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Biomedical subjects

E Lerebours

Publications and source records attributed to E Lerebours.

At least 91 records · Page 5Linked to original sources
PubMed1989

Yogurt and fermented-then-pasteurized milk: effects of short-term and long-term ingestion on lactose absorption and mucosal lactase activity in lactase-deficient subjects.

Lactase-deficient subjects absorb lactose in yogurt more effectively than lactose in other dairy products. However, as all previous studies were performed without a double-blind design and only after a single ingestion of the test product, the mechanism of this enhanced absorption remains unclear. The aims of this double-blind study were 1) to evaluate lactose absorption after prolonged ingestion of yogurt and fermented-then-pasteurized milk (FPM) and 2) to assess the modification of the lactase activity of the duodenal mucosa. In 16 lactase-deficient subjects we confirmed that yogurt enhances lactose digestion, this beneficial effect being destroyed by pasteurization. Moreover, the long-term (8 d) ingestion of either yogurt or FPM does not modify the results of hydrogen breath tests in comparison with a 24-h ingestion. The mucosal lactase (Dahlquist method) and beta-galactosidase (ONPG method) activities were not significantly modified by yogurt or FPM ingestion. These results suggest that in lactase-deficient subjects no adaptation occurs after eating yogurt or FPM and that the increased lactose absorption in yogurt must be mainly related to an intraluminal process.

Adolescent↗
PubMed1989

Jejunal motility during cyclic total parenteral nutrition in patients with Crohn's disease.

Our aim was to study the jejunal motility (a) in seven patients receiving longterm (median: 24 days) cyclic total parenteral nutrition (CTPN) for an acute exacerbation of Crohn's disease involving the ileum and/or the colon without any sign of occlusion and (b) in six healthy volunteers undergoing the same parenteral nutrition for one day after an overnight fast. Continuous recordings, lasting 20 hours, were carried out in patients after correction of their nutritional status and significant improvement of the Crohn's disease activity index. In five of the seven patients, we recorded seven to 14 phase III episodes (PIII) (median: 10), both more frequent and slower during the nocturnal part of the recording time as compared with diurnal. Seven to 18 PIIIs (median: 12) were found in controls. The overall duration of the motor activity was not different between these five patients and controls. In the remaining two patients, no PIII episode was recorded and 79% and 57% respectively of the whole recording time consisted of irregular motor activity. Our work therefore, shows that: (a) PIIIs remain and have a circadian variation in their periodicity and propagation velocity, in most of our patients undergoing longterm CTPN (b) CTPN does not determine a longer duration of motor rest of the small bowel in patients than in controls submitted for a short period of time to the same parenteral intake.

Adult↗
PubMed1989

[Severe diarrhea caused by Ticlid associated with disorders of small intestine motility].

Ticlopidine is a potent inhibitor of platelet aggregation whose mechanism of action remains unknown. It might act through an increase of intraplatelet PGE1 and PGD2. Benign diarrhea is the most common side effect during ticlopidine treatment. We report four cases of severe chronic diarrhea with fecal incontinence in patients treated by ticlopidine. In two patients manometric recording of jejunal motility was performed. Abnormal motility patterns were observed in both cases: bursts of 3-11 propagated contractions occurring every 2 min and migrating at a rate of 0.6 cm/s, preceded and followed by a brief period of quiescence. Migrating motor complexes and a low percentage of time of quiescence were noted on both recordings. These disorders in intestinal motility may play a role in the pathogenesis of diarrhea observed with ticlopidine.

Aged↗
PubMed1989

[Upper gastrointestinal hemorrhage caused by anti-inflammatory agents].

The aim of this study was to describe the clinical and evolutive characteristics of gastroduodenal bleeding occurring in patients receiving nonsteroidal anti-inflammatory (NSAI) drugs, containing salicylates or not, and to determine the relative toxicity of the NSAI drugs without salicylates. Eight hundred and fourty-five consecutive patients with upper gastrointestinal bleeding related to endoscopically proven peptic ulcer or gastroduodenal erosions were admitted between 1983 and June 1987 to an intensive care unit for digestive tract hemorrhage. Of these, 267 were using anti-inflammatory drugs; 151 (56 p. 100) were taking NSAI drugs other than salicylates, 97 salicylates (36 p. 100) and 10, steroids (4 p. 100). Patients taking nonsteroidal drugs without or with salicylates were compared with patients bleeding from gastroduodenal ulcer or erosion not receiving anti-inflammatory therapy. Patients receiving nonsteroidal drugs not containing salicylates were older (70 p. 100 over 65 years of age vs 46 p. 100, p less than 0.001) and the proportion of female patients was greater (54 p. 100 vs 33 p. 100, p less than 0.001) than in the other group. No significant difference was observed with regard to the following parameters: percentage of gastric lesions, concomitant anticoagulant therapy, need for surgical hemostasis, or mortality. Patients taking aspirin had more gastric lesions (75 p. 100 vs 64 p. 100, p less than 0.05) and less need for surgical hemostasis (7 p. 100 vs 15 p. 100, p less than 0.05); the other parameters did not differ. NSAI drugs other than salicylates were taken more often for osteoarthritis than salicylates (33.6 p. 100 vs 17.4 p. 100, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1988

