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Biomedical subjects

Pierre Loubeyre

Publications and source records attributed to Pierre Loubeyre.

5 recordsLinked to original sources
PubMed2006

Pharmacological prevention of serious anaphylactic reactions due to iodinated contrast media: systematic review.

OBJECTIVE: To review the efficacy of pharmacological prevention of serious reactions to iodinated contrast media. DESIGN: Systematic review. DATA SOURCES: Systematic search (multiple databases, bibliographies, all languages, to October 2005) for randomised comparisons of pretreatment with placebo or no treatment (control) in patients receiving iodinated contrast media. Review methods Trial quality was assessed by all investigators. Information on trial design, population, interventions, and outcomes was abstracted by one investigator and cross checked by the others. Data were combined by using Peto odds ratios with 95% confidence intervals. RESULTS: Nine trials (1975-96, 10 011 adults) tested H1 antihistamines, corticosteroids, and an H1-H2 combination. No trial included exclusively patients with a history of allergic reactions. Many outcomes were not allergy related, and only a few were potentially life threatening. No reports on death, cardiopulmonary resuscitation, irreversible neurological deficit, or prolonged hospital stays were found. In two trials, 3/778 (0.4%) patients who received oral methylprednisolone 2x32 mg or intravenous prednisolone 250 mg had laryngeal oedema compared with 11/769 (1.4%) controls (odds ratio 0.31, 95% confidence interval 0.11 to 0.88). In two trials, 7/3093 (0.2%) patients who received oral methylprednisolone 2x32 mg had a composite outcome (including shock, bronchospasm, and laryngospasm) compared with 20/2178 (0.9%) controls (odds ratio 0.28, 0.13 to 0.60). In one trial, 1/196 (0.5%) patients who received intravenous clemastine 0.03 mg/kg and cimetidine 2-5 mg/kg had angio-oedema compared with 8/194 (4.1%) controls (odds ratio 0.20, 0.05 to 0.76). CONCLUSIONS: Life threatening anaphylactic reactions due to iodinated contrast media are rare. In unselected patients, the usefulness of premedication is doubtful, as a large number of patients need to receive premedication to prevent one potentially serious reaction. Data supporting the use of premedication in patients with a history of allergic reactions are lacking. Physicians who are dealing with these patients should not rely on the efficacy of premedication.

Adrenal Cortex Hormones↗
PubMed2005

Percutaneous CT-guided multisampling core needle biopsy of thoracic lesions.

OBJECTIVE: The purpose of our study was to evaluate the diagnostic yield and the complication rate of percutaneous CT-guided coaxial 18-gauge (1.25-mm diameter) multisampling (five samples) core needle biopsy (CNB) of suspected thoracic lesions. MATERIALS AND METHODS: The records of 75 consecutive patients (29 women, 46 men; age range, 33-92 years) who underwent percutaneous CT-guided adjustable coaxial 18-gauge multisampling (five samples) CNB of a suspected thoracic lesion (eight mediastinal lesions, two chest wall lesions, two pleural lesions, and 63 intrapulmonary lesions) were reviewed. RESULTS: Ninety-seven percent (73/75) of CNB specimens were considered adequate for a specific diagnosis by the histopathology staff. Diagnostic yield was 97% (95% confidence interval, 91-99%) (72/74) (number of correct diagnoses obtained at CNB / number of definitive diagnoses). There were 61 malignant lesions and 11 benign lesions. There was no false-negative result when CNB was considered adequate for a specific diagnosis by the histopathology staff. Pneumothorax occurred in 19% (12/63 intrapulmonary lesions). One patient required placement of a chest tube. Minor postbiopsy hemoptysis occurred and resolved spontaneously in 11% (7/63) of patients. CONCLUSION: Percutaneous CT-guided coaxial multisampling large CNB of suspected thoracic lesions, in a mainly cancer-based population, is an accurate procedure for a specific histologic diagnosis and has a low rate of complications.

Adult↗
PubMed2002

High opacification of hilar pulmonary vessels with a small amount of nonionic contrast medium for general thoracic CT: a prospective study.

OBJECTIVE: The main goal of this study was to determine whether in thoracic helical CT for general indications a high opacification of hilar pulmonary vessels could be obtained using a small amount of nonionic contrast medium. SUBJECTS AND METHODS: Two hundred consecutive patients referred for contrast-enhanced thoracic CT for malignancies or infections prospectively entered the study. They were randomly assigned to one of two simple bolus injection protocols (100 patients in each protocol): 60 mL of a nonionic contrast agent (250 mg I/mL) injected at a 3 mL/sec flow rate, or 80 mL of the same contrast agent injected at a 4 mL/sec flow rate. No saline flush or bolus triggering system was used. Hilar and mediastinal vessel enhancement was qualitatively (using a 4-point scale) and quantitatively (arterial attenuation values) assessed. Perivenous artifacts were also assessed. RESULTS: No extensive perivenous artifacts were noted. No significant difference was noted regarding pulmonary venous enhancement. Excellent opacification of the pulmonary veins was observed in 66% of patients injected at 3 mL/sec and in 56% of patients injected at 4 mL/sec (p > 0.192). A highly significant difference was noted for pulmonary artery enhancement. Excellent opacification of the pulmonary arteries was noted in 83% of patients injected with a 3mL/sec flow rate and in 61% of patients injected with a 4 mL/sec flow rate (p = 0.001). CONCLUSION: A high level of opacification of hilar pulmonary vessels, with no major perivenous artifacts, can be obtained with a small amount of nonionic contrast medium using a simple bolus injection.

Adult↗
PubMedDate not supplied

Multidetector multiphase contrast-enhanced liver CT: prospective study comparing two contrast material injection rates on vascular and liver parenchyma enhancement in patients with varied cirrhotic status.

BACKGROUND: To compare 2 rates of contrast material injection, with dose tailored to patient body weight (bw) and automatic bolus triggering system, on vascular and liver parenchyma enhancement at multidetector multiphase contrast-enhanced liver computed tomography (CT) of patients with varied cirrhotic status. METHODS: One hundred and thirty consecutive patients with varied cirrhotic status, referred for contrast-enhanced liver CT evaluation of focal liver nodule(s), were prospectively and randomly assigned to 1 of 2 routine contrast-enhanced liver CT protocols: 2 mL/kg of bw of a nonionic contrast agent (300 mg I/mL) injected at a 3 mL/sec, versus 2 mL/kg of bw of the same contrast agent injected at 4 mL/sec. Quantitative vascular and liver parenchyma enhancements were obtained. Attenuation values of the abdominal aorta during the arterial phase CT, of the main portal vein during the portal venous phase CT, and of the liver parenchyma during the arterial, the portal venous, and the equilibrium phases liver CT, were compared with multiple 2-way analysis of variance. RESULTS: Significantly higher attenuation values were noted in the abdominal aorta with a 4-mL/sec-flow rate. Attenuation values were not significantly different in the portal vein and in the liver parenchyma, whatever was the patient cirrhotic status. CONCLUSIONS: With dose tailored to body weight and automatic bolus triggering system, adjusting flow rate makes no difference in patients with regard to liver or portal vein enhancement, regardless of presence/absence of cirrhosis.

Adult↗