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D Caillaud

Publications and source records attributed to D Caillaud.

15 recordsLinked to original sources
PubMed1999

Increased resting energy expenditure is related to plasma TNF-alpha concentration in stable COPD patients.

UNLABELLED: The objective of this study was to test whether increased resting energy expenditure (REE) in chronic obstructive pulmonary disease (COPD) patients is related to increased cost of breathing and/or to increased cytokine production. In 36 non-inflammatory (CRP: 17.6 +/- 13.1 mg.l(-1), mean +/- SD; orosomucoid: 0.71 +/- 0.18 g.l(-1)), non-malnourished (BMI: 23.6 +/- 4.3 kg.m(-2)), clinically stable, non severely hypoxic COPD patients (60.5 +/- 8.9 years) we measured REE, pulmonary function and plasma cytokine concentrations (TNF-alpha, IL1 and IL6). REE was increased by 10 +/- 11% (P< 0.001) above predicted values. Plasma TNF-alpha concentration was increased in all patients (mean value 26.3 +/- 14.3 pg.ml(-1)). Excess REE (with respect to values predicted by Harris-Benedict equations) was correlated with plasma TNF-alpha concentration (P< 0.005), but not with the degree of airway obstruction, lung overinflation, or with oxygen cost of breathing. Theophylline treatment resulted in a significant increase in REE by 15%. IN CONCLUSION: non-malnourished, clinically stable, non-severely hypoxic COPD patients display an increased REE that is related with plasma TNF-alpha concentration (without apparent systemic inflammation) and to theophylline treatment, but that is independent of parameters of respiratory function.

Basal Metabolism↗
PubMed1999

Sublingual-swallow immunotherapy (SLIT) in patients with asthma due to house-dust mites: a double-blind, placebo-controlled study.

A double-blind, placebo-controlled study was carried out in 85 patients with a well-documented history of perennial asthma caused by house-dust mites. Patients received either placebo or sublingual immunotherapy (SLIT) with a standardized Dermatophagoides pteronyssinus (DP)-D. farinae (DF) 50/50 extract. After a run-in period, patients received increasing doses up to 300 IR every day for 4 weeks and then three times a week for the following 24 months. The cumulative dose was about 104000 IR, equivalent to 4.2 mg Der p 1 and 7.3 mg Der f 1. Symptom and medication scores and respiratory function were assessed throughout the trial. Serum specific IgE and IgG4 were determined before SLIT (t0) and after 6 (t1), 11 (t2), 17 (t3), and 25 months (t4) of SLIT. Mite exposure was evaluated at t0, t2, and t4 by semiquantitative guanine determinations. Patients aged 15 years and older were asked to assess their quality of life (QoL) by completing the SF20 (Short Form Health Status Survey) plus two items at t0, t2, and t4. Use of inhaled corticosteroids and beta2-agonists was significantly decreased after 25 months of treatment in both groups (P<0.03). SLIT patients showed significant improvements in respiratory function at t4 (% predicted FEV1 (P = 0.01), VC (P = 0.002), morning (P = 0.01) and evening (P = 0.03) PEFR), and reduction in daytime asthma score (P = 0.02). In the SLIT group, the post-treatment PD20 was 1.75 times higher than the baseline value. There was no change in PD20 in the placebo group. Compared to the placebo group, the SLIT group showed a significant increase in specific IgE DP(P = 0.05), IgE DF(P = 0.02), IgG4 DP(P = 0.001), and IgG4 DF (P = 0.001) levels after SLIT. QoL scores were similar in both groups at t0 and t2. At t4, all scores were better in the SLIT group than in the placebo group, with the differences being most marked for the general perception of health (P = 0.01) and physical pain (P = 0.02). Adverse events were similar in the two groups. This study shows that SLIT in house-dust-mite-related asthma has a good safety profile and improves respiratory function, bronchial hyperreactivity, and QoL.

Administration, Sublingual↗
PubMed1999

Acquired angioedema with C1 inhibitor deficiency: is the distinction between type I and type II still relevant?

