[Liver denervation aggravates the hemodynamic response to hemorrhage in the conscious rat].
Explore the source record for details and available documents.
Animals↗
Biomedical subjects
D Roulot
Publications and source records attributed to D Roulot.
Nadolol for prophylaxis of gastrointestinal bleeding in patients with cirrhosis. A randomized trial.
This controlled trial was designed to evaluate the prophylactic effect of nadolol on gastrointestinal bleeding in cirrhotic patients with large oesophageal varices who had never bled. Nadolol or placebo was given randomly to two groups of 53 patients. The percentage of patients free of gastrointestinal bleeding 1 year after inclusion in the study was 83 +/- 6% (mean +/- S.D.) in the nadolol group and 80 +/- 6% in the placebo group. In the nadolol and placebo groups, 40 and 47 patients, respectively, were compliant, i.e., took nadolol or placebo continuously. The percentage of patients who were free of bleeding 1 year after inclusion was 97 +/- 3% in the subgroup of compliant nadolol patients. This percentage was significantly higher than that of patients who were free of bleeding in the placebo group (P less than 0.03) as well as in the subgroup of compliant placebo patients (77 +/- 6%; P less than 0.02). We concluded that, although there was no overall significant effect of nadolol on the risk of bleeding in cirrhotic patients in good condition with large oesophageal varices, this study suggests that nadolol reduced the risk of bleeding in compliant patients.
Clinical Trials as Topic↗
Lymphadenopathy-associated virus type 2 in AIDS and AIDS-related complex. Clinical and virological features in four patients.
Lymphadenopathy-associated virus type 2 (HIV 2) was isolated from 3 patients with AIDS and 1 with AIDS-related complex. Clinical features were similar to those in patients infected with HIV 1. Viral isolates were characterised by hybridisation with HIV 1 and HIV 2 DNA probes. HIV 1 and HIV 2 serological studies were performed by enzyme-linked immunosorbent assay (ELISA), western blot, and radioimmunoprecipitation assay. HIV 2 IgG antibodies were detected in all sera. The molecular weights of the most representative HIV 2 proteins were determined by immunoblot. Cross-reactivity was restricted to HIV 1 and HIV 2 core proteins. In all 4 patients the neurotropism of HIV 2 was demonstrated by virus isolation from the cerebrospinal fluid and/or by evidence of intrathecal HIV 2 IgG synthesis. All sera were antibody negative by HIV 1 ELISA. An assay specific for HIV 2 is needed for screening of blood donations and for diagnosis and seroepidemiological study of HIV 2 infection.
AIDS-Related Complex↗
Cholangitis in the acquired immunodeficiency syndrome: report of two cases and review of the literature.
We report the cases of one patient with the acquired immunodeficiency syndrome as a result of human immunodeficiency virus type 1/lymphadenopathy associated virus type 1/human T-cell lymphotrophic virus type III (HIV-1/LAV-1/HTLV-III) infection and of another patient with AIDS related complex caused by human immunodeficiency virus type 2/lymphadenopathy associated virus type 2 (HIV-2/LAV-2) infection, who were suffering from cholangitis. The manifestations and possible mechanisms for cholangitis in these patients and in 10 previously reported similar cases are reviewed.
Acquired Immunodeficiency Syndrome↗
[Palliative treatment of adenocarcinoma of the rectum by Nd-YAG laser. Immediate and long-term results. Study of factors related to the initial destruction of the tumor].
Fourty-five patients, 28 men, 17 women (mean age 73 +/- 18 yrs) with rectal carcinoma underwent palliative endoscopic neodymium YAG laser therapy. Rectal hemorrhage ceased in 89 p. 100 of affected patients after 3 +/- 2 sessions and a normal rectal transit was restored in 80 p. 100 of affected patients after 3 +/- 1 sessions. Total destruction of intraluminal tumor was achieved in 40 p. 100 of patients after 4 +/- 1 sessions. Symptomatic improvement was more frequent in patients in whom total destruction of intraluminal tumor was achieved (p less than 0.01). Stepwise logistic regression selected 2 independent variables capable of predicting tumoral destruction: the kind of surgical contraindication, more often related to cancer extension (p less than 0.001) and a greater tumor length (p less than 0.03) in patients in whom destruction of intraluminal tumor was incomplete. Twenty-eight patients were subsequently treated after palliation was achieved. Cumulative probability of remaining improved at 6 months when treatment was not stopped was 40 p. 100 (confidence limits to 95 p. 100: 23 p. 100-59 p. 100). Five complications occurred, 3 rectovaginal fistulas and 2 stenosis.
