303 results on '"Pfitzenmeyer P"'
Search Results
102. Some factors influencing reburrowing activity of soft-shell clam, Mya arenaria
- Author
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Pfitzenmeyer, H. and Drobeck, K.
- Abstract
Abstract: Three size-groups of soft-shell clams,Mya arenaria, averaging 45, 60, and 74 mm in shell length were placed in aquaria and their rate of reburrowing measured. The substrate in each aquarium consisted of sand particles: (I) less than 0.5 mm, (II) 0.5 to 1 mm, (III) 1 to 2 mm, (IV) 2 to 4 mm, and (V) an equal combination of the previous 4 sizes. New specimens were tested at every 5 C rise or fall in ambient water temperature and observations were made periodically for 48 hours. The three variables, water temperature, clam size, and sediment particle size were highly significant (1% level), in influencing clam reburial activities by the end of the second hour through the termination of the experiment 48 hours later. Optimum water temperatures for reburrowing were between 8.8 and 21 C. After 48 hours, 62% of the small, 39% of the medium, and 21% of the large clams had reburrowed in all experimental tests combined. The aquarium with less than 0.5 mm substrate particle size had the greatest percentage of reburrowed clams of each size. As the particle size increased, progressively less reburrowing took place. Most reburrowing took place between 4 and 8 hours after the start of the experiment.
- Published
- 1985
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103. Annual cycle of gametogenesis of the soft-shelled clam, Mya arenaria , at Solomons, Maryland
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Pfitzenmeyer, H.
- Abstract
Abstract: Samples of three year-classes of the soft-shelled clam,Mya arenaria, were dredged at approximately two-week intervals from the mouth of the Patuxent River, Maryland. Changes in gonadal development were noted from histologically prepared sections of male and famale clams. Two separate periods of gametogenesis were noted. More gametes are formed during the autumn or primary period of maturation than during the spring or secondary period. Clams as small as 25 mm in shell length were found to contain mature gametes. Follicle cell inclusions and other cells observed in the gonad are discussed along with their seasonal changes.
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- 1983
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104. Molluscs of the Chesapeake Bay
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Pfitzenmeyer, Hayes
- Published
- 1990
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105. Annual cycle of gametogenesis of the soft-shelled clam, Mya arenaria , at Solomons, Maryland
- Author
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Pfitzenmeyer, H.
- Abstract
Abstract: Samples of three year-classes of the soft-shelled clam,Mya arenaria, were dredged at approximately two-week intervals from the mouth of the Patuxent River, Maryland. Changes in gonadal development were noted from histologically prepared sections of male and famale clams. Two separate periods of gametogenesis were noted. More gametes are formed during the autumn or primary period of maturation than during the spring or secondary period. Clams as small as 25 mm in shell length were found to contain mature gametes. Follicle cell inclusions and other cells observed in the gonad are discussed along with their seasonal changes.
- Published
- 1965
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106. Benthic survey for populations of soft-shelled clams, Mya arenaria , in the lower Potomac River, Maryland
- Author
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Pfitzenmeyer, H. and Drobeck, K.
- Abstract
Abstract: Exploratory sampling of the potential soft-shelled clam bottoms in the Potomac estuary was conducted to define the range and densities of the subtidal populations ofMya arenaria. Bottom samples were taken at depths ranging from 3 to 11 feet with the Maryland hydraulic clam dredge using a 3/8-inch mesh conveyor belt. Clam populations ranged from the mouth of the river to Popes Creek, approximately 40 miles upriver. The more dense populations of over 300 bushels per acre were found between Sandy Point and Swan Point, or 16 to 33 miles from the river mouth. Clam densities were extremely variable in this area, and were related to changes in bottom type and the instability of shoal water bottoms brought about by wind and wave action. Sixteen other benthic macro-invertebrates which were collected in 189 bottom samples are reported along with their relative densities and distribution in the river. The pelecypodsMacoma balthica andM. phenax were the most abundant and widely distributed invertebrates collected by the dredge throughout the sampled area. The number of species declined with the decreasing upriver salinity gradient, indicating the essentially marine elements in the benthic fauna.
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- 1963
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107. Periods of spawning and setting of the soft-shelled clam, Mya arenaria , at Solomons, Maryland
- Author
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Pfitzenmeyer, Hayes
- Abstract
Abstract: A spawning and setting study of the soft-shelled clam under natural conditions was conducted in the lower Patuxent River. Clam larvae and spat samples were taken weekly from the end of a pier in approximately 6 feet of water. Periods of abundance which were correlated with daily surface water temperatures and salinities, indicated two annual periods of spawning and setting. Early umbone larvae first appeared in May when the mean surface temperature was 16.7°C (range 15.0 to 18.5) and a mean salinity of 10.1‰ (range 8.2 to 11.5). The second spawning period began in September or October when temperatures decreased to a mean of 21.7°C (range 19.0 to 24.8) and a salinity of 15.5‰ (range 14.2 to 16.9). Setting usually followed the appearance of larvae by one or two weeks. Examination of the gonad of the soft-shelled clam from Maryland waters revealed that the two peaks of spawning are the result of two separate maturations and not a cessation in spawning due to the high summer temperatures.
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- 1962
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108. Purpura rhumatoïde du sujet âgé : À propos d'un cas
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Popitean, L., Manckoundia, P., Camus, A., Martin-Pfitzenmeyer, I., and Pfitzenmeyer, P.
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- 2006
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109. Acute tubulointerstitial nephritis due to Salmonella typhimurium infection
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Ghiringhelli, F., Manckoundia, P., and Pfitzenmeyer, P.
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- 2004
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110. Validation of the Dementia Quality of Life Instrument (DQoL) in French language,Validation psychométrique du questionnaire Dementia Qualify of Life (DQoL) en langue française
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Schwebel, G., Drame, M., JOLLY Damien, Boyer, F., Morrone, I., Pollina, L. D. I., Aquino, J. -P, Pfitzenmeyer, P., Rouaud, O., George, M. -Y, Ankri, J., Blanchard, F., and Novella, J. -L
111. Amyloïdose pulmonaire de type AA associée à une maladie de Hodgkin
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Pfitzenmeyer, P., primary, Massin, F., additional, Fargeot, P., additional, Bonneau, P., additional, Michiels, R., additional, and Jeannin, L., additional
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- 1988
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112. Tentative outline for inventory of molluscs: Mya arenaria (soft-shell clam)
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Pfitzenmeyer, H.
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- 1990
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113. Notes on the Nudibranch, Elysia chlorotica , from Chesapeake Bay, Maryland
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Pfitzenmeyer, Hayes
- Abstract
Abstract: Nudibranchs,Elysia chlorotica Gould, ranging from 5 mm to 28 mm in length, were identified for the first time at two locations in the Chesapeake Bay. This is a southward extension of its reported former range which was Massachusetts to New Jersey. A brief discussion of ecological data and activity associated with the organisms is presented.
