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Biomedical subjects

R Colin

Publications and source records attributed to R Colin.

At least 37 records · Page 2Linked to original sources
PubMed1999

Postoperative management of stage II/III colon cancer: a decision analysis.

BACKGROUND & AIMS: Two separate decisions must be made for the management of patients with resected stage II/III colon cancer: whether to begin adjuvant chemotherapy and whether patients should be included in a follow-up protocol consisting of regular monitoring of carcinoembryonic antigen level and of colonoscopy and imaging. The standard management for these patients is adjuvant chemotherapy for stage III patients and follow-up for stage II/III patients with resected colon cancer. METHODS: Decision analysis was used to compare the effectiveness (5-year survival rate) and cost-effectiveness ratio of 7 strategies of treatment and follow-up. RESULTS: The most cost-effective strategies were adjuvant chemotherapy for all patients with stage II/III resected colon cancer, with either no follow-up or follow-up only for patients aged less than 75 years with a seric preoperative carcinoembryonic antigen level of >5 ng/mL (5-year survival, 62.3% or 62.7%; cost per surviving patient, $8254 or $8657, respectively). The order of efficacy of the strategies was insensitive to changes in the values of the studied variables. The method of follow-up does little to improve 5-year survival but adds substantial cost. CONCLUSIONS: The current standard strategy may not be the most cost-effective strategy for the management of patients with resected colon cancer.

Cohort Studies↗
PubMed1999

Octreotide in refractory functional epigastric pain with nutritional impairment--an open study.

AIM: To test the therapeutic efficacy of octreotide administered subcutaneously for the relief of chronic refractory epigastric pain severe enough to provoke nutritional impairment. SUBJECTS AND METHODS: Seventeen patients were enrolled in an open trial. Epigastric pain had lasted from 1 to 8 years (median: 5 years), following anti-reflux surgery in eight patients. Median weight loss was 10% (range 10-15). The initial dose of octreotide was 50 microgram b.d, adjusted during the follow-up visits which were scheduled for months 1, 3, 6, 8, 10, 12 and every 3 months. At each visit, overall symptomatic improvement, frequency and intensity of symptoms were checked on a 10-cm visual analogic scale. RESULTS: At month 1, a progressive improvement of pain intensity was reported in 15 of the 17 patients, while octreotide was a therapeutic failure in two. In four out of 15, the daily dose of octreotide was increased to 100 microgram b.d. In these 15 patients, median follow-up was 7 months (3-27). The symptomatic benefit was maintained in each patient at month 3, with a median weight gain of 3.5 kg.2-5 An attempt to stop octreotide led to recurrence of symptoms in 2-3 days which were as intense as before the treatment. The 11 patients followed-up for at least 6 months reported persistent improvement of symptoms with octreotide and a median weight gain of 4 kg.3-7 Four patients were followed up for more 11-27 months: octreotide was withdrawn gradually in two who remained asymptomatic. Six of the 17 patients experienced minor side-effects, but none developed biliary sludge. CONCLUSIONS: This open study suggests that octreotide could be a promising alternative treatment when all others fail in refractory chronic functional epigastric pain severe enough to limit food intake and to induce nutritional impairment. These results must be tested by a placebo-controlled study.

Adult↗
PubMed1999

[Detection and surveillance of left atrial thrombosis by transesophageal echocardiography].

