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P Loup

Publications and source records attributed to P Loup.

At least 19 recordsLinked to original sources
PubMed2005

Markov modelling of immunological and virological states in HIV-1 infected patients.

The purpose of this study was to evaluate the evolution of HIV infected patients and to bring out some significant factors associated with this pathology. The main criteria revealing the State of illness is viral load measurement (VL). However the CD4 lymphocytes also represent an important marker as these reflect the State of the immune reservoir. Many studies have been carried out in this field and different models have been proposed with a view to a better understanding of this disease. Multi State Markov models defined in terms of CD4 counts, or in terms of viral load, have proved to be very useful tools for modelling HIV disease progression. The model we have developed in this study is based on both the CD4 lymphocytes counts and VL. Markov models are characterized by transition intensities. In this paper we explored several structures in succession. First, we used a homogeneous continuous time Markov process with four states defined by crossed values of CD4 and VL in a given patient at a given time. Then, the effect of certain covariates on the infection process was introduced into the model via the transition intensity functions, as with a Cox regression model. Since the hypothesis of homogeneity may be unrealistic in certain cases, we also considered piecewise homogeneous Markov models. Finally, the effects of covariates and time were combined in a piecewise homogeneous model with a covariate. We applied these methods to data from 1313 HIV-infected patients included in the NADIS cohort.

Age Factors↗
PubMed2002

[Alcohol consumption by young adults from three cities in Southern France].

AIM: To identify potential factors of change in alcohol consumption and regional differences which could explain why and how habits are evolving. SUBJECTS AND METHODS: Four hundred and thirty three subjects aged 20 to 34 years, were recruited by random sampling in Marseilles, Montpellier and Toulouse. A quantitative food frequency questionnaire was used to collect data on alcohol consumption. A stepwise logistic regression was applied to the total sample, to the sub-sample of drinkers, and to the sub-samples of drinkers of each type of alcoholic beverage. Factors associated with each type of alcoholic consumption were analyzed by city. RESULTS: Montpellier and Toulouse samples were pooled because of the similarity in alcoholic consumption, which was different from that in Marseilles. There are significantly more drinkers in Montpellier/Toulouse than in Marseilles (74.4% versus 53.8%; p=0.001) and also more binge drinking subjects (31.1% versus 10.3%; p=0.001). Age, tobacco, leisure physical activity are independently associated with alcoholic consumption, female sex and Marseilles, being inversely associated. These two last factors are similarly associated with binge drinking, as well as age. CONCLUSION: The study of the factors for alcoholic consumption by site suggests that differences in behavior could explain these results. These distinct characteristics should be considered when implementing anti-alcoholic prevention in youth.

Adult↗
PubMed1982

Endoscopic noninvasive manometry of esophageal varices: prognostic significance.

Our study attempts to establish a relation between the pressure in the esophageal varices and the clinical outcome in 18 patients in whom sclerotherapy for bleeding esophageal varices was performed. The measured pressure was compared to the endoscopic findings. Before sclerotherapy, a noninvasive manometric measurement was performed on the varices using a spheric membrane manometer fixed at the tip of an endoscope. Twelve of our 18 patients suffered repeated hemorrhage which led to death in five. We discovered a relation between the measured pressure and the outcome. Beside this, we measured the highest pressures in the largest varices. The relation that seems to exist between the pressure in the esophageal varices, the endoscopic findings, and the severity of the portal hypertension may provide new opportunities for research in this field.

Adolescent↗
PubMed1981

[Treatment of refractory ascites by means of the LeVeen shunt].

Amongst the surgical treatments that have been suggested for refractory ascites, the one that has met with the greatest success is the LeVeen shunt. It nevertheless involves certain risks and might even be fatal. The authors' brief experience in this domain has confirmed its positive immediate effects and has also brought to light some of its drawbacks. The large number of potential complications leads one to conclude that the LeVeen shunt should be reserved for refractory ascites and hepato-renal syndrome, and should not be prematurely employed in other situations.

Aldosterone↗
PubMed1981

[Gastroesophageal reflux: long-term results of surgical management].

73 patients presenting with hiatus hernia and reflux oesophagitis verified endoscopically, were controlled and checked by endoscopy 5 to 15 years after surgical correction of reflux. In half of these cases the intervention consisted of a "fundoplicatio" and in the other half, of a "hemi-fundoplicatio" or closure of the angle of His. The long-term results show a higher degree of efficiency of the "fundoplicatio" particularly that which concerns the curing of the oesophagitis. The adjunction of a vagotomy-pyloroplasty in 9 patients showed an increase in the frequency of bile reflux in the stomach. The absence of cancer in the oesophagus in the 73 patients controlled after a period of many years, suggests that correction of the reflux and of the oesophagitis constitutes a high measure of efficiency.

Adult↗
PubMed1980

[Cirrhotic ascites and the renin-angiotensin system].

