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Biomedical subjects

H Herman

Publications and source records attributed to H Herman.

At least 19 recordsLinked to original sources
PubMed2001

Efficacy of celecoxib, a cyclooxygenase 2-specific inhibitor, in the treatment of ankylosing spondylitis: a six-week controlled study with comparison against placebo and against a conventional nonsteroidal antiinflammatory drug.

OBJECTIVE: To evaluate the short-term efficacy of celecoxib, a cyclooxygenase 2-specific inhibitor, in the treatment of ankylosing spondylitis (AS). METHODS: The study was a 6-week randomized, double-blind, placebo-controlled trial with 3 treatment arms: placebo, ketoprofen 100 mg twice daily, and celecoxib 100 mg twice daily. Patients who had AS according to the modified New York criteria, without peripheral synovitis and with active disease (pain > or =40 mm on a 100-mm visual analog scale [VAS] and an increase in pain of at least 30% after nonsteroidal antiinflammatory drug withdrawal) were eligible for study. Primary outcome measures were change in pain intensity (VAS) and change in functional impairment (Bath Ankylosing Spondylitis Functional Index [BASFI]). RESULTS: Of the 246 randomized patients, 76 were allocated to receive placebo, 90 ketoprofen, and 80 celecoxib. There were no statistically significant differences between treatment groups at study entry. During the 6 weeks of the study, the decrease in pain and functional impairment was greater in the active treatment groups than in the placebo group, with a trend in favor of celecoxib when the 2 active treatments were compared. The mean changes were -13 mm, -21 mm, and -27 mm (P = 0.006) for pain and 1, -6, and -12 (P = 0.0008) for BASFI score in the placebo, ketoprofen, and celecoxib groups, respectively. During treatment, the number of patients reporting epigastric pain was 6 (8%), 13 (14%), and 10 (13%) in the placebo, ketoprofen, and celecoxib groups, respectively. CONCLUSION: The results of this study confirm the clinically relevant antiinflammatory effect of celecoxib at a 200-mg daily dosage, with significant improvement of both pain and function in patients with AS.

Adult↗
PubMed2001

Elucidation of protein-lipid interactions in a lysozyme-corn oil system by Fourier transform Raman spectroscopy.

Lysozyme (25% in D2O, corn oil, and their emulsions (10% w/w oil/D2O solution) were examined by Fourier transform Raman spectroscopy. Emulsions showed three layers, namely, top oil, middle cream, and bottom aqueous layers. Raman spectral analysis revealed hydrophobic interactions involving both protein and lipid components. Compared to lysozyme in D2O, the difference spectrum obtained after subtraction of oil from the cream layer spectrum showed reduced intensity of tryptophan bands at 760, 1013, 1340, and 1360 cm(-)(1), reduced intensity ratio of the tyrosine doublet at 850 and 830 cm(-)(1), and increased intensity of the C-H bending band at 1455 cm(-)(1). Compared to corn oil, the difference spectrum after subtraction of lysozyme from the cream layer spectrum indicated decreased intensity at 2855 cm(-)(1) (lipid CH(2) symmetric stretch) and 3011 cm(-)(1) (unsaturated fatty acid hydrocarbon chain =C-H stretch) and a higher intensity ratio of the C-H stretching band at 2900 cm(-)(1) to bands at 2885 and 2933 cm(-)(1). Spectra of the top and bottom layers resembled corn oil and lysozyme, respectively, except for changes in the D2O band. Raman spectroscopy can be used to detect structural changes in proteins, lipids, and D2O due to protein-lipid interactions.

Corn Oil↗
PubMed2001

[Upper gastrointestinal bleeding in patients treated by low-dose aspirin].

AIM OF THE STUDY: To estimate the number of people treated by low-dose aspirin (<330 mg daily) in France and to evaluate the risk of upper gastrointestinal bleeding associated with low-dose aspirin treatment. SUBJECTS AND METHODS: One thousand six hundred and two patients with upper gastrointestinal bleeding were included between January and June 1996 in 4 French areas. Data about patients characteristics, drugs recently used, and bleeding lesions were prospectively collected. Five hundred seventy five cases were matched for sex, age and area with control people without previous upper gastrointestinal bleeding. Low-dose aspirin intake in the population was estimated from the control group. Aspirin intake in the previous 7 days in cases and in controls was compared by logistic regression, adjusted for other gastrotoxic drugs intake. RESULTS: Low-dose aspirin is taken by about 1.2 millions adults in France. In 1 602 patients, gastrointestinal bleeding was related to a peptic ulcer in 34%. Aspirin was associated with higher risk of upper gastrointestinal bleeding: OR=1.68 (1.03-2.74) with low-dose, and OR 1.42 (0.91-2.21) with higher doses. CONCLUSION: About 2.8% of the population is exposed to low-dose aspirin in France. This treatment seems to be associated with a high risk of upper gastrointestinal bleeding.

