratoire, CHU Purpan, 31059 Toulouse Cedex, France
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Vellas B, Gillette-Guyonnet S, Nourhashémi F, Rolland Y, Lauque S, Ousset PJ, Moulias S, Andrieu S, Fontan B, Adoue D, Lafont C, Baumgartner R, Garry P, Albarède JL. [Falls, frailty and osteoporosis in the elderly: a public health problem]. Rev Med Interne 2000; 21:608-13. [PMID: 10942977 DOI: 10.1016/s0248-8663(00)80006-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Elderly people can be subdivided into three groups: healthy elderly persons (65-70% of the population), elderly subjects with diseases (about 5%) and frail old people. Frailty represents "age-related physiologic vulnerability resulting from impaired homeotasic stock and a reduced capacity of the organism to withstand stress". It could lead elderly subjects to pathological, barely reversible, ageing. CURRENT KNOWLEDGE AND KEY POINTS One of the main objective of geriatricians is to develop useful screening tools to identify people at high risk, thus allowing them to benefit from preventive interventions as early as possible. It has been suggested that the decline in homeostatic stock involves numerous physiological systems. Those at the core of frailty would be neuromuscular changes resulting in sarcopenia, neuroendocrine dysregulation, and immune disorders. A recent study has shown that increased levels of interleukin 6 is a risk factor for frailty. FUTURE PROSPECTS AND PROJECTS Work in progress aimed at identification of at-risk patients should: lead to early detection; draw attention on underestimated fields such as the nutritional status, sarcopenia, or gait disorders; promote the development of the standardized gerontological evaluation in order to identify the different components of frailty; and promote the development of non-pharmacological programmes including physical training, nutritional managing, and optimal social life.
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Affiliation(s)
- B Vellas
- Service de médecine interne et gérontologie clinique, hôpital Purpan-Casselardit, CHU, Toulouse, France
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Vellas B, Gillette-Guyonnet S, Nourhashemi F, Rolland Y, Lauque S, Ousset PJ, Moulias S, Andrieu S, Lafont C, Adoue D, Baumgartner RJ, Garry PJ, Albarède JL. [Falls, fragility and osteoporosis in elderly persons: a public health problem]. Rev Med Interne 2000; 20 Suppl 6:527S-528S. [PMID: 10645563 DOI: 10.1016/s0248-8663(00)87542-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- B Vellas
- Service de médecine interne et gérontologie clinique, CHU Purpan-Casselardit, Toulouse, France
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Abstract
The role of the interaction between actin and the secondary actin binding site of myosin (segment 565-579 of rabbit skeletal muscle myosin, referred to as loop 3 in this work) has been studied with proteolytically generated smooth and skeletal muscle myosin subfragment 1 and recombinant Dictyostelium discoideum myosin II motor domain constructs. Carbodiimide-induced cross-linking between filamentous actin and myosin loop 3 took place only with the motor domain of skeletal muscle myosin and not with those of smooth muscle or D. discoideum myosin II. Chimeric constructs of the D. discoideum myosin motor domain containing loop 3 of either human skeletal muscle or nonmuscle myosin were generated. Significant actin cross-linking to the loop 3 region was obtained only with the skeletal muscle chimera both in the rigor and in the weak binding states, i.e., in the absence and in the presence of ATP analogues. Thrombin degradation of the cross-linked products was used to confirm the cross-linking site of myosin loop 3 within the actin segment 1-28. The skeletal muscle and nonmuscle myosin chimera showed a 4-6-fold increase in their actin dissociation constant, due to a significant increase in the rate for actin dissociation (k(-)(A)) with no significant change in the rate for actin binding (k(+A)). The actin-activated ATPase activity was not affected by the substitutions in the chimeric constructs. These results suggest that actin interaction with the secondary actin binding site of myosin is specific for the loop 3 sequence of striated muscle myosin isoforms but is apparently not essential either for the formation of a high affinity actin-myosin interface or for the modulation of actomyosin ATPase activity.
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Affiliation(s)
- J Van Dijk
- Centre de Recherche de Biochimie Macromoléculaire du Centre National de la Recherche Scientifique, Institut Féderatif de Recherche 24, Montpellier, France
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Dupond AS, Lacour JP, Lafont C, Ortonne JP. [Prevalence of hepatitis C virus in oral erosive lichen]. Ann Dermatol Venereol 1998; 125:676-8. [PMID: 9835954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE An increased prevalence of hepatitis C virus (HCV)-related hepatitis has been reported in patients with lichen planus. The aim of our retrospective study was to determine whether there is a relationship between the erosive form of oral lichen planus and HCV. PATIENTS AND METHODS A retrospective study was conducted in a consecutive sample of 28 patients suffering from oral erosive lichen planus and seen in our department between 1992 and 1996. Anti-HCV antibodies were detected in all cases by third generation recombinant immunoblot assay. PCR was performed to detect HCV RNA in the serum sample from 19 patients. RESULTS Eight patients (29 p. 100) tested positive for HCV antibodies. These results were compared with the rate of HCV chronic carriers which is between 1 and 2 p. 100 in our region (Southern France). Among these 8 patients, 7 had severe chronic liver disease, and 5 of them were actively replicating the virus. DISCUSSION Our results suggest a strong relationship between erosive oral lichen planus and HCV-related chronic hepatitis. We conclude that patients with the erosive form of oral lichen planus should be systematically evaluated for HCV infection.
