[Letter: Pseudotumoral pulmonary schistosomiasis due to Schistosoma mansoni].
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Biomedical subjects
Publications and source records attributed to G Huchon.
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OBJECTIVE: The main objective of the SCOPE study was to estimate the total direct medical costs of patients with treated chronic obstructive pulmonary disease (COPD) in France according to severity stages. METHODS: Total medical resources consumption of a sample of COPD patients was collected over a 12-month period through a national physician survey (including both general practitioners and lung specialists). This survey was completed for 255 patients. Data were then extrapolated to all patients with diagnosed and treated COPD in France. Average total medical resources consumption of a COPD patient per year was 4366 euros. Among this cost 41% was directly related to COPD follow-up, 25% to COPD-related complications (mainly exacerbations), and 34% to other diseases. More than one-third of the total direct COPD cost was related to hospitalizations and 31% to drug consumption. COPD-related costs increased markedly with severity based on FEV1 (but data suggested the existence of a threshold effect). SCOPE data did not show any evidence of a significant relationship between direct medical cost and patient age, sex, addiction to tobacco, or duration of COPD. The total medical consumption of COPD patients in France was 3.5 billion euros and accounted for 3.5% of the total medical expenditures (prevalence of COPD was estimated 1.3% in the general population). RESULTS: The SCOPE study revealed the high level of medical resources consumption of patients with COPD. CONCLUSIONS: The burden of COPD itself and its complications appeared to be of considerable magnitude in France especially for severe COPD.
The aim of this study was to compare the efficacy and safety of once daily dosing with moxifloxacin (BAY 12-8039) with that of coamoxiclav given three times daily for the treatment of acute exacerbation of chronic bronchitis (AECB). Moxifloxacin (one 400 mg tablet daily) was administered orally for 5 days and co-amoxiclav (three 625 mg tablets daily) was given orally for 7 days. The study was randomized, non-blinded, multinational (12 countries) and multicentre (68 centres). A total of 575 patients, all with clear signs of AECB, were treated, 292 with moxifloxacin and 283 with co-amoxiclav. Of these, 512 patients were evaluable for efficacy (261 in the moxifloxacin group and 251 in the co-amoxiclav group). The primary efficacy parameter was clinical response at 14 days in the evaluable population. A clinical success was classified as resolution or improvement of symptoms. Variables used to assess clinical response included wheeze, cough, dyspnoea, sputum volume, rales and rhonchi. The success rate for moxifloxacin in the evaluable patients was 96.2% and that for co-amoxiclav was 91.6%. The 95% confidence intervals for this difference (0.4%; 8.7%) indicate equivalence in the treatments. Sputum samples were taken from patients and 140 of these contained a pathogen, Haemophilus influenzae being the most frequently isolated. Moraxella catarrhalis and Streptococcus pneumoniae were also commonly isolated pathogens. The eradication rate at 14 days in the evaluable patients was 87.7% in the moxifloxacin group and 89.6% in the coamoxiclav group. Both drugs were well tolerated with no significant differences in the numbers of drug-related adverse events or the numbers of patients withdrawing because of an adverse event. These results and the broad spectrum of antibacterial activity make moxifloxacin a promising and safe alternative to conventional therapy for the empirical treatment of AECB.
Frequency of ectopic hormonal secretions by lung carcinomas is evaluated about 10 percent. Clinical and biological manifestations are less frequently registered than circulating hormonal products which can be considered as evolution markers of the disease. The main secretions and their clinical consequences are described: parathyroid hormone (PTH), calcitonin (CT), growth hormone (GH), antidiuretic hormone (ADH), corticotrophin hormone (ACTH) and gonadotrophins (HCG, LH, FSH). Problems raised by detection of these hormone-like acting products are studied and different hypothesis are suggested as explanation of these secretions.
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Two methods of assessing the permeability of the respiratory epithelium have been compared: the ratio of serum albumin concentration to bronchoalveolar albumin (BA/S Alb) and the clearance of the aerosolized 99mTc-diethylene-triamine-penta-acetic acid (Tc-DTPA). The study population consisted of a control group of 21 normal subjects (group C1) in whom BA/S Alb was determined, a control group of 26 normal subjects (group C2) in whom the clearance of Tc-DTPA was measured and a group of 27 patients with interstitial lung disease including 20 with sarcoidosis (group PI) in whom both BA/S Alb and the clearance of Tc-DTPA were measured. BA/S Alb was higher in group PI (3.55 +/- 2.44 mg X g-1) than in group C1 (0.67 +/- 0.31 mg X g-1; p less than 0.001). The clearance of Tc-DTPA was higher in group PI (3.64 +/- 4.05% X min-1) than in group C2 (1.18 +/- 0.31% X min-1; p less than 0.01). BA/S Alb value exceeded the normal value of 1.33 mg X g-1 in 23 of the 27 patients, but the clearance of Tc-DTPA exceeded the normal value of 1.82% X min-1 in 15 of the 27 patients (X2 = 6.4; p less than 0.02). No correlation has been observed between BA/S Alb and the clearance of Tc-DTPA.(ABSTRACT TRUNCATED AT 250 WORDS)
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