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Biomedical subjects

L Descos

Publications and source records attributed to L Descos.

At least 55 records · Page 3Linked to original sources
PubMed1986

Salt or no salt in the treatment of cirrhotic ascites: a randomised study.

To compare the effect of diet, cirrhotic patients with ascites were randomised into two treatment groups: (1) a low sodium diet (21 mmol) per day or (2) an unrestricted sodium intake. Both groups received effective doses of diuretics (spironolactone or, if necessary, spironolactone and furosemide. One hundred and forty patients from 12 liver units were included according to well defined criteria (group 1: 76; group 2: 64). After an initial four to seven day period of bed rest and salt restriction (21 mmol sodium pd), randomisation was done in each centre. We saw no significant difference between the two groups with respect to clinical and biochemical data; mortality or withdrawal (definitive or temporary) because of biochemical disturbances (group 1: 34%, group 2: 22%); the time for complete disappearance of ascites was significantly shorter (p = 0.014) for the salt restricted patients actuarial survival (curves plotted up to the 120th day) was not statistically different (p = 0.18), but division into subgroups using various prognostic factors showed that survival was significantly better for salt restricted patients without previous gastrointestinal bleeding (p = 0.02); hospitalisation time and costs were identical in both groups. We conclude that the advantage of a normal salt diet was not shown in this study.

Adult↗
PubMed1985

Biological measurements of Crohn's disease activity--a reassessment.

Fifty-eight patients with Crohn's disease were studied in order to compare disease activity as measured by a clinical scoring system, with nutritional status, the laboratory measurements reflecting nutritional status, and the serum levels of acute phase proteins, using principal component analysis and stepwise multiple regression analysis. We confirmed that orosomucoid is the laboratory measurement which correlates best with clinical assessment of disease activity, followed by ESR and C-reactive protein. Serum albumin correlated poorly with clinical disease activity, although body weight showed an inverse correlation. Serum fibronectin, a protein involved in the production of fibrous tissue, did not detect the presence of fibrous strictures in the intestine.

Acute-Phase Proteins↗
PubMed1984

[Hydatid cyst of the psoas muscle. Diagnosis using the CT scanner].

A 30-year-old Maroccan man was admitted with a swelling in the right iliac fossa and right flank. Serology gave negative results but ultrasonography and CT scan images were suggestive of a hydatid cyst of the psoas muscle. A cystectomy was followed by total recovery. Hydatid cysts are rarely detected in France and their clinical and diagnostic characteristics are discussed. Ultrasonography and particularly CT scaner imaging are effective diagnostic procedures, avoiding unnecessary needle punctures and enabling adequate therapeutic measures to be instituted.

Adult↗
PubMed1983

Assessment of appropriate laboratory measurements to reflect the degree of activity of ulcerative colitis.

Eleven laboratory parameters were compared with the clinical grading of disease activity in 44 patients with ulcerative colitis, using multiple stepwise regression analysis to identify which measurements significantly reflect the severity of the disease. Only 2 parameters, serum orosomucoid and haematocrit showed significant correlation with clinical status. It is suggested that in the method of assessing disease activity proposed by Truelove and Witts the haemoglobin, which in this study was found to have no value, could be replaced by an equally simple test, the haematocrit. Comparisons are made between the relative usefulness of these parameters in ulcerative colitis and Crohn's disease.

Adult↗
PubMed1983

C-reactive protein as a predictor of relapse in asymptomatic patients with Crohn's disease.

Comparison of the Crohn's Disease Activity Index (CDAI) with serum levels of the acute phase proteins during a 4-year study period of 50 patients with Crohn's disease has shown the serum C-reactive protein (CRP) to be a sensitive indicator of clinical status. Five patients are described in whom raised CRP levels reliably predicted relapse at a time when the patients were asymptomatic and the CDAI was normal. Measurement of serum CRP by radial immunodiffusion is cheap and simple, and if performed frequently in the follow-up of patients with Crohn's disease it may permit earlier, and therefore possibly more effective, treatment of relapse.

Adolescent↗
PubMed1983

Comparison of six treatments of ascites in patients with liver cirrhosis. A clinical trial.