Change in energy and protein status during chemotherapy in patients with acute leukemia.

The energy and protein status of 12 adult patients with acute leukemia (AL) was investigated during induction chemotherapy. Parenteral nutrition (PN) (nonprotein [NP], 31.4 kcal/kg/d; nitrogen [N], 0.177 g/kg/d) was started on day 6 after the beginning of chemotherapy and continued through all of the cytopenic phase. A clinical and metabolic evaluation, including measurement of resting energy expenditure (REE) by indirect calorimetry, was performed on each patient within the 2 days before beginning chemotherapy (D0), on the third day of chemotherapy (D3), and then weekly from day 7 until the end of the cytopenic phase. Measured REE at day 0 (29.5 +/- 1.4 kcal/kg/d) was significantly higher (+34 +/- 6%) than theoretical REE. Chemotherapy induced a significant decrease in REE at day 3 (26.2 +/- 1.7 kcal/kg/d; P less than 0.05), but during the cytopenic phase REE was not different significantly from its initial values (D0). A positive energy balance was observed during the whole study after the beginning of PN. In contrast, mean nitrogen balance remained negative always, due to a sharp increase in urinary nitrogen loss during the cytopenic phase. The fact that nutritional support falls short of its goal may explain why no improvement in tumor response to therapy has been described in most studies.

Acute Disease↗
PubMed1988

Effects of intravenous and intraduodenal fat on jejunal motility and on plasma cholecystokinin in man.

The effects of intravenous and intraduodenal fat on jejunal motility were studied in nine normal volunteers. Using a nitrogen hydraulic infusion system, recording was performed continuously during 4 hr of fasting and 5 hr of 100 ml/hr infusion of fat (Intralipid 10%) given either intraduodenally (group ID) or intravenously (group IV) and 9 hr after the end of fat administration successively. The two experiments were performed at seven-day intervals in random order. In six of the nine subjects, a third experiment, in which 20 g of cholestyramine was given by mouth during intraduodenal fat infusion (group ID + C), was carried out. Venous blood samples were drawn for measurement of serum triglyceride levels and radioimmunoassay of plasma cholecystokinin. Intraduodenal fat, alone or plus cholestyramine, induced a significant reduction in incidence of phase III of the migrating motor complex. Intravenous fat reduced the incidence of phase III. However, this reduction was significant only during the last 3 hr of fat infusion, corresponding to the highest serum triglyceride concentration. In the three groups, fat infusion induced a significant increase in duration of phase II, leading to a postprandial-like pattern. Plasma cholecystokinin increased significantly in the three groups during fat administration, with a significant positive correlation between serum triglyceride concentration and plasma cholecystokinin in the group IV. The data suggest that, in addition to its known inhibitory effects on activity fronts when acting luminally, fat given intravenously may inhibit phase III activity. The effects in both instances may be mediated in part by cholecystokinin.

Adult↗
PubMed1988

[Methods of enteral nutrition].

The technique used for enteral nutrition has recently been improved by the development of certain new procedures: percutaneous endoscopic gastrostomy, a small-caliber catheter, use of a single container for a 24 hour period, ambulatory enteral nutrition in the hospital, and a wide range in the preparation and composition of nutritive mixtures. This paper reviews the different techniques used and evaluates the cost of enteral nutrition in the hospital.

Costs and Cost Analysis↗
PubMed1988

[Colonic pseudo-obstruction associated with diffuse digestive and vesical motor anomalies. Apropos of 2 cases].

