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Biomedical subjects

B Cochet

Publications and source records attributed to B Cochet.

At least 19 recordsLinked to original sources

Calcium absorption from milk in lactase-deficient subjects.

Intestinal calcium absorption from milk containing lactose (+) and from another containing glucose (-) was studied in eight patients with normal lactase (NL) and seven lactase-deficient (LD) subjects to determine if lactase deficiency is implicated in Ca absorption. The results were compared with data obtained from Ca ingestion in a water solution. Ca absorption was measured by a double-isotope technique and the kinetic indices were obtained by a deconvolution method. With (-), Ca absorption was identical in NL and LD subjects and slightly higher than with water solution (15%, NS). With (+), Ca absorption in NL subjects was identical with that from water solution; in LD subjects it increased (23%, p less than 0.02). These data indicate that: Ca is absorbed equally well from milk as from water solution; (+) favors Ca absorption in LD subjects, which suggests that milk ingestion might be encouraged in LD subjects to avoid Ca deficiency; and (-) should be a valuable alternative for lactose-intolerant patients.

Animals↗

Effect of absorbable and nonabsorbable sugars on intestinal calcium absorption in humans.

The effects of glucose, galactose, and lactitol on intestinal calcium absorption and gastric emptying were studied in 9, 8, and 20 healthy subjects, respectively. Calcium absorption was measured by using a double-isotope technique and the kinetic parameters were obtained by a deconvolution method. The gastric emptying rate was determined with 99mTc-diethylenetriaminepentaacetic acid and was expressed as the half-time of the emptying curve. Each subject was studied under two conditions: (a) with calcium alone and (b) with calcium plus sugar. Glucose and galactose increased the calcium mean transit time and improved the total fractional calcium absorption by 30% (p less than 0.02). Lactitol decreased the mean rate of absorption (p less than 0.001) and reduced the total fractional calcium absorption by 15% (p less than 0.001). The gastric emptying rate did not appear to influence directly the kinetic parameters of calcium absorption. These results show that both glucose and galactose exert the same stimulatory effect as lactose on calcium absorption in subjects with normal lactase whereas lactitol mimics the effects of lactose in lactase-deficient patients. Thus the absorbability of sugars determines their effect on calcium absorption.

Adult↗

A simple method for measurement of intestinal calcium absorption in humans by double-isotope technique.

We describe a method for the fast calculation of total fractional calcium absorption (TFCaA) by the double-isotope technique (45Ca orally and 47Ca intravenously). The gamma- and beta-activities of plasma or urine samples were measured simultaneously. 47Ca activity was obtained by a gamma-ray spectrometer after exclusion of scandium 47. The 45Ca activity was measured directly by subtracting the 47Ca plus 47Sc component from the total beta-activity. In addition, 45Ca activity was determined after 8 weeks, to allow for 47Ca and 47Sc decay. There was good correlation between these two methods of measuring 45Ca activity. TFCaA was calculated both by deconvolution taken as a reference method and from the equilibrium quotient 45Ca/47Ca observed in several blood or urine samples collected at different times. The most convenient sampling time for calculation of this ratio was reappraised, taking into account the type of solution ingested orally (water or milk). The results indicate that simultaneous counting of gamma- and beta-activities of an appropriate plasma or urine sample provides a good and rapid measure of the calcium absorption. This method is considered to be useful as a clinical tool.

Adult↗

Effects of lactose on intestinal calcium absorption in normal and lactase-deficient subjects.

The effect of lactose on intestinal calcium absorption was studied in 12 normal-lactase subjects and 7 lactase-deficient subjects. Calcium absorption was compared by using the double isotope technique with or without the presence of an oral load of 50 g of lactose in each subject. The kinetic parameters were measured by the deconvolution method. In the normal lactase group, the lactose prolonged the duration of absorption at a maximum rate and therefore increased the total fractional calcium absorption from 0.224 +/- 0.039 to 0.356 +/- 0.076 (p less than 0.001). In the lactase-deficient subjects, the lactose decreased the total absorption from 0.255 +/- 0.039 to 0.209 +/- 0.032 (p less than 0.005); this effect resulted in a decrease of the maximum absorption rate. There was no significant difference between the two groups when calcium was ingested alone. These results indicate that the effect of lactose on calcium absorption is dependent on intestinal lactase activity.

Adult↗

[Pharmacokinetic study of a cephalosporin: cefoperazone in patients with a Kehr drain].

