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Biomedical subjects

O Chassany

Publications and source records attributed to O Chassany.

At least 55 records · Page 3Linked to original sources
PubMed1994

A randomised clinical trial of the effect of informed consent on the analgesic activity of placebo and naproxen in cancer pain.

To determine whether informed consent in a therapeutic trial modifies the analgesic effect of naproxen and placebo, we conducted a prospective, randomised, single dose, placebo-controlled trial. Patients were randomly selected to receive or not information concerning the study. All patients included were then given a single dose of naproxen and placebo according to a crossover, double-blind design. Forty-nine patients with mild or moderate cancer pain which did not need narcotic analgesics entered the study. Twenty-five received both treatments without any information and constituted the uninformed group. Twenty-four had a complete information about the trial; six refused to participate. The 18 others constituted the informed-consent group. Visual analogue scales of pain before and 30, 60, 120 and 180 min after the intake of naproxen and placebo were recorded. As an analgesic, naproxen was more effective than placebo in both groups of patients (p = 0.001). For naproxen as well as for placebo, the analgesic effect was better in the informed-consent group compared to the uninformed group (p = 0.012). The difference in therapeutic activity between naproxen and placebo was moderately higher in the uninformed patients (p = 0.08). We concluded that, in contrast with parallel studies, giving information in a crossover, placebo-controlled trial may increase the apparent efficacy of both the tested agent and the placebo, and decrease the perceived difference the two.

Adult↗
PubMed1994

Binding of retinoid analogues to albumin and lipoproteins of human plasma.

The interactions of ten retinoid derivatives with human serum albumin (HSA) and lipoproteins have been investigated in vitro by an erythrocyte-partitioning technique that allows a quantitative estimation of the protein and erythrocyte binding. It was found that all these compounds were highly bound to HSA and lipoprotein. The binding to HSA was superior or similar to the binding to lipoprotein in the case of carboxylic acid derivatives. For the neutral derivatives, the binding to lipoproteins was generally higher than the binding to HSA. Retinoid binding to lipoproteins was strongly related to the computed octanol water partition coefficient (CLOGP).

Albumins↗
PubMed1994

Prevalence of HIV infections among patients attending a Parisian anonymous testing center between 1988 and 1993.

The prevalence of HIV infection was assessed among 15,611 consecutive patients attending a Parisian anonymous testing center from April 1988 to June 1993. Sera (17,910) were tested for the presence of anti-HIV antibodies using two different enzyme-linked immunosorbent assays. Seropositivity was verified by Western blotting. The sera were also assayed for HIV antigenemia detection in 2,493 cases. Six hundred and seventy-seven patients were found to be anti-HIV antibody positive: among them 666 were infected by HIV-1 and only 11 by HIV-2. Antigenemia was detected in 108 samples (4.3%). In all cases but 5, antigenemia was associated with the presence of specific antibodies. Risk factors for HIV infection could be determined for 5,735 patients. The HIV prevalence rates were 5.2% in 1988-89, 4.9% in 1990, 3.4% in 1991, 2.8% in 1992 and 1.8% for the 6 first months of 1993 (p < 0.01). Only one patient was coinfected with HTLV-1. This study shows a trend of decreasing seropositivity rates among the patients attending the anonymous testing center since 1990. By contrast, the percentage of seropositive patients with antigenemia was stable between 1988 and 1993.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Methotrexate serum binding in rheumatoid arthritis.

The serum binding of methotrexate was determined by equilibrium dialysis using radiolabelled methotrexate. Methotrexate was only albumin-bound in serum. The binding was 46% in controls versus 42% in rheumatoid arthritis and 44% in cancer. Serum binding was significantly decreased by salicylate and high concentration of naproxen. Hypoalbuminemia and concomitant administration of salicylate or naproxen may influence methotrexate toxicity.

Arthritis, Rheumatoid↗
PubMed1993

[Anonymous and free-of-charge centers for screening for HIV infection. Results of 30 months of activity in Public Assistance in Paris hospitals].

