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Biomedical subjects

M Roche

Publications and source records attributed to M Roche.

At least 55 records · Page 3Linked to original sources
PubMed1992

HRT: an analysis of benefits, risks and costs.

A cost-effectiveness analysis of hormone replacement therapy (HRT) was undertaken to assess the relative benefits of different treatment strategies, and to identify which factors most influence cost-effectiveness. The current lack of conclusive evidence on the effects of HRT, especially in relation to combined therapy and cardiovascular disease, necessitated the use of a large number of assumptions in our model. In terms of net health benefits, the potential reduction in cardiovascular disease would have greatest impact, and would overshadow any small increase in breast cancer risk possibly associated with long-term use. Net expenditure by the NHS will depend critically on the direct costs of treatment, rather than on any indirect costs incurred or averted as a result of side-effects. In terms of cost-effectiveness, long-term prophylactic treatment of hysterectomised women and treatment of symptomatic women with a uterus compare favourably with other accepted health care interventions.

Breast Neoplasms↗
PubMed1992

Further studies on proteinases and alpha 2-macroglobulin activity in diabetic plasma.

Loss of chymotrypsin binding capacity of alpha 2-macroglobulin in diabetic plasma on in vitro incubation, could be partially prevented by phenylmethyl sulphonyl fluoride and pepstatin A. Prior ten-fold dilution of plasma with 0.02 M phosphate buffer (pH 7.0) completely arrested the process. The phenomenon could not be reactivated by Ca2+, lecithin or bovine serum albumin. Diabetic plasma, like normal plasma, exhibited maximal hydrolytic activities on H-D-Pro-Phe-Arg-p-nitroanilide, H-D-Val-Leu-Arg-p-nitroanilide and H-D-Ile-Pro-Arg-p-nitroanilide. The hydrolytic activities were not significantly diminished on incubation of plasma at 37 degrees C for 12 hr, unlike alpha 2-macroglobulin activity. On gel chromatography on Sephadex G-200, part of the proteolytic activity in diabetic plasma coeluted with alpha 2-macroglobulin in the VO region. A second activity peak (absent in normal plasma) was eluted with a Ve/V0 value of 1.40. Possible role of free proteinases in diabetic plasma in the inactivation of alpha 2-macroglobulin is discussed.

Amino Acid Sequence↗
PubMed1992

The management of hyperlipidaemia: are specialist lipid clinics needed?

A survey of all general practitioners in Oxfordshire was undertaken to determine what use they wanted to make of a district lipid clinic, and to assess how effectively it met their needs. The response rate was 85% (288/340) but some respondents failed to answer each section of every question. One hundred and eighty-five general practitioners (64%) had previously referred patients to the clinic. Most respondents selectively asked for blood cholesterol measurements in patients with major cardiovascular risk factors (94%, 266/283), and few routinely asked for cholesterol as part of a health check (17%, 43/258). Most thought that referral to a clinic was appropriate for children (65%, 149/229), for patients aged 20 to 39 (85%, 209/247), and for older patients aged up to 60 (77%, 186/243). Ninety-four per cent (260/277) wanted access to specialist advice for patients with a cholesterol concentration exceeding 8.0 mmol l-1, and 73% (197/270) wanted specialist advice before starting treatment with a lipid-lowering drug. Although most respondents rated the service provided by the clinic favourably, more than half would have liked more information on prognosis, drug treatment, long-term follow-up, and screening of family members. We conclude that general practitioners would like access to specialist advice for the management of severe hyperlipidaemias, and that cardiovascular screening programmes in primary care have important resource implications for specialist services.

Adult↗
PubMed1990

[Physico-chemical properties of 4 endodontic sealing cements].

Four endodontic sealers were compared with two series of tests, in thin layer and in 10 mm long and 5 mm diameter rods. Under these conditions, the Pulp Canal Sealer showed the best ability to present a thin layer and the same flow than the Cortisomol. Its setting time was 15 minutes. Forty-eight hours later, the Sealite showed a very good tightness compared to the other sealers. At 30 days, the Pulp Canal Sealer and the OZn-Eugénol were the tightest ones. Less water was absorbed with the Cortisomal and the Sealite. Is there, for these sealers, any correlation between water-absorbtion and tightness?

Absorption↗
PubMed1990

A radioautographic comparison of in vivo 3H-proline and 3H-serine incorporation in the pulpal dentine of rat molars: variations according to the different zones.