Adenocarcinoma↗
[Ulcerative colitis caused by Histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome].
The authors report a case of ulcerative colitis due to Histoplasma capsulatum in a previously healthy 35 year-old french geologist with acquired immune deficiency syndrome (AIDS). Gomori-Grocott and PAS stains and indirect immunofluorescence revealed Histoplasma capsulatum in colonic biopsies. The search for LAV antibody was positive. T-lymphocyte analysis revealed 10/mm3 OKT4 with OKT4/OKT8 ratio of 0.16. Histoplasmosis should be considered in subjects with ulcerative colitis according to the epidemiological context. In patients with AIDS relapses after discontinuation of treatment are to be expected and suppressive therapy with an imidazole derivative should probably be continued indefinitely.
Acquired Immunodeficiency Syndrome↗
Reversible acute renal failure during enalapril treatment in patient with chronic glomerulonephritis without renal artery stenosis.
Explore the source record for details and available documents.
Acute Kidney Injury↗
[Relation between plasma catecholamines, the severity of the liver disease and hemodynamics in patients with cirrhosis].
Plasma noradrenaline and adrenaline concentrations were measured in 75 patients with cirrhosis in order to attempt to correlate these concentrations and liver failure and hemodynamic changes. The increased noradrenaline concentration was not correlated with the degree of liver failure estimated by Pugh's classification, with the cause of cirrhosis, with the presence of acute alcoholic hepatitis or with the presence of ascites. Adrenaline concentration was higher in cirrhotic patients with acute alcoholic hepatitis than in those without these lesions. Noradrenaline concentration was significantly correlated with heart rate, wedged hepatic venous pressure and renal blood flow. Noradrenaline concentration was also negatively correlated with stroke volume and adrenaline concentration was negatively correlated with cardiac output and stroke volume. These findings confirm the relationships between portal hypertension, sympathetic hyperactivity and renal function in patients with cirrhosis.
Adult↗
[Prevention of hemorrhagic recurrences caused by rupture of esophageal varices, with endoscopic ligation. Prospective study of 50 patients].
OBJECTIVES: Endoscopic sclerotherapy is effective to prevent bleeding of oesophageal varices but is associated with frequent adverse effects. Endoscopic ligation represents a new endoscopic alternative treatment to sclerotherapy. The purpose of this study was to assess efficacy and safety of endoscopic variceal ligation in 50 consecutive patients with cirrhosis who had recently bled from oesophageal varices. METHODS: Patients were followed from 6 to 1140 days (median 310 days). Nine patients were bleeding actively when ligation was performed. RESULTS: Eleven patients (22%) had 13 recurrent bleedings requiring blood transfusion during follow-up. Six recurrences occurred during the first month (3 from bleeding varices, 3 treatment-induced); seven recurrences occurred latter (6 from bleeding varices, 1 treatment-induced). Varices were eradicated in 33 patients (66% of all patients, 82% of patients who survived more than 30 days). Variceal eradication was achieved in 2-9 endoscopic ligation sessions (median 3). Eighteen patients died during the study; one died from bleeding. No patient developed major complications; five patients only complained of mild dysphagia for 24 to 48 hours. CONCLUSION: Endoscopic ligation is a safe and effective method to prevent recurrent bleeding from oesophageal varices.
Endoscopy↗
Prevalence of cryoglobulins and hepatitis C virus infection in HIV-infected patients.
PURPOSE AND METHODS: In order to evaluate the prevalence of positive hepatitis C virus (HCV) serology and cryoglobulinemia in human immunodeficiency virus (HIV)-infected patients, the prevalence and the clinical significance of cryoglobulinemia were prospectively studied in a cohort of 86 HIV-infected subjects seen as outpatients. They were compared to a control group consisting of 101 HIV-HCV+ patients being followed at the same hospital. RESULTS: HCV serology was positive in 53/86 (61.6%) patients, 25 (47.2%) of whom had detectable cryoglobulins in their sera although only 1 had clinical symptoms consistent with cryoglobulinemia. Cryoglobulinemia was also detected in 9/33 (27.3%) HCV- patients, with only one of them presenting clinical symptoms. Although the mean cryoglobulin concentration was lower for HIV+ patients than in controls (268 versus 585 mg/l, p < 0.01), their prevalence (39.5% and 27.2%, respectively) was higher (p < 0.03). CONCLUSION: Cryoglobulinemia is frequently detected in HIV-infected patients, regardless of their HCV serology, but is poorly correlated with clinical symptoms.
Adult↗