The results of 30 months of activity of anonymous and free-of-charge HIV detection centres in Paris hospitals are presented. During this period (April 1988 to December 1990), 15805 subjects were seen. This population accounts for about 11 percent of all French anonymous and free detection centres in 1990, and for 26 percent of the number of subjects consulting in detection centres of the same type. Risk factors could be listed in 8132 consulting subjects: 73 percent were heterosexuals and not drug-addicts; 19.5 percent were homo- or bisexuals; 6 percent were drug-addicts; 0.6 percent were both homosexuals and drug-addicts; 29 percent of the 7806 persons questioned about their use of condoms stated that they used them often or always. A total of 15271 blood samples were taken. The percentage of seropositivity was 4.73 percent with a significant fall from 5.87 percent in 1988 to 4.38 percent in 1990; 23.4 percent of homosexual drug-addicts, 17.6 percent of heterosexual drug-addicts, 9.3 percent of homo- or bisexuals and 1.3 percent of heterosexuals were seropositive. In the seropositive population, 46.4 percent were homo- or bisexuals, 29.8 percent were drug-addicts, 19.7 percent were heterosexuals and 3.7 percent were homosexual drug-addicts. Three subjects had been contaminated by blood transfusion. The percentage of seropositive subjects in our study was superior to the mean found in other anonymous and free detection centres (4.73 percent versus 3 percent in 1990), this probably reflecting the high prevalence of the infection in the Paris region. The seropositive subjects usually belonged to the categories primarily affected by the HIV. The percentage of seropositivity in our drug-addicts (17.6 percent) was much lower than that usually reported in French drug-addicts (30 to 40 percent).

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Prospective study of the prescription of non-steroidal anti-inflammatory agents in a reception medical service of a university hospital. Influence of the prescriptor].

Non-steroidal anti-inflammatory drugs (NSAIDs) are estimated to be excessively prescribed. We have prospectively collected all drug prescriptions written by 50 doctors in an Outpatient Service, during a 5-day period. The purpose of this study was to draw the outline of NSAID prescriptors. Junior doctors (66%) wrote more controversial NSAID prescriptions (66%) than other doctors.

Ambulatory Care↗
PubMed1992

[Prevention of gastroduodenal lesions induced by non-steroidal anti-inflammatory agents. Economic analysis from a survey of 356 physicians].

In order to obtain information on prescribing habits concerning the prevention of gastroduodenal lesions induced by non-steroidal anti-inflammatory agents (NSAI), 356 physicians practicing in 2 French departments were asked to fill a posted questionnaire. Fifty-one percent of these doctors gave an assessable answer. Among these, 84 percent occasionally prescribe "gastric protectors" associated with NSAI's in 32 percent of the prescriptions. They use antacids (48 percent), anti-H2 products (27 percent), sucralfate (11 percent) or prostaglandins (13 percent). This represents a daily cost of additional treatment ranging from 0.87 to 2.49 francs. If fibroscopies and further consultations necessitated by the prescription of NSAI's are taken into account, then 86 to 140 percent must be added to the cost of NSAI's. The profitability of these preventive measures in terms of public health will be really estimated only when the number of severe gastroduodenal lesions effectively prevented by taking topical gastric protectors or anti-secretory agents will be known.

Antacids↗
PubMed1992

Endoscopic evaluation of the effect of ketoprofen, ibuprofen and aspirin on the gastroduodenal mucosa.

Endoscopic lesions of the gastric mucosa were evaluated in 12 healthy volunteers after administration of single doses of ketoprofen (25 mg), ibuprofen (200 mg) and aspirin (500 mg) in a randomized, double-blind, cross-over study. The grades of the lesions (according to Lanza's scale) were lower after the administration of ketoprofen than aspirin and were comparable to ibuprofen. An endoscopic score greater than 1 was observed in 3 cases after ibuprofen or ketoprofen, and in 8 cases after aspirin. At a time when low, single doses of NSAIDs are widely used as analgesics, gastroscopy makes it possible directly to assess the local aggressivity of these molecules. In this way it was possible to demonstrate that the local toxicity of NSAIDs was lower than that of aspirin.

Adult↗
PubMed1992

Simultaneous noninvasive evaluation of gastric emptying and orocaecal transit times. Use in studying the actions of cisapride in diabetic patients.

The aim of the study was to use a novel combination of two methods for the simultaneous evaluation of two effects of oral cisapride in 10 diabetic patients with autonomic neuropathy; gastric empyting time was measured by following radio-opaque markers and orocaecal transit time by the sulphasalazine-sulphapridine method. The study was of double-blind, randomized, placebo-controlled, cross-over design. It was possible to evaluate the effect of a prokinetic drug on gastric emptying and orocaecal transit times using these two noninvasive techniques at the same time. Cisapride significantly reduced both the gastric empyting (1.2 h versus 2.1 h) and orocaecal tansit (5.9 h versus 7.7 h) times.

