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Biomedical subjects

J Sternon

Publications and source records attributed to J Sternon.

At least 19 recordsLinked to original sources
PubMed2006

[Insulin analogues: place of detemir (Levemir)].

Insulin detemir (Levemir) is a soluble long-acting human insulin analogue acylated with a 14-carbon fatty acid. Insulin detemir is 98-99% albumin bound in plasma. It has a more predictable glucose-lowering effect than NPH insulin or insulin glargin. There is a dose-response relationship, but at the dose of 0.4 units/kg (an average normal dose), the duration of action reaches nearly 24 h. Therefore, detemir, most often injected once per day at bedtime, seems to be the ideal basal insulin in the basal-prandial therapy for type 1 diabetic patients. The boli of insulin, in order to cover shown to reduce the risk of (severe) hypoglycaemias, particularly nocturnal (up to 50 %). Fasting hyperglycaemia is often lower, but it is not necessarily true for glycated haemoglobin. In addition, detemir has been associated with less weight gain than NPH insulin. Detemir is well tolerated and no specific safety concerns have been raised.

Delayed-Action Preparations↗
PubMed2006

[Omalizumab, an anti-IgE monoclonal antibody to treat severe asthma].

Omalizumab (Xolair) is the first representative of a new therapeutical class for severe allergic asthma. By neutralizing Ac IgE, omalizumab fulfils an anti-inflammatory action of which the effect has been shown beneficial in the treatment of severe allergic asthma and particularly in severe asthma for which the therapeutical arsenal is for the time being disappointing and associated to frequent side effects there where omalizumab is well tolerated.

Anti-Asthmatic Agents↗
PubMed2005

[Obesity in adult patients: check up and treatment].

Obesity is now one of the major health problems in industrial countries as well as in developing world. Excess caloric intake and reduction of the physical activity are the main causes of obesity. This epidemic precedes a tremendous increase of type 2 diabetes, which is generally linked to weight excess. Obesity and type 2 diabetes are associated with morbidity and mortality and are very expensive for the social security. The important point is to define the risks linked to obesity taking into account the Body Mass Index and the importance of visceral obesity evaluated by waist measurement. After medical check up, a strategy will be discussed with the patient, including moderate caloric restriction and increased physical activity. Our patients and also some doctors suggest "popular diets" whose efficacy has not been demonstrated as superior. On a short time basis, low carbohydrate and high protein diets have some advantages, which can help our obese subjects but on long term, only hypocaloric and equilibrated diets are advisable. Drugs that proved their efficacy and tolerance may be prescribed in case of failure. Three drugs are presented, orlistat, sibutramine and metformine: their efficacy, secondary effects, interactions and finally their positioning. Bariatric surgery will be proposed to highly selected patients presenting morbid obesity.

Adult↗
PubMed2005

[Rimonabant (Acomplia), specific inhibitor of the endocannabinoid system].

The endocannabinoid system plays a major role in the regulation of body energy by stimulation of the appetite in the hypothalamus and increase of fat accumulation in adipocytes. The blockade of the cannabinoid system (CB1) by the specific inhibitor (rimonabant) decreases food intake and adiposity in animals and in humans. Moreover rimonabant lowers tobacco addiction. Clinical studies (RIO-LIPIDS and RIO-EUROPE) have recently confirmed that rimonabant combined with a hypocaloric diet over 1 year, promoted significant decrease of body weight, waist circumference and improvement of dyslipidemia. Rimonabant was well tolerated with mild and transient side effects. The future place of rimonabant in the strategy of obesity is still to be clarified.

Anti-Obesity Agents↗
PubMed2004

[Linezolid (Zyvoxid)].

Linezolid is a novel antibiotic administrable by the intravenous as well as the oral route. It is aimed by its re-imbursement conditions at treating proven beta-lactam- or glycopeptide-resistant staphylococcal and enterococcal infections in the hospital and post-discharge outpatient. It has various indications: pulmonary infections, complicated skin and soft tissue infections, infections in the febrile neutropenic patient, urinary tract infections, intra-abdominal infections, chronic osteitis. Bacteriologic documentation of the infection is required to avoid overconsumption and development of resistance. The oral forms exhibit complete bio-availability. Caution is recommended with regard to linezolid's MAO inhibitory effect and the risk of thrombocytopenia requiring weekly hematologic monitoring.