Cefoperazone is a semi-synthetic cefalosporine for parenteral use which has an excellent activity against a wide range of grampositive and gramnegative bacteria, especially Pseudomonas aeruginosa, Enterobacter, Proteus indole positive and Serratia marcescens. The pharmacokinetics of the new antibiotic have been studied in patients who had undergone cholecystectomy and choledochotomy for lithiasis and who required T-tube drainage of the bile duct. Five patients were anicteric and one was icteric. Mean serum concentration of cefoperazone determined by a microbiological method) measured after a two-hour intravenous perfusion of 2 g cefoperazone was 198.6 microgram/lm; this level is higher than the mean level measured in normal subjects (134 microgram/ml) but lower than the mean level measured in patients with hepatic insufficiency (208 microgram/ml). Apparent half life of elimination was longer (mean 4.1 hours) in the patients than in controls (mean 1.6 hours) and compares with that of patients with hepatic insufficiency (mean 4.3 hours). The distribution volume and renal clearance are similar to that in healthy volunteers and patients with hepatic insufficiency. Extrarenal clearance of cefoperazone was significantly lower in our patients (15.8 ml/min), as it is in patients with hepatic insufficiency (7.3 ml/min), than in the control group (59.4) ml/min). Cefoperazone concentrations in the bile were 10-20 times higher than those in the serum; in the icteric patient the concentrations achieved were still higher than the MIC values for organisms commonly encountered in the bile. These results open the way to the use of cefoperazone to treat infectious biliary diseases, particularly angiocholitis, which need a high biliary antibiotic concentration.

Adult↗

[Pharmacokinetic study of a cephalosporin, cefoperazone, in liver failure].

The pharmacokinetics of cefoperazone, a semi-synthetic cephalosporin for parenteral use with a spectrum covering P. aeruginosa, E. cloacae, indole-positive Proteus and S. Marcescens, was studied after a 2-h intravenous infusion of 2 g of the drug in 6 patients with moderate liver function impairment (viral hepatitis in 4 cases, alcoholic fatty liver and cirrhosis in 2 cases). At the end of the infusion, mean serum concentrations (determined by a bioassay) were 208 microgram/ml in the patients and 134 microgram/ml in healthy volunteers. The half-life was 4.3 h in patients and 1.6 h in healthy volunteers. Volume of distribution and renal clearance were similar in the two groups. Extrarenal clearance of cefoperazone was lower in the patients (7.3 ml/min) than in the control group (59.4 mg/min). Urinary excretion of biologically active drug was markedly increased in the patients (79% of the dose) compared with healthy volunteers (24%). This study provides evidence that liver function impairment increases with both the apparent half-life of elimination and the urinary excretion of the drug. The results raise the question of the desirability of cefoperazone dosage adjustment in patients with hepatic diseases.

Adult↗

[Diagnosis of lactase deficiency with the expired hydrogen (H2) test].

To determine the sensitivity and specificity of breath hydrogen (H2) in detecting lactase deficiency, breath H2 collected by end-expiratory sampling and capillary blood glucose were measured after ingestion of 50 g of lactose in 36 patients with biopsy-proved isolated lactase deficiency, 42 with normal lactase activity and 6 with lactase deficiency secondary to mucosal lesions. All patients had digestive symptoms clinically compatible with lactose malabsorption. The maximum increase in breath H2 concentration was more than 1.1 mumol/l (25 ppm) in all patients with isolated lactase deficiency, and less than 0.88 mumol/l (20 ppm) in 88% of patients with normal lactase activity; there were 5 false-positive results, attributed in one case to small bowel colonization and in another case to rapid transit after gastric surgery. Secondary lactase deficiency was accurately detected by neither breath H2 nor blood glucose.

Adult↗

[Excess mortality in out-patients psychiatry: first results of a Geneva study].

The project intends to prove an excess of mortality among the out-patients of the official psychiatric center of Geneva. The study is of the follow-up retrospective type. The primary results confirm the hypothesis. They show an increased relative risk of death by suicide and other non natural causes, for both sexes, as well as by natural causes (especially respiratory diseases) but only among women.

Adult↗

Asphyxia caused by laryngeal impaction of an esophageal polyp.

We report a case of asphyxia due to laryngeal obstruction by an esophageal polyp with subsequent cerebral anoxia and death. We review the clinical manifestations and pathological aspects of benign esophageal tumors, with emphasis on the importance of an early diagnosis if a patient has repeated sensations of a regurgitated pharyngeal mass.

Asphyxia↗

[Heparin treatment. Comparison between intravenous and subcutaneous administration].