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- 1960
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114. Monoclonal gammopathy of undetermined significance in elderly. About 80 cases
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Pfitzenmeyer, P., Guiguet, M., D'Athis, P., and Maoulida, I.
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- 1995
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115. Percutaneous ethanol injection of parathyroid adenomas in primary hyperparathyroidism.
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Verges, B, Cercueil, J P, Pfitzenmeyer, P, Pascuad, F, Vaillant, G, Brun, J M, and Putelat, R
- Subjects
- *
ADENOMA , *DRUG administration , *ETHANOL , *HYPERPARATHYROIDISM , *INJECTIONS , *PARATHYROID gland tumors , *TRANSDERMAL medication , *ULTRASONICS , *DISEASE complications - Published
- 1991
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116. Mini motor test: a clinical test for rehabilitation of patients showing psychomotor disadaptation syndrome (PDS)
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Mourey F, Camus A, d'Athis P, Blanchon M, Martin-Hunyadi C, de Rekeneire N, and Pfitzenmeyer P
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- 2005
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117. Development of a clinical test of gait in frail elderly by a cognitive approach of locomotion.
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Beauchet, O., Dubost, V., Nevers, A., Stierlam, F., A Blanchon, M., Mourey, F., Pfitzenmeyer, P., and Gonthier, R.
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COGNITIVE therapy , *DISEASES in older people - Abstract
OBJECTIVE: From a cognitive approach of locomotion, we studied the feasibility and the reproducibility of a clinical test of gait which is devoted to predict fall.METHODOLOGY: With a cross-sectional design, we studied the gait of 30 old subjects (average age 82.6±7.1 years). The gait course consisted of a 10m length in a well light room, with regular walking shoes. Two conditions were examined: walking with and without explicit cognitive task (mental arithmetic and verbal flow task). Time (seconds) and number of steps were collected by two operators Deviations and stops were video-taped. Number of figures was recorded with a tape recorder. The difficulty to perform gait conditions was estimated by each subject with a quotation ranging from 0 (easy gait) to 10 (difficult gait).RESULTS: Increases of time, steps, deviations and stops were observed when gait was associated to a cognitive task (6.4 seconds and 4.6 steps with mental arithmetic; 10.5 seconds and 6.7 steps with verbal flow task). All subjects managed this test. These results were reproducible across tests and operators. Walking with mental arithmetic was the most easy gait condition for subjects.CONCLUSIONS: The simplicity and the reproducibility of this test make it as adequate instrument of gait evaluation in geriatrics. Walking with mental arithmetic is the condition that must to be used. Validation of its predictive value for fall in frail elderly subjects remains to be shown. [Copyright &y& Elsevier]
- Published
- 2002
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118. Herpes simplex esophagitis in the immunocompetent subject: a case report.
- Author
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Manckoundia, P., Popitean, L., Mignot, A., Ramanantsoa, M., Lévêque, L., Martin Arveux, I., and Pfitzenmeyer, P.
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- 2004
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119. Aging affects the mental simulation/planning of the “rising from the floor” sequence.
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Saimpont A, Mourey F, Manckoundia P, Pfitzenmeyer P, and Pozzo T
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- 2010
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120. Assessment of the use of hypolipidemic agents (HAs), mainly statins, in elderly subjects aged 80 years and more in Burgundy: analysis of 13,211 patients.
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Manckoundia P, Lorenzini M, Disson-Dautriche A, Petit JM, Lorcerie B, Debost E, Menu D, and Pfitzenmeyer P
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- Adrenergic beta-Antagonists therapeutic use, Aged, 80 and over, Cardiovascular Agents therapeutic use, Coronary Artery Disease drug therapy, Diabetes Mellitus drug therapy, Drug Prescriptions, Female, Fibric Acids therapeutic use, France, Humans, Hypertension drug therapy, Male, Peripheral Arterial Disease drug therapy, Platelet Aggregation Inhibitors therapeutic use, Polypharmacy, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypolipidemic Agents therapeutic use
- Abstract
Only few studies have investigated the use of HA in elderly subjects and there are no data in very elderly subjects. We assessed the prescription of HA and analyzed the relationship between such prescriptions and frailty markers among persons aged 80 and more in an observational study. We recorded the prescriptions for 13,211 patients aged 80-109 years and affiliated to the "Mutualité-Sociale-Agricole (MSA)" of Burgundy over a 1-month period. The prescription of a HA among all included patients, and the existence of serious long-term disease(s) (LTD), polypharmacy or a prescription of cardiovascular drugs among patients receiving a HA were recorder. Among the 13,211 patients, 3412 aged 80-98 years were treated with an HA. The main HA were statins (70.4%), and fibrates were used in 27.3% of cases. Of these 3412 patients, 2250 had one or several LTD mainly coronaropathy, hypertension, diabetes mellitus or peripheral artery disease. The mean number of drugs per prescription was 6.37. Among subjects treated with HA, 40% also received antiplatelets, 35.6% β-blockers and 30% inhibitors of the renin-angiotensin system. For 99% of the patients, the prescription of HA was a renewal. Prescribers were mainly general practitioners (96.8%). Statins are the most widely prescribed HA even among very elderly subjects. However, after 80 years the prescription of HA, mainly statins, decreases with aging. This could be explained by polypathology, polypharmacy and the deterioration in metabolic functions which are markers of frailty. This study should encourage research into the use of statins in very elderly subjects., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)
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- 2012
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121. Factors associated with caregivers' underestimation of quality of life in patients with Alzheimer's disease.
- Author
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Zhao H, Novella JL, Dramé M, Mahmoudi R, Barbe C, di Pollina L, Aquino JP, Pfitzenmeyer P, Rouaud O, George MY, Ankri J, Blanchard F, and Jolly D
- Subjects
- Activities of Daily Living, Aged, Aged, 80 and over, Alzheimer Disease epidemiology, Alzheimer Disease psychology, Cognition physiology, Comorbidity, Cost of Illness, Data Interpretation, Statistical, Depression complications, Depression psychology, Educational Status, Female, France epidemiology, Humans, Male, Neuropsychological Tests, Sex Factors, Alzheimer Disease therapy, Caregivers psychology, Quality of Life
- Abstract
Objective: The aim of this study was to identify the factors associated with differences between how Alzheimer's disease (AD) patients and their caregivers rate the patient's health-related quality of life (QoL)., Methods: Cross-sectional, multicentre study. Patients were 65 years or more, suffering from mild to moderate AD, native French speakers, with a main caregiver. Interrater agreement of the QoL-AD was assessed using the intraclass coefficient. A generalised linear model was used to identify factors related to the difference in health-related QoL scores between patients and their caregivers., Results: The 122 patients of the study were 82 ± 6 years old and mainly women (69%). Independent factors related to the difference between patients and caregivers were: Mini Mental State Exam score (β = 0.32; 95% CI = 0.05-0.59); instrumental activities of daily living score (β = -0.61; 95% CI = -1.14 to -0.07); total Neuropsychiatric Inventory score (β = 0.10; 95% CI = 0.05-0.59), and Zarit's burden score (β = 0.09; 95% CI = 0.01-0.17)., Conclusion: Practitioners must take into account the trend towards underestimation when health-related QoL is rated by caregivers or proxies., (Copyright © 2012 S. Karger AG, Basel.)
