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Biomedical subjects

D Urbain

Publications and source records attributed to D Urbain.

At least 55 records · Page 3Linked to original sources
PubMed1991

Efficacy of oral fluconazole in the treatment of AIDS associated oesophageal candidiasis.

To assess the efficacy and tolerance of fluconazole in the treatment of oesophageal candidiasis, 47 AIDS patients with this infection were enrolled in an open prospective study using fluconazole 100 mg given orally once daily. Clinical cure was obtained in all of 41 evaluable patients, with confirmation of cure in all of 31 patients who underwent post-treatment oesophagoscopy. Forty patients were followed up for at least 30 days; none suffered a relapse of oesophagitis but seven had a recurrence of stomatitis which was effectively treated with fluconazole. Fluconazole was well tolerated. Nausea was noted in three patients one of whom interrupted therapy. Transient mild elevation of ALT/AST was noted in five of 41 patients (12%). Fluconazole appears to be a safe and effective agent for oral therapy of oesophageal candidiasis associated with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Insulin-like growth factor I: a good indicator of functional hepatocellular capacity in alcoholic liver cirrhosis.

To assess the value of serum insulin-like growth factor I (IGF-I) determination in liver disease, 21 patients hospitalized for active alcoholic cirrhosis (19 males, 2 females), 56 +/- 2 y (mean +/- SE) were studied at admission. Individual scores of hepatic alterations (Child score) ranged from 6 to 12 (mean: 9 +/- 1). Basal IGF-I levels were dramatically decreased, averaging 0.11 +/- 0.02 U/ml vs 0.70 +/- 0.08 U/ml in 15 control subjects. In cirrhotic patients, IGF-I values were inversely correlated with the modified Child index (r = 0.57, p less than 0.01). A highly significant positive correlation (r = 0.68, p less than 0.001) was evidenced between IGF-I levels and aminopyrine breath test values (which provide quantitative estimates of the hepatic functional capacity). In contrast, no significant relationship was found between IGF-I levels and various nutritional parameters (albumin, prealbumin, retinol binding protein) after partial correlation analysis. The present data suggest that, in alcoholic cirrhosis, the decrease of circulating IGF-I values is mainly related to alterations of liver function, and that IGF-I can be used as a good indicator of functional hepatocellular capacity.

Adult↗
PubMed1991

Cholestasis in patients with the acquired immune deficiency syndrome: comparison between ultrasonographic and cholangiographic findings.

Cholestasis in patients with acquired immune deficiency syndrome was systematically investigated by ultrasonography and endoscopic retrograde cholangiopancreatography. The two procedures were found to be complementary, and showed similar results in 56.2% of the cases. Ultrasonography was superior in detecting common bile duct wall thickening, whereas endoscopic retrograde cholangiography was superior in demonstrating intrahepatic narrowing of the biliary tract.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Aminopyrine breath test in alcoholic cirrhosis.

Aminopyrine breath test was performed in 91 consecutive alcoholic cirrhotic patients in order to evaluate its clinical value in this group of patients. As compared with routine liver biochemical tests, aminopyrine breath test was found to be altered most frequently (93.5% of cases). A one-year follow-up was obtained in 69 patients. The one-year mortality rate was only 11% for values of aminopyrine breath test greater than or equal to 2%, whereas it reached 53.5 for results inferior to 2%. The prognostic value of the test was not, however, different from that of the Child-Turcotte classification.

Adult↗
PubMed1987

Comparison of two 99mTc(V)-dimercaptosuccinic acid preparations.

99mTc(V)-DMSA labelled either by increasing the pH together with a low concentration of Sn, or by increasing the pH only are compared in vitro and in vivo. The gel chromatographic separation shows that after incubation with blood, all the 99mTc(V)-DMSA preparations are stable and do not bind to the plasma proteins. The behavior in rats as well as in clinical studies does not demonstrate any distinctive characteristics between the different radiomolecules. It seems that the pH of the solution is an important factor which controls the formation of 99mTc(V)-DMSA.

Animals↗
PubMed1986

The clinical value of 201Tl per rectum scintigraphy in the work-up of patients with alcoholic liver disease.

The clinical value of thallium 201 per rectum scintigraphy in the work-up of patients with alcoholic liver disease was evaluated using data obtained in 104 patients. The 25th min ratio of heart to liver activities was used as an index of portal systemic shunting. This ratio was found to be normal in alcoholic patients with normal liver biopsy and also in those presenting only steatosis. It was slightly higher in patients with liver fibrosis and significantly higher values were observed in patients with liver cirrhosis. High values of the ratio were associated with a higher risk of portal systemic encephalopathy and/or gastrointestinal bleeding. The prognostic value of the test was supported by the fact that good correlations were observed between the ratio and widely accepted prognostic scores such as the Child score or the Orrego index. Moreover, high ratios were associated with an increased mortality risk at one year. We conclude that this simple test is interesting in the screening of cirrhotics at risk of encephalopathy, gastrointestinal hemorrhage, or early death.

Adult↗
PubMed1986

Thallium scintigraphy in the evaluation of portal systemic shunting. The problem of rectal absorption.