Out of 1,141 successive transoesophageal echocardiographic studies performed prospectively between 01/05/1993 and 31/12/1995, 26 cases of left atrial thrombosis were observed (2.2%); 5 were in the left atrium (20%), 19 in the left atrial appendage (73%) and the thrombi were in both atrium and left atrial appendage in 2 cases (7%). The 26 patients included 15 women and 11 men, with an average age of 69 +/- 16 years (range 25-89 years); 22 patients (84%) had permanent atrial fibrillation and 4 were in sinus rhythm. Only 5 of the patients were on oral anticoagulant therapy. All had underlying cardiac disease: 11 mitral valve diseases; 10 dilated cardiomyopathies; 2 hypertrophic cardiomyopathies; 3 other cardiac diseases. The indication for transoesophageal echocardiography was systemic embolism in 13 cases (50%); before D.C. cardioversion in 10 cases (38%) and before percutaneous mitral valvuloplasty in 3 cases. The thrombus was adherent in 18 cases (69%) and mobile in 8 cases (31%). Spontaneous contrast was observed in 23 cases (88%). Intravenous heparin was given as soon as the diagnosis was made. In 4 patients, thrombectomy was indicated in view of the threatening nature of the thrombus and/or the necessity for associated valve replacement. In 22 patients, heparin was relayed by oral anticoagulants on the 10th day of treatment. Control transoesophageal echocardiography was not performed because of the patient's refusal or poor general condition. The other 15 patients were reexamined 1 to 5 times between the 4th day and 12th month: a regression was observed in 13 cases (86%) which was complete in 11 and partial in 2 cases. No cases of embolism occurred during follow-up but six patients died: 1 of the operated cases and 5 of the patients treated medically (3 cardiac failures and 2 cerebral haemorrhages). The authors conclude that left atrial thrombosis is rare in the absence of classical embolic cardiac disease. With the exception of the surgical indication of a life-threatening thrombus and/or associated surgical mitral valve disease, anticoagulant therapy results in complete or partial regression of the thrombus visualised by transoesophageal echocardiography which is essential for follow-up. The prognosis depends on the severity of the underlying heart disease.

Adult↗
PubMed1999

[Risk factors of contamination by hepatitis C virus. Case-control study in the general population].

UNLABELLED: In 30% of patients with hepatitis C virus, the source of infection is unknown. OBJECTIVE: To identify the risk factors of infection by hepatitis C virus in a case-control study. METHODS: Cases had positive hepatitis C virus serology, and were living in Fecamp (Normandy, France). Controls (2 for each case) were age and sex-matched subjects with negative hepatitis C virus serology, living in Fecamp. Demographic, medical, professional, and environmental data were collected. Statistical analysis included chi 2 or Fisher's exact test and multiple logistic regression. RESULTS: The risk factors of hepatitis C virus by univariate analysis were: history of transfusion, high number of sexual partners, hepatitis C virus infection in a relative, history of digestive or genitourinary surgery, an invasive medical procedure, digestive endoscopy, biopsy, lumbar or pleural puncture, medical care after an accident, injections, multiple deliveries or abortion. Risk factors of hepatitis C virus infection by multivariate analysis: hepatitis C virus infection in a relative (Odds ratio: 4.58), history of transfusion (Odds ratio: 2.32), of a surgical procedure (Odds ratio: 2.50), of medical care after an accident (Odds ratio: 1.51), of injections (Odds ratio: 2.24). CONCLUSION: Our results suggest the possible nosocomial transmission of hepatitis C virus. Intrafamilial transmission is also possible.

Accidents↗
PubMed1999

[Hemorrhaging eso-gastro-duodenal ulcers: epidemiology and management. A multicenter prospective study].