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- 2012
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122. [Geriatric investigation in front of a balance disorders in the older elderly].
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Manckoundia P, Mourey F, and Pfitzenmeyer P
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- Aged, Humans, Geriatric Assessment, Postural Balance, Sensation Disorders diagnosis
- Published
- 2011
123. A case of meningitis due to Achromobacter xylosoxidans denitrificans 60 years after a cranial trauma.
- Author
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Manckoundia P, Mazen E, Coste AS, Somana S, Marilier S, Duez JM, Camus A, Popitean L, Bador J, and Pfitzenmeyer P
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- Aged, 80 and over, Humans, Male, Achromobacter denitrificans physiology, Meningitis microbiology, Skull pathology, Wounds and Injuries pathology
- Abstract
Background: Achromobacter xylosoxidans (AX) is a non-fermentative aerobic gram-negative bacillus. It is an opportunistic pathogen and the causative agent of various infections. We report an original case of late posttraumatic meningitis due to AX denitrificans., Case Report: An 83-year-old man was hospitalized for acute headache, nausea and vomiting. The emergency brain computer tomography (CT) scan did not reveal any anomaly. In his medical history, there was an auditory injury due to a cranial trauma incurred in a skiing accident 60 years earlier. Cytobiochemical analysis of the cerebrospinal fluid (CSF) revealed increased levels of neutrophils and proteins. The CSF bacterial culture was positive: the Gram stain showed a gram-negative bacillus, oxidase + and catalase +, and the biochemical pattern using the API 20 NE strip revealed AX dentrificans. Late posttraumatic meningitis on a possible osteomeningeal breach was diagnosed even though the breach was not confirmed because the patient declined a second brain CT scan. The patient was successfully treated with meropenem., Conclusions: This report demonstrates the importance of searching for unusual or atypical organisms when the clinician encounters meningitis in a particular context, as well as the importance of adequate follow-up of craniofacial traumas.
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- 2011
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124. "Card sorting": a tool for research in ethics on treatment decision-making at the end of life in Alzheimer patients with a life threatening complication.
- Author
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Pazart L, Vidal C, Chalon DF, Gauthier S, Schepens F, Cretin E, Beal JL, Pfitzenmeyer P, and Aubry R
- Abstract
Background: End stage dementia is a particularly difficult aspect of care for patients with Alzheimer's disease and related dementias. In care institutions, caregivers and family are concerned by treatment decision-making for an acute life threatening complication occurring in Alzheimer patients at the end of life. How should the best treatment pathway be decided: to treat or not to treat? Which arguments are used for decision-making? These are mainly ethical questions which are currently difficult to express and investigate., Methods/design: Cross sectional multicentre study of clinical cases involving 67 health centres (university hospitals, general hospitals, local hospitals and homes for the elderly) in the east of France. The method was based on the "card sorting" technique, with a set of 36 cards, each labelled with a different item relating to arguments for treatment decision-making. For each clinical case, medical staff and carers expressed in a meeting the pieces of information which they believed had been taken into account in the decision. Each participant received a card game, selected fewer than ten and ranked them according to the importance they attached to each one. All selected cards were then put on the table anonymously for participants, respecting the order of importance of the cards in each pile. Lastly, all games were photographed together in order to analyse occurrence and order frequencies. The cards were then classified on the table by frequency to open the discussion. Discussion time, which was conducted by the head carer of the department, concerned the clinical situation of the patient based on the shared responses., Discussion: During team meetings, the "card sorting" method was quickly adopted by professionals as a tool to assist with discussion beyond the context of the study. The participants were not compelled to mention their feelings in relation to a case, and it is significant that the anonymity which we tried to maintain so that each person felt "listened to" without value judgement was very often discarded by the individuals themselves.
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- 2011
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125. An atypical case of giant cell arteritis (Horton's disease) associated with facial swelling, confusion, and pericarditis in an elderly woman.
- Author
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Blot M, Guépet H, Aubriot-Lorton MH, Pfitzenmeyer P, and Manckoundia P
- Subjects
- Aged, Confusion diagnosis, Diagnosis, Differential, Edema diagnosis, Female, Follow-Up Studies, Giant Cell Arteritis diagnosis, Humans, Magnetic Resonance Imaging, Pericarditis diagnosis, Tomography, X-Ray Computed, Confusion etiology, Edema etiology, Giant Cell Arteritis complications, Pericarditis etiology
- Published
- 2010
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126. Psychobehavioral disorders, orthostatic hypotension, and falls related to a pheochromocytoma in a very elderly subject: a case report.
- Author
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Somana S, Marilier S, Mazen E, de la Vega MF, Camus A, Popitean L, Pfitzenmeyer P, Pfitzenmeyer P, and Manckoundia P
- Subjects
- Adrenal Gland Neoplasms surgery, Adrenalectomy, Aged, 80 and over, Aggression, Anxiety etiology, Diabetes Mellitus, Type 2 etiology, Diabetes Mellitus, Type 2 therapy, Fatigue etiology, Female, Humans, Irritable Mood, Pheochromocytoma surgery, Verbal Behavior, Accidental Falls, Adrenal Gland Neoplasms diagnosis, Hypotension, Orthostatic etiology, Pheochromocytoma diagnosis
- Published
- 2010
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127. Analysis of postural control in elderly subjects suffering from Psychomotor Disadaptation Syndrome (PDS).
- Author
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Matheron E, Dubost V, Mourey F, Pfitzenmeyer P, and Manckoundia P
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- Aged, 80 and over, Female, Humans, Male, Severity of Illness Index, Postural Balance, Psychomotor Disorders diagnosis
- Abstract
PDS is a geriatric affliction, described in 1999, characterized by postural impairments, including backward disequilibrium, freezing, a deterioration in the ability to anticipate postural adjustments, anxiety and fear of falling, inducing loss of autonomy. This study compared 10 subjects suffering from PDS, aged 87.3+/-4.9 years, with 10 control subjects, aged 85.4+/-7.9 years concerning postural control (body sway amplitude). In all participants, postural control was assessed using the SwayStar system in natural (spontaneous) and standardized stances, eyes open and eyes closed over a period of 40 s. It was found that: (1) with eyes open, subjects with PDS showed greater body sway amplitude than did controls whatever the position (natural or standardized) and the plane (sagittal or frontal) considered (F(1,16)=6.05; p=0.026), (2) with eyes closed, subjects with PDS showed greater body sway amplitude than did controls in the natural stance whatever the plane (F(1,18)=7.65; p=0.013). In conclusion, PDS has a negative effect on postural control. This data must be taken into account during the rehabilitation of patients with this syndrome., (Copyright 2009 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2010
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128. Stroke in the very old: incidence, risk factors, clinical features, outcomes and access to resources--a 22-year population-based study.