Adult↗
PubMed1992

Protection against aspirin-induced gastric lesions by lansoprazole: simultaneous evaluation of functional and morphologic responses.

The protective effect of lansoprazole, a new proton pump inhibitor, against aspirin-induced gastric lesions was studied in a double-blind crossover trial with a simultaneous measure of the functional capacities of the mucosal barrier (by a recording of the gastric potential difference) and of the morphologic changes in the mucosa (by gastric endoscopy). After 1 week of treatment with lansoprazole (30 mg per day) or placebo, each healthy volunteer received 1 gm aspirin by mouth. Recording of the gastric potential difference lasted for 3 hours and was followed by gastric endoscopy. Morphologic lesions induced by aspirin were effectively prevented by lansoprazole: Lanza score was 0.67 +/- 0.98 (mean +/- SD) versus 2.25 +/- 1.1 with placebo (p < 0.005, ANOVA). Conversely, the decrease in the gastric potential difference was similar. The inhibition of acid secretion induced by lansoprazole was therefore sufficient to prevent aspirin-induced mucosal lesions without reinforcing the defense capacities of the mucosa. This simple pharmacologic model makes it possible to simultaneously evaluate the functional and morphologic effects of aspirin intake on the gastric mucosa.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1992

Correlation between echographic gastric emptying and appetite: influence of psyllium.

The correlation between ultrasonographic gastric emptying and appetite was studied. Echographic evaluation of gastric emptying by measurement of the antral vertical diameter and assessment of sensations of hunger and satiety using analogue visual scales were performed simultaneously in 12 healthy volunteers. Measurements were carried out after the intake of 10.8 g psyllium or placebo in a randomised, crossover, double blind trial. The correlation between echographic gastric emptying and sensations of hunger and satiety was excellent (p < 0.001) after the intake of either psyllium or placebo. Psyllium significantly delayed gastric emptying from the third hour after a meal. It increased the sensation of satiety and decreased hunger at the sixth hour after the meal. The association between echographic measurement and visual scales is a simple method of evaluating the relationship between the stomach and appetite. The pharmacodynamic effect of psyllium should be confirmed by longterm therapeutic trials.

Adolescent↗
PubMedDate not supplied

[Synthesis: certainties/uncertainties in the prevention of venous thrombosis in medical patients].

In medical patients there are numerous and variable risk factors for deep vein thrombosis. Placebo-controlled clinical trials are rare. The efficacy of standard heparin or low molecular weight heparin for the prevention of deep vein thrombosis is clearly demonstrated for patients with recent myocardial infarction, ischaemic stroke with hemiplegia or severe pulmonary sepsis with lung failure. Pharmacological prophylaxis is probably also efficient in patients with a severe acute disease and a certain history of deep vein thrombosis. For all other medical and especially for bedridden elderly patients, use of low molecular weight heparin might decrease the incidence of deep vein thrombosis but might not modify the overall mortality. In these situations, placebo-controlled clinical trials are needed for best evaluation of the benefit-risk ratio.

Aged↗
PubMedDate not supplied

Binding of anthracycline derivatives to human serum lipoproteins.

The binding of eight anthracycline analogues (including mitoxantrone) to isolated serum lipoproteins (high, low and very low density lipoproteins) was studied in order to elucidate some determinants of their interaction with lipidic structures. Serum lipoproteins were isolated by ultracentrifugation. Drug binding experiments were run by ultrafiltration at 37 degrees C and pH 7.4. Anthracycline concentrations (total and free) were determined by HPLC with fluorometric detection. All the ligands were significantly bound to the three lipoprotein classes, and for each ligand the binding increased as the lipidic fraction of lipoprotein increased. From doxorubicin to iododoxorubicin, there was a tenfold increase in lipoprotein binding (doxorubicin < mitoxantrone < epirubicin < daunorubicin < pirarubicin < aclarubicin < zorubicin < iododoxorubicin). For all the ligands studied, the extent of lipoprotein binding appears to be related to chemical determinants of lipophilicity.

Antibiotics, Antineoplastic↗