BACKGROUND: Acquired angioedemas are divided into type I associated with lymphoproliferation and type II caused by anti-C1-inhibitor antibodies. Recent reports have suggested that this distinction is not so clear-cut, mainly because of the presence of antibodies against the C1 inhibitor in some cases belonging to the type I group. We report herein 2 additional cases of acquired angioedema with anti-C1-inhibitor antibody. MATERIAL AND METHODS: One man and 1 woman had had acquired angioedema for several years. In the man, a monoclonal component had been detected several years before the present study. In the second patient, a monoclonal component was detected during the study. The following data were studied on successive blood samples collected during angioedema manifestations: complement component levels, functional activity of the classical pathway, functional and antigenic C1 inhibitor doses, ELISA test to detect autoantibodies to C1 inhibitor and Western blot analysis of the C1 inhibitor. RESULTS: In both patients, CH50 and C4 activities were decreased, and an autoantibody to C1 inhibitor was detected. In 1 case, the antibody appeared after the monoclonal component; in the second case, it appeared before and belonged to a different immunoglobulin class. CONCLUSION: Our data suggest that the distinction between type I and type II acquired angioedema is no longer valid because of overlapping in some cases.

Aged↗
PubMed1998

Pleural mesothelioma: dose-response relation at low levels of asbestos exposure in a French population-based case-control study.

A hospital-based case-control study of the association between past occupational exposure to asbestos and pleural mesothelioma was carried out in five regions of France. Between 1987 and 1993, 405 cases and 387 controls were interviewed. The job histories of these subjects were evaluated by a group of experts for exposure to asbestos fibers according to probability, intensity, and frequency. A cumulative exposure index was calculated as the product of these three parameters and the duration of the exposed job, summed over the entire working life. Among men, the odds ratio increased with the probability of exposure and was 1.2 (95% confidence interval (CI) 0.8-1.9) for possible exposure and 3.6 (95% CI 2.4-5.3) for definite exposure. A dose-response relation was observed with the cumulative exposure index: The odds ratio increased from 1.2 (95% CI 0.8-1.8) for the lowest exposure category to 8.7 (95% CI 4.1-18.5) for the highest. Among women, the odds ratio for possible or definite exposure was 18.8 (95% CI 4.1-86.2). We found a clear dose-response relation between cumulative asbestos exposure and pleural mesothelioma in a population-based case-control study with retrospective assessment of exposure. A significant excess of mesothelioma was observed for levels of cumulative exposure that were probably far below the limits adopted in most industrial countries during the 1980s.

Adult↗
PubMed1995

[Chemotherapy of small cell bronchial cancers. Prognostic importance of complete response (1,280 patients). Groupe Petites Cellules].

OBJECTIVE: Pretherapeutic prognostic factors for patients given chemotherapy for small cell lung carcinoma have been widely studied. We evaluated response to chemotherapy in patients included in 4 multicentric trials with less restrictive entry criteria in order to determine the contribution of clinical outcome as a predictive factor. METHODS: Pretherapeutic and therapeutic prognostic factors were assessed in 1280 patients included in 4 successive multicentric therapeutic trials on chemotherapy for small cell lung carcinoma conducted from January 1, 1983 to April 1, 1992. Logrank test for univariate analysis and Cox's stepwise method for multivariate analysis were used to evaluate the results. RESULTS: Univariate analysis identified pretherapeutic factors as significant for prognosis: Karnofsky index (p < 0.0001), alkaline phosphatase level (p < 0.0002), white cell count (p < 0.0005), age (p = 0.0007), presence of brain metastasis (p = 0.0004), presence of liver metastasis (p = 0.03), initial extension (p = 0.04). Multivariate analysis taking into account pretherapeutic and therapeutic factors demonstrated that complete response after the second and after the sixth treatment session were predictive of longer survival (p = 0.0001). This factor was more powerful than all the pretherapeutic factors including the Karnofsky index, initial extension and brain metastasis. CONCLUSION: For patients with small cell lung carcinoma, the prognostic value of early response to chemotherapy suggests that high-doses should be used starting at the first session.

Adult↗
PubMed1992

[Community-acquired pneumonia in healthy adults: 188 patients treated with spiramycin in private practice].

