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Biomedical subjects

M Beaugrand

Publications and source records attributed to M Beaugrand.

At least 109 records · Page 6Linked to original sources

Comparison of two sucralfate dosages presented in tablet form in duodenal ulcer healing.

Two hundred twenty-two patients with endoscopically proven duodenal ulcers participated in a controlled trial to assess and compare the effects of two dosage regimens of sucralfate tablets on ulcer healing, i.e., 1 g four times daily (group A, n = 131) and 2 g twice daily (group B, n = 128). Healing was defined as complete re-epithelialization. Clinical and endoscopic assessments were performed after four weeks (Day 28) and, if complete healing was not achieved, after four more weeks (Day 56). After four weeks, in group A (n = 114: eight patients were lost and nine were withdrawn), the ulcers had healed in 90 patients (79 percent), and in group B (n = 108: six patients were lost and 14 were withdrawn), the ulcers had healed in 80 patients (74 percent). The cumulative healing rates after eight weeks were 94 percent in group A and 95 percent in group B. No serious adverse effect was observed in either group. These results suggest that sucralfate tablets in a dosage of 2 g twice daily are as effective as 1 g four times daily in the treatment of acute duodenal ulcers and could lead to better patient compliance.

Adult↗

Elevation of CA 125 in patients with benign and malignant ascites.

The presence of CA 125, an ovarian cancer-associated antigen, was assessed in serum and ascites from patients with ovarian cancer (n = 47), hepatocellular carcinoma (n = 21), and liver cirrhosis (n = 40). Abnormal levels of serum CA 125 were observed in 49% of ovarian cancer patients, and in 89% of these same patients with ascites. In all cases of cirrhosis or hepatocellular carcinoma with ascites, CA 125 levels were above 35 U/ml. The specificity and sensitivity of CA 125 measurement for detecting ascites in chronic liver diseases were 73% and 100%, respectively. Furthermore, the CA 125 level was always higher in ascites than in serum. The authors conclude that CA 125 is a nonspecific marker of ascites. This result must be considered in the interpretation of CA 125 elevation in patients with ovarian cancer. Moreover, CA 125 may be of value in the diagnosis and monitoring of peritoneal diseases.

Adult↗

[Granulomatous hepatitis in cytomegalovirus infection in healthy adults].

The authors report 16 cases of cytomegalovirus (CMV) disease in previously healthy adults. Constant features included pyrexia lasting 3 to 8 weeks and mononucleosis occurring 2-3 weeks after the onset of fever. Moderate hepatomegaly without jaundice, splenomegaly and morbilliform or petechial rush were observed in 30 to 50 p. 100 of cases. None had pharyngitis. Mild increase in serum transaminase activity (2 to 5 N) was present in 13 of the 16 patients, but increased alkaline phosphatase activity was observed in only 3 of them. Liver biopsy was obtained in 10 patients. Liver lesions were characterised by the association of intra lobular granuloma, abundant mononuclear cells in the sinusoids and hepatic peri-venous inflammation but hepatocellular necrosis was not prominent. Typical intracellular inclusions were not seen, either in hepatocytes or in cells of biliary ducts. The diagnosis was ascertained by positive viremia and or viruria and presence of IgM antibodies. The outcome was favourable although clinical and biological signs lasted for about 8 weeks. The authors conclude that adults with chronic pyrexia, no pharyngitis and sub-clinical hepatitis with mild increases in transaminase activity and histologic mononucleosis hepatitis showing mononuclear infiltrates and granuloma formation are likely to have CMV disease.

Adult↗

[Fibronectin in the ascitic fluid: its diagnostic significance].

We studied fibronectin concentration in the ascitic fluid of 102 patients, 71 with cirrhosis, 13 with hepatocellular carcinoma, 12 with malignant peritonitis, and six with miscellaneous disease. Fibronectin concentrations in the first three groups were 45 +/- 45 mg/l, 54 +/- 84 mg/l, and 144 +/- 123 mg/l, respectively. The difference between patients with cirrhosis and malignant peritonitis was significant (p less than 0.01). However, fibronectin concentration greater than 100 mg/l had a sensitivity of 58 per cent and a specificity of 86 per cent for the diagnosis of malignant peritonitis. Ascitic fluid protein content over 30 g/l had the same sensitivity and specificity was 90 per cent. Among cirrhotic patients, high fibronectin concentrations were demonstrated in those with long-standing ascites (m = 134 +/- 58 mg/l) whereas the lowest concentrations were found in patients with severe hepatocellular failure (m = 12 +/- 9 mg/l). Concentrations were significantly different, according to whether or not spontaneous bacterial peritonitis occurred later (20 +/- 13 mg/l versus 52 +/- 49 mg/l); 83 per cent of patients with spontaneous bacterial peritonitis during their clinical course had initial fibronectin concentrations above 30 mg/l in their ascites. We conclude that: 1) measurement of fibronectin concentration in ascitic fluid is of poor diagnostic value for discrimination between malignant and non malignant ascitic, 2) low concentrations of fibronectin are associated with the occurrence of spontaneous bacterial peritonitis in cirrhotic patients. Hypothetically, the quantitative defect of fibronectin could be responsible for bacterial opsonization impairment in these patients.

Ascitic Fluid↗

[Serum and tissue concentrations of zinc after oral supplementation in chronic alcoholics with or without cirrhosis].