Plasma renin activity and plasma aldosterone have been measured in 31 patients in different clinical stages of alcoholic cirrhosis. Plasma renin activity and plasma aldosterone were within the normal range in patients with compensated cirrhosis and in patients with untreated cirrhosis and ascites. These results are not in keeping with the traditional concepts of reduced "effective' blood volume with stimulation of the renin-angiotensin system. In ascites treated with diuretics, and in the hepato-renal syndrome, the renin-angiotensin system was, however, stimulated. Peritoneo-venous shunt was followed by suppression of this stimulation.

Aldosterone↗
PubMed1980

[Anatomical study of the intramural esophageal branches of the vagus nerve with gastric distribution in man].

Thoraco-abdominal oseophagus was removed in continuity with the stomach during autopsy of 30 patients--two patients had undergone troncular vagotomy and pyloroplasty, the other 28 had not been operated on. In 22 cases (including the 2 which had undergone vagotomy) one or more branches of the thoracic vagus nerve existed. These branches (intramural nerves) reached the stomach after passing for 1.5 to 10 cm between the two muscular layers (of the oesophagus). They originated more often from the anterior (18) than from the posterior vagus nerve (-6). Intramural nerves are spared during abdominal vagotomy: are they the cause of some therapeutic failures of vagotomy?

Esophagus↗
PubMed1980

[Initial experiences with peritoneo-venous shunting by means of the Le Veen pressure-sensitive valve in the treatment of refractory ascites].

Of all different surgical treatments of ascites, the peritoneo-venous shunt actually seems to be the less risky method. Our short experience confirms the success of this method, but also its contradictions and reveals a little known complication: the thrombosis of the superior vena cava. Its superiority over the lympho-venous anastomosis has been proven in one of our patients.

Adult↗
PubMed1979

[Modification of gastric emptying after a selective proximal vagotomy. Barium and isotope studies].

The study of gastric emptying by isotopic and barium feeding, in 43 patients, before and 6 months after highly selective vagotomy, showed no retention after this type of operation. Whereas during the first 45 minutes following ingestion of the test meal, there was no modification of emptying, a significant acceleration thereafter was demonstrated by both methods. The isotopic meal allows continuous study of gastric emptying which appears to be more regular after the operation. There was no difference in gastric emptying between patients suffering from post-prandial gastric fullness, mild diarrhea or dumping syndrome.

Adult↗
PubMed1979

[Starch peritonitis. Apropos of 13 cases].

First known as an inert and harmless substance, starch powder has been used from 1950 by surgical gloves factories in place of talcum. Its innocuousness is now being denied, but many surgeons still do not know its adverse side effects. 13 cases of glove starch peritonitis, seen between 1971 and 1978, allow the authors to review clinical signs, diagnostic and treatment possibilities as well as the risk of a new operation. To limit the quantity of starch powder introduced into the peritoneal cavity is so far the only mean to prevent this complication and to compel the surgical team to strict discipline.

Adult↗
PubMed1979

[Prognosis of iatrogenic and accidental vascular trauma].

The prognostic of vascular trauma does not only depend on the associated lesions and time before treatment. Without obvious symptoms, serious vascular lesions can be overlooked. A preexisting arteriosclerosis explains the different outcome in geriatric patients. 84 cases of vascular trauma were observed between 1969 and 1977. 33 of these cases were iatrogenic. The patients involved are examined clinically and undergo ultrasonic velocity detection before and after effort (test of Strandness). The outcome showed 5 deaths, 7 amputations and 8 vascular sequela. Only 2 deaths and 3 amputations are directly related to the vascular trauma.

Amputation, Surgical↗
PubMed1978

[Liver tumors and oral contraceptives].

Benign liver cell tumors in young women are reported with increasing frequency. An association between benign tumors and oral contraceptive use was first suggested in 1973 by Janet Baum. During the past ten years we have observed 15 benign liver cell tumors, all of the focal nodular hyperplasia type. Ten of the 15 women were taking or had taken oral contraceptives. This association was found not to be statistically significant (0.06 greater than p greater than 0.05). We also diagnosed 2 liver cell carcinomas in women who had taken contraceptives.

Adult↗
PubMed1978

[Postoperative reflux gastritis].

Postoperative reflux gastritis is generally considered a definite clinical syndrome. It is the possible sequel to any gastric surgery suppressing pyloric continence. Incidence of this complication is still difficult to evaluate, whereas enterogastric reflux is often seen during endoscopy. 75 patients were studied clinically and endoscopically, and their gastric mucosa histologically, after gastric surgery. Results were compared to those in a 2nd group of patients whose reflux induced symptoms had been brought under control by endoscopically confirmed surgical correction of reflux. Enterogastric reflux is common (80%), but its effect on the gastric mucosa is observed endoscopically only when it is relatively marked (69%). Clinical suspicion of reflux gastritis is most often confirmed by endoscopy, but endoscopic reflux gastritis is symptomatic in only half of patients undergoing surgery. Foveolar hyperplasia is the only histological criterion related to reflux gastritis.

Adult↗