Two patients with acute colectasia, and acute urinary retention following pregnancy (case n. 1) and Klebsiellae septicemia (case n. 2) requiring endoscopic exsufflation in both cases, were seen. At onset, both patients had esophageal and anorectal manometric abnormalities with right colonic transit delay, and in case n. 2 urodynamic perturbation. Several months later, abnormalities disappeared in case 1, but remained unchanged in case 2. Jejunal manometry performed in case 2 showed decreased interdigestive complex frequency. These data suggest that: 1) acute colectasia may be major expression of digestive and urinary motility disorders, 2) acute colectasia can be the first symptom of a chronic disease, suggesting the usefulness of manometric studies in these patients, once the acute episode is over.

Adult↗
PubMed1987

Somatostatin effect on rectal muscle in human healthy volunteers.

The effect of somatostatin on the rectal muscle has been studied in 15 healthy volunteers who received on 2 separate days and in a random order a continuous 1-hour infusion somatostatin (250 micrograms initially as an intravenous bolus and then 250 micrograms/h via infusion) or placebo (saline 0.15 M). Our results show that somatostatin significantly reduces the rectal basal tone after 30 and 50 min of infusion without modifying the rectal distensibility. Although they were obtained through a pharmacological increase of plasma somatostatin levels, these data suggest that somatostatin could play a part in the reservoir function of the rectum.

Adult↗
PubMed1987

[Controlled study of propranolol in the prevention of recurrent hemorrhage in cirrhotic patients].

The aim of this study was to assess, by a pragmatic controlled trial, the value of propranolol in the prevention of recurrent bleeding in patients with cirrhosis. From January 1982 to December 1984, 368 cirrhotic patients were admitted for bleeding episode due to portal hypertension. Ninety-nine patients were included in the trial 24 h after cessation of bleeding (5 days on the average after hospital admission) and were randomly assigned to 2 groups: 51 patients receiving propranolol at doses that reduced the resting heart rate by 25 p. 100 and 48 receiving neither treatment nor placebo. Ninety-one per cent presented a rupture of varices, and 9 p. 100 acute gastric erosions: 94 p. 100 had an alcoholic cirrhosis. The distribution according to Child Turcotte's classification was grade A: 45.5 p. 100, B: 45.5 p. 100, C: 100 p. 100. The two groups were not significantly different excepted for previous bleeding episodes. The cumulative percentages of recurrent bleeding were not significantly different: between the treated and untreated groups (60 p. 100 vs. 68 p. 100 at 18 months); between the compliant patients (n = 39) and untreated and not compliant patients altogether; between the treated and untreated patients of Child's grade A on the one hand, and patients grades B and C on the other hand. The curves of cumulative survival were not significantly different between treated and untreated patients (66 p. 100 vs. 78 p. 100 at 18 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Anticholinergic pharmacological studies of the lower oesophageal sphincter: importance of the technique of pressure recording.

To assess lower oesophageal sphincter (LOS) response to anticholinergic drugs, six healthy subjects were repeatedly studied according to two experimental procedures. In Method A, water-filled catheters were infused by a classical syringe pump and the recording assembly permitted only one orifice to be stationed within the LOS. The study was not conducted in a double-blind fashion. Method B was a double-blind study, in which water-filled catheters were infused by a hydraulic infusion system and the recording assembly permitted two or three orifices to be stationed within the LOS. The results showed that: Whatever the method used, LOS responses to pentagastrin (0.1, 0.3, 0.6, 1.2 micrograms/kg) were not significantly different under control experiments. With Method A, atropine infusion markedly reduced LOS responses to pentagastrin. With Method B, atropine infusion did not modify LOS responses to pentagastrin. These results raise the possibility that technical factors could account for conflicting reports of the effect of atropine on the pentagastrin-stimulated lower oesophageal sphincter.

Adult↗
PubMed1986

[Epidemiology of cancer of the pancreas. Current data].

In view of the poor prognosis of pancreatic cancer, improvements in our knowledge of its epidemiology are desirable. The present study describes its main geographical and chronological features and presents an up-to-date view of the principal risk factors associated with that disease. Mortality from pancreatic cancer is characterized by its increase with age, its predominance among males and its preferential ethnic and geographical distribution. The most striking point, however, is the increase of incidence noted since 1950, with an as yet unexplained tendency to stabilization. Among the various risk factors suspected of being associated with pancreatic cancer, only tobacco smoking seems to be well established. The methodological problems encountered in analytical studies explain that the role of nutritional, occupational and associated pathological factors remains hypothetical in the present state of our knowledge.

Adult↗