H Mayaudon

Bégin Military Teaching Hospital, Sant Manden, Île-de-France, France

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Publications (171)129.35 Total impact

  • Journal des Maladies Vasculaires 03/2014; 39(2):85. · 0.24 Impact Factor
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    ABSTRACT: The aim of this study, based on clinical data collected from six Paris area diabetes centers, was to determine predictors of response to liraglutide, as defined by HbA1c level and weight loss in type 2 diabetic patients after 1-year liraglutide treatment. The response criteria were defined as a reduction of more than 1.0 percentage point in HbA1c and a weight loss more than 3 kg of initial body weight. All patients were categorized into four groups: non-responders, HbA1c responders, weight responders, and double responders for both HbA1c and weight. 243 patients were included during 8 months but 18% of them discontinued the treatment at 6 months. Data were exploited for 162 patients still on liraglutide treatment at the 1-year visit. The average HbA1c reduction was 0.98 ± 1.5% and weight loss was 4.7 ± 7.1 kg. More than one quarter (25.5%) of patients were non-responders, 23% weight responders only, 21% HbA1c responders only, and 25.5% both HbA1c and weight responders. Comparing to non-responders, double responders (HbA1c and weight) were significantly younger with shorter diabetes duration and higher initial BMI. This type of survey in routine practice allows to precise the best indications, while waiting for results of the large ongoing interventional studies.
    Médecine des Maladies Métaboliques 02/2014; 8(1):56–60.
  • Journal des Maladies Vasculaires 03/2013; 38(2):105. · 0.24 Impact Factor
  • Journal des Maladies Vasculaires 03/2013; 38(2):105. · 0.24 Impact Factor
  • La Presse Médicale 12/2012; · 0.87 Impact Factor
  • Journal des Maladies Vasculaires 03/2012; 37(2):79–80. · 0.24 Impact Factor
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    ABSTRACT: Thyroid metastasis of solid tumors is rare and often asymptomatic. Differential diagnosis with malignant thyroid tumor is difficult. We report a 65-year-old man who presented with a solitary intrathoracic thyroid nodule of the left lobe, inaccessible to fine needle biopsy. His past medical history was remarkable for a nephrectomy for a kidney clear cell carcinoma one year before. The PET-scan did not show any abnormal fixation. A left lobo-isthmectomy was performed. Histologic examination revealed an intrathyroid metastasis of kidney carcinoma.
    La Revue de Médecine Interne 03/2011; 32(3):e37-9. · 0.90 Impact Factor
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    ABSTRACT: Introduction L’influence de la réduction de la chute nocturne de fréquence cardiaque (FC) sur la néphropathie n’étant pas bien documentée, cette étude se propose d’en évaluer la responsabilité sur l’excrétion urinaire d’albumine (EUA) des diabétiques. Matériels et méthodes Ce travail repose sur une population de 96 diabétiques (âge moyen : 54,4 ± 15,2 ans, ancienneté du diabète : 15 ± 10,4 ans), ne recevant pas de traitement à visée cardiovasculaire. Lors d’une évaluation initiale (A0), une MAPA permet de séparer ces patients en 2 groupes selon que le rapport FC nuit / FC jour est inférieur à 0,90 (non dipper, N = 34) ou supérieur à cette valeur (dipper, N = 62). L’influence sur l’EUA est appréciée par son évolution à 5 ans d’intervalle et par sa valeur à A5. Résultats Les patients non dippers pour la FC sont plus âgés que les dippers (59,6 ± 13,4 vs 51,5 ± 15,5 ans, p < 0,01) mais l’ancienneté du diabète ne diffère pas de façon significative entre les 2 groupes. Pour l’ensemble de la population, la progression de l’EUA entre A0 et A5 est corrélée au rapport FC nuit / FC jour (r = 0,601, p < 0,0001), qui explique 36,1% de la variance de la progression. A A5, l’EUA est corrélée à FC nuit / FC jour (r = 0,418, p < 0,0001), ce rapport expliquant 17,5% de la variance de l’EUA. L’EUA est corrélée à l’âge des patients (r = 0,347, p = 0,0006), qui explique 12,1% de sa variance. Le rapport FC nuit / FC jour est également corrélé à l’âge des patients (r = 0,234, p = 0,02), l’âge n’expliquant que 5.5% de la variance de ce rapport. Conclusion La réduction de la chute nocturne de la FC, très probablement en relation avec la neuropathie cardiovasculaire, exerce donc un effet délétère sur le rein du diabétique, indépendamment du caractère non dipper de la PA.
    Diabetes & Metabolism 03/2011; 37(1). · 2.39 Impact Factor
  • Diabetes & Metabolism - DIABETES METAB. 01/2011; 37(1).