Acetamides↗
PubMed2004

[Memantine (Ebixa), glutaminergic modulator].

Alzheimer's disease (AD) is the most common etiology of dementia. Its incidence increases with age following an exponential trend of line between 60 and 90 years old. Anti-cholinesterasic drugs reduce modestly AD symptoms. However, they have no basic impact on the pathological evolution of the disease. Memantine offers another therapeutic approach in AD with a dissimilar mechanism of action, confronting neurotoxic effects of glutamate overload. It prevents the elevation of glutamate which destroys cholinergic neurons by inhibiting the N-methyl-D-aspartate (NMDA) receptors. Its clinical efficiency has been demonstrated during 28 weeks with 20 mg/day, in patients presenting moderate or severe AD and mild or moderately vascular dementia. Its use in association with anti-cholinesterasic (donepezil) revealed more interesting results with a significant improvement of cognitive functions and activities of daily live, compared to association placebo-donepezil. We are waiting for results of further lenghter studies, including more, well-defined, patients.

Alzheimer Disease↗
PubMed2004

[Ezetimibe (Ezetrol): the statins' partner].

Ezetimibe is a new cholesterol absorption inhibitor that selectively inhibits dietary and biliary cholesterol absorption from the intestine. This drug inhibits cholesterol absorption without affecting the absorption of triglycerides, biliary salts and fat-soluble vitamins. Inhibition of cholesterol absorption using ezetimibe 10 mg/day alone resulted in substantial reductions of plasma LDL-C concentrations (approximately 18%). Coadministration of ezetimibe 10 mg/day with statins 10 mg/day showed LDL lowering comparable to or greater than that of the highest dose of the respective statin alone. Combination therapy of ezetimibe with statins helped more patients in achieving their target LDL-C goal. Ezetimibe in coadministration with statins or alone had also favourable effects on triglycerides and HDL. In clinical studies, ezetimibe alone or coadministered with a statin was shown to have a safety profile (asymptomatic mild increases in aminotransferase levels, without evidence of rhabdomyolysis) similar to placebo or to the statin alone. Large clinical studies on clinical endpoints are in progress.

Animals↗
PubMed2004

[Antiplatelet therapy in 2005].

Atherothrombosis is a common physiopathologic process resulting in morbid or fatal ischemic events affecting the cerebral, coronary, or peripheral arterial circulation. Antiplatelet agents are effective in preventing recurrence of vascular events among patients with established vascular disease or with multiple risk factors. Aspirin was the most widely studied antiplatelet drug but the optimal dose remains difficult to define. This article summarizes new data on antiplatelet agents including aspirin, clopidogrel, dipyridamole and glycoprotein IIb/IIIa antagonists with the aim of giving practical recommendations in this very moving field of therapy.

Humans↗
PubMed2003

[Telithromycin, first ketolide].

Telithromycine is the first ketolide on the market. Its characteristics are the two sites fixation on the bacterial ribosomia and and as a consequence a good activity on the majority of penicillin and macrolides resistant bacteria, included S. pneumonia and S. pyogenes. Telithromycine represents an alternative to beta-lactames and moxifloxacine to treat communautary pneumonia, bacterial pharyngoamygdalitis, suppurative sinusitis and bronchitis. There are nevertheless problems with drugs interactions and risk of resistance development.

Anti-Bacterial Agents↗
PubMed2003

[H1 histamine antagonists].

Histamine is an important mediator for early phase allergic reactions that are involved in atopic diseases, mediated by specific IgE antibodies. After allergenic contact, its liberation induces unpleasant symptoms like itching, several manifestations as local vasodilatation, bronchoconstriction, mucus hypersecretion. Antagonists of H1 histamine receptors are the most prescribed drugs, due to their symptomatic effects at the levels of nasal or conjunctival mucosa, and the skin. Their major indications cover allergic rhinitis, either seasonal or perennial, and idiopathic chronic urticaria, as a first line medication. The pharmacological evolution allows to distinguish three generations of products differing at the levels of specificity, long acting period, and toxicity. The authors are discussing the respective benefits of two recent molecules presented as 3rd generation molecules: fexofenadine and levocetirizine, while repositioning their use among available treatment strategy.

