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Biomedical subjects

M Barrie

Publications and source records attributed to M Barrie.

10 recordsLinked to original sources
PubMed2006

Endoscopic retrograde cholangiopancreatography after a liquid fatty meal: effect on deep common bile duct cannulation time.

BACKGROUND AND STUDY AIM: Endoscopic retrograde cholangiopancreatography (ERCP) is an important gastrointestinal endoscopic procedure in the study and treatment of pancreaticobiliary diseases. The critical step of the procedure is cannulation of the common bile duct (CBD) and/or the pancreatic duct. Cannulation can be a technical challenge at times. Fat is a natural stimulator for bile secretion and relaxation of the sphincter of Oddi. The objective of this study was to determine the effect of a liquid fatty meal on deep CBD cannulation during ERCP. PATIENTS AND METHODS: We performed a randomized double-blind study in 84 patients to examine the effect of a liquid fatty meal on deep CBD cannulation during ERCP, in a teaching medical center. In the study group, each patient had a liquid fatty meal orally about 1 hour before the procedure. In the control group, each patient had the same volume of a non-fat meal. The appearance of the major papilla, the cannulation rate, the cannulation time, and the fluoroscopy time during cannulation were compared for the two groups. RESULTS: The orifice of the CBD/pancreatic duct was much more easily identified in the group who ingested the fatty meal. Compared with the non-fat meal group, in the fatty meal group the mean and the median deep CBD cannulation times were shorter, at 8.0 minutes vs. 14.7 minutes ( P = 0.005) and 8.0 minutes vs. 11.5 minutes ( P = 0.008), respectively. Additionally, in the fatty meal group, the mean and the median fluoroscopy times during deep CBD cannulation were lower, at 3.3 minutes vs. 6.1 minutes ( P = 0.040) and 2.5 minutes vs. 3.9 minutes ( P = 0.013), respectively. There were no complications, such as aspiration, associated with the liquid meals given shortly before the ERCP procedure. CONCLUSIONS: To avoid prolonged cannulation and unnecessary radiation exposure, patients should have a liquid fatty meal before ERCP procedures.

Catheterization↗
PubMed2001

Safety and efficacy of temozolomide in patients with recurrent anaplastic oligodendrogliomas after standard radiotherapy and chemotherapy.

PURPOSE: Most primary oligodendrogliomas and mixed gliomas (oligoastrocytoma) respond to treatment with procarbazine, lomustine, and vincristine (PCV), with response rates of approximately 80%. However, limited data on second-line treatments are available in patients with recurrent tumors. A novel second-generation alkylating agent, temozolomide, has recently demonstrated efficacy and safety in patients with recurrent glioblastoma multiforme and anaplastic astrocytoma. This study describes the effects of temozolomide in patients with recurrent anaplastic oligodendroglioma (AO) and anaplastic mixed oligoastrocytoma (AOA). PATIENTS AND METHODS: Forty-eight patients with histologically confirmed AO or AOA who had received previous PCV chemotherapy were treated with temozolomide (150 to 200 mg/m2/d for 5 days per 28-day cycle). The primary end point was objective response. Secondary end points included progression-free survival (PFS), time to progression, overall survival (OS), safety, and tolerability. RESULTS: Eight patients (16.7%) experienced a complete response, 13 patients (27.1%) experienced a partial response (objective response rate, 43.8%), and 19 patients (39.6%) experienced stable disease. For the entire treatment group, median PFS was 6.7 months and median OS was 10 months. For objective responders, median PFS was 13.1 months and median OS was 16 months. For complete responders, PFS was more than 11. 8 months and OS was more than 26 months. Response correlated with improved survival. Temozolomide was safe and well tolerated. Twelve patients developed grade 1/2 thrombocytopenia and three patients developed grade 3/4 thrombocytopenia. CONCLUSION: Temozolomide is safe and effective in the treatment of recurrent AO and AOA.

Adult↗
PubMed1997

Alcoholic epilepsy: a unified and dynamic classification.

The interactions between alcohol and the CNS are complex and there are experimental data suggesting that chronic and acute effects are different and often opposite. An intriguing hypothesis is that repeated alcohol withdrawal seizures (AWS) may render the brain more excitable, leading to an epileptogenic state reminiscent of the 'kindling' model. To gain insight into this question we compared alcoholic patients with seizures related to episodes of AW (AWS) and patients with seizures unrelated to episodes of AW (UAWS). There were several significant differences between the AWS and UAWS groups. Age at admission for seizure was younger in the AWS groups (p < 0.005), seizure number was higher among patients with a history of seizures before admission in the UAWS group (p < 0.05). Neurologic signs were more frequent in the UAWS group (p < 0.05). Duration of intoxication was longer in the UAWS group and brain atrophy demonstrated by CT scan was more common in the UAWS group than the AWS group. Based on these findings, we propose a dynamic classification in which patients presenting seizures unrelated to any cause other than alcohol are classified in several successive stages of 'alcoholic epilepsy', the first being characterized by AWS and the last by persistent chronic seizures.

Adult↗
PubMed1996

Myoclonic alcoholic epilepsy.

We describe 2 patients with chronic alcoholism who over a period of several years developed epilepsy associated with a cerebellar syndrome and action myoclonus. The clinical picture suggested progressive myoclonic epilepsy, but subsequent investigations did not confirm this diagnosis. Myoclonus worsened during abstinence and was relieved during indulgence. We believe that this special clinical syndrome should be recognized as a complication of chronic alcoholism.

Adult↗
PubMed1995

An epidemiological and clinical approach to adolescent suicide. A comparison between suicidal and non-suicidal clinical groups in a health foundation center for French students.

Suicidal behaviour among young people represents a major public health problem. This study seeks to compare the major sociological, clinical, schooling and family features of suicidal and non-suicidal subgroups of adolescents hospitalised in the Health Foundation Center for French Students of neufmoutiers en Brie (France). All these adolescents suffered from the severe mental disorders. The adolescents from the suicidal subgroup presented significantly fewer psychoses and more mood disorders than those of the non-suicidal subgroup. Half of the patients from the suicidal subgroup presented some features of personality disorders, mostly borderline personality disorders. Nevertheless, their global functioning was more frequently improved between admission and discharge than was the case for the non-suicidal group.

Adolescent↗
PubMed1984

A neurological basis for visual discomfort.

Certain patterns of stripes are judged to be unpleasant to look at. They induce illusions of colour, shape and motion that are sometimes perceived predominantly to one side of fixation. People who suffer frequent headaches tend to report more illusions, and if the pain consistently occurs on the same side of the head the illusions tend to be lateralized. The parameters of the patterns that induce illusions (including their shape, spatial frequency, duty cycle, contrast and cortical representation) closely resemble those that elicit epileptiform electroencephalographic abnormalities in patients with photosensitive epilepsy. The viewing conditions under which such abnormalities are likely to appear are also those under which more illusions are seen.

Adolescent↗