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Biomedical subjects

P Hillon

Publications and source records attributed to P Hillon.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Comparison of the effects of a cardioselective and a nonselective beta-blocker on portal hypertension in patients with cirrhosis.

The effects on cardiac output and portal venous pressure of atenolol, a cardioselective beta-blocker, and propranolol, a nonselective beta-blocker, were compared in patients with portal hypertension due to cirrhosis. One hour after p.o. administration of 100 mg of atenolol, cardiac output decreased by 32%, and portal venous pressure by 16%; the decrease in cardiac output and the decrease in portal venous pressure were significantly correlated. One hour after p.o. administration of 40 mg of cardiac output and the decrease in portal venous pressure were not correlated. Whereas the decrease in cardiac output was similar after atenolol or propranolol, the decrease in portal venous pressure was significantly less marked after the former than after the latter beta-blocker. It is concluded that: (a) the decrease in portal venous pressure determined by atenolol results mainly from reduction in cardiac output; (b) the decrease in portal venous pressure determined by propranolol results not only from reduction in cardiac output, but also from extracardiac effects of this beta-blocker, and (c) atenolol might be less efficient in the prevention of recurrent gastrointestinal bleeding in cirrhosis, since the decrease in portal venous pressure is less marked than that which occurs with propranolol.

Atenolol↗
PubMedDate not supplied

Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a prospective study of factors associated with rebleeding.

In a previous randomized trial, we demonstrated that propranolol prevented recurrent gastrointestinal bleeding in patients with cirrhosis. We have undertaken the present study in a new group of patients to ascertain the factors associated with rebleeding. Among 232 patients with cirrhosis admitted for gastrointestinal bleeding, 127 were included. They received propranolol orally at a dose reducing the heart rate by 25%. The median follow-up period was 682 days. The following factors were studied: cause of cirrhosis; severity of cirrhosis; hepatocellular carcinoma recognized after inclusion; compliance; persistent decrease in heart rate; dose of propranolol; alcohol abstinence; previous history of hemorrhage; time interval from hemorrhage to onset of propranolol administration, and source of bleeding. The percentage of patients free of rebleeding was 71% at 1 year and 57% at 2 years. Only five factors were significantly and independently associated with rebleeding: occurrence of hepatocellular carcinoma; lack of compliance; lack of persistent decrease in heart rate; lack of abstinence, and previous history of bleeding. In conclusion, this study confirms the results of our previous trial and suggests that certain factors play a role in the mechanism of rebleeding in patients receiving propranolol.

Adult↗
PubMedDate not supplied

Postprandial hemodynamic responses in patients with cirrhosis.

The hemodynamic response to a 800 kcal liquid meal was investigated in 24 patients (study group) with cirrhosis and two control groups. One control group of six cirrhotic patients (volume control) had a calorie-free equivolumic electrolyte solution. The second control group (normal control) of six patients with normal hepatic function had the same test meal. Cardiac index, mean arterial pressure, heart rate, hepatic venous pressures, hepatic blood flow and azygos blood flow (only measured in the study group) were measured before and 30 and 60 min after the meal. Systemic circulatory responses were generally absent. Hepatic blood flow and wedged hepatic venous pressure increased significantly in both cirrhotic patients and normal controls; however, cirrhotic patients tended to have a quicker response (peaks at 30 min) than normals (peaks at 60 min). Azygos blood flow showed large postprandial variability, but overall did not change significantly. These results demonstrate that the splanchnic circulation of the patient with cirrhosis reacts differently from normals to the physiologic stimulus of a meal, and in particular appears to have precocious vasoactive reactivity.

Alcoholism↗
PubMedDate not supplied

Non-steroidal anti-inflammatory drug prescribing patterns in general practice: comparison of a general practitioner-based survey and a pharmacy-based survey in France.