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    ABSTRACT: Introduction SUDOSCAN est une nouvelle technologie rapide et non invasive destinée à évaluer la fonction sudorale au niveau des mains et des pieds qui reflète le degré de neuropathie autonome. Cette méthode est basée sur la mesure de conductances au niveau de la peau résultant de la réaction électrochimique entre les ions chlorures de la sueur et des électrodes en contact avec la paume des mains et la plante des pieds. Le but de cette étude était de comparer les conductances mesurées au niveau des pieds aux tests d’Ewing et à l’analyse Spectrale du Holter ECG dans l’évaluation de la neuropathie autonome cardiaque (NAC). Patients et méthodes Cette étude a été conduite chez 257 patients diabétiques entre janvier et juin 2009 dans 1 centre hospitalier à Pune en Inde. Les patients ont bénéficié d’un dosage de l’HbA1c, d’une évaluation de la NAC par la mesure de la variabilité sinusale par Holter (mesure de la puissance spectrale) et les tests d’Ewing et d’une mesure de la neuropathie périphérique autonome par SUDOSCAN. Les patients ont été classés selon les valeurs des conductances électrochimiques des pieds (CECP, exprimées en micro-Siemens, μS) en sujets sans risque (CECP > 60 μs), à risque modéré (40 à 60 μS) ou à risque élevé (< 40 μS). Résultats L’âge moyen des 257 sujets était de 53 ± 11 ans, l’ancienneté de leur diabète 8 ± 11 ans, leur indice de masse corporelle (IMC) de 26 ± 5 kg/m2 et leur HbA1C de 8,2 ± 2,4%. La première mesure par SUDOSCAN a permis d’obtenir les 3 groupes suivants : 127 sujets sans risque, 64 avec un risque modéré et 66 avec un risque élevé. L’IMC et l’HbA1C ne différaient pas entre les 3 groupes. La composante basse fréquence de la puissance spectrale (LF) était diminuée chez les patients à risque élevé (CECP < 40 μS) comparativement aux patients à risque modéré (40–60 μS) et sans risque (> 60 μS) (136±203 vs 201 ± 330 et 258 ± 418 ms2 respectivement (p = 0,0006)). Chez les patients à risque élevé 32% avaient 2 tests d’Ewing perturbés contre 9 et 13% chez ceux ayant un risque modéré et sans risque (p < 0,0001). Des différences comparables étaient observées pour un test d’Ewing perturbé (41% contre 27 et 33% respectivement, p < 0,0001). Conclusion SUDOSCAN est un outil prometteur qui permet par l’intermédiaire de l’exploration de la fonction sudorale chez le sujet diabétique de détecter la présence d’une atteinte du système autonome cardiaque. Cette technique est d’autant plus intéressante que nous manquons de moyens simples et performants pour explorer la neuropathie autonome cardiaque.
    Diabetes & Metabolism - DIABETES METAB. 01/2011; 37(1).
  • H Mayaudon, P-O Miloche, B Bauduceau
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    ABSTRACT: The current sudomotor function tests are too time-consuming to be used for diabetic patients in daily practice. EZSCAN is a new, patented technology that measures electrochemical skin conductance (ESC) through reverse iontophoresis and chronoamperometry. The aim of the present study was to assess the sensitivity, specificity and reproducibility of the method in type 2 diabetic patients in comparison to control subjects with no risk of diabetes. A total of 133 type 2 diabetic patients and 41 control subjects were tested. Participants placed their hands and feet on nickel electrodes, and an incremental low direct current was applied to the anode for 2 min. ESC was calculated from the resulting voltage and generated current. ESC diagnostic accuracy was analyzed by ROC curve modeling, and reproducibility was assessed using Bland-Altman analysis. The ESC of hands and feet was significantly reduced in diabetic patients (53±16μSi and 67±14μSi, respectively) compared with control subjects (68±16μSi and 80±7μSi, respectively; P<0.0001). ESC values had a sensitivity of 75% and specificity of 100%, with an area under the ROC curve of 0.88 at a threshold of 50% on the EZSCAN scale. Coefficients of variation in hand and foot measurements were 15 and 7%, respectively. The good sensitivity, specificity and reproducibility of EZSCAN make it a feasible alternative for assessing sudomotor dysfunction, a clinical manifestation of autonomic neuropathy in diabetic patients. The test takes<3 min to perform, and requires neither special patient preparation nor medical personnel training.
    Diabetes & Metabolism 12/2010; 36(6 Pt 1):450-4. · 2.39 Impact Factor
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    ABSTRACT: Hypercalcaemia during pregnancy is rare but requires a systematic approach for its diagnosis and its treatment. We report a 32-year-old pregnant female at 32 weeks of gestation who presented a severe hypercalcaemia, due to primary hyperparathyroidism. The delivery allowed the birth of a healthy child who had a serum calcium level in the normal range. Eight days later, the mother was operated from a parathyroid adenoma allowing normalisation of calcaemia. Hyperparathyroidism during pregnancy is rarely reported; it can lead to severe complications for both the mother and the infant. The newborn can present tetania due to hypocalcaemia and hypoparathyroidism can be definitive. Surgery should be discussed when serum calcium level of the mother is markedly elevated.