48 patients with acute deep venous thrombosis of the lower limbs were treated with sodium heparin. In 23 patients heparin was injected subcutaneously (s.c.) twice a day and in 25 patients heparin was given by continuous intravenous perfusion (i.v.). Pain and edema disappeared after 8.7 days (s.c.) and 11.7 days (i.v.) respectively. One non fatal pulmonary embolism occurred in each group. A second venography was performed in 24 patients after 7 days of treatment and revealed no difference between the two groups. As judged by repeated thrombin time determination, anticoagulation was ineffective on at least one day in 39% of patients treated subcutaneously and in 60% of patients treated intravenously. The two pulmonary embolisms occurred in patients with ineffective anticoagulation. It is concluded that heparin may be used either intravenously or subcutaneously in the treatment of acute deep venous thrombosis. Thromboembolic complications occurred with both methods of treatment when anticoagulation was ineffective.

Heparin↗

[Exhaled hydrogen test in the detection of lactase deficiency].

To determine the validity of breath H2 measurements in detecting lactase deficiency, capillary blood glucose and breath H2 were measured after ingestion of 50 g lactose in 34 patients with abdominal symptoms or diarrhea. 18 patients had biopsy-proven lactase deficiency and 16 normal lactase activity. Blood glucose determination produced 2 false-positive results while breath H2 measurements provided 2 false-negative and 4 false-positive results.

Adult↗

[The hand in diabetes. Study of 97 diabetics compared to a control group].

To determine whether there is hand involvement specific to diabetes, 97 diabetics were compared with the same number of matched controls. Hands were examined with particular emphasis on skin, intrinsic muscles, articular mobility, sense of touch and vibration, digital systolic pressure, and radiological analysis of bones and joints. The most significant involvement, clearly present in 7 cases and less specifically in 12 other diabetics, included all of the following: atrophy and weakness of intrinsic muscles, painful interphalangeal rigidity limiting extension or flexion of the fingers, periarticular swelling of the phalanges, and trophic changes of the skin. Separately, these changes are not specific to diabetes: in the control group, although less frequent, they were found in patients aged 60 and over and are considered to be signs of senescence. Diabetes apparently accelerates the process of aging. Diabetic changes in the hand appear to be facilitated by neuropathy but not by arterial involvement. X-ray revealed a higher incidence of osteopenia and above all of vascular calcifications in the diabetic.

Adult↗

Peutz-Jeghers syndrome associated with gastrointestinal carcinoma. Report of two cases in a family.

Patients with the Peutz-Jeghers syndrome carry a slight, though definite, increased risk of gastrointestinal carcinoma. The malignant potentiality of Peutz-Jeghers hamartomatous polyps, generally considered benign, is supported by this report. Two cases of metastasising gastrointestinal carcinoma associated with the Peutz-Jeghers syndrome are described in a 56 year old female and her 29 year old son. Both mother and son died from duodenal and gastric carcinomas respectively, which developed in hamartomatous polyps with extensive metastases. Both cases also showed dysplastic areas within hamartomatous polyps. These features indicate that hamartomatous polyps may, in some cases, be the precursors of digestive tract carcinomas.

Adenocarcinoma↗

[Incidence of lactose intolerance in postmenopausal osteoporosis].

The incidence of lactose intolerance was determined in 31 women with idiopathic postmenopausal osteoporosis. Nine subjects exhibited a pathological rise in blood glucose (less than 20 mg/100 ml) after receiving 50 g lactose. The absorption of glucose and galactose, xylose, and fat was normal in the 31 patients. Daily intake of calcium was below the normal range in 3 subjects with and in 6 subjects without lactose intolerance. The association between lactase deficiency and osteoporosis is stressed.

Adult↗

[The exhaled hydrogen test: its value in the quantitative diagnosis of carbohydrate malabsorption].

A study has been conducted to determine the accuracy of breath-H2 measurements for quantitating the malabsorption of small amounts of carbohydrate. H2 pulmonary excretion was measured after an overnight fast at 30-min intervals for 4 h in 7 healthy subjects after ingestion of 4 doses of lactulose (2.5,5,10 and 50 g). In 3 subjects the test was repeated without lactulose. The volume of H2 excreted was directly proportional to the amount of ingested lactulose: mean cumulative H2 excretion over a 2-h period after 5, 10 and 50 g was 2.9, 6.6 and 37.6 ml H2 respectively; H2 response after the 2.5-g dose was not perceptible. Individual H2 excretion before lactulose ingestion was highly variable: 0.096 +/- 0.075 mlH2 (mean +/- 1 SD); the individual base line rate over a fasting period showed marked fluctuations. It is concluded that the inter- and intraindividual variations of H2 excretion limit the accuracy of the H2 breath test for quantitating malabsorption of small amounts of carbohydrate.

Breath Tests↗