PURPOSE: In order to assess biases occurring in primary care prescription studies, we compared non-steroidal anti-inflammatory drug (NSAID) prescribing patterns reported by general practitioners directly (GP-based survey) and from a pharmacy-based survey of general practitioner prescribing (pharmacy-based survey). METHODS: Volunteer GPs of the administrative area of Côte d'Or (France) returned a mailed questionnaire on NSAID prescribing patterns for consecutive patients seen during a 2-month period. In order to obtain a reference basis, pharmacies of the same administrative area provided all prescriptions that included NSAIDs during a 1-week period originating in general practice. RESULTS: The rate of participation was 25% for the GPs and 40% for the pharmacies. Participant GPs were representative of GPs of the area with regard to sex, year of graduation and practice area but pharmacies from rural areas were over-represented. The GP-based survey and the pharmacy-based survey provided respectively 770 and 1050 prescriptions. There were no differences between either survey in the type of NSAIDs prescribed and in the most frequently associated drugs. GPs who volunteered in the GP survey prescribed NSAIDs more frequently orally and at higher doses than GPs involved in the pharmacy-based survey. They also prescribed more gastroprotective drugs, especially in the elderly. None of these results could be explained by differences in patient characteristics and GP practice areas. CONCLUSION: GPs who actively participate in prescription surveys exhibit prescribing patterns that fit better with official recommendations than the average. Although selection biases cannot be ruled out, it is suggested that some changes in GP prescription habits may have been induced by the survey itself.

Adolescent↗
PubMedDate not supplied

[Markers of the hepatitis B virus and chronic alcoholism. Prevalence and risk factors].

In this retrospective study, the prevalence of hepatitis B virus markers was studied in groups of heavy drinkers and primary hepatocellular carcinoma patients (202 patients), hospitalized for the first time in a medical department of gastroenterology in France. HBs Ag, anti-HBs and anti-HBc were respectively detected in 1.1, 25.8 and 20.9 p. cent of alcoholic patients without hepatocellular carcinoma. The overall prevalence of hepatitis B virus infection was 26.9 p. cent. The presence of hepatitis B virus markers did not depend on excess alcohol consumption, sex, age, alcoholic liver disease intensity, or previous gastrointestinal bleeding or hospitalization, but was related to racial group and residence in countries with a high prevalence of HBs Ag. HBs Ag, anti-HBs and anti-HBc were observed in 0, 36.4 and 36.4 p. cent of the alcoholic cirrhotic patients with hepatocellular carcinoma and the prevalence of hepatitis B virus markers was 45.5 p. cent. The findings reported in this study suggest that hepatitis B virus infection has no major role in determining the rate of progression of alcoholic liver disease and plays a far lesser causal role in hepatocellular carcinoma in France than in high incidence regions.

Alcohol Drinking↗
PubMedDate not supplied

[Rectocolonic cancers in young patients. A population study (Côte-d'Or: 1976-1983].

Between 1976 and 1983, 1,783 colorectal cancers were diagnosed among the Cote-d'Or residents; of these 44 (2.5 p. 100) were under age 45. Cancer developed more often on familial polyposis (11.4 p. 100), ulcerative colitis (2.3 p. 100) or in the Lynch cancer family syndrome (4.6 p. 100) before 45 than in older patients: 0.2 p. 100 (p less than 0.01), 0.2 p. 100 (NS) and 0 p. 100 (p less than 0.01) respectively. There was no significant difference between young and older patients concerning the site, the histologic type or the stage of diagnosis. Curative resection rates were similar before age 45 (68.2 p. 100) as after that age (61.8 p. 100). Operative mortality was lower in younger (3.3 p. 100) than in older patients (12.6 p. 100; NS). After surgery for cure (operative mortality excluded) the 5-year corrected survival rates were similar in the two age groups: 69.4 +/- 8.8 p. 100 and 64.0 +/- 1.8 p. 100 respectively (NS). These data suggest that with the exception of predisposing diseases there is no important difference between young and older patients with regard to the anatomoclinical and evolutive aspects of colorectal cancers.

Adolescent↗