Thallium-201 scintigraphy is an attractive method for studying the portal systemic shunting. However, the technique is sometimes hampered by a low rectal absorption. The present work shows that cirrhotic patients present a significantly lower activity in the regions of interest in relation to the low absorption of the tracer as compared with non-cirrhotic subjects (p less than 0.01). This study also demonstrates that the dilution of the tracer in a large volume cannot be envisaged in order to increase the surface contact and secondarily the absorption, because part of the tracer can reach the inferior vena cava via portal systemic communications in the lower part of the rectum. Oral administration of the thallium was also attempted but this route cannot be used in relation to its poor absorption and due to the difficulty in separating liver from intestinal activity. The study also shows that even in the case of low activity in the regions of interest, the interpretation of the test in cirrhotic patients is usually possible on the condition that the curves of radioactivity in the liver and cardiac areas are ascending. Using these criteria, only 6.7% of the tests were in fact not interpretable in this study.

Female↗
PubMed1985

Perirenal urinoma secondary to prostatic obstruction.

We report a case of perirenal urinoma secondary to benign prostatic hypertrophy. This rare complication of bladder outlet obstruction was due to subsequent hydronephrosis and increased pressure in the renal cavities, leading to rupture of caliceal fornix and allowing perirenal extravasation of urine. Complete resolution of the urinoma was obtained with bladder decompression and conservative management.

Humans↗
PubMed1984

Antithrombin III, plasminogen and alpha 2 antiplasmin in jaundice. Clinical usefulness and prognostic significance.

In this prospective study, antithrombin III, plasminogen and alpha 2 antiplasmin which are synthetised by the liver were measured and compared with the Normotest, Thrombotest and fibrinogen concentrations in 92 consecutive jaundiced patients. Antithrombin III appeared to be the most discriminant coagulation test in differentiating hepatocellular from cholestatic jaundice. A high correlation was observed between antithrombin III, plasminogen and alpha 2 antiplasmin values suggesting that the liver synthesis of these parameters was closely linked. The prognostic significance of the blood coagulation tests in patients with jaundice has been studied. In parenchymatous liver disease, antithrombin III, plasminogen and alpha 2 antiplasmin were superior to the Normotest, Thrombotest and fibrinogen concentrations in predicting the prognosis of the patients at the time of admission. In cholestatic jaundice, however, none of the blood coagulation tests studied had a prognostic significance.

Adult↗
PubMedDate not supplied

Portal venous-esophageal luminal pressure gradient in cirrhosis.

The portal venous-esophageal luminal pressure gradient may be more important than the absolute portal venous pressure in explaining hemorrhages caused by esophageal varices. A continuous recording of portal venous pressure and the esophageal luminal pressure enabled the authors to study the gradient between these pressures in 12 cirrhotic patients with varices of different size and under different circumstances, in particular inspiration, expiration, coughing and a Valsalva maneuver. A significant increase of portal venous pressure occurred during inspiration (+15%), coughing (+77%) and Valsalva maneuver (+157%). The value of portal venous-esophageal luminal pressure gradient increased during inspiration (+38%), coughing (+90%) and Valsalva maneuver (+69%) while it decreased during expiration (-14%).

Adult↗
PubMedDate not supplied

Cut-off point, timing and pitfalls of the 13C-urea breath test as measured by infrared spectrometry.

BACKGROUND: The best timing and the best cut-off level of the 13C-urea breath test have not yet been well established. AIMS: To evaluate the cut-off value and the influence of medication on the 13C-urea breath test as measured by infrared spectrometry. METHODS: A series of 223 patients, sent for endoscopy performed 13C-urea breath test in fasting conditions with 75 mg of 13C-urea and 20 ml of citric acid. Breath samples were collected before and then 10, 20, 25 and 30 minutes after ingestion. As gold standard, histological examination of gastric biopsies was used. A questionnaire was completed concerning the intake of medication, likely to influence the test, in the 2 months preceding the test. Sensitivity, specificity, positive predictive value and negative predictive value at 10, 20, 25 and 30 minutes at different cut-off values (3, 3. 5, 4, 4. 5, 5.0 0/00 DOB] were calculated. RESULTS: A total of 182 patients did not take medication. There was no significant difference between the different cut-off levels at different times. Compared with the group of 41 patients who did take medication, likely to influence the test, the differences were significant (Fisher exact test). CONCLUSION: There was no significant difference between the different cut-off values. A 10-minute test with a cut-off level between 4 and 5% delta over baseline (sensitivity: 100%, specificity: 95%) is, therefore, proposed. To avoid false negative results due to unknown intake of medication, every patient submitted to the 13C-urea breath test should fill out a questionnaire.

Breath Tests↗
PubMedDate not supplied

Hypophosphatemia and refeeding: a corrective or a preventive attitude?

Hypophosphatemia is a rare but potentially lethal complication of the refeeding of cachectic patients. Up until now a careful monitoring of the serum phosphor level was recommended and the deficit was corrected as needed. Illustrated by two case reports we propose the use of a preventive schedule in patients with a normal renal function. We show that preventively treated patients do not develop hypophosphatemia and thereby avoid serious complications such as sudden death. In the presence of normal kidney function we propose to administer phosphor at 2 x 10 mmol/day orally or between 10 and 30 mmol IV depending on the initial phosphor levels. Further treatment is then adapted to measured levels. In the presence of kidney malfunction we propose to keep the corrective schedule.

Adult↗