Acetates↗
PubMed2003

[Erectile dysfunction and phosphodiesterase type 5 inhibitors].

Erectile dysfunction affects 150 millions of men and its prevalence increases with age. The improvement of life expectancy will increase the worldwide prevalence to 300 million in 2025. Oral treatments are nowadays the first line therapy for the vast majority of people as they have a good reliability and tolerance and restore more spontaneity. The authors relate the widespread interest in phosphodiesterase type 5 inhibitors with the advent of sildenafil for the treatment of erectile dysfunction and present characteristics of 2 new phosphodiesterase type 5 inhibitors in Belgium, tadalafil and vardenafil.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2002

[Crohn's disease].

The etiology of Crohn's disease remains unclear. However, a better knowledge of the immune alterations at the intestinal mucosa level allowed to improve the therapeutic management of these patients. The alternatives to the usual corticotherapy are the use of budesonide (a topical form of steroids) in the mild to moderate diseases or the use of immunomodulators molecules such as the anti-TNF antibodies (infliximab) in the severe diseases, resistant to conventional medications. In the chronic active diseases that became steroid-dependent, it is recommended to initiate immunosuppressants such as azathioprine or methotrexate. The use of these molecules requires an optimal adaptation of doses and a regular clinical and biological follow-up to prevent drug-related complications. Surgery should be reserved for treating complications.

Combined Modality Therapy↗
PubMed2002

[Acute diarrhea in adults].

The cause of an acute diarrhea is often infectious and a lot of pathogens are implicated: bacteria, parasites and viruses. The clinical approach required several steps and induce different advices such as avoiding stool cultures in the absence of fecal leucocytes, supportive therapy with rehydration, diverse empirical and urgent antibiotherapies. The increasing incidence of antimicrobial resistance of enteropathogens argues against the overconsumption of antibiotics.

Acute Disease↗
PubMed2002

[The choice and administration of corticoids in COPD].

Although the role of steroid inhalations is well established for the chronic treatment of asthmatic patients, their use in the chronic treatment of patients with COPD remains controversial. Steroid inhalations do not prevent the yearly FEV1 decline, which is an important prognostic factor of the disease. Inhaled steroid are not indicated for the treatment of early disease. For the patient with advanced disease (FEV1 < 50% of the predicted value) and presenting several exacerbations each year, inhaled steroids reduce the number of exacerbations and slow the progressive decline of quality of life. There is no place for continued oral glucocorticoid treatment. For mixed conditions (COPD and asthma), inhaled steroid may be of value.

Adrenal Cortex Hormones↗
PubMed2002

[Conjugated vaccines].

Conjugate vaccines extend the vaccinal prevention for children to more diseases. Conjugating the capsular polysaccharide to a carrier protein transforms a T-independent antigen in a T-dependent, allowing protection of the children (before 2 years of age) against Haemophilus influenzae type b, meningococcal C and pneumococcal infections. This article reviews the 3 conjugate vaccines and their results with focus on some questions: antigens interference in the immunological response, serological subrogate for protection, herd immunity and replacement of circulating serotypes.

B-Lymphocytes↗
PubMed2002

[Conjugate vaccines].

Conjugate vaccines extend the vaccinal prevention for children to more diseases. Conjugating the capsular polysaccharide to a carrier protein transforms a T-independent antigen in a T-dependent, allowing protection of the children (before 2 years of age) against Haemophilus influenzae type b, meningococcal C and pneumococcal infections. This article reviews the 3 conjugate vaccines and their results with focus on some questions: antigens interference in the immunological response, serological subrogate for protection, herd immunity and replacement of circulating serotypes.

Adult↗
PubMed2002

[Recent therapeutic strategies and new drugs].

Recent therapeutic strategies are presenting concerning the use of morphine, benzodiazepines, hypoglycemic agents, glucocorticoids and several specific treatments are indicated. Three new molecules deserve special attention: tiotropium, fondaparinux and omalizumab.

Antibodies, Anti-Idiotypic↗