- Author
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Béjot Y, Rouaud O, Jacquin A, Osseby GV, Durier J, Manckoundia P, Pfitzenmeyer P, Moreau T, and Giroud M
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- Age Factors, Aged, 80 and over, Disability Evaluation, Disease Progression, Female, France epidemiology, Humans, Incidence, Kaplan-Meier Estimate, Length of Stay, Logistic Models, Male, Odds Ratio, Population Surveillance, Recovery of Function, Registries, Risk Assessment, Risk Factors, Severity of Illness Index, Stroke diagnosis, Stroke etiology, Stroke mortality, Stroke physiopathology, Time Factors, Treatment Outcome, Health Resources statistics & numerical data, Health Services Accessibility statistics & numerical data, Health Services for the Aged statistics & numerical data, Stroke therapy
- Abstract
Background: For several years, the burden of stroke in very old patients has been increasing in western countries. Nevertheless, we have little information about this new challenge in individuals >or=80., Methods: We ascertained all first-ever strokes in the population of Dijon, France (150,000 inhabitants), from 1985 to 2006. The incidence of stroke, risk factors, clinical presentation, resource mobilization and 1-month outcome were evaluated in individuals >or=80 and compared to the data obtained in younger patients., Results: We collected 1,410 first-ever strokes in people >or=80 years (39%) versus 2,130 in those <80 years. The incidence was 997/100,000, and 68/100,000, respectively. Over the 22 years, the incidence of stroke in individuals >or=80 years rose significantly. A lower prevalence of diabetes, hypercholesterolemia and alcohol intake, as well as a higher prevalence of hypertension, atrial fibrillation, previous myocardial infarction and use of prestroke antiplatelet agents were noted in patients >or=80 years. The clinical presentation was severer and the 1-month outcome in terms of case fatality and handicap was worse, despite improvements observed over time. Finally, in patients >or=80 years, the use of CT scan, MRI, cervical Doppler, angiography and carotid surgery were significantly lower than for younger patients. Length of stay >30 days was more frequent, and discharge to prestroke residence was less common. However, all these improved between the first and the last study periods., Conclusions: Our findings have important implications not only for clinical management but also for initiating preventive strategies and health policy., ((c) 2009 S. Karger AG, Basel.)
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- 2010
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129. [A cardiorespiratory decompensation in the course of rheumatoid arthritis].
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Marilier S, Martin-Pfitzenmeyer I, Mazen E, Da Silva S, Pfitzenmeyer P, and Manckoundia P
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- Aged, 80 and over, Female, Humans, Arthritis, Rheumatoid complications, Heart Failure etiology, Respiratory Insufficiency etiology
- Abstract
Rheumatoid arthritis (RA) may include rare extra-articular manifestations, and particularly cardiopulmonary involvement. We report a 83-year-old woman, with RA, who presented with both pulmonary and heart failures that were related to the RA, resulting from the presence of mediastinal and axillary lymph nodes, and pleural and pericardial effusions. This was confirmed by the dramatic improvement after a specific treatment of RA.
- Published
- 2009
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130. [Antidepressant use in demented elderly subjects: current data].
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Bélicard-Pernot C, Manckoundia P, Ponavoy E, Rouaud O, and Pfitzenmeyer P
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- Aged, Antidepressive Agents adverse effects, Humans, Antidepressive Agents therapeutic use, Dementia complications, Depression drug therapy, Depression etiology
- Abstract
Depression and behavioural and psychological symptoms of dementia (BPSD) have a significant impact on the worsening of dementia because they increase the cognitive and functional decline and they have a significant impact on the vital prognosis. Physicians should be particularly careful in the use of antidepressants in the elderly, particularly in the frail elderly. Indeed, most studies have included patients aged at least 65 years without frailty criteria, but rarely those aged over 75 years and/or frail. As they are used in clinical practice, selective serotonin reuptake inhibitors, which initially appeared to have low risks, have been associated with many and dangerous adverse effects, particularly in elderly subjects. At present, there is a lack of data to assess the benefit-risk ratio of antidepressants in the treatment of depression and BPSD in patients with Alzheimer's disease or other dementias. Among the drugs frequently used in studies in order to evaluate these indications, citalopram and moclobemide are those associated with a low risk of adverse events and a significant effectiveness on depression signs and behavioural and BPSD. It is necessary to assess the effectiveness and adverse effects of antidepressants in demented elderly subjects through several studies.
- Published
- 2009
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131. [Should all old hypertensive subjects have Mini-Mental State Examination?].
- Author
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Manckoundia P, Marilier S, Mazen E, Perret-Guillaume C, Rouaud O, Mahmoudi R, Joly L, Bénétos A, and Pfitzenmeyer P
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- Aged, Cognition Disorders epidemiology, Dementia, Vascular epidemiology, Dementia, Vascular psychology, Humans, Hypertension complications, Hypertension psychology, Mental Status Schedule
- Abstract
Hypertension constitutes a recognized risk factor of vascular dementia but also of Alzheimer-type dementia. Various longitudinal studies showed that midlife blood pressure level is one of the factors conditioning the onset of dementia syndrome in late life. The high risk of dementia is linked to leukoaraiosis, vascular rigidity, microcirculation disorders, oxidative stress, blood pressure fluctuations including orthostatic hypotension and strokes, all of those being associated with hypertension. Numerous clinical trials showed the positive effect of effective treatment of hypertension on the prevention of cognitive disorders and dementias. Thus, screening and early management of dementia and cognitive decline, in particular in the hypertensive subject, are essential. The Mini-Mental State Examination (MMSE) is a major first-intention screening test because it allows a full assessment of cognitive aptitudes. If cognitive decline is suspected and the MMSE score is considered to be abnormal, the elderly subject must be sent to a specialist or a referent memory centre; the MMSE is only a first stage in the diagnostic reasoning. MMSE should be included in the follow-up of all hypertensive elderly subjects and should be performed once a year by the general practitioner.
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- 2009
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132. Prognostic factors in stage D heart failure in the very elderly.