One hundred and eighty eight outpatients with community acquired pneumonia have been treated by spiramycin in general practice. Community acquired pneumonia was defined by the association of fever > or = 38 degrees C, respiratory symptoms as cough, sputum production, dyspnea or thoracic pain, and pulmonary opacity on the chest X-Ray. The mean age of patients was 44.7 +/- 16.6 and few of them had concomitant chronic illness, as cardiovascular (9%) or bronchopulmonary disease (9%). Twenty one percent of patients have been included after a previous antibiotherapy failure. In 92% on these cases, prior antibiotherapy was a beta lactam. At inclusion, the fever was greater than 39 degrees C in 56% of patients, 58% had localized crepitations at the chest auscultation. The chest X-Ray was performed 1.4 +/- 2.1 days after inclusion and showed a lobar consolidation in 77%. One third of patients presented a clinical picture evoking acute bacterial pneumonia. One hundred and seventy one patients have been reviewed for a second evaluation 4 +/- 1.5 days after inclusion. One hundred and eighty seven patients have visited for the long term follow up 19 +/- 6.5 days after the onset of treatment. Ninety six per cent of them have consulted with a control chest X-ray. At this visit, the antibiotherapy was changed in 2 other patients with of failure. Overall, 83% of patients were clinically and radiologically cured by Spiramycin 3 MU twice a day for 13 +/- 3.5 days. Fourteen percent of patients were improved without necessity of changing the antibiotic regimen. This study confirms the efficacy of spiramycin in the management of community acquired pneumoniae in general practice, either in first line therapy of after the failure of beta lactam.

Adult↗
PubMed1990

Atypical enolase isoenzyme in serum: a macroenolase formed from the alpha gamma-hybrid form.

We report an abnormal pattern for enolase (EC 4.2.1.11) isoenzymes in the serum of a patient with squamous cell lung carcinoma. The alpha alpha-isoenzyme was present but the alpha gamma form was not detected, and near the point of application on the electrophoretogram was an abnormal band. We determined that the abnormal fraction corresponded to a macroenolase, composed of the alpha gamma-isoenzyme complexed with IgG. From a practical point of view, the presence of such a macroenolase, containing gamma-subunits, results in falsely increased results for neuron-specific enolase (NSE) in procedures that determine only the NSE concentration without consideration of the enolase isoenzymes.

Aged↗
PubMed1988

Enzymatic determination of serum neuron-specific enolase in small cell lung cancers. Utility of the serum neuron-specific enolase/serum nonneuronal enolase ratio.

Increasing interest is shown in the determination of the serum neuron-specific enolase for the diagnosis and the follow-up studies of small cell lung cancers. We report results obtained by an enzymatic procedure that permits the simultaneous determination of the neuron and nonneuron-specific enolase and the calculation of the ratio of these two components. The utility of this ratio which characterizes elevations of the serum neuron-specific enolase from a poor or rich source of this component was tested in 38 patients with small cell lung carcinoma and in 57 subjects suffering from other bronchogenic cancers. The control group consisted of 37 blood donors and 56 patients with respiratory disease. For the diagnosis, the sensitivity and the specificity of the enzymatically determined neuron-specific enolase compared well with published results obtained by radioimmunoassay and enzymoimmunoassay. The use of the ratio clearly increases the specificity of the test, since only 5.3 percent of false positive results are found when bronchogenic tumors other than small cell carcinoma are studied. The sensitivity was 76 and 100 percent in diagnosis of limited and extensive forms, respectively. The use of this ratio in the follow-up of the patients and for the determinations in hemolyzed samples is set out.

Adult↗
PubMed1985

[Lessons from a long-term survey on the effects of massive occupational exposure to asbestos. The AMISOL affair 10 years later].

For the past 10 years the authors have followed up a cohort of workers who had been massively exposed to dust in an asbestos textile factory which closed down in 1974. They report on the difficulties of all kinds they encountered during this epidemiological survey. The most original result is that they were able to establish that the radiological and functional manifestations of asbestosis pursue their course after the subjects have ceased to be exposed. Another important point is the early development of lesions in peripheral bronchioles, detected by volume-flow loops. The authors insist on the psycho-social problems at the site of work or in daily life which arise from the use of asbestos or of fibres with similar properties. Social protection, at present well organized, should suppress the risk of asbestosis in Western countries. However, a number of problems remain to be solved, notably those concerning the long-term risk of pleural mesothelioma, the mode of action of the fibers and the immune reactions they induce, and the economic and social consequences of a hypothetical ban on asbestos--a material very difficult to replace. This study embodies, in miniature, all the problems of society associated with asbestos during this second half of the XX th century.

Asbestosis↗