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Biomedical subjects

L Jeannin

Publications and source records attributed to L Jeannin.

At least 19 recordsLinked to original sources
PubMed2004

[COPD in elderly patients].

INTRODUCTION: Patients with COPD are growing in number and are getting older, with 75% of deaths occurring after the age of 75; the proportion of women is increasing. STATE OF THE ART: There are few data regarding COPD in the elderly. The related medical and social demands are significant and rise as age and respiratory disability increase. Admission rates to hospital are increasing and, despite the development of services as alternatives to hospital admission, the portion of healthcare resources taken up by elderly COPD patients continues to rise. PERSPECTIVES: Costly therapeutic interventions for COPD should only be employed if they improve the patient's health related quality of life, which is hard to evaluate and correlates poorly with lung function parameters. Although depression is common and more often found in this condition than in others, it cannot be attributed purely to the effects of COPD. CONCLUSION: Preventive measures and new strategies towards more efficient care of elderly patients with COPD must be developed to improve quality of life and to reduce health care costs.

Aged↗
PubMed2003

[COPD in elderly patients].

INTRODUCTION: Patients with COPD are growing in number and are getting older, with 75% of deaths occurring after the age of 75; the proportion of women is increasing. STATE OF THE ART: There are few data regarding COPD in the elderly. The related medical and social demands are significant and rise as age and respiratory disability increase. Admission rates to hospital are increasing and, despite the development of services as alternatives to hospital admission, the portion of healthcare resources taken up by elderly COPD patients continues to rise. PERSPECTIVES: Costly therapeutic interventions for COPD should only be employed if they improve the patient's health related quality of life, which is hard to evaluate and correlates poorly with lung function parameters. Although depression is common and more often found in this condition than in others, it cannot be attributed purely to the effects of COPD. CONCLUSION: Preventive measures and new strategies towards more efficient care of elderly patients with COPD must be developed to improve quality of life and to reduce health care costs.

Age Factors↗
PubMed2000

[Lung disease due to Mycobacterium xenopi excluding AIDS. Apropos of 8 cases].

Between 1994 and early 1999, Mycobacterium xenopi was isolated in 11 HIV-negative patients seen at the Respiratory Disease Department of the Dijon University Hospital. Eight of these patients met the criteria of lung infection. Clinical and radiological features simulated pulmonary tuberculosis which delayed diagnosis until the germ was identified. Treatment is considered to be mandatory though it is difficult to manage and often disappointing. In spite of long-term medical care, sometimes associated with surgery, outcome is currently determined by the underlying disease rather than by Mycobacterium xenopi infection.

Aged↗
PubMed1999

Standard combination versus alternating chemotherapy in small cell lung cancer: a randomised clinical trial including 394 patients. 'Petites Cellules' Group.

PURPOSE: to compare standard and alternating administration of chemotherapy combinations in small cell lung cancer (SCLC) patients. MATERIAL AND METHODS: in a multicenter clinical trial, 394 previously untreated SCLC patients were randomised to receive, every 4 weeks, eight courses of either a standard regimen with CCNU, cyclophosphamide, adriamycin (CCA) and VP16 or an alternating regimen (CCA regimen alternating with cisplatin-vindesine-VP16). RESULTS: overall response rate was higher in the standard group (78%) than in the alternating group (64%) (P = 0.0001). Complete response rate was also higher in the standard group (32%) than in the alternating group (18%) (P = 0.004). The median survival in the overall SCLC population was 306 days in the standard group and 272 days in the alternating group (P = 0.08). In limited SCLC patients, median survival was higher in the standard group (421 days) than in the alternating group (328 days) (P = 0.01). Grade III/IV haematological toxicity was lower in patients in the alternating group (25 versus 47%) (P < 0.001). CONCLUSION: the standard regimen was better than the alternating regimen for patients with limited forms of SCLC. The alternating regimen, associated with better haematological safety and ensuring a fairly similar survival, may be considered in patients with extensive SCLC. Pleiomorphic resistance mechanisms to chemotherapy make it difficult to define a non-cross-resistant chemotherapy regimen.

Adult↗
PubMed1999

Organometallic 99mTc-aquaion labels peptide to an unprecedented high specific activity.

