PubMed Health⌕ Search

Biomedical subjects

J M Vetel

Publications and source records attributed to J M Vetel.

16 recordsLinked to original sources
PubMed1992

Effects of acetorphan, an enkephalinase inhibitor, on experimental and acute diarrhoea.

Acetorphan is an orally active inhibitor of enkephalinase (EC 3.4.24.11) with antidiarrhoeal activity in rodents apparently through protection of endogenous enkephalins and a purely antisecretory mechanism. Its antidiarrhoeal activity in man was assessed in an experimental model of cathartic induced secretory diarrhoea as well as in acute diarrhoea of presumed infectious origin. In six healthy volunteers receiving castor oil and pretreated with acetorphan or placebo in a crossover controlled trial, the drug significantly decreased the number and weight of stools passed during 24 hours. About 200 outpatients with severe acute diarrhoea (more than five stools per day) were included in a randomised double blind study of acetorphan against placebo. The significant antidiarrhoeal activity of acetorphan was established using a variety of criteria: (i) the duration of both diarrhoea and treatment were diminished; (ii) no acetorphan treated patient withdrew from the study whereas five dropped out because of worsening in the placebo group; (iii) the frequency of symptoms associated with diarrhoea--for example, abdominal pain or distension, nausea and anorexia--remaining after two weeks was nearly halved; (iv) using visual analogue scales acetorphan treatment was found more effective than placebo by both investigators and patients. There was statistically no significant difference between acetorphan and placebo in respect of side effects, particularly constipation, which often accompanies the antidiarrhoeal activity of mu opioid receptor agonists this difference is attributable to the lack of antipropulsive activity of acetorphan in man. The efficacy and tolerance of acetorphan suggest that enkephalinase inhibition may represent a novel therapeutic approach for the symptomatic management of acute secretory diarrhoea without impairing intestinal transit.

Adolescent↗
PubMed1990

[Geriatric hospital facilities].

Nowadays (and prior to any hospital reform), geriatric hospital structures rest on medium or long length stay units and on acute geriatry departments when these are available. However, to limit relations between hospital and the elderly to these three structures would be an oversimplification. The organization of emergency admission units for the elderly, the medico-social preparation of these patients before they return home, the setting up of geriatric consultations in both out-patient clinics and specialized hospital departments are all major topics not to be neglected. Moreover, geriatric day-hospitals offer hospital treatment without accommodation which is a solution desired by many old people. What can be suggested for the mentally deficient or demented old patient admitted to a hospital, if not the cooperative efforts of geriatric and psychiatric teams working in suitable architectural structures? Finally, we must insist on the need for coordination between hospital and non-hospital structures, so that the entire "geriatric network" becomes reality without any break in care between structures.

Aged↗
PubMed1982

[Therapeutic trials in outpatients. Apropos of triazolam trials].

Clinical trials conducted in general practice are more especially interesting as they enable to test a drug in the real conditions of use. On the other hand, these trials are beneficial to the G.P. (new image, rupture of his loneliness, change in his prescription habits, contact with hospitals). The methodology, as for hospital studies, must be rigorous. As a matter of fact, these two types of studies are additional and the cooperation between the G.P.'s and the pharmaceutical industry can conduct to the solution of specific problems: drug interaction--long-term therapeutic effect--new indications. This double blind cross over study comparing triazolam and nitrazepam conducted by G.P.'s on insomniacs is the first French clinical study intended for the registration application and done according to this methodology. This work is an exemple of the new opportunity offered to G.P.'s in future. The results have shown that: on 54 patients (23 male and 31 female) of an average age: 48, 32 have preferred triazolam, 13 have preferred nitrazepam, 9 have had no preference.

Adult↗