Adult↗
PubMed2000

The vibrational spectrum of methyltrioxorhenium(VII).

The inelastic neutron scattering and high-resolution FT-Raman spectra of methyltrioxorhenium are reported. Literature assignments of the modes below 1600 cm(-1) are largely confirmed with the exceptions of the methyl torsion and the ReO3 bending modes. The methyl torsion is observed for the first time at 200 cm(-1), while the band at 230 cm(-1) assigned previously to the torsion is shown to be a component of the factor group splitting of the solid. In the FT-Raman spectrum, the bands that derive from the E modes in the isolated molecule are split by the Cs site symmetry of the crystal. This allows an unambiguous assignment of these modes to be made. On this basis, the assignment of the ReO3 bending modes is reversed with the asymmetric mode at 325 cm(-1) and the symmetric mode at 276 cm(-1).

Fourier Analysis↗
PubMed2000

Epidemiology and course of acute upper gastro-intestinal haemorrhage in four French geographical areas.

OBJECTIVE: To compare incidence rates and epidemiological characteristics of acute upper gastrointestinal haemorrhage (AUGIH) in France with those of other European studies. DESIGN: Population-based multi-centre prospective survey. SETTING: 29 public hospitals and 96 private specialists in gastroenterology in four administrative areas in France during 1996. SUBJECTS: A total of 2133 AUGIH patients 18 years and over were included in the six-month study. OUTCOME MEASURES: Incidence and mortality. RESULTS: The overall incidence in France was 143 cases per 100000 persons per year, classified as out-patients (16%), emergency admissions (59%) and in-patients (25%). The incidence rates increased with age except for in-patients, and were higher in males. Peptic ulcer (36.6%), varices (13.7%) and erosive disease (12.3%) were the most frequent diagnoses. In 677 patients (31.7%), aspirin, antiinflammatory drugs or corticosteroids were taken on the 7 days before bleeding. The overall mortality (out-patients excluded) was 14.3% (10.7% for emergency patients and 23% for in-patients). Mortality was associated with comorbidities (especially malignancies, cirrhosis, asthma or respiratory deficiency), was lower in emergency patients using non-steroid anti-inflammatory drugs, and higher in in-patients using corticosteroids. CONCLUSIONS: In France, patients with AUGIH are frequently managed as out-patients. Gastrotoxic drug use is frequently associated with AUGIH and constitutes a strategic opportunity for preventive treatment. Discrepancies between countries are not clearly explained either by demographic factors or by drug use, but this may be related to the emphasis on AUGIH in in-patients.

Acute Disease↗
PubMed2000

[Management of upper digestive hemorrhage occurring in the community: patterns of patient care in 4 French administrative areas].

AIMS: To describe patterns of health care management in patients with upper gastrointestinal hemorrhage and to identify factors linked to the different patterns. PATIENTS AND METHODS: We conducted a prospective study of patients over 18 with upper gastrointestinal hemorrhage (inpatients excluded) among all public hospitals and private practice gastroenterologists in 4 French administrative areas (3 in Northern France and one in the South West). RESULTS: One thousand six hundred and two patients were included over a six-month period (1996). An endoscopic procedure was performed in 1532 patients in public (70%) or private (20.5%) hospitals, or at private office (9.5%). Hospitalization was necessary in 78.8% of the patients in university, non university public or private hospitals (38.9, 45.5 and 15.6%, respectively) with a median duration of 6.5 days. Admission was associated to old age, short delay between hemorrhage and endoscopic procedure, previous gastrointestinal bleeding, cirrhosis or cancer, bleeding from peptic ulcer or esogastric varices. Endoscopic hemostasis was performed in 21.4% of the patients, more often in university and no university public hospitals. Surgery was necessary in 4% of the patients. Death rate was 10.7%. Important geographical variations were observed concerning referral patterns. Patients' characteristics did not differ between the 4 areas. On the other hand, health care supply provided in the management of upper gastrointestinal hemorrhage was different in the four French geographical areas. CONCLUSION: a) An initial endoscopic procedure is nearly always performed in patients with an upper gastrointestinal hemorrhage in France; in 1 patient out of 10, endoscopy was performed in a private gastroenterologist office; b) hospital admission was strongly related to epidemiological and clinical criteria of severity; c) the geographical variations observed in referral patterns depend in part on health care supply; d) upper gastrointestinal haemorrhage status could be used as an indicator of the quality of health care organizations.

Adult↗
PubMed1999

[Hemorrhaging eso-gastro-duodenal ulcers: epidemiology and management. A multicenter prospective study].

