Correlation between the nature and amount of carbohydrate in meal intake and insulin delivery by the artificial pancreas in 24 insulin-dependent diabetics.

We have studied the effects of mixed meals and dextrose intake on blood glucose and insulin delivery by the artificial pancreas in 24 insulin-dependent diabetics. A group of 12 patients had 3 mixed meals containing at random 20, 40, and 60 g of complex carbohydrate along with protein and fat; another group of 12 diabetics, comparable in weight, age, and duration of diabetes, received at random 20, 40, and 60 g of dextrose. Dextrose ingestion led to a higher initial blood glucose increase than did the mixed meal, but the duration of blood glucose increase lasted significantly longer after the mixed meal than after the dextrose load. The areas under the curves of hyperglycemia were not significantly different. There was a high (but not linear) correlation between the total amount of insulin delivered in order to restore initial blood glucose values and the amount of CHO consumed. There was no correlation with age, body weight, duration of diabetes, nor with the nature and order of administration of the CHO load; 5.1 +/- 1.6 to 13.7 +/- 2.1 units of insulin were needed for a period of 94 +/- 11 to 132 +/- 11 min. It is suggested that some of the data obtained in this study might be useful in the programming of an open-loop insulin infusion system.

[Clinical evaluation of the tolerability of gadodiamide, a new nonionic contrast agent in MRI of the central nervous system]. / Evaluation clinique de la tolérance du gadodiamide, nouvel agent de contraste non-ionique pour l'IRM du système nerveux central.

Gadodiamide injection (Gd-DTPA-BMA) is a new non-ionic paramagnetic contrast agent for which the safety at the dose 0.1 mmol/kg was evaluated during a European multicentre study on a large population of adult patients who had an MR examination of the central nervous system with contrast medium. The safety analysis was performed on 2,102 patients by recording the adverse events observed during injection and up to 24 hours after the injection. Adverse events due or probably due to gadodiamide injection were observed in 102 patients (4.4%) with injection-site associated discomfort (heat, coldness, pain at the injection site) in 37 patients (1.8%) and adverse events other than discomfort (headache, nausea, vomiting) in 35 patients (3.1%). No adverse events of severe intensity or death were reported during the trial. Gadodiamide injection was shown to be safe and well tolerated and represents a non-ionic alternative to the current products in the field of MR imaging of the central nervous system.

[Adrenomyeloneuropathy in adults. Relationship with adrenoleukodystrophy in children (author's transl)]. / Adrénomyéloneuropathie de l'adulte. Ses rapports avec l'adrénoleucodystrophie de l'enfant.

The case reported concerns a man in whom appeared gradually, since the age of twenty-seven years, difficulty in walking and sexual impotence. The neurological syndrome consisted of pyramidal signs and objective sensory disorders of the lower limbs, intermittent sphincter disorders and mild mental deterioration, which was progressive. Biopsy of a sensory nerve showed rarefaction of myelinated fibres. The endocrine syndrome consisted of peripheral adrenal insufficiency, which was undoubted but with biologic evidence only. There was no response of plasma cortisol during five stimulation tests with tetracosactide and there was a gradual rise in plasma A.C.T.H. The clinical picture was thus that of an adrenomyeloneuropathy.

[Adrenoleukodystrophy (Schilder-Addison's disease): a probable case in an adult (author's transl)]. / Un cas probable d'adrénoleucodystrophie (maladie de Schilder-Addison) chez un adulte.

Adrenoleukodystrophy (Schilder-Addison's disease) is a sex-linked recessive syndrome usually observed in children, associating neurological disorders and Addison's disease. Its outcome is death after a few years. The authors report the case of a man in whom a spastic paraparesis and a mental deterioration appeared at the age of 30 years. A biological adrenal deficiency was found: plasma cortisol and urinary 17-hydroxy-steroids and 17-ketosteroids failed to increase after synacthen stimulation; plasma ACTH level was above normal. Since two nephews of the patient suffered from adrenoleukodystrophy, the same disease is likely in the reported patient.

Evaluation of the clinical safety of gadodiamide injection, a new nonionic MRI contrast medium for the central nervous system: a European perspective.

Gadodiamide injection is a new nonionic paramagnetic, extracellular contrast medium. Its safety at a dose of 0.1 mmol/kg body weight was evaluated in a large European multicentre trial on adults referred for contrast-enhanced MRI of the central nervous system. Safety analysis was performed on 2102 patients, in whom adverse events during and up to 24 h after injection were recorded. Adverse events related or possibly related to gadodiamide injection were observed in 102 patients. Injection-associated reactions classified as discomfort (sensation of heat or coldness, pain or pressure at the injection site) occurred in 37 patients (1.8%) and other adverse events (e.g. headache, nausea) were observed in 65 patients (3.1%). No serious adverse event was reported. Efficacy analysis, performed on 2273 patients, and based on comparison of T1- and T2-weighted images before and T1-weighted images after injection showed that more diagnostic information was obtained after gadodiamide injection in 1424 (62.6%) patients: management of 386 (17.0%) patients was affected by the new information given and that a new diagnosis was made in 755 (33.3%) patients. Gadodiamide injection was shown to be safe and well tolerated. It represents a nonionic alternative to the current products for MRI of the central nervous system.

Transient global amnesia after cerebral angiography. A case report.

We report on a case of transient global amnesia after cerebral angiography in which a nonionic contrast medium was used. The complication observed showed no evidence of any definite cause.