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Affiliation(s)
- A S Dupond
- Service de Dermatologie, Hôpital Archet-2, Nice
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Vellas B, Lafont C, Adoue D, Albarède JL. Au IIème Congrès Européen de Gérontologie (Madrid, 10 septembre 1991). Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)81299-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Vellas B, Grancher AS, Adoue D, Lafont C, Fontan B, Albarède JL. [Dietary intake recommended for elderly persons]. Presse Med 1992; 21:574-9. [PMID: 1533920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Recommendations for dietary intake in elderly persons must account for wide interindividual variation. We propose different recommendations for: generally self sufficient elderly persons in good health. The recommended dietary intakes are very similar to those for adults, with a few exceptions (reduced calorie intake, the importance of protein and certain vitamins or minerals: vitamins B6, D, C, calcium, zinc ...); patients with an intercurrent disease or an event causing a loss of appetite and a reduction in dietary intake. Recommendations for these subjects should aim at correcting or preventing deficiencies by the use of supplementary and complementary nutritional products; subjects in a state of protein-calorie malnutrition. Recommended dietary intake should take into account the effect of malnutrition on the digestive functions of the pancreas and the intestine in the elderly. Such recommendations must be based on the findings of numerous studies now being carried out and of which we report here the first results.
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Affiliation(s)
- B Vellas
- Service de Médecine interne et Gérontologic, CHU Purpan, Toulouse
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Vellas B, Baumgartner RN, Wayne SJ, Conceicao J, Lafont C, Albarede JL, Garry PJ. Relationship between malnutrition and falls in the elderly. Nutrition 1992; 8:105-8. [PMID: 1591453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Due to the multifactorial nature of falls in the elderly population, it is difficult to determine causal relationships for risk factors for falls. In some cases, other risk factors may play a role. For example, the association between poor nutrition status and falls has not been studied extensively. The association of commonly demonstrated nutritional deficiencies in the elderly with factors such as balance, gait, and mobility may lead to new insights into causes of falls in the elderly not previously established. In this article, we review how malnutrition can be a risk factor for falls, how falls can induce malnutrition, and the possible relationship between mobility and nutrition in the elderly.
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Affiliation(s)
- B Vellas
- Departement de Medecine Interne et Gerontologie Clinique, C.H.U. Purpan Casselardit, Toulouse, France
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Vellas BJ, Balas D, Lafont C, Senegas-Balas F, Albarede JL, Ribet A. Adaptive response of pancreatic and intestinal function to nutritional intake in the aged. J Am Geriatr Soc 1990; 38:254-8. [PMID: 2107244 DOI: 10.1111/j.1532-5415.1990.tb03499.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- B J Vellas
- Department of Geriatric Medicine, CHU Purpan, Toulouse, France
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Blum CJ, Lafont C, Ducasse M, Hoff M, Labarre I, Bayard F, Albarede JL. Thyroid function tests in ageing and their relation to associated nonthyroidal disease. J Endocrinol Invest 1989; 12:307-12. [PMID: 2768758 DOI: 10.1007/bf03349994] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Thyroid function tests of 179 euthyroid geriatric inpatients (83 +/- 6 yr) unaffected by acute diseases or malnutrition were investigated and compared with those of 76 ambulatory healthy younger subjects (42 +/- 13 yr). Elderly population was divided in three groups, respectively: group G I (n = 37, 65-78 yr), group G II (n = 64, 79-85 yr) and group G III (n = 78, over 85 yr). Severity-of-illness index of the patients was evaluated at entry in the study protocol. While total thyroxine (TT4), free triiodothyronine (FT3) and TSH levels remained unchanged, circulating total triiodothyronine (TT3) was significantly lower (113 +/- 32 vs 150 +/- 31 ng/dl, p less than 0.05) and free thyroxine (FT4) was significantly higher (12.4 +/- 2.7 vs 10.3 +/- 2.3 pg/ml, p less than 0.05) in aged people. Furthermore, TT3 decreased significantly from 130 +/- 36 in G I to 110 +/- 33 in G II and to 108 +/- 25 in G III (p less than 0.01), and FT4 increased progressively although not significantly in the same groups. A close correlation was found between TT3 and severity index in male observations only (r = -0.43, p less than 0.01), as well as between FT4 and severity index in both sexes (r = 0.51, p less than 0.001 for men, r = 0.21, p less than 0.01 for women). These data suggest that thyroid function tests have to be cautiously interpreted in a geriatric population, particularly in relation to the severity of the clinical state, and reference values should be determined for TT3 and FT4 in the ageing process.
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Affiliation(s)
- C J Blum
- Département d'Endocrinologie, INSERM U 168, CHU de Rangueil, Université Paul-Sabatier, Toulouse, France
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Kleisbauer JP, Kleisbauer A, Lafont C, Moreno JP. [Value of the use of delayed-action sulfamides in chronic broncho-pulmonary infections (46 cases)]. Mars Med 1970; 107:835-837. [PMID: 5476982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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