UNLABELLED: A new peptide labeling method that uses the organometallic aquaion [99mTc(H2O)3(CO)3]+ has been developed. METHODS: A selection of amino acids was labeled at different concentrations with the organometallic aquaion, and the labeling yield was determined by high-performance liquid chromatography. This investigation has shown histidine to be a very potent ligand, with specific activities of up to 6 TBq/micromol (160 Ci/micromol) ligand. Histidine derivatives have been coupled to neurotensin(8-13) (NT[8-13]) and have been labeled with the aquaion, resulting in high specific activities with (N(alpha)-histidinyl)acetic acid-NT(8-13) similar to those with histidine. RESULTS: Histidine derivatives of NT(8-13) labeled using this approach fully retained their receptor affinity, showing KD values of all investigated NT analogs below 1 nmol/L on colon carcinoma HT29 cells. Biodistrbution experiments in BALB/c mice showed complete clearance of (N(alpha)-histidinyl)acetic acid-NT(8-13) from the blood after 24 h and no unwanted accumulation in any tissue. CONCLUSION: The novel labeling method using the organometallic 99mTc-aquaion combines the advantage of highest specific activities with minimal functionalization of proteins and peptides under retention of biologic affinity.

Animals↗
PubMed1998

Relative survival analysis of 252 patients with COPD receiving long-term oxygen therapy.

OBJECTIVES: A survival analysis was conducted on patients with COPD receiving long-term oxygen therapy (LTOT) to compare two different statistical methods. METHODS: We used a multivariate crude (observed) survival model (Cox) and a multivariate relative survival model (Hakulinen). Only the latter is able to correct the survival by adjusting it to the normal life expectancy of the studied patients. PATIENTS: Two hundred fifty-two hypoxemic COPD patients (207 male) requiring LTOT were included. Mean PaO2 was <50 mm Hg before oxygen therapy. Mean age was >69 years (SE: 9.9). They had severe bronchial obstruction: mean FEV1 was <33% (10.6) of predicted values, with some CO2 retention: mean PaCO2 was 45.6 (7.1) mm Hg. By December 31, 1995, 189 patients had died (75%) and 13 (5%) were unavailable for follow-up. RESULTS: The overall crude survival was poor: 80.9% after 1 year, 67.1% after 2 years, 34.7% after 5 years, and 7.1% after 10 years. In the crude multivariate analysis (Cox), the negative prognostic factors were age and hypercapnia. The overall relative survival (Hakulinen), corrected for life expectancy, was 82.8% after 1 year, 70.8% after 2 years, 41.5% after 5 years, and 10.25% after 10 years. In the final multivariate relative model, age was no longer significant and the only bad prognostic factor was hypercapnia with a relative risk of 1.97 (1.16 to 3.34). CONCLUSION: This work shows the inadequacy of the Cox observed survival model when it comes to appreciating the real prognostic impact of age, because of the confusing factor associated with a normal life expectancy.

Adult↗
PubMed1997

[Unexplained pulmonary edema: demonstration of obstruction to pulmonary venous return by transesophageal echocardiography. Apropos of 4 cases].

The usual causes of pulmonary edema are left ventricular dysfunction, mitral valve disease or left atrial myxoma. Obstruction to pulmonary venous drainage is a rare and unrecognised diagnosis which should be considered when the usual investigations are unproductive. The authors report four cases in which transesophageal echocardiography showed pulmonary edema to be due to compression of one or more pulmonary veins by a mediastinal mass (2 cases), by the false lumen of dissection of the aorta (1 case) and postoperative stenosis of the pulmonary veins (1 case). These cases underline the diagnostic value of this technique which rapidly provides diagnostic information with privileged visualisation of the pulmonary veins and abnormalities of acceleration of blood velocities in the Doppler mode due to obstruction.

Aged↗
PubMed1997

[Synthesis of peptide and pseudo-peptide analogs of cholecystokinin].

We describe selective CCKA receptor antagonists, based on the 1-oxo-1,2,3,4-tetrahydro-beta-carboline-3-carboxylic acid core. Selectivity A vs B is discussed on the basis of molecular modelling. Chemical preparation uses electrophilic cyclization of isocyanates derivating from unnatural tryptophan esters. A stereoselective version of the reaction is given. A few peptides incorporating unnatural tryptophans are prepared, with a view of SAR.