- Author
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Martin-Pfitzenmeyer I, Gauthier S, Bailly M, Loi N, Popitean L, d'Athis P, Bouvier AM, and Pfitzenmeyer P
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- Aged, Aged, 80 and over, Cardiovascular Diseases mortality, Comorbidity, Female, Humans, Male, Nervous System Diseases mortality, Pain mortality, Predictive Value of Tests, Prognosis, Prospective Studies, Renal Insufficiency mortality, Risk Factors, Aging, Heart Failure mortality, Hospitalization statistics & numerical data, Palliative Care statistics & numerical data
- Abstract
Background: The clinical characteristics of frail older patients with advanced heart failure have scarcely been studied., Objective: To describe this population and to identify some prognostic factors of mortality., Methods: 104 patients aged 75 years and older hospitalized with refractory heart failure were enrolled in a prospective multicentric study., Results: Mean age was 87.2 +/- 5.3 years. Dyspnea (79.8%), crepitant rales (76.9%) and peripheral edema (73.1%) were particularly frequent. Signs of low cardiac output such as renal insufficiency (46.9%), cutaneous low flow (40.4%), and systolic hypotension (< or =100 mm Hg) (24.3%) were observed less often. Signs of cognitive impairment including anxiety (55.4%), sleep disorders (43.7%) and delirium (35.5%) were frequent. Asthenia and chronic pain were noted in 92.3 and 37.5% of cases, respectively. Mortality rates were 32.7, 59.6 and 71.2% during hospitalization, at 6 months and at 12 months, respectively. According to the multivariate Cox model, six significant factors suggesting a poor prognosis were observed: chronic renal insufficiency, past neuropsychological pathology, long-term treatment with nitrates, presence of edema, low cutaneous flow, and pain. The ability to sit on a chair was the only significant factor associated with a good prognosis., Conclusion: Our study identified some clinical and prognostic factors which had been observed in very old patients with refractory heart failure. Pain management has to be a priority in these patients in order to improve their quality of life.
- Published
- 2009
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133. Assessment of cardiac autonomic nervous activity in frail elderly people with postural abnormalities and in control subjects.
- Author
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Mourey F, Brondel L, Van Wymelbeke V, Buchheit M, Moreau D, and Pfitzenmeyer P
- Subjects
- Aged, Aged, 80 and over, Electrocardiography, Ambulatory, Female, Follow-Up Studies, Heart physiopathology, Humans, Male, Prognosis, Autonomic Nervous System physiopathology, Frail Elderly, Heart innervation, Heart Rate physiology, Posture physiology, Psychomotor Disorders physiopathology
- Abstract
Heart rate variability (HRV), which is considered to reflect the activity of the autonomic nervous system (ANS), has been shown to decline with age. The aim of the present study was to explore cardiac ANS in older patients showing frontal-subcortical dysfunction with "Psychomotor Disadaptation Syndrome" (PDS), through the 24-h HRV. We enrolled 14 patients with PDS (mean age: 84.5+/-6.9 years), they were compared to 13 frail control subjects (mean age: 80.6+/-6.7 years). Cardiac ANS activity was assessed by 24-h ECG recordings from three leads with a Holter digital monitor. The decrease in cardiac ANS activity observed in PDS subjects was greater than the alteration found in normally aging subjects. The abnormalities of ANS that aggravate the effects of aging can be seen as a type of physical deconditioning. Such patients could benefit from particular attention in physical training.
- Published
- 2009
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- View/download PDF
134. Change in taste preference in undernourished elderly hospitalized subjects during periods of infection and convalescence.
- Author
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Van Wymelbeke V, Jiang T, and Pfitzenmeyer P
- Subjects
- Aged, Aged, 80 and over, Analysis of Variance, C-Reactive Protein, Coffee, Communicable Diseases complications, Convalescence psychology, Dietary Sucrose, Female, Frail Elderly, Hospitalization, Humans, Male, Malnutrition etiology, Malnutrition psychology, Communicable Diseases psychology, Diet, Dietary Supplements, Energy Intake, Malnutrition diet therapy, Taste Perception
- Abstract
Aim: To determine the impact of taste pleasure supplements on modifications of food intake in hospitalized frail elderly patients., Methods: Thirty hospitalized frail elderly patients tasted different formulas of a high-protein coffee supplement: -supplement C, commercial version; - supplement CA with artificial coffee flavor; - supplement CS with sucrose and - supplement CAS with sucrose and artificial coffee flavor. The preference for the supplements was analyzed by the Friedman test followed by a post hoc Tukey's test. The food intakes in each period were compared by repeated ANOVA and the food intakes of the two periods were compared using Student's t test. All measurements were made during periods of infection and convalescence., Results: The supplements CAS and CS were significantly more appreciated than the current commercial version C (P < .05). The patients could be classified into two groups: consumers (consuming the supplements) and nonconsumers (just tasting the supplements). Taking supplements can increase the total energy intake for consumers (P < .01), especially during periods of infection; no modification was observed in the non-consumers., Conclusion: The use of supplements to increase sensory pleasure can be one feasible way to increase energy intake in hospitalized elderly patients with an infectious disease.
- Published
- 2009
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- View/download PDF
135. [Gait and dementias].
- Author
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Manckoundia P, Mourey F, and Pfitzenmeyer P
- Subjects
- Accidental Falls prevention & control, Adult, Aged, Aged, 80 and over, Alzheimer Disease physiopathology, Basal Ganglia physiopathology, Cerebellum physiopathology, Cerebrovascular Circulation, Gait Disorders, Neurologic epidemiology, Gait Disorders, Neurologic physiopathology, Gait Disorders, Neurologic prevention & control, Gait Disorders, Neurologic rehabilitation, Humans, Middle Aged, Motor Cortex physiopathology, Parkinson Disease physiopathology, Patient Education as Topic, Physical Therapy Modalities, Postural Balance, Posture, Prevalence, Sensation Disorders etiology, Sensation Disorders physiopathology, Dementia physiopathology, Gait Disorders, Neurologic etiology
- Abstract
Objectives: The aim of this paper was to describe gait disorders and their consequences in primary dementias, and to prove the positive impact of their prevention and rehabilitation., Method: The most relevant articles on gait and dementias available on Medline were analyzed., Results: The prevalence of gait and balance disorders is between 9 and 52% in Alzheimer-type dementia in which frontal gait and apraxic gait are described. Gait disorders, appearing with a prevalence of over 71% in vascular dementia, seem to be an early indicator of this dementia in which hemiparetic gait, frontal gait and unsteady gait are commonly described. As clinical practice shows, gait disorders appear to be frequent in dementia with Lewy bodies and Parkinson's dementia, both being characterized by Parkinsonian gait; however, there are very few prevalence studies concerning gait disturbances in these two dementias. The balance and gait assessment in demented subjects is based on the analysis of sit-to-stand/back-to-sit and one-leg balance, the measurement of gait speed, the Timed-Up-and-Go and the dual task tests. Although there are few studies on the topic, the benefit of the motor rehabilitation on functional independency in demented subjects is now recognized. The programs used for motor rehabilitation of demented people must be individual with targeted objectives, and associate strength and balance exercises, attentional tasks, immediate and working memories and praxis, in the context of multidisciplinary intervention. However, there is no consensus on a standard rehabilitation program of demented subjects., Conclusion: Future studies have to analyse gait disorders in demented subjects in order to clarify their pathophysiology. Besides, they may confirm the benefit of rehabilitation and suggest consensual programs.
- Published
- 2008
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- View/download PDF
136. [Stroke in elderly: what have we learned from stroke epidemiology in younger people].