UNLABELLED: The aim of this study was to estimate the incidence, and to describe the characteristics and medical care in patients with bleeding upper gastrointestinal ulcers in the general population. PATIENTS AND METHODS: A study was performed over six months in 1996 in 4 French geographical areas: Finistère, Gironde, Seine-Maritime, and the Somme (3 million people minimum 18 years). All public or private hospitals, and specialist gastroenterologists in private practice participated in the study, based on a standardized questionnaire. RESULTS: Over 6 months 793 patients with bleeding ulcers were identified, corresponding to 27 per 100,000 inh./year or 24,000 cases in France. Most patients were men (60%) and 40.1% were 75 years and older. The ulcer was oesophageal (6%), gastric (47%), or duodenal (69%). In 406 patients (51.2%) a chronic disease was present (cancer, cirrhosis, circulatory, respiratory or cardiac disease). In 237 cases (29.9%) the ulcer occurred in patients, 453 patients (57.1%) were admitted and 103 patients (13%) were managed as outpatients. Gastrotoxic drugs were taken by 349 patients (44%): non steroidal anti-inflammatory drugs (18.7%), aspirin (21.2%, including 2/3 with doses under 330 mg/day), corticosteroids (7.8%) and 24.3% had anticoagulant therapy. Patients were managed in university hospitals (39.3%), other public or non profit hospitals (44.2%) or private hospital (16.5%) with geographical differences between the 4 areas. Therapeutic endoscopy was performed in 16.9% and a surgical procedure was performed in 5.9%. The mortality rate (outpatients excluded) was 13.5% (n = 93), but only 2% (n = 16) of death were associated with a bleeding ulcer: mortality was higher in inpatients (24.1%) than in out patients (8.1%). A chronic disease was also associated with higher mortality (17.9% versus 8.1%). CONCLUSION: Bleeding ulcers are frequent and severe, especially in inpatients or associated with chronic conditions. A gastrotoxic drug used is found in about fifty percent of the cases.

Adolescent↗
PubMed1999

[Not Available].

Explore the source record for details and available documents.

Journal Article↗
PubMed1998

The Low-Lying States of He2.

The near-infrared emission spectrum of He2, excited in a Be hollow cathode discharge, has been recorded at high resolution using a Fourier transform spectrometer. The c3Sigma+ g-a3Sigma+ u (0-0, 1-1, 2-2, 1-0, and 2-1) and C1Sigma+ g-A1Sigma+ u (0-0 and 1-1) transitions have been observed in the 9000-15 000 cm-1 spectral region. A global analysis of the six lowest excited states of He2 (c3Sigma+ g, b3Pig, a3Sigma+ u, C1Sigma+ g, B1Pig, and A1Sigma+ u) was carried out by combining our measurements with previously reported infrared data for the b3Pig-a3Sigma+ u system [S. A. Rogers et al., Mol. Phys. 63, 901 (1988)] and with laser measurements for the B1Pig-A1Sigma+ u transition [H. Solka et al., Mol. Phys. 60, 1179 (1987)]. To account for the fine structure in the a3Sigma+ u state, high precision r.f. measurements were included in the global fit. A consistent set of improved molecular constants was derived for the c3Sigma+ g (v = 0, 1, and 2), b3Pig (v = 0 and 1), a3Sigma+ u (v = 0, 1, and 2), C1Sigma+ g (v = 0 and 1), B1Pig (v = 0 and 1), and A1Sigma+ u (v = 0 and 1) levels. A study of the vibrational dependence of these constants was also performed, leading to the equilibrium parameters for the six electronic states. Copyright 1998 Academic Press.

Journal Article↗
PubMed1998

Fourier Transform Emission Spectroscopy of the A2Pi-X2Sigma+ Transition of BeD.

The A2Pi-X2Sigma+ Deltav = 0 sequence of BeD was observed in the 19 500-20 800 cm-1 spectral region using a Fourier transform spectrometer. The emission spectrum was excited in a Be hollow cathode discharge lamp with a He/D2 gas mixture. The observed lines were assigned to the 0-0 to 6-6 bands. The Deltav = -1 sequence was too weak to be seen in our Fourier transform spectra. We therefore used a previously recorded but unpublished arc emission spectrum to identify the 0-1 to 5-6 Deltav = -1 bands. Consequently, all of the diagonal bands could be linked together and the vibrational intervals determined. The Deltav = 0 and Deltav = -1 data were fitted together in a global fit and effective constants derived. Using the information available from the study of the C2Sigma+-X2Sigma+ system [R. Colin, C. Drèze, and M. Steinhauer, Can. J. Phys. 61, 641 (1983)], the v = 8-12 vibrational levels of the ground state were added in a Dunham fit. A set of Dunham Y constants was determined for the X2Sigma+ state along with traditional equilibrium parameters for the A2Pi excited state. The equilibrium bond lengths were found to be 1.341742(5) Å for the ground state and 1.33309(4) Å for the excited state. A reanalysis of the previously published A2Pi-X2Sigma+ 0-0 to 3-3 Deltav = 0 bands of BeT [D. De Greef and R. Colin, J. Mol. Spectrosc. 53, 455-465 (1974)] was also performed. Copyright 1998 Academic Press.