Cholecystokinin↗
PubMed1996

Fatal ball-valve airway obstruction by an extensive blood clot during mechanical ventilation.

A ball-valve airway obstruction by a blood clot cast of almost the whole bronchial tree occurred in a small-cell lung cancer patient, who had been on mechanical ventilation for 9 days. Chest radiographs revealed overinflated lungs. Attempts to remove the cast via fibreoptic bronchoscopy were unsuccessful and the patient died. A postmortem extraction of the clot was performed with a rigid tube. This case is rare because of absence of severe haemoptysis and lung volume reduction.

Aged↗
PubMed1995

[Evaluation of the ventilatory function in elderly subjects].

OBJECTIVES: Many elderly subjects are at risk of respiratory failure due to effect of age on ventilatory system and the deleterious effects of toxins and respiratory diseases. As spirometry is the main technique currently used to detect altered ventilatory function we first used this method in very elderly subjects then compared the results with clinical measurements of chest and abdominal ampliation. METHODS: Among 65 subjects over 75 years of age, with no cardiorespiratory or neuropsychologic impairment and who had undergone spirometry and chest and abdominal ampliation measurements in 1991, 24 were re-examined in 1994 using exactly the same techniques. Forced vital capacity and maximum expiratory volume/second were measured at the patient's home with a previously calibrated spirometer. All tests were run according to the recommendations of the European Respiratory Society. Variations in upper chest, lower chest and abdominal circumferences were also recorded. RESULTS: Mean age of the subjects was 84.1 +/- 3.7 years and all spirometric tests were reproductible within a given measurement session. There was no significant difference for forced vital capacity or for maximum expiratory volume/second between the 1991 and the 1994 values with variations of 2.1 +/- 0.4 and 9.4 +/- 3.4% respectively. Four of the 24 initially asymptomatic subjects had signs of obstruction which resolved in 2 with the salbutamol and/or ipratropium bromide. The correlations between spirometric data and chest and abdominal ampliations were significative. CONCLUSIONS: Spirometry can be an effective tool in elderly patients. In addition to frequent discovery of reversible bronchial obstruction (7 to 41% according to the series), it can be used to screen for reduced ventilatory "reserve". Chest ampliations measures also appear to be simple means of determining which subjects could benefit from physical therapy aimed at improving chest and abdominal musculature.

Aged↗
PubMed1994

Nasal intermittent positive pressure ventilation. Long-term follow-up in patients with severe chronic respiratory insufficiency.

Prior studies have shown that nasal intermittent positive pressure ventilation (NIPPV) can improve arterial blood gas values, prevent symptoms resulting from alveolar hypoventilation, and decrease hospitalization in patients with chronic respiratory failure. Most studies have involved small samples of patients followed up for a limited time. This study reviews our experience during 5 years use of NIPPV in 276 patients with kyphoscoliosis, posttuberculosis sequelae, Duchenne-type muscular dystrophy, COPD, and bronchiectasis followed up for > or = 3 years while receiving NIPPV. Outcomes were compared for patients who survived short term eg, died or converted to management with a tracheostomy and intermittent positive ventilation (TIPPV) during year 1 or year 2 on a regimen of NIPPV and long term, eg, survived more > or = 2 years on a regimen of NIPPV. The most favorable outcome was achieved by patients with kyphoscoliosis and posttuberculosis sequelae with improvement in PaO2 and PaCO2 (p < 0.0001) and a reduction in days of hospitalization for respiratory illness (p < 0.0001) for > or = 2 years while receiving NIPPV. Patients with Duchenne-type muscular dystrophy also had fewer hospital days during NIPPV (p < 0.003) but only 9 of 16 patients (56 percent) continued using NIPPV for the duration of followup. Benefit was also more short term for patients with COPD and bronchiectasis. NIPPV can sustain improvement in gas exchange, while reducing hospitalization for substantial periods of time. NIPPV can be an attractive and effective alternative to other methods of assisted ventilation such as TIPPV.

Adult↗