- Author
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Bejot Y, Rouaud O, Gentil A, Caillier M, Manckoundia P, Pfitzenmeyer P, Osseby GV, Moreau T, and Giroud M
- Subjects
- Adult, Age Factors, Aged, 80 and over, Animals, Humans, Middle Aged, Risk Factors, Stroke prevention & control, Aged statistics & numerical data, Stroke epidemiology
- Abstract
Stroke in the elderly has more major differences compared to young people: it is the first complication of atherothrombosis disease associated with the following risk factors: hypertension, diabetes, hypercholesterolemia, tobacco consumption and sleep apnea syndrome; AVC is the first consequence of atrial fibrillation; from a clinical point of view, seizure at the onset of the stroke is more frequent; prognosis is characterized by a high risk of dementia (20%); primary and secondary prevention is very efficacious even in very old patients, not only on the risk of stroke, but also on the risk of dementia; time trends at Dijon show a slight decrease of incidence rates of stroke only over 85 years, while prevention of stroke has taken advantage of real progress in precocious diagnosis and innovative treatments. In contrast, we observed a decrease of case-fatality rates at any day with a delay in age of onset of stroke, reaching five years in men and eight years in women, suggesting an increase of life expectancy without stroke, reflecting a certain efficacy of prevention.
- Published
- 2008
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- View/download PDF
137. [Dementia syndrome in an elderly subject related to valproic acid use: a case report].
- Author
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Manckoundia P, Disson-Dautriche A, Rouaud O, Richard D, Tavernier-Vidal B, and Pfitzenmeyer P
- Subjects
- Aged, Anticonvulsants administration & dosage, Female, Humans, Valproic Acid administration & dosage, Anticonvulsants adverse effects, Dementia chemically induced, Valproic Acid adverse effects
- Abstract
In addition to the usual adverse effects, the chronic use of the valproic acid can entail dementia syndrome. We describe the case of a 68-year-old woman who had presented a dementia syndrome due to the use of valproic acid for one year. This drug was prescribed in order to prevent a potential convulsive crisis after an ischemic stroke in a patient who did not have a history of epilepsy. This case shows that each clinician must be careful about all medications consumed by the patient in the face of cognitive disorders.
- Published
- 2008
- Full Text
- View/download PDF
138. Clinical determinants of failure in balance tests in elderly subjects.
- Author
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Manckoundia P, Buatois S, Gueguen R, Perret-Guillaume C, Laurain MC, Pfitzenmeyer P, and Benetos A
- Subjects
- Age Factors, Body Mass Index, Brief Psychiatric Rating Scale, Cross-Sectional Studies, Female, Geriatric Assessment, Humans, Male, Middle Aged, Sex Factors, Aged physiology, Physical Fitness, Postural Balance
- Abstract
We assessed the role of clinical and biological parameters on performance in four balance tests in elderly subjects. An observational study was conducted in the Center for Preventive Medicine of Nancy (France) in 2368 community-living elderly subjects aged 60 and older. Body mass index (BMI), Mini-Mental State Examination (MMSE), clock test, "Health score" and use of psychotropic drugs (UPD) were assessed. Participants performed four balance tests: "one-leg-stand" (OLS), "timed-up-and-go" (TUG), "rise-from-the-floor" (RFF) and "sit-to-stand" (STS). The statistical analysis showed that women were almost twice as likely to fail balance tests as men. In both women and men, the following determinant factors of the performance in balance tests were found: for OLS: age, BMI and health score; for TUG: age, BMI, clock test and health score; for RFF: BMI and health score. In addition, in women other determinant factors were: MMSE for OLS, UPD for TUG, age and clock test for RFF. In men, the clock test and the UPD were also significant determinant factors for OLS. Similar results were found for STS. In conclusion, female sex, overweight, low cognitive status, low self-perception of health and UPD were associated with a higher risk of failure in balance tests.
- Published
- 2008
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- View/download PDF
139. Acute bacterial prostatitis: heterogeneity in diagnostic criteria and management. Retrospective multicentric analysis of 371 patients diagnosed with acute prostatitis.
- Author
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Etienne M, Chavanet P, Sibert L, Michel F, Levesque H, Lorcerie B, Doucet J, Pfitzenmeyer P, and Caron F
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Bacterial Infections drug therapy, Community-Acquired Infections microbiology, Cross Infection microbiology, France, Hospitals, University, Humans, Male, Middle Aged, Prostate-Specific Antigen blood, Prostatitis drug therapy, Recurrence, Retrospective Studies, Bacterial Infections diagnosis, Prostatitis diagnosis, Prostatitis microbiology
- Abstract
Background: There is currently a lack of consensus for the diagnosis, investigations and treatments of acute bacterial prostatitis (AP)., Methods: The symptoms, investigations and treatments of 371 inpatients diagnosed with AP were analyzed through a retrospective study conducted in four departments - Urology (U), Infectious Diseases (ID), Internal Medicine (IM), Geriatrics (G) - of two French university hospitals., Results: The cause of admission, symptoms, investigations and treatments depended markedly on the department of admission but not on the hospital. In U, patients commonly presented with a bladder outlet obstruction, they had a large imaging and functional check-up, and received alpha-blockers and anti-inflammatory drugs. In ID, patients were febrile and received longer and more appropriate antibiotic treatments. In G, patients presented with cognitive disorders and commonly had post-void urine volume measurements. In IM, patients presented with a wide range of symptoms, and had very diverse investigations and antibiotic regimen.Overall, a 3:1 ratio of community-acquired AP (CA-AP) to nosocomial AP (N-AP) was observed. Urine culture isolated mainly E. coli (58% of AP, 68% of CA-AP), with venereal agents constituting less than 1%. The probabilistic antibiotic treatments were similar for N-AP and CA-AP (58% bi-therapy; 63% fluoroquinolone-based regimen). For N-AP, these treatments were more likely to be inadequate (42% vs. 8%, p < 0.001) and had a higher rate of bacteriological failure (48% vs. 19%, p < 0.001). Clinical failure at follow-up was more common than bacteriological failure (75% versus 24%, p < 0.001). Patients older than 49 had more underlying urinary tract disorders and a higher rate of clinical failure (30% versus 10%, p < 0.0001)., Conclusion: This study highlights the difficulties encountered on a daily basis by the physicians regarding the diagnosis and management of acute prostatitis.
- Published
- 2008
- Full Text
- View/download PDF
140. Backward disequilibrium in elderly subjects.
- Author
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Manckoundia P, Mourey F, Pérennou D, and Pfitzenmeyer P
- Subjects
- Accidental Falls, Aged, Gait physiology, Humans, Posture physiology, Vestibular Diseases physiopathology, Visual Perception physiology, Aging physiology, Postural Balance physiology, Psychomotor Disorders physiopathology
- Abstract
Backward disequilibrium is observed frequently in daily clinical practice. However, there are no epidemiological data concerning this postural disorder. Defined by a posterior position of the centre of mass with respect to the base of support, backward disequilibrium is abnormal postural behavior, usually characterized by a posterior trunk tilt in standing and sitting positions, which predisposes subjects to backward falls. Many afflictions whether they are somatic (degenerative, ischemic and traumatic brain lesions), psychosomatic (psychomotor disadaptation syndrome, confinement to bed, nonuse situations) or psychological (depression) can cause backward disequilibrium. A vicious circle of falls, and loss of autonomy can arise and this is the main consequence of backward disequilibrium. Thus, in this paper, we review backward disequilibrium in elderly subjects with regard to the causes, consequences, assessment, and management.
