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Biomedical subjects

D Rigaud

Publications and source records attributed to D Rigaud.

At least 73 records · Page 4Linked to original sources
PubMed1987

Effects of a moderate dietary fibre supplement on hunger rating, energy input and faecal energy output in young, healthy volunteers. A randomized, double-blind, cross-over trial.

The effects of moderate dietary-fibre supplementation on satiety, energy intake and faecal energy excretion were studied in 20 young healthy volunteers of normal body weight, mean body mass index 20.9, receiving a dietary fibre supplement of 7.3 g per day in a randomized, double-blind, cross-over study. Hunger feeling, energy intake, and defaecation pattern, were recorded daily during a 2-week control period and then, during two 4-week treatment periods. Furthermore, faecal energy output was determined during the last week of each treatment period. The fibre treatment, as compared to placebo, resulted in a significantly higher faecal energy excretion: 173 kcal/d (163-183 kcal/d) vs 153 kcal/d (135-171 kcal/d), respectively (P less than 0.05); a decrease in hunger rating (using a visual analogue scale) (P less than 0.05); an increase in number of bowel movements (P less than 0.05), and a softer consistency of the stools (P less than 0.05). There was no significant difference in mean energy intake between the two treatment periods. This study demonstrated that moderate dietary fibre supplementation in normal man increases faecal energy excretion with simultaneously decreased hunger feeling. These beneficial effects may have therapeutic value in the management of obesity.

Adult↗
PubMed1986

Peripheral venous complications of a hyperosmolar (960 mOsm) nutritive mixture: The effect of heparin and hydrocortisone. A multicenter double-blinded random study in 98 patients.

Peripheral intravenous nutrition with hyperosmolar solutions usually results in a high rate of venous complications. The aim of this multicenter double blind randomised study in 98 patients has been to measure: (a) tolerance by the peripheral veins being perfused with a protein-glucose-lipid nutritive mixture of 960 mOsm/l (group A, n = 33), (b) the protective effect of the additive to the nutritive mixture of either heparin: 1000 IU/1 (group B, n = 32) or heparin with hydrocortisone (5 mg/l) group C, n = 33). Tolerance by the veins was evaluated on a single vein site during a 48 h perfusion with 21 per day. The following complications: oedema, erythema, induration, thrombophlebitis led to the interruption of the perfusion. The rate of interruptions of perfusions for total venous complications and for thrombophlebitis has been respectively: at 24 h, in group A: 39 and 15%, in group B: 6 and 3%, in group C: 12 and 0%; at 48 h: in group A: 82 and 42%, in group B: 53 and 18%, in group C: 36 and 6%. Venous complication rates for 24 and 48 h were significantly lower in groups B and C (p<0.05) than in group A and there was no inter group difference between groups B and C. These results suggest that peripheral venous nutrition infusing 14.1 g of nitrogen and 8.5 MJ per day can be performed with a hyperosmolar solution of 960 mOsm/1, if that heparin be added to the nutritive mixture and the perfusion site be changed daily. Under these conditions the observed venous complications rate is equal to or less than 6% of cases.

Journal Article↗
PubMed1986

Intragastric pH profile during acute respiratory failure in patients with chronic obstructive pulmonary disease. Effect of ranitidine and enteral feeding.

The ability of H2 receptor antagonists and continuous enteral alimentation to maintain high intragastric pH in patients with chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation was evaluated by continuously monitoring intragastric pH prior to and following sequential addition of ranitidine or continuous enteral alimentation (or both) to their therapeutic regimen. Prior to therapy, intragastric pH was less than 4.0 for 75 +/- 10 percent of the time, but never less than 1.0. Nevertheless, this moderate gastric acidity was associated with evidence of mucosal injury. Ranitidine failed to continuously maintain a high intragastric pH (pH less than 4.0 for 35 +/- 11 percent of the time; p greater than 0.2 compared to patients treated with placebo). Following administration of continuous enteral alimentation, intragastric pH fell, and ranitidine therapy only partially blocked this increase in gastric acidity induced by continuous enteral alimentation. We conclude that without treatment, patients with COPD who have acute respiratory failure may develop gastric mucosal injury despite the presence of only moderate intragastric acidity; however, ranitidine and continuous enteral alimentation are not effective in maintaining a high intragastric pH.

Acute Disease↗
PubMed1985

A comparative evaluation of secretin bolus and secretin infusion as secretin provocation tests in the Zollinger-Ellison syndrome.