Journal Article↗
PubMed1998

Quality of Life in Reflux and Dyspepsia patients. Psychometric documentation of a new disease-specific questionnaire (QOLRAD).

OBJECTIVE: To develop a disease-specific QOL instrument (QOLRAD) addressing patient concerns in gastroesophageal reflux disease (GERD) and dyspepsia. Patients. 759 male (45%) and female (55%) patients with a mean age of 48.4 years (sd 15.2) were used in the psychometric evaluation. MAIN OUTCOME MEASURES: A pilot version of QOLRAD, the Gastrointestinal Symptoms Rating Scale (GSRS) and the SF-36 were completed prior to endoscopy. Items with a high ceiling effect, items measuring a different construct, i.e. with a low squared multiple correlation (R < 0.5) with the other items, items that showed redundancy by a high correlation (>0.80) with another item were removed. A confirmatory factor analysis was also performed. RESULTS: The final questionnaire included 25 items depicting problems with emotions, vitality, sleep, eating/drinking, and physical/social functioning. The internal consistency reliability was high (alpha value overall 0.97, dimensions 0.89-94). Construct validity, i.e. the associations between similar constructs in the QOLRAD, the SF-36 and the GSRS scores was confirmed. Pain and symptom severity were markers of impaired QOL. The impact on health-related QOL was similar across the functional gastrointestinal disorders with the exception of patients with a normal endoscopy, who did slightly worse. CONCLUSION: The QOLRAD is a short and user-friendly instrument with excellent psychometric properties. Its responsiveness to change in (AVMC1) clinical trials is currently being explored.

Adolescent↗
PubMed1998

Factors influencing corpus argyrophil cell density and hyperplasia in reflux esophagitis patients treated with antisecretory drugs and controls.

A cross sectional study was designed to elucidate the factors influencing the argyrophil cell population in patients with gastroesophageal reflux disease treated with omeprazole (N = 201) or H2-receptor antagonists (N = 118) and in control patients (N = 215). Fasting gastrinemia and Helicobacter pylori serology were determined. Gastritis, Helicobacter pylori infection, and argyrophil cell density and hyperplasia were evaluated in gastric biopsies. The argyrophil cell density was higher in both treatment groups than in controls (P = 0.002 and P = 0.051), whereas argyrophil cell hyperplasia was similar in the three groups. According to multivariate analysis, positive Helicobacter pylori serology was an independent parameter that decreased both density and grade of hyperplasia of argyrophil cells. Female gender and hypergastrinemia were independent factors increasing argyrophil cell density and hyperplasia, whereas antisecretory therapy, age and active gastritis were not. In addition, atrophic gastritis independently increased argyrophil cell hyperplasia. The prevalence of atrophic gastritis was significantly higher in Helicobacter pylori-positive than in negative patients and lower in the patients treated long-term with omeprazole than in the other groups.

Adult↗
PubMed1997

Detection and genotyping of the hepatitis C RNA in tear fluid from patients with chronic hepatitis C.

