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Biomedical subjects

F Joubaud

Publications and source records attributed to F Joubaud.

At least 19 recordsLinked to original sources
PubMed1991

Prevention of recurrent variceal bleeding in alcoholic cirrhotic patients: prospective controlled trial of propranolol and sclerotherapy.

We conducted a prospective randomized controlled study to evaluate the effectiveness of propranolol and sclerotherapy, compared to a control group, in the prevention of variceal rebleeding in alcoholic cirrhotic patients. Among the 79 patients included, the distribution of patients according to Child-Pugh classification was: A, 22%; B, 40%; and C, 38%. Propranolol was given twice daily with a mean final dose of 54 +/- 16 mg/day, this resulted in a mean reduction in resting heart rate of 26 +/- 7%. Sclerotherapy was performed weekly using 1% polidocanol. End points were rebleeding or death. During the mean follow up of 19 +/- 16 months, 43 patients bled and 22 patients died. The cumulative percentages of patients free of rebleeding at 1 year were: propranolol, 81% (95% confidence interval (CI): 63-92); sclerotherapy, 64% (95% CI: 45-82); control, 54% (95% CI: 36-71); these differences did not reach statistical significance. The cumulative percentages of patients alive at 1 year were: propranolol, 92% (95% CI: 76-98); sclerotherapy, 79% (95% CI: 58-91); control, 81% (95% CI: 60-93); these differences were not statistically significant. Alcohol withdrawal, which occurred in 66% of patients, was an independent predictive factor associated with a decreased risk of rebleeding or death. In conclusion, a life table analysis of patients free of rebleeding, as well as of patients surviving, revealed a tendency in favour of propranolol. The lack of a statistical support for these two favorable effects could be due to poor statistical power.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy↗
PubMed1991

[Abnormalities of the intrapetrous internal carotid artery].

The abnormalities of the internal carotid artery along its intrapetrosal course are infrequent, but they are interesting because of the etiological hypotheses that must be put forward and because they sometimes have extremely serious consequences if middle ear surgery is performed without a preliminary study of the anatomy and vasculature of this region. No statistics likely to produce accurate guidelines are available at present, as the literature has reported too few cases. After attempting to explain these aberrant variations on the basis of anatomical and embryological considerations, we describe one case encountered in the ENT department of Brest University Hospital, then discuss it according to the data provided by the literature.

Carotid Artery, Internal↗
PubMed1988

[Clinico-immunological profile of hepatic and extrahepatic diseases accompanied by anti-mitochondrial antibodies].

In a 13 year retrospective study mitochondrial antibodies were found in 1.71 p. 100 of patients about 60 years old with a strong female predominance. The presence of these antibodies was associated with a significantly increased level of the three classes of immunoglobulin and a marked cholestatic syndrome. In 76.9 p. 100 of cases the antibodies were associated with hepatic disease, mainly of immunological origin (67.7 p. 100). Primary biliary cirrhosis was the most frequent with significantly increased levels of mitochondrial antibodies, immunoglobin M, alkaline phosphatase and cholesterol. However, there was no correlation between the antibody levels and the clinical, biological and histological stages, thus ruling out any prognostic significance. The use of human cultured cells in the antibody detection assay increased the positivity of antinuclear antibodies compared with assays using classical rat liver substrates. Six sera were positive for anticentromere antibodies: 5/6 showed signs of the CRST syndrome with a primary biliary cirrhosis in 3/5 cases. The frequency of the association of primary biliary cirrhosis and other autoimmune diseases supports the results of previous reports as well as the finding of an association between mitochondrial antibodies and other auto-antibodies. In 3 cases primary biliary cirrhosis was associated with a chronic pancreatitis, suggesting a pluriglandular sicca syndrome, and in 3 other cases with a monoclonal IgA gammopathy. Mitochondrial antibodies are associated with other auto-immune non-hepatic diseases in 15.4 p. 100 of cases. The presence of increased levels of mitochondrial antibodies without any other auto-antibody associated with a chronic non-surgical cholestasis and an increased level of immunoglobulin M is still strongly suggestive of primary biliary cirrhosis.

Adult↗
PubMed1984

[Leukemoid eosinophilic reaction in angioimmunoblastic adenopathy].

A case of eosinophilic leukemoid reaction is described. This picture is seldom encountered during the course of angio-immunoblastic adenopathy. After reviewing various diagnoses and pointing out similar cases of the literature, the authors discuss the possible pathophysiologic mechanisms of eosinophilia in this disorder.

Aged↗
PubMed1978

[Unusual digestive manifestations during rheumatoid purpura. Apropos of 2 cases].

We have observed two unusual forms of rheumatoid purpura with digestive symptoms in two young girls aged 16 years. In the first case, the signs of complete duodenal stenosis led to a surgical operation which led to the discovery of an infiltrated mesenteric band of adhesions containing numerous lymph nodes, with on the oedematous loops of small intestine, numerous ecchymoses. In the second case, the duodenal-jejunal radiological abnormalities suggested protein-losing enteropathy. especially as this patient like the first, had major hypoproteinemia without albuminuria. The Cr51 radioisotope test confirmed this quite exceptional diagnosis in this disease.

Adolescent↗
PubMed1977

[Extrinsic compression of the celiac trunk by the arcuate ligament of the diaphragm. Apropos of 5 cases].

The authors report 5 cases (3 women and 2 men) of extrinsic stenosis of the coeliac axis by the arcuate ligament of the diaphragm. In one of the latter, the stenosis of the coeliac axis was associated with chronic calcific pancreatitis. These 5 patients were operated on. Division of the arcuate ligament gave on the whole very favourable results. (3 excellent results, one good and one average result). The authors then recall the clinical, angiographic and pathogenic data in this disease which remains exceptional. The diagnosis should be made and operation decided only after a fairly long period of observation during which one has elimiatned the diagnoses of gastro-intestinal, gall bladder, pancreatic and above all psychiatric disease by endoscopy, radiography and symptomatic medical treatment.

Adult↗