GIH secretin bolus (2 CU/kg) and infusion (3 CU/kg/h) have been randomly compared in 9 ZES patients and 10 age-matched DU patients. Serum gastrin and gastric acid variations were studied before and after either mode of secretin administration in the same individuals. Plasma secretin modifications were monitored in parallel. In both ZES and DU, secretin bolus and infusion induced similar gastrin responses (maximal changes and integrated responses). However, secretin infusion had a greater effect on acid output than bolus: larger inhibition in DU and larger increase in ZES. The additive diagnostic value of gastric acid secretion study during a secretin provocation test, as already reported, favors the use of 3 CU/kg/h secretin infusion over that of 2 CU/kg secretin bolus.

Administration, Oral↗
PubMed1985

[Consequences of antral and duodenal acidification on acid secretion, gastrin response and gastric emptying in duodenal ulcer patients and normal subjects].

The present study intended to investigate the effect of antroduodenal acidification on gastric acid secretion and emptying, gastrin and somatostatin release in response to food in healthy subjects as well as in duodenal ulcer patients. Ten duodenal ulcer patients and 9 normal controls were studied twice: the same 400 ml liquid protein meal (proteins: 10 g) was introduced into the stomach; then intragastric pH was either maintained at pH 4.5 or allowed to decrease in response to the meal. Acid secretion was calculated using the intragastric titration method (for which the intragastric pH is fixed at pH 4.5) and using the serial dilution indicator method (which allows antral acidification) respectively. Gastric emptying was estimated according to: a) iterative measurements of intragastric meal residual volume; b) volume passing through the pylorus. These two tests were performed in a random order and during each, plasma gastrin and somatostatin responses to the meal were determined. In healthy subjects, antral acidification following the meal was associated with a significantly lower acid secretion (17.3 +/- 0.9 mmol/h; m +/- SEM) than when the pH was maintained at pH 4.5 (20.2 +/- 1.3; p less than 0.05). Moreover, gastric emptying was slower when the pH was allowed to decrease (t 1/2: 26.2 +/- 1.4 min) than when the pH was constant (t 1/2: 20.5 +/- 2.2 min; p less than 0.05). By contrast, in the duodenal ulcer group, neither acid output nor gastric emptying were significantly different in the two situations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Release of pancreatic polypeptide in response to the intragastric administration of a meal is not different in duodenal ulcer patients and normal subjects].

The high basal and meal-induced acid secretions in duodenal ulcer patients has led to the concept that vagal hyperactivity is a common factor in the pathogenesis of peptic ulcer. For these reasons, since pancreatic polypeptide secretion is known to be under vagal control, we studied the pancreatic polypeptide release after intragastric administration of two protein meals (10 and 20 g protein in 400 ml) in 18 duodenal ulcer patients and in 17 normal subjects. After a 10 g protein meal was administered, gastric pH was either maintained at pH 4.5 or allowed to decrease. The 20 g protein meal induced a higher pancreatic polypeptide release than did the 10 g protein meal (p less than 0.05): the integrated pancreatic polypeptide responses were 1.07 +/- 0.5 and 3.21 +/- 0.58 nmol/l/60 min respectively in the duodenal ulcer group and 0.46 +/- 0.21 and 2.67 +/- 0.69 nmol/l/60 min respectively in the control group. On the other hand, the responses to the two protein meals in duodenal ulcer patients were not different from those obtained in normal subjects, despite the higher meal-induced acid secretions in the duodenal ulcer group. pancreatic polypeptide increase was not larger when gastric pH was fixed than when it was allowed to decrease, 0.56 +/- 0.21 and 1.7 +/- 0.63 nmol/l/60 min respectively in normal subjects and 1.07 +/- 0.5 and 1.07 +/- 0.49 nmol/l/60 min respectively in duodenal ulcer patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Abnormal pancreatic polypeptide release by secretin infusion in Zollinger-Ellison syndrome.