    La Revue de Médecine Interne 11/2010; 31(11):e9-10. · 0.90 Impact Factor
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    ABSTRACT: The aim of this paper is to provide the fundamental background of the inflammation theory associated with type 2 diabetes, to discuss the clinical consequences of low-grade inflammation, particularly in terms of cardiovascular risk, and to infer some clinical therapeutic strategies deriving from drugs that already exist or are in development. This non-exhaustive work is the result of a Pubmed(®) research, based on requests including the following keywords: diabetes, inflammation, innate immunity, obesity, reticulum endoplasmic stress, cytokines, endothelial dysfunction. Obesity and type 2 diabetes are linked with a low-grade inflammation state that reflects the activation of innate immunity where metabolic, environmental and genetic factors are implicated. The role of endoplasmic reticulum stress and unfold protein response is underlined. Inflammation markers are predictive for the risk to develop diabetes, and are associated with an increased cardiovascular risk. While lifestyle modifications are followed by an improvement in inflammation markers, treatments inferred from the inflammation theory are of great interest, although quite moderate effects on glycaemic control have been observed with some of them. The development of molecules targeting different inflammatory mechanisms could lead in diabetic patients to improvement of both glycaemia and cardiovascular prognosis.
    Diabetes & Metabolism 11/2010; 36(5):327-38. · 2.39 Impact Factor
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    ABSTRACT: Diabetes and dementia, which have a complex relationship between them, are undergoing extensive growth in their fields. The occurrence of hypoglycaemia, the potential severity of which has just been pointed out in some recent studies, must be included in these relationships. In fact, diabetes is the cause of decline in cognitive functions and most certainly is involved in the occurrence of vascular dementia. The brain, which is highly dependent on glucose for its metabolism, is particularly vulnerable to hypoglycaemia in children and the elderly. Animal studies and pathoanatomical observations confirm the clinical impression of the reality of genuine post-hypoglycaemic encephalopathy. The impact of mild hypoglycaemia however is being debated. Lastly, the existence of dementia promotes the occurrence of hypoglycaemia due to disorders related to eating habits or poor treatment management. This hypoglycaemic risk however must not constitute a pretext for exaggerated laxity in achieving the blood glucose objectives.
    Diabetes & Metabolism 10/2010; 36 Suppl 3:S106-11. · 2.39 Impact Factor
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    ABSTRACT: Pituitary apoplexy is well known as the first manifestation of pituitary tumour. Conversely, haemorrhage of a pituitary adenoma, revealed by anticoagulant therapy, is very uncommon. Two weeks after initiation of anticoagulant therapy for a deep venous thrombosis, an 83-year-old woman presented with intracranial hypertension and blindness. CT-scan revealed pituitary hematoma within a large adenoma. Three months after surgery, partial visual defect persisted in association with panhypopituitarism. When pituitary disorder is known, hemorrhage risk should be taken into account in the prescription of anticoagulant therapy.
    La Revue de Médecine Interne 08/2010; 31(8):e1-2. · 0.90 Impact Factor
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    ABSTRACT: Pituitary apoplexy is well known as the first manifestation of pituitary tumour. Conversely, haemorrhage of a pituitary adenoma, revealed by anticoagulant therapy, is very uncommon. Two weeks after initiation of anticoagulant therapy for a deep venous thrombosis, an 83-year-old woman presented with intracranial hypertension and blindness. CT-scan revealed pituitary hematoma within a large adenoma. Three months after surgery, partial visual defect persisted in association with panhypopituitarism. When pituitary disorder is known, hemorrhage risk should be taken into account in the prescription of anticoagulant therapy.
    La Revue de Médecine Interne 08/2010; 31(8). · 0.90 Impact Factor
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    ABSTRACT: A 55-year-old woman presented with a recent diabetes mellitus associated with pancreatic and renal malformations. This atypical diabetes raised the possibility of maturity onset diabetes of the young (MODY) and a genetic research was performed. These malformations led to MODY5 diagnosis that was confirmed by the presence of HNF1beta gene mutation.
    La Revue de Médecine Interne 03/2010; 31(6):e5-6. · 0.90 Impact Factor
  • Diabetes & Metabolism - DIABETES METAB. 01/2010; 36.
  • Diabetes & Metabolism - DIABETES METAB. 01/2010; 36.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 55-year-old woman presented with a recent diabetes mellitus associated with pancreatic and renal malformations. This atypical diabetes raised the possibility of maturity onset diabetes of the young (MODY) and a genetic research was performed. These malformations led to MODY5 diagnosis that was confirmed by the presence of HNF1β gene mutation.
    Revue De Medecine Interne - REV MED INTERNE. 01/2010; 31(6).