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Biomedical subjects

M Amouretti

Publications and source records attributed to M Amouretti.

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

Pharmacokinetics and protein binding of cefpiramide in patients with alcoholic cirrhosis.

The pharmacokinetics of cefpiramide, a new cephalosporin, were investigated after a single 1 gm intravenous injection in 11 patients with alcoholic cirrhosis and compared with those of 11 healthy subjects. In patients with cirrhosis the plasma elimination half-life was three times longer than that in normal subjects. The total plasma clearance was decreased significantly (p less than 0.001): 12.3 +/- 6.5 ml/min in patients and 25.6 +/- 4.6 ml/min in healthy volunteers, respectively. The urinary excretion of unchanged drug (percent of intravenous dose) for patients (69.8% +/- 29.9%) was statistically higher (p less than 0.01) than that for subjects (16.2% +/- 3.9%). The renal elimination became increasingly important with hepatic impairment. Protein binding of cefpiramide was reduced significantly in the group with cirrhosis. The average unbound fraction was 10.4% +/- 9.5% in patients with cirrhosis and 1.9% +/- 0.3% in normal subjects (p less than 0.01). Because the rate of elimination from plasma in patients is slower, the dosage regimen of cefpiramide would probably be modified in cirrhosis.

Adult↗
PubMed1990

[Treatment of gallbladder lithiasis by piezoelectric extracorporeal lithotripsy].

We report the results of extracorporeal piezoelectric lithotripsy of gallbladder stones, using the EDAP LT 01 device, in 60 patients treated without anaesthesia or analgesia. Fragmentation was satisfactory (i.e. with fragments less than 5 mm wide) in 31 patients (52 per cent) after multiple sessions (mean: 1.6). The satisfactory fragmentation rate was higher in patients with stones smaller than 20 mm (63 vs 8 per cent; P less than 0.01) and not different in patients with solitary or multiple stones (53 vs 50 per cent). After bile acid dissolution treatment during 3, 6 and 12 months, the stone-free rates were 23, 41 and 64 per cent respectively, and significantly better at 3 and 6 months in patients with satisfactory fragmentation (42 vs 4 per cent; P less than 0.05, and 71 vs 9 per cent; P less than 0.01). Fourteen patients (23 per cent) reported biliary colic, but only one required cholecystectomy. No severe complication was observed. Piezoelectric lithotripsy is safe, requires short hospitalization and gives interesting results when the stones are less than 20 mm wide.

Adult↗
PubMed1990

Ursodeoxycholic acid for primary sclerosing cholangitis.

The effects of ursodeoxycholic acid (UDCA, 750-1250 mg/day) were evaluated prospectively in 15 patients with primary sclerosing cholangitis (PSC). Five patients had associated inflammatory bowel disease. After 6 months of treatment, the proportion of patients suffering from fatigue or pruritus decreased from 60% to 20% and from 33% to 20%, respectively. No exacerbation of associated disorders was observed. Serum alkaline phosphatase levels (normal less than 100 IU/l) decreased from 401 +/- 53 to 222 +/- 42 (mean +/- S.E.; p less than 0.001), those of gamma-glutamyl transpeptidase, (normal less than 40 IU/l) from 520 +/- 89 to 185 +/- 32 (p less than 0.001) and those of alanine aminotransferases, (normal less than 30 IU/l) from 79 +/- 12 to 42 +/- 6 (p less than 0.02). In three patients, the discontinuation of UDCA was associated with an aggravation of the liver test results. In conclusion, this study shows that 6 months of treatment with UDCA leads to clinical and biochemical improvements in patients with PSC. These results suggest that UDCA could be an effective treatment for PSC, and may justify a controlled therapeutic trial.

Adult↗
PubMed1990

[Evaluation of decontamination procedures used at digestive endoscopy units in Gironde].

Decontamination procedures used for endoscopes were noted in 23 digestive endoscopy units, public and private, in the department of Gironde and compared to recommended procedures. Serial, bacteriological samples were obtained from one esogastroscope and one colonoscope in each unit, after upper endoscopy and colonoscopy diagnostic procedures at the end of the endoscopy session. Six units of 23 used complete decontamination procedures. In the 17 other units, principal errors of decontamination procedures were: inadequate cleaning of internal channel of scopes (12 units) and lack of utilization of glutaraldehyde between each endoscopy (8 units). Bacteriological samples were negative in 11/12 endoscopes after a complete decontamination procedure and in 8/39 after an inadequate procedure (p less than 0.01). Complete procedures are efficacious but not used often enough. Information and changes in endoscopic practices are necessary in digestive endoscopy units.

Bacterial Infections↗
PubMed1989

[Tissue effects of extracorporeal lithotripsy on a model of experimental biliary calculi in dogs].