3H proline and 3H serine were injected intraperitoneally to rats which were killed 4 and 24 hours later. The incorporation of the labelled precursors was studied in the odontoblasts, predentine and dentine of the first lower molars. After radioautography, statistically significant differences in grain density appeared between the furcation, occlusal and lateral areas of the pulp chamber. The incorporation of predentine components into dentine was faster in the lateral than in the occlusal area, the slowest being detected in the furcation area. These differences may be related to the distribution of occlusal forces in the rat molar.

Animals↗
PubMed1990

[Intraperitoneal hyperthermic chemotherapy in the treatment of peritoneal carcinosis of digestive origin. A case report and physiopathology].

The authors describe their first experience of IP hyperthermochemiotherapy using mitomycin C under hypothermic coverage at 32 degrees C, in a female patient with peritoneal carcinosis secondary to stomach cancer. Postoperative complications were not observed. Tested mitomycin blood levels evidenced good absorption via the peritoneal route. 4 months later, the patient is doing well and the authors are propounding the method be started in a series of patients, in order to assess its long-term efficacy.

Adult↗
PubMed1989

Would primary health care workers give appropriate dietary advice after cholesterol screening?

The purpose of this study was to obtain information on the dietary knowledge of primary health care workers and on their ability to apply this knowledge in practice. A total of 128 primary health care workers (53 general practitioners and 61 nurses) in 12 practices and 14 primary care facilitators were surveyed by questionnaire between December 1987 and June 1988. All of the practices were participating in a project to promote prevention in primary care and offered health checks designed to identify and deal with cardiovascular risk factors. The questionnaire focused on issues related to managing patients with moderate hypercholesterolaemia. The results of the study showed some important gaps in the health workers' knowledge--for example, only 91 understood that dietary intake of polyunsaturated fatty acids as a proportion of total fat intake should be increased in a diet designed to reduce serum lipid concentrations. Appreciable gaps in their ability to give practical and appropriate dietary advice were also identified: 35 gave advice that would have led to the patient losing weight (although his history indicated that he was not overweight), and 27 gave only negative advice, offering no suggestions about substituting healthy foods for unhealthy ones. The demand for primary health care workers to give dietary advice is increasing and is likely to increase further if a national screening programme for hypercholesterolaemia is recommended. The results of this survey point to a need for improved nutritional education and training in dietary counselling for general practitioners, nurses, and primary care facilitators.

Clinical Competence↗
PubMed1989

Evaluation of a hospital teaching program for breast self-examination.

The purpose of this study was to evaluate the results of a hospital teaching program for breast self-examination. The retention of breast self-examination knowledge and the frequency and accuracy of breast self-examination of 50 subjects 9 months after hospitalization were examined. Findings of the study were that the majority of patients believed they had adequate knowledge to perform breast self-examination following the instructional program and 76% reported performing breast self-examination on a regular basis 9 months post hospitalization. Confidence in their knowledge and ability to perform breast self-examination as well as perceived susceptibility to breast cancer and perceived benefits of breast self-examination were positively related to subjects' breast self-examination practices.

Attitude to Health↗
PubMed1989

[Perforation of the cervical esophagus and hypopharynx complicating surgery by an anterior approach to the cervical spine].

Difficult diagnostic and therapeutic problems are raised by perforations of the cervical oesophagus or hypopharynx in patients undergoing surgery to the cervical spine via an anterior approach. Based on their experience of three recent cases, the authors review the diagnostic approach, based on clinical examination and diatrizoate sodium oesophageal series, and propose conservative treatment consisting of surgical drainage with or without suture of the perforation and without removal of the osteosynthesis material, appropriate antibiotic therapy and hypercaloric enteral nutrition via nasogastric tube. The prevention of this complication is based on correct use of surgical retractors.

Adult↗
PubMed1988

[Action of adenosine on intestinal motility after experimental mesenteric ischemia in dogs].

The purpose of the present work was to demonstrate beneficial action of adenosine on intestinal motility in the dog after experimental ischemia and to establish the role of A1- and A2-purinergic receptors. Adenosine was compared to an A1-agonist (N6-cyclohexyl-adenosine or CHA), an A2-agonist (5'-(N-ethyl) carboxamido-adenosine or NECA) and an inhibitor of adenosine cellular uptake (dipyridamole). Motility was analyzed by recording the electromyogram with intraparietal electrodes. Experimental ischemia was obtained by clamping the superior mesenteric artery during two hours. Under physiologic conditions, adenosine (1 mg.kg-1.i.v.) increased myoelectric complexes frequency by 49 p. 100 and the jejunal motility index by 46 p. 100. CHA (1 microgram.kg-1.i.v.) and dipyridamole (0.5 mg.kg-1.i.v.) increased myoelectric complexes frequency by 42 p. 100 and 67 p. 100 while NECA (1 microgram.kg-1.i.v.), increased the motility index by 30 p. 100. Adenosine and NECA increased mesenteric arterial blood flow by 35 p. 100 and 57 p. 100 respectively. After a two hours ischemia the return to normal electromyogram was 10.1 +/- 5.7 h. Adenosine (administered 10 min after the end of ischemia) reduced this recovery period to 3.3 +/- 0.8 h, NECA to 1.3 +/- 0.8 h and dipyridamole to 5.0 +/- 2.6 h. We conclude that, under physiological conditions, adenosine modifies jejunal motility directly via A1-receptors of smooth muscle and indirectly via A2-receptors of mesenteric vessels. On the other hand, after experimental ischemia, adenosine improves the post-ischemic restoration via vessels A2-receptors only.

