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J Melchior

Publications and source records attributed to J Melchior.

At least 19 recordsLinked to original sources
PubMed2000

Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection.

Two randomized double-blind, placebo-controlled parallel group clinical trials were performed to investigate the effect of a standardized extract (SHA-10) of Andrographis paniculata fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infections. 46 patients in the pilot study and 179 patients in the phase III study completed the study according to the protocol. Medication was taken three times daily for a minimum of 3 days and a maximum of 8 days for the pilot study, and for exactly three days in the phase III study. The primary outcome measures in the patients self-evaluation were: related to pain in the muscle, cough, throat symptoms, headache, nasal symptoms and eye symptoms and temperature. The physician's fixed score diagnosis was based mainly on sign/symptoms: ears, nose, oral cavity, lymph glands-tonsils and eyes. The total symptom score showed a tendency toward improvement in the pilot study (p = 0,08), while both the total symptom score and total diagnosis score showed highly significant improvement (p < or = 0.0006 resp. 0.003) in the verum group as compared with the placebo. In both studies throat symptoms/signs, were found to show the most significant improvement.

Adolescent↗
PubMed2000

[Complications of renutrition].

Several deaths were reported when total parenteral nutrition came into use in the early seventies. These deaths resulted from overzealous total parenteral nutrition leading to what was termed the refeeding syndrome. Actually, this syndrome had been reported years earlier, especially at the end of the second world war. The refeeding syndrome includes hypophosphatemia, water and electrolyte overload, hypertonic states, vitamin deficiencies and neurological disorders. Malnourished patients on enteral and/or parenteral nutrition are exposed to specific complications linked to artificial nutrition. Bronchial inhalation is the main complication of enteral nutrition, while the venous access is the source of most of the complications related to parenteral nutrition. Thrombophlebitis and infection of the central venous lines can be avoided by proper preventive measures. While refeeding syndrome and other metabolic complications is uncommon in malnourished patients on enteral or parenteral nutrition, the potential gravity of these complications implies careful preventive measures. A specific guideline for the treatment of phyophosphatemia is presented.

Catheterization↗
PubMed1994

Two years' effectiveness of intravenous pamidronate (APD) versus oral fluoride for osteoporosis occurring in the postmenopause.

Bisphosphonates seem to be effective as antiresorptive agents in the prevention and treatment of osteoporosis. However, the optimal dose and route of administration as well as the specific effects on cortical or trabecular bone have not been clarified. To compare pamidronate (APD) with fluoride (F) in the therapy of postmenopausal osteoporosis, 32 osteoporotic women were treated for 2 years either with APD (30 mg as a single intravenous infusion over 1 h every 3 months, n = 16, mean age 65 years) or with fluoride orally (20-30 mg F/day, n = 16, mean age 67 years) in an open study. Both groups received 1 g calcium and 1000 U vitamin D per day, but no estrogens or other drugs acting on bone. Both groups showed the same initial mean number of fractures per patient (2.8 and 2.7). Bone densitometry was performed every 6 months at three sites: lumbar spine and hip with dual-energy X-ray absorptiometry (BMD), distal forearm with single photon absorptiometry and lumbar spine with quantitative computed tomography. Biochemical assessment was performed in blood and urine every 3 months. Lumbar BMD (g/cm2, mean +/- SEM) increased from 0.632 (+/- 0.030) at time 0 to 0.696 (+/- 0.028) at 24 months in the APD group (p < 0.001), and from 0.684 (+/- 0.025) to 0.769 (+/- 0.028) in the fluoride group (p < 0.001). Femoral neck BMD increased significantly from 0.558 (+/- 0.025) to 0.585 (+/- 0.025) (p < 0.01) in the APD group, whereas it did not change in the fluoride group.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1990

[Inversion of uterus].

Inversion of the uterus is a rare condition, basically described in old treatises on obstetrics. On the basis of one recent case, the authors recall details of the diagnosis, treatment and prognosis, while referring to previous older works. The usual description is given of the three anatomical degrees of inversion of the uterus, depending on the extent of invagination of the fundus of the uterus. The aetiology of this event is not always very clear, but faulty manoeuvres at the time of delivery may help to promote its occurrence. Diagnosis is relatively easy, except in cases which are not exteriorized. Treatment relies on reduction of the inversion, which should take place as early as possible, and prevention of a relapse. The prognosis was formerly catastrophic, but has currently been transformed by the progress made in improving intensive care.

Adult↗
PubMed1989

[Artificial induction of labor at term for medical reasons. Comparison of 2 technics for labor induction, oxytocin + early artificial rupture of the membranes versus prostaglandin E2 vaginal gel. Open randomized controlled study].

Labor induction for medical reasons is a situation rather well-controlled by the combination: "oxytocin-amniotomy" when the cervix is favorably open. However, new induction techniques are currently under study, especially vaginal administration of PGE2 which presents the advantage of being simple to administer and better accepted by the patients. This study compared the classical technique, oxytocin perfusion and early artificial rupture of the membranes, with the vaginal administration of PGE2 gel (first dose: 1 mg, second dose 1 or 2 mg, six hours later). The success rate of both techniques is comparable, approximately 70 p. cent. Also, the times between amniotomy and delivery are identical, approximately 5 hours. On the contrary, the lapses of time between the onset of the induction and the delivery, vary significantly, being always longer in the PGE2 group. However, the dose of vaginal PGE2 gel as well as the time of artificial membrane rupture could be modified in order to decrease the delay of the effect.