Extracorporeal shock waves represent a new method to treat gallstones. This study was designed to evaluate: 1) the effectiveness of a recently available lithotripter (EDAP LT 01) for gallstone fragmentation; 2) adverse tissue reactions after treatment; 3) the optimum conditions for use of this apparatus in man. A human cholesterol stone was surgically implanted into the gallbladder of ten 20-25 kg mongrel dogs. One dog was used as a control. The other nine animals were divided into three groups (A, B and C). Two 60 min sessions of lithotripsy were carried out twice a week. Sonographic and CT examinations were performed 9 and 16 days after operation. The animals were killed 21 days after operation. Satisfactory fragmentation was obtained in 4 of the 9 animals, and in 2 dogs no stone fragments were detected. Fragments were found in the common bile duct in 5 dogs. In 2 animals a pathologic aspect of the papilla of Vater was observed. Marked hematoma was observed in the animals treated at 5 and 10 pulses/sec. In 5 cases, hematoma was observed in the gallbladder and in one case the gallbladder was ruptured. Hematoma was also noted in the hepatic vascular bed in 3 animals. Except for microscopic hemorrhagic lesions observed at the base of the right lung, no lesions were detected in any other organ. Shock waves produced by the EDAP LT 01 are effective for fragmentation of gallstones. However, in view of the tissue reactions observed at the higher pulse rates, the pulse rate should not exceed 2.5 pulses/s for use in man.

Animals↗
PubMed1986

Effect of sucralfate on the bioavailability of cimetidine.

Twelve, healthy fasting, subjects received 200 mg cimetidine orally either with water or 1 g sucralfate in a randomized, single dose, two-way crossover study. Blood samples were taken for 12 h and urine was collected for 24 h. Cimetidine in plasma and urine was analysed by HPLC. There was no significant difference between the two treatments in peak plasma concentration, time to peak plasma concentration, area under the plasma concentration-time curve and urinary excretion. The results indicate that sucralfate did not reduce the bioavailability of cimetidine.

Adult↗
PubMed1985

[Efficacy of ranitidine and cimetidine in the treatment of gastric or duodenal ulcer resistant to an initial treatment with cimetidine. Multicenter controlled therapeutic trial].

In a controlled clinical trial conducted in 28 centers, 354 ambulatory patients with a cimetidine-resistant duodenal or gastric ulcer (at least six weeks of treatment at a dose of 1 g/day) confirmed by endoscopy were allocated at random to either ranitidine or cimetidine treatment: 166 patients received cimetidine (1.6 g/day in 4 oral doses), and 188, ranitidine (0.3 g/day in 2 oral doses). The two groups differed significantly with regard to sex and history of gastrointestinal hemorrhage but not with regard to age, weight, history of peptic disease, history of perforated ulcer, duodenal/gastric ulcer ratio, number of smokers and alcohol consumers. The criterion of effectiveness was endoscopic healing of the ulcer after six weeks of treatment; in case of doubt, vital staining with methyl blue was performed. A significant difference was observed between the results of the two treatments in the duodenal group (p less than 0.05) but not in the gastric group, the healing rates being respectively 71 p. 100 and 65 p. 100 with ranitidine, and 59 p. 100 and 44 p. 100 with cimetidine. Twelve patients developed side-effects with a highly significant difference between the two groups: 11 patients under cimetidine and one patient under ranitidine (p less than 0.001). These results show the effectiveness of ranitidine as a complementary treatment in cimetidine-resistant peptic ulcers of duodenal location.

Adult↗
PubMed1985

[Congenital hepatic fibrosis disclosed late by hepatic encephalopathy].

A case of hepatic encephalopathy revealing congenital hepatic fibrosis in a 47-year-old woman is reported. The characteristic features of this observation were: a) the long clinical latency of a congenital disease usually discovered in childhood or in adolescence; b) the existence of hepatocellular insufficiency which appeared without any other reason than an ordinary infection; c) the absence of digestive bleeding or portacaval shunt, factors always found in the rare, previously described cases of encephalopathy in congenital hepatic fibrosis.

Ammonia↗
PubMed1984

High density lipoprotein cholesterol and apoprotein A1 in healthy volunteers during long-term moderate alcohol intake.

Moderate alcohol consumption is associated with lower cardiovascular mortality. The effect of moderate alcohol intake during 5 weeks on lipoproteins, especially on the high density lipoprotein (HDL) cholesterol total (of which the levels are inversely predictive of coronary heart disease) and apoproteins A, A1 and B, was studied in 7 normal men. HDL cholesterol total appreciated by the heparin manganese precipitation method and phosphotungstate magnesium method increased (p less than 0.01) during alcohol consumption. The composition of HDL was modified by alcohol consumption: increase of the esterified/total cholesterol ratio (p less than 0.05) and phospholipids (p less than 0.05) without significant modification of triglycerides. Low density lipoprotein and very low density lipoprotein did not vary significantly. Apoprotein A1 increased during alcohol consumption (p less than 0.05) with a transitory increase of apoprotein A. There was no significant modification of apoprotein B.

Adult↗