Adenosine↗
PubMed1988

[Changes of erythrocyte and lymphocyte membrane fluidity after plasma extraction in children with type II homozygous hypercholesterolemia].

Two young girls with type IIa homozygotic familial hypercholesterolemia were treated by plasma exchange to reduce circulating cholesterol levels, values prior to treatment being abnormally elevated (greater than 10 mmol/l). Simultaneous determination of membrane fluidity (by fluorescence polarization) of erythrocytes and lymphocytes showed marked decreases due principally to an increase in the intramembrane cholesterol/phospholipid ratio. Values after treatment showed a tendency to return to physiologic levels without, however, attaining normal values. In vitro studies of cholesterol incorporation in these membranes demonstrated the primordial role of cholesterol in these processes of membrane rigidity, and their reversibility. It is suggested that certain physical membranal properties could provide a useful index to assess need for more or less frequent plasma exchanges.

Child↗
PubMed1986

Relationships between electromyographic ileal and colonic motility patterns in cats during fasting and feeding.

The relationship between ileal and colonic electromyographic motility patterns were investigated in six awake cats chronically fitted with subserosal electrodes implanted in the smooth muscles of the ileum and colon. Smooth muscle electrical activity (electromyogram) was recorded in both fed and fasted conditions under a 12-12 hours dark-light schedule. It consisted of electrical long spike bursts having two different patterns for each condition. Short sequences of three to five long spike bursts were propagated either aborally or orally from any part of the colon; they were most frequent during the interdigestive or fasting period and no relationship was observed between these long spike bursts and the electrical activity of the ileum. During the digestive or feeding period, the colonic activity was organized in long sequences of 10-15 long spike bursts, termed migrating spike bursts, which started near the caecal junction and propagated aborally to the distal colon. These migrating spike bursts were correlated with the ileal motility. This relationship demonstrated between ileum and colon after feeding is dependent upon the amount of food intake.

Animals↗
PubMed1985

[Differentiation of the effects of antispasmodic agents on the electromyogram of the sphincter of Oddi and the duodenum of the alert rabbit].

The electrical activity of the sphincter of Oddi and gastro-intestinal tract had been recorded on 21 negative atropineesterase conscious rabbits by means of chronically implanted electrodes located in the digestive wall. An analysis of the action of different spasmolytic and analgesic drugs was realized. Electromyograms of the sphincter of Oddi presented (a) isolated or in series spike potentials occurring independently of electrical activities of the duodenum (b) recurring spike potentials correlated with intestine spikes. The independent activity of the sphincter of Oddi was not controlled by the cholinergic system, contrary to the intestine-dependent activity (effect of the fempiverinium, atropine like drug). The pitofenone had inhibited the spike potentials of both the sphincter and intestine because its papaverinic effect. The noramidopyrine, analgesic drug without morphine-like effects, had induced activation and inhibition at low and high posology respectively.

Ampulla of Vater↗
PubMed1985

[Electromyographic profile of the human jejunum after abdominal surgery].

The purpose of this work was to describe the electromyographical profile of the jejunum observed after various types of abdominal operations. The electromyogram of the first 140 centimeters of the small intestine was recorded on a continuous basis by an intraluminal tube between the 6th and 20th day after abdominal surgery in twenty patients. Results allow us to describe a profile of the patient's intestinal electromyogram after abdominal surgery. It was characterized by three consecutive periods: a) early reappearance of migrating myoelectric complexes occurring during the first period; b) a very short second period beginning immediately before the expulsion of gases; during this period the electrical activity fluctuated and appeared disorganised; c) finally, during the third period, after gas expulsion, peristaltic rushes were associated with normalized migrating myoelectrical complexes. Both early and permanent migrating myoelectrical complexes characterize the normal postoperative period. Continuous linear integration of the jejunal electromyogram might be a useful tool for the monitoring of postoperative intestinal motility as a routine procedure.

Abdomen↗