PubMed Health⌕ Search

Biomedical subjects

F Gremy

Publications and source records attributed to F Gremy.

7 recordsLinked to original sources
PubMed1992

Lactitol or lactulose in the treatment of chronic hepatic encephalopathy: results of a meta-analysis.

Lactitol (beta-galactosido-sorbitol) has been recently compared with lactulose for the treatment of chronic hepatic encephalopathy in a few studies, each comprising a small number of patients. The results are controversial. We studied the efficiency and tolerance of both compounds by using a meta-analysis on the basis of published controlled trials. Our study only included controlled or randomized trials comprising cirrhotic patients with chronic hepatic encephalopathy. Analyzed parameters were the portosystemic encephalopathy index of Conn after treatment, the percentage of improved patients and the percentage of patients who had ill effects related to the treatment (flatulence, diarrhea). Bibliographical screening revealed five studies comparing the effects of lactitol and lactulose in chronic hepatic encephalopathy. Four crossover studies were done that included 48 patients and one parallel study that included 29 patients. The duration of the treatment ranged from 3 to 6 mo. All studies found a similar efficiency with both drugs. However, they exhibited some discrepancies in the relative frequency of adverse reactions (flatulence). Meta-analysis showed no statistical differences in the portosystemic encephalopathy index after lactitol or lactulose treatment. The percentage of improved patients after lactitol or lactulose was similar. In contrast, the analysis revealed a higher frequency (p less than 0.01) of flatulence in patients treated with lactulose compared with those treated with lactitol. In conclusion, this meta-analysis shows no statistical difference between therapeutic effects of lactitol and lactulose, but it does show a higher frequency of flatulence with lactulose. This suggests that lactitol should be preferred to lactulose for the treatment of chronic hepatic encephalopathy.

Chronic Disease↗
PubMed1991

[Corticoid therapy in the treatment of acute alcoholic hepatitis. Results of a meta-analysis].

A meta-analysis of 10 randomized trials comparing steroid therapy with placebo or abstention was performed. Trials were pooled for severity of acute alcoholic hepatitis and time of analysis. Papers with survival analyses at one and three months were included. The robustness of this meta-analysis was analysed after exclusion of trials analysing survival at three months only, trials including mild forms, or atypical trials. Comparisons were made use the Der Simonian-Laird and Mantel-Haenszel-Peto methods. All results were statistically significant. However, if only one medium size trial were to be added, the results would no longer be significant. Taking into account the complications of steroid therapy, we conclude that further clinical trials are necessary to confirm the effectiveness of steroid therapy, especially for the group of patients with severe alcoholic hepatitis.

Acute Disease↗
PubMed1991

[Which controls should be chosen in a case-control study? Survey of bladder cancer in Hérault].

A case-control investigation about bladder cancer was carried out in Herault department with 219 incident cases from January 1987 to May 1989 and two control groups: 196 hospital controls randomized from hospital admission lists and 794 population controls randomized from census data. According to the comparison for those two groups, there are few socio-demographic differences; but hospital controls are more exposed to smoking, coffee, alcohol, artificial sweetners. So, the odds ratios with those hospital controls are under-estimated. We can evaluate the resulting biais.

Aged↗
PubMed1978

[Classical special investigations in hospital neurology. Evaluation of their diagnostic contribution (author's transl)].

A quantitative analysis of the diagnostic contribution of the classical special investigation normally used in hospital neurology. Six examinations were studied: laboratory blood investigations, electroencephalogramm, lumbar puncture, optic fundus, standard skull X-ray, standard spine X-ray. The analysis involved 548 patients in whom 2219 examinations were performed with a yield of 26 "corrected" diagnosis (a diagnosis in which there was a clinical error corrected in the light of the results of these examinations).

Bayes Theorem↗
PubMed1978

[Evaluation of the effectiveness of a diagnostic examination: from data to medical decision (author's transl)].

It is desirable to assess the value of special investigations by objective criteria. Conditional probabilities are suitable for this purpose. Sensitivity and specificity indicate the prevalence of a sign in a disease. Predictive values estimate the probability of a disease when a sign is present and the probability of absence of disease when the sign is absent. Comparison between the informational value of a sign or examination with concepts of cost or of risk to the patient is then possible. This made be used as a basis for determining a strategy for special investigations in the establishment of a diagnosis.

Bayes Theorem↗