- Published
- 2008
- Full Text
- View/download PDF
141. [Deep-vein thrombosis despite a low D-Dimer level].
- Author
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Manckoundia P and Pfitzenmeyer P
- Subjects
- Aged, 80 and over, Humans, Leg blood supply, Male, Ultrasonography, Venous Thrombosis blood, Venous Thrombosis diagnostic imaging, Fibrin Fibrinogen Degradation Products analysis, Venous Thrombosis diagnosis
- Abstract
Objective: Deep-vein thrombosis is common but not easy to diagnose. It is generally considered that the diagnosis can be ruled out in subjects with a D-Dimer level lower than a reference threshold value. We report a case where this hypothesis was misleading., Method: An 89-year-old man was hospitalized for a pain in his left lower leg, which had been persistent for 5 days., Results: The venous duplex ultrasound found two recent deep-vein thrombi in this leg while the D-Dimer level was lower than 220 UI/ml at admission., Conclusion: This case illustrates the importance of prudent interpretation of the serum D-Dimer level.
- Published
- 2007
- Full Text
- View/download PDF
142. A new formula for correction of total calcium level into ionized serum calcium values in very elderly hospitalized patients.
- Author
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Pfitzenmeyer P, Martin I, d'Athis P, Grumbach Y, Delmestre MC, Blondé-Cynober F, Derycke B, and Brondel L
- Subjects
- Aged, 80 and over, False Positive Reactions, France, Homeostasis, Hospitals, Humans, Hypercalcemia blood, Hypocalcemia blood, Inpatients, Linear Models, Protein-Energy Malnutrition blood, Statistics, Nonparametric, Calcium blood, Hematologic Tests standards, Hypercalcemia diagnosis, Hypocalcemia diagnosis, Serum Albumin
- Abstract
Ionized calcium (Ca(2+)) seems to be the best measure of active serum calcium but, in France, numerous laboratories do not have Ca(2+) analyzers so that numerous clinicians use Payne's formula to obtain adjusted calcium (Ca(Ad)) values. In frail very elderly patients with protein/energetic malnutrition and very low concentrations of albumin, "correction" with Payne's formula usually gives false hypercalcemic results, so that hypocalcemia may be seriously underdiagnosed. Two hundred and ninety-four patients of 80 years and older with serum albumin level < 35 g/l were included in four French hospitals for elderly people. Biological measurements were standardized in order to determine Ca(2+) and total calcium (Ca(T)) in accordance with approved guidelines. Ca(Ad) was calculated with Payne's formula whereas the dependence of Ca(2+) with serum protein, albumin and Ca(Ad) was investigated by linear regression, the goodness-of-fit of each equation with the measure of Ca(2+) being studied. Taking into account serum protein and albumin levels, multiple linear regression gave the equation: Ca(2+) (mmol/l)=0.188-0.00469 protein (g/l)+0.0110 albumin (g/l)+0.401 Ca(Ad) with r(2)=0.442. The relative difference between the measure and the value given by the equation did not depend upon the center, and the correlation between measured and computed values of Ca(2+) was better, for any group, with our formula than with Payne's formula. When Ca(2+) was expressed with Ca(T) instead of Ca(Ad), albumin term was no longer significant and the new equation was: Ca(2+) (mmol/l)=0.592-0.00449 protein (g/l)+0.410 total calcium (mmol/l) with r(2)=0.438. We propose an alternative to direct measurement of Ca(2+) with a simple formula usable in geriatric units, which are often deprived of high-performance equipment.
- Published
- 2007
- Full Text
- View/download PDF
143. [Backward disequilibrium in the elderly: review of symptoms and proposition of a tool for quantitative assessment].
- Author
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Manckoundia P, Pérennou D, Pfitzenmeyer P, and Mourey F
- Subjects
- Accidental Falls, Aged, Gait physiology, Humans, Psychomotor Disorders physiopathology, Geriatric Assessment, Postural Balance physiology, Posture physiology
- Abstract
Purpose: Although there is currently no epidemiological data on backward disequilibrium, this disturbance of posture does not seem to be rare in frail elderly., Actualities and Strong Points: Backward disequilibrium is characterized by the following criteria: the location of buttocks on the anterior side of the seat while the trunk rested at the back of the armchair in the sitting position; an inadequate forward of the trunk and a backward projection of the trunk outside the base of support during sit-to-stand; and a posterior projection of the center of mass outside the base of support in the standing position. Several pathological situations either somatic (degenerative, ischemic and traumatic brain lesions), psycho-somatic (psychomotor disadaptation syndrome, extended bed confining, non-use) or psychological (depression) affections can entail backward disequilibrium. Falls, loss of autonomy and the risk of the vicious circle with its causes are the main consequences of backward disequilibrium., Prospects and Projects: Although the geriatrician is familiarized with backward disequilibrium, there is no scale to quantify it. In this paper we review causes, consequences and management of backward disequilibrium, and in order to assess it, we propose a semi-quantitative scale, based on some activities of everyday living which are sitting position, sit-to-stand, back-to-sit and standing position. So, a backward disequilibrium score could be determined.
- Published
- 2007
- Full Text
- View/download PDF
144. Is backward disequilibrium in the elderly caused by an abnormal perception of verticality? A pilot study.
- Author
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Manckoundia P, Mourey F, Pfitzenmeyer P, Van Hoecke J, and Pérennou D
- Subjects
- Accidental Falls, Aged, 80 and over, Humans, Pilot Projects, Severity of Illness Index, Vestibular Function Tests, Geriatric Assessment, Postural Balance physiology, Posture physiology, Vestibular Diseases etiology, Visual Perception physiology
- Abstract
Objective: We hypothesised that backward disequilibrium (BD), defined by a posterior position of the centre of mass with respect to the base of support, could be caused by a backward tilt in the perception of verticality., Methods: The relationship between BD, the perception of verticality, and the history of falls in 25 subjects aged 84.5+/-7.4 years was analysed. An original ordinal scale, the BD scale (BDS), was used to quantify BD. Postural (PV) and haptic verticals (HV) were measured in sagittal plane., Results: BDS scores closely correlated with the number of falls (r = 0.81, p =10(-5)). The more the PV was tilted backward, the greater the BDS scores (r = -0.95, p<10(-6)), with a huge backward tilt of about 15 degrees in 4 subjects with severe BD. In these subjects, the tilt in perception of verticality was transmodal since a severe backward HV tilt was also found., Conclusions: This transmodality suggested high-order cognitive disruption in the construction of the subjective vertical used in postural control by subjects showing BD, which confirmed our hypothesis., Significance: This study clearly shows that perception and action with respect to gravity are closely related and brings a new insight about fall mechanisms in the elderly.
- Published
- 2007
- Full Text
- View/download PDF
145. [Psychomotor disadaptation syndrome].