UNLABELLED: The aim of this study was to estimate the incidence, and to describe the characteristics and medical care in patients with bleeding upper gastrointestinal ulcers in the general population. PATIENTS AND METHODS: A study was performed over six months in 1996 in 4 French geographical areas: Finistère, Gironde, Seine-Maritime, and the Somme (3 million people minimum 18 years). All public or private hospitals, and specialist gastroenterologists in private practice participated in the study, based on a standardized questionnaire. RESULTS: Over 6 months 793 patients with bleeding ulcers were identified, corresponding to 27 per 100,000 inh./year or 24,000 cases in France. Most patients were men (60%) and 40.1% were 75 years and older. The ulcer was oesophageal (6%), gastric (47%), or duodenal (69%). In 406 patients (51.2%) a chronic disease was present (cancer, cirrhosis, circulatory, respiratory or cardiac disease). In 237 cases (29.9%) the ulcer occurred in patients, 453 patients (57.1%) were admitted and 103 patients (13%) were managed as outpatients. Gastrotoxic drugs were taken by 349 patients (44%): non steroidal anti-inflammatory drugs (18.7%), aspirin (21.2%, including 2/3 with doses under 330 mg/day), corticosteroids (7.8%) and 24.3% had anticoagulant therapy. Patients were managed in university hospitals (39.3%), other public or non profit hospitals (44.2%) or private hospital (16.5%) with geographical differences between the 4 areas. Therapeutic endoscopy was performed in 16.9% and a surgical procedure was performed in 5.9%. The mortality rate (outpatients excluded) was 13.5% (n = 93), but only 2% (n = 16) of death were associated with a bleeding ulcer: mortality was higher in inpatients (24.1%) than in out patients (8.1%). A chronic disease was also associated with higher mortality (17.9% versus 8.1%). CONCLUSION: Bleeding ulcers are frequent and severe, especially in inpatients or associated with chronic conditions. A gastrotoxic drug used is found in about fifty percent of the cases.

Adolescent↗
PubMed1998

Amorphous phase formation in plasma-sprayed hydroxyapatite coatings.

The amorphous phase content of air plasma-sprayed hydroxyapatite coatings is dependent upon spraying and deposition conditions. X-ray diffraction and optical microscopy were used to investigate the influence of spray parameters on the formation of the amorphous phase. Results show three factors which most influence the formation of the amorphous phase: dehydroxylation of the molten particle during flight, the cooling rate as it impinges onto the metal substrate, and the substrate temperature. Crystalline regions were identified as unmelted particles and elongated recrystallized areas. Amorphous phase regions vary throughout the coating but are more commonly found at the coating-substrate interface, i.e., the regions decrease toward the surface of the coating. Such an inhomogeneous distribution of phase content is expected to affect the clinical process of bone deposition, and therefore successful implant fixation.

Biocompatible Materials↗
PubMed1997

[Treatment of uncomplicated recurrent cystitis in women: lomefloxacin versus norfloxacin].

OBJECTIVE: compare the acceptability of 3-day regimen with that of 10-day regimen of fluoroquinolones for the treatment of recurrent uncomplicated lower urinary tract infection in women. METHODS: a multicentric, randomized open trial was conduced in 421 patients by gynecologic and general practitioners to determine acceptability, efficacy and safety of lomefloxacin 400 mg in a once a day dose given for three days compared with norfloxacin 800 mg in twice a day dose given for ten days for the treatment of recurrent uncomplicated lower urinary tract infection in women. RESULTS: acceptability, assessed at day 14, was significantly better for lomefloxacin group than norfloxacin group, respectively 57,1 p.100 and 38,0 p.100. Clinical success rate at day 14 was 97,2 p.100 for lomefloxacin and 97,5 p.100 for norfloxacin; at day 30 clinical success rate was respectively 97,6 p.100 and 98,1 p.100 relapse at one year was comparable between two groups. Adverse events were reported respectively in 15,6 p.100 and 16,6 p.100 of the patients, vaginal infections, dermatologic disorders and digestive disorders (abdominal pain, nausea) predominated. There were no serious adverse event. CONCLUSION: the acceptability is better for a 3-day regimen of lomefloxacin than a 10-day regimen of norfloxacin for treatment of recurrent uncomplicated lower urinary tract infection in women for comparable efficacy and safety.

Adult↗
PubMed1997

Endoluminal exclusion of an iliac artery aneurysm by Wallstent endoprosthesis and PTFE vascular graft.