UNLABELLED: A national multicenter study (34 centers) compared six treatments in 328 patients with cirrhotic ascites. Excluded were patients with g.i. bleeding within the last six months, chronic encephalopathy, cancer, tuberculosis or the following complications persisting after three weeks: acute encephalopythy, fever greater than 38 degrees C, infected ascites or biochemical abnormalities: blood urea greater than 8 mmol/l, natremia less than 130 mmol/l, kaliemia less than 2.5 or greater than 5.5 mmol/l, WBC greater than 12000 mm3, total bilirubin greater than 85.5 mumol/l. In each center patients were randomized into two treatment groups, each center using 2 of 6 proposed treatments: (1) Spironolactone and 500 mg Na p.d (77 patients), (2) Spironolactone + furosemide or Moduretic (amiloride + hydrochlorothiazide) and 500 mg Na p.d (80 patients), (3) Spironolactone + Furosemide or Moduretic and unrestricted sodium diet (86 patients), (4) Concentrated ascites reinfusion and 500 mg Na p.d. (36 patients), (5) Unmodified ascites reinfusion and 500 mg Na p.d. (23 patients), (6) Slow ascites drainage and 500 mg Na p.d. (31 patients). Statistical analysis methods were X2, variance analysis and Spotvoll-Stoline and Dunn-Sidak tests. Before treatment, there was no significant difference between the 6 groups. RESULTS: After one month of treatment, no difference was found in the frequency of total or partial regression of ascites, complications of cirrhosis, mortality, acceptability of treatment. Mechanical treatments induced more rapid weight loss but more frequent recurrence; comparison of groups 2 and 3 did not confirm any benefit associated with unrestricted Na diet. Duration of treatment and hospitalization were shorter in group 4 than in groups 3 and 6.

Amiloride↗
PubMed1982

[Acquired epidermolysis bullosa with Crohn's disease. Report of two cases and review of literature (author's transl)].

Two cases of acquired epidermolysis bullosa (A. E. B.) are reported in patients suffering from Crohn's disease. Microscopic examination showed in both cases a subepidermal blister with pieces of basal membrane among the roof of the blister. In the second case, linear deposits of IgG and C3 were observed by direct immunofluorescence at the dermoepidermal junction in the juxtalesional skin. No circulating antiepidermis antibody were found by indirect immunofluorescence in any of the two cases. Presence of immune complexes was evidenced. A review is presented of similar cases in the literature and of the frequence of the pathological associations. No peculiar feature of A. E. B. when associated to Crohn's disease was found: the course of the two diseases is independent; however, we did observe an improvement of skin lesions by the time of the intestinal remission in the first case. The pathogenesis of this association is still unclear. Autoimmune mechanism might possible play a role, but is still unknown.

Adult↗
PubMed1981

Simultaneous onset of ulcerative colitis in the rectum and in a segment of colon used for colpopoiesis: report of a case.

A patient is described in whom a segment of colon used to construct an artificial vagina was therefore removed from intestinal continuity and was affected by typical idiopathic ulcerative colitis. The onset of disease was simultaneous in this loop of colon and in the rectum. There was no evidence of local infection. An increased ratio of IgE-plasma cells was found in both the mucosa of the grafted colon and that of the rectum, but anticolonic antibodies were not detected in the serum. After removal of the loop of colon used for colpopoiesis, the patient continued to suffer from distal proctocolitis for almost a year, but has since then maintained a stable remission without treatment. The etiology of ulcerative colitis is discussed, and attention is drawn to the unusual psychologic aspects of this case.

Adult↗
PubMed1981

Assessment of appropriate laboratory measurements to supplement the Crohn's disease activity index.

The ability of 11 laboratory parameters to reflect the degree of activity of Crohn's disease, using a clinical index as reference point was compared by means of multiple stepwise regression analysis. Activity was best defined in decreasing order by orosomucoid, sedimentation rate, C reactive protein, alpha-1-antitrypsin, albumin, haematocrit, IgM, circulating immune complexes, serum iron, IgG, and IgA. The haematocrit, the only laboratory measurement in the Crohn's disease activity index developed by the National Cooperative Study Group in the USA, is less discriminant than acute phase reactants. Only three parameters-namely, orosomucoid, sedimentation rate, and C reactive protein-have a significant weight and should be complementary to a simple clinical index.

Adolescent↗
PubMed1981

Relationships between the extent of ileal lesion of resection and vitamin B12, bile salt and fat absorption.

Vitamin B12 Urinary excretion, stool weight, fecal fat excretion, fecal 14C glycocholate excretion and 14CO2 output after I-14C glycocholate ingestion, were measured in 13 patients with non-operated ileal Crohn's disease (NOC), 14 patients with ileal resection for ileal Crohn's disease, with or without right colectomy (RC), and 11 patients with ileal resection with or without right colectomy for pathology other than Crohn's disease (RNC). A positive linear relationship was found between stool weight and 14C glycocholate fecal excretion. The logs of fecal fat and 14C glycocholate excretions were related to the extent of the ileal lesion of resection; a similar but negative relationship was observed for vitamin B12 urinary excretion. Fecal fat excretion and respiratory 14CO2 output were significantly higher in patients with right colectomy.

Breath Tests↗
PubMed1980

Adult celiac disease associated with HLA-DRw3 and -DRw7.

Celiac disease (CD), which occurs in Europe with varying frequency, is known to be associated with HLA-B8 and even more strongly with HLA-Dw3 because of the high linkage disequilibrium between these two antigens. After typing for HLA-A, -B and -DR antigens in adult patients with CD, we can confirm the high prevalence of B8 (72.7%) and of DRw3 (63.7%). However we find that DRw7 is also significantly increased (54.5%); DRw3 and DRw7, taken together, represent 86% of our 22 patients.

Absorption↗