Seric and hepatic zinc concentrations are decreased in chronic alcoholics, particularly those with cirrhosis. The purpose of this study was: 1) to assess the duration of zinc intake necessary to normalize seric and hepatic zinc concentrations; 2) to demonstrate that this supplementation did not increase zinc concentrations in other tissues (erythrocytes, leukocytes and hair) and did not induce adverse reactions. Twenty alcoholic patients with (group A: n = 13 or without (group B: n = 7) cirrhosis received zinc sulfate 600 mg daily during 10 days, 10 patients with alcoholic cirrhosis during 30 days (group C) and 7 during 60 days (group D) and were compared with a group of 30 normal subjects. Serum zinc concentrations increased to normal values in all groups of patients. Hepatic zinc increased significantly in groups B (p less than 0.05) and D (p less than 0.01). Zinc concentrations in erythrocytes, leukocytes and hair were unchanged. No adverse reactions were observed. We conclude that seric zinc concentrations reached normal values in alcoholics with or without cirrhosis by daily supplementation of 600 mg zinc sulfate during 10 days to 2 months while hepatic zinc concentrations increased but remained under normal values in some patients, particularly those with cirrhosis.

Administration, Oral↗

[Severe jaundice in Legionnaires' disease: a case with early hepatic biopsy].

Although liver tests are frequently disturbed in Legionnaires' disease, jaundice occurs rarely except as a terminal event. The authors report the case of a 68 year-old man with jaundice as a presenting feature of the disease. Jaundice deepened rapidly until death a few days later. Drugs and other causes of cholestasis could be ruled out. An early liver biopsy was performed. The liver was histologically normal except for mitochondrial margination in the hepatocytes. No Legionella could be demonstrated by direct fluorescent assay. These findings suggest that: jaundice in Legionnaires' disease is not related to direct bacterial insult, cholestasis is probably consecutive to endotoxinemia, the mitochondrial margination, a rare histologic finding, could result from Legionnaires' disease. This last point needs confirmation by further studies.

Aged↗

CA 125 (ovarian tumour-associated antigen) in ascitic liver diseases.

The presence of Ca 125, an ovarian cancer-associated antigen, was assessed in serum from patients with liver diseases with (n = 26) and without (n = 26) ascites. Abnormal levels of serum CA 125 were observed in all patients with ascites and in 4 patients without ascites (15%). We conclude that CA 125 is a non-specific marker of ascites whatever the origin: ovarian carcinoma, cirrhosis or peritoneal inflammatory process.

Antigens, Neoplasm↗

[Hepatitis and mononucleosis syndrome related to the ingestion of salazosulfapyridine].

The authors report the case of a patient treated by salazosulfapyridine and presenting with hepatitis and mononucleosis. The clinical pattern was similar to infectious mononucleosis including pharyngitis and lymphadenopathy but infection by Epstein Barr virus or cytomegalovirus has been ruled out by serological tests. Responsibility of salazosulfapyridine was highly suggested by the following facts: hepatocellular necrosis was sharply centrolobular, plasmocytosis was the main finding in the white blood cells count and all abnormalities rapidly improved after treatment withdrawal. The authors point out that salazosulfapyridine intolerance could mimic infectious mononucleosis and viral hepatitis. In such cases the drug must be rapidly withdrawn to avoid massive hepatic necrosis.

Adult↗

[Does oral zinc improve the cellular immunity of patients with alcoholic cirrhosis?].

A depressed response to delayed hypersensitivity skin tests is frequent in patients with alcoholic cirrhosis. Immune dysfunction in these patients is presumably dependent on nutritional factors. Zinc deficiency, a common finding in alcoholic cirrhosis, inhibits cellular immunity and might be one of these factors. The aim of our study was to show that zinc supplementation may improve cellular immunity in patients with alcoholic cirrhosis. We therefore compared 2 groups of patients: patients in the treated group (n = 18) had a daily oral intake of zinc-sulfate, 200 mg, during 2 months, patients in the non treated group (n = 20) received no supplementation. Both groups had a free diet. Delayed hypersensitivity skin tests to 7 antigens were performed with the Multitest IMC System at the beginning and at the end of the study. The immunity score was determined by the number of tests producing a skin induration greater than 2 mm. The evolutive index, calculated in each patient, was the difference between the final and initial immunity scores. The 2 groups were similar for all studied parameters. Cumulated immunity scores improved from 35 to 53 in treated patients (p less than 0.02), and from 42 to 44 (NS) in non treated patients. The evolutive index was 1 +/- 1.4 in treated patients and 0.1 +/- 1 in non treated patients (p less than 0.05). We conclude that in patients with alcoholic cirrhosis, daily intake of zinc sulfate, 200 mg, improves responsiveness to delayed hypersensitivity skin tests.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

[Influence of diazepam premedication on upper digestive fiberscopy. 81 cases].

Upper gastrointestinal endoscopy is routinely used to follow up patients with digestive disease. The influence of premedication with diazepam on the procedure and on patients' acceptance of a second endoscopy was evaluated in a double-blind trial conducted on 81 patients randomized to 3 types of intravenous premedication: placebo (group A, 29 patients), diazepam 5 mg (group B, 27 patients) and diazepam 10 mg (group C, 25 patients). Endoscopy was performed under unfavourable conditions (refusal or agitation) in 12, 4 and 1 patients respectively of groups A, B and C (P less than 0.02). Out of 65 patients questioned one month later, 1 (group A) sternly refused a second endoscopy, 10 accepted unreservedly (O in group A, 4 in group B, 6 in group C; P less than 0.05 between A and C) and 54 accepted reluctantly. To find out whether diazepam was beneficial by impairing memory, a memory score on duration of the procedure was established; there were no significant differences between the three groups (P less than 0.001), but they did not correlate with the patients' acceptance of a second endoscopy. It is concluded that premedication with diazepam 10 mg i.v. makes upper gastrointestinal endoscopy easier to perform and facilitates acceptance of a repeat endoscopy 1 month later. This effect is probably independent of the impairment in memory induced by diazepam.

Diazepam↗