[Vascular surgery in cerebral ictus].
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Cerebrovascular Disorders↗
Biomedical subjects
P Gasser
Publications and source records attributed to P Gasser.
Interferon and ursodeoxycholic acid combined therapy in chronic viral C hepatitis: controlled randomized trial in 203 patients.
AIMS: This prospective randomized trial was carried out in order to determine whether the long-term administration of ursodeoxycholic acid after discontinuation of interferon had any beneficial effect on the clinical course of hepatitis C virus infection. METHODS: Enrolled in the study were 203 patients with chronic active hepatitis C. They were all given: interferon alpha-2a (3 MU subcutaneously thrice a week) and ursodeoxycholic acid (10 mg/kg/day) for 9 months. At month 9, biochemical responders only were randomized into ursodeoxycholic acid treatment or placebo for 12 additional months (double blind study). RESULTS: At the end of interferon therapy, 71 patients (37%) were virological responders and 107 (56%) patients were biochemical responders and were randomized: 54 into the ursodeoxycholic acid group and 53 into the placebo group. Sustained response was evaluated 12 months after withdrawal of interferon. Sustained biochemical and virological responses were, respectively, 30% and 22% in the ursodeoxycholic acid group and 46% and 32% in the placebo group, which did not significantly differ. Histological evolution of fibrosis and necrotic inflammatory activity were similar in the two groups. CONCLUSION: Continuation of ursodeoxycholic acid therapy after withdrawal of interferon in patients with end-of-treatment response did not result in any significant improvement either in the maintenance of response to interferon or in liver histology.
Adolescent↗
Why study vascular factors in glaucoma?
There is clinical and experimental evidence that both increased intraocular pressure and disturbed circulation are involved in the pathogenesis of glaucomatous damage. Among the many factors discussed, decreased blood pressure and vasospasm are the most important, and these factors may, at least in part, be therapeutically influenced. The basic underlying disorder might be a vascular dysfunction leading to local vasospasm and to systemic hypotension.
Animals↗
Short- and long-term effect of nifedipine on the visual field in patients with presumed vasospasm.
It is assumed that the ocular circulation may be involved in the vasospastic syndrome and patients with vasospasm have visual field defects that are neither ophthalmologically nor neurologically explainable. A retrospective study showed that 20 mg sustained-release nifedipine treatment given orally may be helpful in these cases. There was a marked short-term effect in cases with proven peripheral vasospasms but not in similar cases without such vasospasms. The study also showed that the effect could last for up to 12 months when 20 mg nifedipine was given twice daily but the long-term effect was slightly less than the short-term effect. A number of patients had to discontinue nifedipine treatment due to side-effects.
Adolescent↗
Reaction of capillary blood cell velocity in nailfold capillaries to nifedipine and ketanserin in patients with vasospastic disease.
By using nailfold videomicroscopy in conjunction with local exposure of 60 s to cold air, the acute haemodynamic responses in capillary blood cell velocity 60 min after a single oral dose of 20 mg sustained-released nifedipine and 20 mg ketanserin were evaluated for each substance in 12 patients with vasospastic disease. The results obtained showed that the cold-induced flow stop duration was significantly (P less than 0.05) decreased and capillary blood cell velocity significantly (P less than 0.05) increased after local cooling. Systolic and diastolic blood pressure, heart rate and skin temperature did not differ significantly before and after treatment with either nifedipine or ketanserin. It is concluded that nifedipine and ketanserin are useful agents in the treatment of digital vasospastic disease. Furthermore, in vivo videomicroscopy is one of the few non-invasive and clinically useful direct methods for evaluating the effect of a drug on the microcirculation of normal and ischaemic skin areas.
Blood Flow Velocity↗
Systemic blood pressure and capillary blood-cell velocity in glaucoma patients: a preliminary study.
Systemic hypotension and vasospasm have both been suggested as risk factors for glaucomatous damage. Furthermore, a relationship between the incidence of vasospastic disorders and systemic hypotension has been reported. This preliminary study investigated the relationship between these two risk factors. In 20 glaucoma patients suspected to have vascular risk factors, time of blood-flow standstill was measured under cold provocation in nailfold capillaries and 24-hour blood pressure was monitored. Nine were high-tension glaucoma patients but progressing despite medically well-controlled intraocular pressure, and 11 had normal-tension glaucoma. Thirteen patients were vasospastic, and seven were not. Patients without vasospasm had a significantly lower mean systolic blood pressure during the daytime (113.4 +/- 7.1 mmHg) than vasospastic patients (122.6 +/- 12.8 mmHg), p = 0.026. The time of blood-flow standstill in vasospastic patients, however, correlated with the lowest individual systolic blood pressure reading (r = -0.56; p = 0.049). These low readings occurred mostly during the night ("deepers").
Blood Flow Velocity↗
[Development of instrumental and technical measurement aspects for clinical capillary microscopy].
Clinically oriented investigation in microcirculation was stimulated by the internist O. Müller. After the second World War new electronic methods were established and later converted into clinical techniques. Therefore it became possible to measure capillary blood cell velocity, dynamic capillary blood pressure and transcapillary diffusion of fluorescent tracers in human skin. For many years vital capillaroscopy has been successfully used to study the microcirculation of human skin capillaries. Capillary video-microscopy at the finger nailfold in connection with local cold exposure test are presented as a method with clinical applicability in vasopastic disease.
Capillary Permeability↗
[Cost evaluation of therapeutic management of patients with chronic hepatitis C].
Hepatitis C now poses an important problem of public health in France. The objective of this study was to evaluate the cost of care of 55 patients who were carriers of hepatitis C and treated with interferon alpha. The economic analysis included the blood testing costs, pharmaceutical costs and hospitalization costs. A questionnaire permitted the impact of the treatment on the socio-professional life of each individual to be assessed. The global cost amounted to 1155 359 francs spread among hospitalization costs (55 pour cent), pharmaceutical costs (35.8 pour cent) and blood testing costs (9.2 pour cent). Of 36 actively working patients being treated, 10 modified their activities and 4 of these 10 restarted their initial activities after stopping treatment. This evaluation has shown the disparities which exist in the clinical follow up of patients treated for chronic hepatitis C. It is thus imperative to institute a systematic screening of patients being transfused to permit an early diagnosis, to establish a rigorous standardization of blood testing, to visualise day care treatment and above all to establish a consensus of global care of these patients.
Adult↗