Administration, Intravaginal↗
PubMed1988

[Administration of a single dose of 100,000 U.I. of vitamin D3 in the pregnant woman in winter. The effect on blood calcium level of the newborn infant].

Serum levels of 25-hydroxyvitamin D [25-(OH)D], calcium, phosphate and alkaline phosphatase activity were measured between December and July in 110 pregnant women during the last trimester of pregnancy, and in their infants on the fifth day of life. This study showed a fall, during spring, below 6 ng/ml, of the maternal 25-(OH)D concentration at the time of delivery, and a fall of the 25-(OH)D and calcium concentrations in newborns. The existence of a positive correlation between calcium and 25-(OH)D levels in the newborns suggests that the low calcium concentrations found in the infants born in spring is related to a vitamin D deficiency of the infant and therefore of the mother. The administration of a single low dose of vitamin D3 (100,000 I.U.) on the sixth or seventh month of pregnancy allowed to prevent the seasonal fall in serum calcium and 25-(OH)D concentrations. This dosage appears therefore to be sufficient to reduce the risk of vitamin D deficiency of the newborn and the occurrence of neonatal hypocalcemia.

Adult↗
PubMed1988

[Version by external maneuvers in breech presentations. Analysis of 6 years' practice in the maternity department of Foch Hospital].

The authors report their experience over 6 years of carrying out external cephalic version (ECV) in breech presentations. The precautions that have to be observed during the manoeuvre have been described as well as the contra-indications to it. Analysing the outcome in deliveries and the state of the infants at birth after version and when version has not been carried out shows the value of this manoeuvre in terms of "economy" of the caesarean section rate and lessening in the number of breech deliveries. Evidence is shown of the good results that have been obtained and of the small level of complications. Prognostic factors for failure or of success of the version have been sought. Only multiparity has been confirmed as a factor that helps greatly. Contra-indications have to be looked at carefully to make sure that this manoeuvre stays innocuous. Finally the ways our practice and the results of attempts at ECV have been analysed throughout the 6 year period.

Breech Presentation↗
PubMed1987

[Frequency of hepatitis B antigens in the blood of pregnant women].

In the antenatal clinics of the Hospital Foch at Suresnes we have instituted testing for hepatitis B antigens routinely of all mothers coming to the clinic so that we can look at the immune state of children born to mothers who have the hepatitis B virus and have hepatitis B antigens. The incidence of hepatitis B antigens altogether was 0.77%, which is twice as frequent as found in blood donors at the same hospital. This high incidence is found in women coming from the African and Asian continents where it is found at the same level in blood donors in the Hauts-de-Seine region. If however we examine women born in France who live in the towns the incidence is 0.32%. An enquiry in a standard medical form does not show a true risk factor. When, however, a more precise questionnaire is filled in, we found that risk factors were present in eight out of ten positive cases. We only made this enquiry on sero-positive women. When the baby was born we gave a 1 ml dose of anti-hepatitis B immunoglobulin (100 IU) followed by three injections of 1 ml of vaccine (HEVAC B Institut Pasteur) on the 1st, 30th and 60th day of life. A repeat injection was carried out when the infant was one year old. Altogether 32 newborns were treated: they tolerated the products well and it was effective because all infants developed anti-hepatitis B antibodies in every case that was followed up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

[Cystic fibrosis and pregnancy].

The authors point out the problems that are raised when a patient with cystic fibrosis becomes pregnant. Pregnancy in a patient with cystic fibrosis is rare but these patients do not seem to have diminished fertility. So it is likely that in the future this combination will increase in frequency. The genetic risk is raised. Heterozygotic subjects are about 3 to 5% of the population and there is a risk of 1 in 4 that heterozygotic parents who already have one child with cystic fibrosis will have a second. The BM test and the sweat test are used to screen for the disease at birth. The pregnancy does not always progress well. The level of prematurity is more than 26% and perinatal mortality is 11%. Furthermore, the birthweight of these children is at the lower limits of normal. Finally, the pregnancy makes the mother's state worse with an increase in her lung signs and change in her respiratory function. On the other hand, diabetes seems to be easily controlled. In conclusion, pregnancy seems to be detrimental for these patients.

Adult↗
PubMed1981

[Cervical dysplasia and their treatment with the CO2 laser (author's transl)].

The authors expound on their protocol for the treatment of dysplasias using the CO2 laser after they have reviewed the classification of dysplasia which is at the present time undergoing a lot of controversy. The indication for treatment is basal essentially on the site of the dysplasia in relationship to the endocervical canal. An exocervical lesion call for CO2 treatment with removal of a piece for histological examination and an endocervical lesion equally calls fro conisation carried out with the CO2 laser. A study of the post-operative appearances shows that clinically, colposcopically, cytologically and histologically, scar formation is perfect in 3 weeks due to centripetal metaplasia without spread from the zone of junction. It is essential to understand colposcopy perfectly before starting this from of treatment.

Adolescent↗
PubMed1977

Urethral strictures following transurethral prostatectomy: review of 2,223 resections.

There were 2,223 consecutive transurethral prostatectomies reviewed in regard to the incidence and possible etiology of postoperative urethral strictures. Possible etiologies were evaluated and a mode of stricture formation was postulated. Factors considered to be important were 1) initial calibration of the urethra to determine anatomical adequacy prior to instrumentation, 2) gentle urethral dilatation, 3) the use of perineal urethrostomy in patients with strictures noted at the time of initial endoscopy and 4) the size of the urethral catheter used postoperatively.

Catheters, Indwelling↗