Tear fluid from 51 patients with chronic hepatitis C virus (HCV) infection was analyzed for the presence of the hepatitis C RNA to assess the potential role of this fluid in virus transmission. HCV sequences were amplified from sera and tear fluids by nested polymerase chain reaction using primers from the 5' non coding region of the virus genome. Positive samples were genotyped by the LiPA procedures. HCV RNA was detected in 76.5% (39/51) of the sera and in 9.8% (5/51%) of the tear fluid samples. The presence of the RNA in the tear fluid was independent of the severity of the hepatitis and of the viral load as measured by the branched DNA assay. The genotypes of the tears and serum isolates were different for two patients. For another patient, the HCV RNA was positive in the tear sample but negative in the serum sample. These findings suggest that tear fluid may transmit HCV but the source of HCV RNA in this fluid needs to be better understood.

Chronic Disease↗
PubMed1997

Digestive manifestations in an immunocompetent adult with varicella.

A case of varicella with pancreatic pain as a first manifestation, a typical papulovesicular rash, pulmonary and hepatic and esophageal localizations occurring in an immunocompetent adult is reported. Treatment with intravenous acyclovir resulted in a prompt improvement and recovery in less than 4 days.

Adult↗
PubMed1996

Does chronic supplementation of the diet with dietary fibre extracted from pea or carrot affect colonic motility in man?

The aim of the present study was to assess, in healthy volunteers and under physiological conditions, the acceptability, clinical tolerance and effects on colonic motility of chronic supplementation of the usual diet with new dietary fibre sources. Three studies were carried out, one after a period of habitual diet, and two after randomized 3-week periods of supplementation with fibre extracted either from pea hulls or carrots, added to the meals as a fine powder. The 24 h motility was recorded on an unprepared colon at five levels to determine the initiation site and the number of high amplitude propagated contractions (HAPC) and to quantify motor activity every 30 min, particularly in the two periods following lunch and breakfast. With the habitual diet the motility pattern was an irregular alternation of quiescence and sporadic non-propagated contractions. HAPC always started from the ascending colon and occurred mainly after breakfast. With either type of fibre the 24 h motor profiles, the 24 h variations and the number of HAPC were not significantly modified but a more distal initiation of HAPC was found. The colonic postprandial motor response was more diffuse after dietary enrichment with carrot fibre than after enrichment with pea-hull fibre. In healthy volunteers the long-term addition of fibre extracted from pea hulls and carrots to the usual diet was easy and well-tolerated without clinical side-effects, but with limited colonic motor effects. However, the more distal initiation of HAPC observed could be deleterious.

Adult↗
PubMed1996

[Compared efficiency of three strategies of management of chronic hepatitis C. Effect on the risk of cirrhosis 8 years after diagnosis].

OBJECTIVES AND METHODS: The goal of treating chronic hepatitis C with alfa interferon is to eradicate HCV infection. The actual influence of this treatment on the development of cirrhosis is unknown. Moreover, the poor results and the high cost of this treatment have caused a public health problem. Three strategies were evaluated by decision analysis: no treatment (S1), treatment of chronic active hepatitis only (S2), treatment of all chronic hepatitis (S3). For each strategy, we estimated the probability of the occurrence of the following events based on data in the literature: presence of chronic active hepatitis, chronic persistent hepatitis or cirrhosis at the time of diagnosis; discontinuation of interferon because of adverse events; biological response to treatment; incidence of cirrhosis 8 years after diagnosis without treatment or in case of response to treatment. RESULTS: The risk of cirrhosis was 28.5% with S1, 25.4% with S2, and 25.2% with S3, 8 years after diagnosis. If HCV infection was detected early before cirrhosis, the number of cases of cirrhosis occurring in an 8 year-followup period would be 45,600 with S1, 40,640 with S2, and 40,320 with S3 and the cost of S2 and S3 would be 1.23 10(9) French Francs (FF), and 2.57 10(9) FF, respectively. The mean cost to prevent one case of cirrhosis would vary from 248,000 FF with S2 to 487,000 FF with S3. CONCLUSION: This decision analysis study suggests that the S3 strategy is not suitable for a population of HCV infected patients, because of its low efficiency and high cost.

Antiviral Agents↗