Aneurysms isolated in the iliac artery and measuring more than 3 cm in diameter are associated with an increased rate of rupture and a high mortality rate. The current therapy recommended for such aneurysms is surgical exclusion. Percutaneous exclusion of isolated iliac aneurysms with covered or uncovered stents, however, reduces the morbidity and mortality rates associated with surgery by obviating the need for general anesthesia, avoiding significant blood loss, and reducing in-hospital recuperation time. We report the case of a patient who had an isolated atherosclerotic iliac artery aneurysm that was successfully excluded percutaneously by use of an endovascular prosthesis (WALLSTENT Endoprosthesis) made by Schneider (USA), Inc; Minneapolis, Minn, in conjunction with the Thin-Walled GORE-TEX (polytetrafluoroethylene) Vascular Graft (W.L. Gore & Associates, Inc.; Flagstaff, Ariz). Although various stent devices have been used recently in conjunction with a polytetrafluoroethylene graft to exclude peripheral arterial aneurysms, the self-expandable WALLSTENT has not been used with polytetrafluoroethylene in this fashion and for this purpose until recently. We present herein the technical aspects of endoluminal exclusion of the isolated iliac artery aneurysm with this composite stent-graft.

Aged↗
PubMed1992

Flexible sigmoidoscopy screening in an industrial setting.

Little is known about the yield of colorectal cancer screening programs in an industrial setting. We therefore established a flexible sigmoidoscopy screening program at a chemical manufacturing plant and offered testing to all employees over the age of 40. After a Fleet enema preparation had been administered, a digital rectal examination and sigmoidoscopy were performed on each volunteer worker in the medical office of the plant. The plant had an average census of about 650 workers; 202 were screened during a 2-yr period. The mean (+/- SEM) age of participants was 52 +/- 0.4. Sixty-four employees had polyps (31.7%); data on follow-up colonoscopy were available in 69%. Colonoscopy revealed adenomatous polyps in 23 workers (53.5%), hyperplastic polyps in 10 (23%), and no evidence of neoplasia in 10 (23%). Seven workers did not arrange for follow-up colonoscopy and 12 individuals could not be contacted. No cancers were detected. In the 40- to 50-yr age group, polyps were detected in 19.5% of employees (25% adenomatous). Incidental findings were common, and included prostatic nodules, hemorrhoids, diverticulosis, and proctitis, among others. We conclude that screening sigmoidoscopy can be conveniently and economically performed at the workplace, with a high yield and good worker acceptance. The high yield suggests a possible association between polyp formation and work in a chemical plant. The finding of adenomatous polyps in the younger patients suggests that the threshold for flexible sigmoidoscopy at age 50 needs to be reassessed.

Adult↗
PubMed1991

Vibration analysis of a blood processor centrifuge with anti-twister mechanism.

This paper deals with the vibration analysis of a blood processor centrifuge with an anti-twister mechanism. Blood processors that employ anti-twister mechanisms are becoming increasingly popular because they cause relatively less damage to the blood than the conventional ones, which employ rotating seals. Knowledge of the vibration response of the device in its operating regime is important for trouble-free operation. A simple, three-degree-of-freedom, lumped-parameter, torsional-mode model is presented here. This model was used to analyse an existing blood processor. On comparing experimental and analytical values, it was found that the fundamental frequency as predicted analytically is within 19 per cent of the experimental value; the predicted second harmonic is about 28 per cent higher than the experimental one. Thus the proposed model predicts the fundamental frequency with reasonable accuracy. In design, the goal is to keep the operating frequency of the device sufficiently above the fundamental frequency to avoid resonance problems.

Cell Separation↗
PubMed1987

Clinical manifestations in HLA-B27-positive patients.

The clinical manifestations of rheumatic diseases have been studied in a population of 440 HLA-B27-positive patients. Fifty-eight per cent had peripheral joint involvement. After statistical analysis and clustering of characteristics, three patterns of peripheral joint involvement were found. They were referred to as the X, Y and Z type for mnemotechnical reasons. The X type includes male patients with sacroiliitis, spondylitis, uveitis and uni- or bilateral arthritis of hip and/or shoulder. Y type patients present sacroiliitis, pauci-articular asymmetrical joint involvement and tendinitis. Z type patients are characterized by sacroiliitis, polyarticular symmetrical joint involvement and a positive IgM rheumatoid factor. This classification enables a new approach to the pathology, diagnosis and therapy of the seronegative spondyloarthropathies.

Adolescent↗
PubMed1979

Explorations of antimitotic agents in the treatment of a congenital disease, ichthyosis linearis circumflexa.

Successful therapy of a genetic disorder, Ichthyosis Linearis Circumflexa, was achieved using a low dose systemic cyclophosphamide. Prior to such therapy, 80 to 90% of the body surface was affected; the use of antimitotic agents reduced the extent of the lesions to less than 15% of the body surface. As a result, the clinical status was changed from severely disabling to being compatible with a normal way of life. It is believed that this phenomenon is related to selective effects of cyclophosphamide, such as those on lymphocyte subpopulations. To our knowledge, successful chemotherapy for diseases of genetic or congenital origin has not been previously reported.

Adult↗