- Author
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Manckoundia P, Mourey F, Tavernier-Vidal B, and Pfitzenmeyer P
- Subjects
- Aged, Diagnosis, Differential, Humans, Prognosis, Syndrome, Aging, Postural Balance, Posture, Psychomotor Disorders diagnosis, Psychomotor Disorders physiopathology, Psychomotor Disorders prevention & control, Psychomotor Disorders therapy, Sensation Disorders physiopathology
- Abstract
Purpose: We describe the psychomotor disadaptation syndrome and report the last findings on its physiopathology and therapeutic. This syndrome was first described by Pr Gaudet's team in 1986 and named "psychomotor regression syndrome". This name has been recently changed into "psychomotor disadaptation syndrome"., Actualities and Strong Points: The psychomotor disadaptation syndrome is a decompensation of postural function, gait and psychomotor automatisms due to the alteration of the posture and motor programming. That alteration is linked to subcortical-frontal lesions. Clinically, the psychomotor disadaptation syndrome is characterized by postural impairments (retro-propulsion or backward disequilibrium), non-specific gait disorders, neurological signs (akinesia, reactional hypertonia, alteration of both reactive postural responses and protective reactions) and psychological troubles. Psychological troubles include fear of standing and gait in its acute feature or slowness of cognitive processing and anhedonia in its chronic feature. The psychomotor disadaptation syndrome occurs as a failure to compensate for the effects of the following three factors which entail the reduction of motor functional reserves because of their impact on frontal subcortex: 1) aging, 2) chronic illness named predisposing factors (degenerative or vascular disorders) and both 3) functional and organic acute factors. The latter factors cause a reduction of cerebral blood perfusion. The psychomotor disadaptation syndrome requires multidisciplinary management including medical, physiotherapeutic and psychological approaches., Prospects and Projects: In the next years we have to determine the frequency of psychomotor disadaptation syndrome and its physiopathology needs to be further explored.
- Published
- 2007
- Full Text
- View/download PDF
146. Multidisciplinary management in geriatric day-hospital is beneficial for elderly fallers: a prospective study of 28 cases.
- Author
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Manckoundia P, Gerbault N, Mourey F, d'Athis P, Nourdin C, Monin MP, Camus A, and Pfitzenmeyer P
- Subjects
- Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Prospective Studies, Psychomotor Disorders complications, Psychomotor Disorders psychology, Syndrome, Accidental Falls prevention & control, Adaptation, Psychological, Cognitive Behavioral Therapy, Exercise Therapy, Patient Care Team organization & administration, Psychomotor Disorders therapy
- Abstract
We determined whether management including medical, psychological, and physiotherapeutic approaches, over a period of 6 weeks, has a beneficial effect on motor abilities, psychological status, and independence of elderly fallers with psychomotor disadaptation syndrome (PDS). We included 28 subjects (mean age 81.4 years). They were assessed from a medical, motor, and psychological point of view at both the inclusion and the end of the multidisciplinary intervention. A follow-up was conducted with multidisciplinary assessment at 6 and 9 months after the beginning of the study in order to evaluate duration of benefits of the management. The statistical analysis concerned only subjects who took part in the total multidisciplinary program, i.e., 14 subjects. The multidisciplinary intervention had an overall positive impact on motor abilities as shown by the increase in the mini-motor test scores, the rate of success in rising from the floor and decrease of time for the dual task. This study also showed a reduction in the fear of falling and a decrease in the rate of fallers. This positive effect on motor abilities, fear of falling and rate of fallers was sustained until 9 months after the beginning of the multidisciplinary management. This study shows the importance of a multidisciplinary management of elderly fallers with PDS.
- Published
- 2007
- Full Text
- View/download PDF
147. An unusual complication of anticoagulation therapy in an elderly patient: Pituitary apoplexy with remission of acromegaly.
- Author
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Audia S, Popitean L, Camus A, Pfitzenmeyer P, and Petit JM
- Subjects
- Aged, 80 and over, Humans, Magnetic Resonance Imaging, Male, Pituitary Apoplexy diagnosis, Acromegaly diagnosis, Adenoma diagnosis, Anticoagulants adverse effects, Hypopituitarism diagnosis, Pituitary Apoplexy etiology, Pituitary Neoplasms diagnosis
- Published
- 2006
- Full Text
- View/download PDF
148. [Rheumatoid purpura in elderly: case report].
- Author
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Popitean L, Manckoundia P, Camus A, Martin-Pfitzenmeyer I, and Pfitzenmeyer P
- Subjects
- Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones therapeutic use, Age Factors, Aged, Aged, 80 and over, Disease Progression, Female, Humans, Prognosis, IgA Vasculitis diagnosis, IgA Vasculitis drug therapy, IgA Vasculitis mortality
- Published
- 2006
- Full Text
- View/download PDF
149. Myasthenia gravis associated with a B-cell, non-Hodgkin's lymphoma.
- Author
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Manckoundia P, Martin-Pfitzenmeyer I, and Pfitzenmeyer P
- Published
- 2006
- Full Text
- View/download PDF
150. Impact of cognitive task on the posture of elderly subjects with Alzheimer's disease compared to healthy elderly subjects.
- Author
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Manckoundia P, Pfitzenmeyer P, d'Athis P, Dubost V, and Mourey F
- Subjects
- Accidental Falls prevention & control, Aged, Aged, 80 and over, Alzheimer Disease psychology, Cognition Disorders psychology, Comprehension, Female, Humans, Male, Mental Recall, Mental Status Schedule, Reference Values, Risk Assessment, Visual Perception, Weight-Bearing, Alzheimer Disease diagnosis, Attention, Cognition Disorders diagnosis, Neuropsychological Tests, Postural Balance
- Abstract
The aims of this study were to analyze the effects of cognitive task on static posture in Alzheimer's disease (AD) and in healthy elderly (HE) subjects and to evaluate whether those effects were greater in AD subjects than in HE subjects. We performed a posturographic analysis on 13 subjects with mild AD (mean age, 79.7+/-5.1 years, Mini-Mental State Examination scores between 18 and 23) and on 17 HE subjects (mean age, 78.5+/-4.4 years). After watching a video sequence, the subjects were asked to maintain a stable upright posture while standing on a force platform. Then, the postural sway was measured during the following two conditions: (1) quiet standing and (2) both standing and answering questions about the video sequence. We were interested in the center of pressure (CoP) area and path. For each group, the single task was compared to the dual task for the CoP area and path. We also compared the variability of both CoP area (variation of the CoP area between the single and the dual task) and path (variation of the CoP path between the single and the dual task) between the two groups. We showed that there was no significant difference between the single and the dual task in HE subjects concerning the CoP area and path, in contrast to the AD group, and that variability of both the CoP area and path were significantly greater in the AD subjects than in the HE subjects. This finding may contribute to the risk of falls in AD patients., (Copyright (c) 2005 Movement Disorder Society.)
- Published
- 2006
- Full Text
- View/download PDF
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