In 28 patients with the Zollinger-Ellison syndrome (ZES), 26 studied before and two after tumor excision, and in 26 age-matched control patients with duodenal ulcer (DU), plasma pancreatic polypeptide and serum gastrin concentrations were studied before, during, and after infusion of pure secretin (3 CU/kg/hr). In 21 ZES patients, gastric acid output was simultaneously studied. Fasting pancreatic polypeptide concentrations were over 300 pmol/liter in five of 26 gastrinomas. In DU, secretin caused a nonsignificant increase in plasma pancreatic polypeptide concentration and markedly decreased gastric acid output. In ZES, however, it resulted in a marked increase of both plasma pancreatic polypeptide concentration and gastric acid output. Basal and post secretin pancreatic polypeptide concentrations showed no correlation with gastric acid output, serum gastrin levels, or the age of the subjects, in DU patients as well as in ZES. These concentrations were not different in ZES patients who had a vagotomy compared to nonvagotomized ZES patients. Furthermore, the pancreatic polypeptide response to intravenous secretin was abolished by gastrinoma excision.

Adult↗
PubMed1984

Consecutive phases of gastric acid response to secretin in rats with chronic hypergastrinemia.

Secretin is known to inhibit gastric acid secretion but in some cases is able to stimulate both gastrin release and acid output. Different studies suggest that gastrin concentration at the parietal cell level modulates the acid response to secretin. Our purpose was to investigate in rats with chronic endogenous hypergastrinemia, as well as in control rats, the effect of an intravenous bolus of secretin GIH (from 0.25 to 4 clinical units (CU)/rat) on acid secretion. Both groups of rats were equipped with a chronic double gastric fistula allowing the collection of diluted gastric secretion every 2 min. We observed a dose-related inhibition of acid output (ID 50 less than 0.5 CU/rat) by secretin. In addition, in rats with hypergastrinemia; the acid response was phasic: an initial increase of acid output forewent its inhibition by 4 CU secretin. This phasic response suggests that secretin could act on acid secretion by releasing mediators which stimulate (as gastrin) and/or inhibit (as somatostatin) acid output.

Animals↗
PubMed1984

[Pancreatic endocrine tumors with digestive effects. Physiopathological and clinical aspects].

Endocrine tumours of the gastro-intestinal tract, especially pancreatic, play an important role in the regulation of digestive function and in the embryogenesis of the endocrine cells of the body. Histologically, about 50 p. 100 of these tumours are composed of several types of endocrine cell. However, in the majority of cases, the clinical and biological syndrome that they produce is related to the hypersecretion of only one of the peptide hormones secreted. One point of interest is the lack of correlation between tumour size, plasma concentration of the secreted peptide hormones, the effects of these endocrine oversecretions on the target organ(s) and the severity of the clinical presentation. This suggests phenomena of adaptation at each stage (tumour, peritumoral tissues and target organ). The diagnosis of gastro-intestinal endocrine tumors has been significantly improved by the development of reliable radioimmunological assays of the digestive hormones and modern techniques of medical imagery (ultrasonography, CAT scanning, selective portal angiography, aspiration biopsy under ultrasonic control). The prognosis of these tumours which are often malignant is better than that of gastro-intestinal adenocarcinoma. This justifies therapeutic intervention with the twin aim of controlling the effects of endocrine hypersecretion and tumour reduction. Surgical excision of the tumour should always be considered; if the tumour process is malignant chemotherapy will be required currently based on the association of 5-fluoro-uracil and streptozotocin.

Adenoma, Islet Cell↗
PubMed1984

[Zollinger-Ellison syndrome. Therapeutic aspects].

This review considers the place of surgery with its two indications: 1) suppression of the target organ of gastrin hypersecretion (total gastrectomy or other surgical procedures on the stomach), 2) radical tumour excision. The authors also discuss the use of anti-secretory drugs currently used in the Zollinger-Ellison syndrome and the respective usefulness of these different techniques in acute and chronic Zollinger-Ellison syndromes. The role of anti-tumour chemotherapy is also discussed.

Cimetidine↗
PubMed1983

[Influence of mixed venous blood PO2 on the pulmonary arterial pressure in chronic obstructive pulmonary disease (COPD): correlations in 128 patients].

Hypoxic vasoconstriction is one of the main determinants of pulmonary arterial hypertension in C.O.P.D. The authors study in two groups of respiratory insufficiency patients (82 C.O.P.D. and 46 non-C.O.P.D.) correlations between mean pulmonary arterial pressure (PAP) and gasometric values. They show that: --no correlation exists in the patients who suffer from a restrictive syndrome; --in the obstructive patients, correlations are poorer between PAP and PaO2 or PvO2 than between PAP and a factor made up of these two parameters, according to the percentage of their theoretical values.

Blood Pressure↗