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Biomedical subjects

X Hébuterne

Publications and source records attributed to X Hébuterne.

At least 19 recordsLinked to original sources
PubMed2002

Fatigue is associated with high circulating leptin levels in chronic hepatitis C.

BACKGROUND AND AIMS: Fatigue is a frequent and disabling symptom reported by patients with chronic hepatitis C (CHC). Its mechanism is poorly understood. Recent attention has focused on the role of leptin and energy expenditure in CHC. Our aims were to analyse fatigue in CHC and to determine its relationship with disease activity, resting energy expenditure (REE), circulating leptin, and tumour necrosis factor alpha (TNF-alpha). METHODS: Seventy eight CHC patients, 22 healthy controls, and 13 primary biliary cirrhosis (PBC) patients underwent measurements of REE, body composition, leptin, and TNF-alpha. All subjects completed the fatigue impact scale (FIS) questionnaire. A liver biopsy and viral load measurements were performed in all patients. RESULTS: Thirty eight of 78 CHC patients considered fatigue the worst or initial symptom of their disease. The fatigue score of patients was significantly higher than that of controls (53.2 (40.1) v 17.7 (16.9); p<0.0001) and was more pronounced in females (p=0.003). Leptin was increased significantly in CHC patients compared with controls (15.4 (20.7) v 6.4 (4.1) ng/ml; p<0.05). In CHC patients, the fatigue score correlated significantly with leptin corrected for fat mass (r=0.30, p=0.01). This correlation increased when the physical domain of fatigue was included (r=0.39, p=0.0009). Furthermore, a similar positive correlation was found in PBC patients (r=0.56, p=0.04). No correlation was found between fatigue and age, REE, liver function tests, viral load, or the METAVIR score in CHC patients. CONCLUSIONS: Fatigue is present in CHC patients and is more pronounced in females. The FIS questionnaire is clinically relevant and may be useful for future therapeutic trials aimed at reducing fatigue. Fatigue may be partly mediated by leptin.

Adult↗
PubMed2001

Effects of oral creatine supplementation on maximal pedalling performance in older adults.

This study was conducted to investigate the effects of giving short-term doses of creatine by mouth to healthy older male subjects, taking into account their training status. A group of 42 volunteers was divided into three: a sedentary group composed of elderly sedentary men [n = 14, mean age 70.1 (SEM 1.2) years], a trained group composed of elderly trained cyclists [n = 14, mean age 66.4 (SEM 1.4) years] and a young group composed of young sedentary men [n = 14, mean age 26.0 (SEM 1.2) years]. In each group, double-blind randomization was carried out: one half was given creatine (3x5 g x day(-1)), and the other was given an iso-nitrogenated placebo (3x10 g x day(-1)). Before and after the 5 days during which the supplements were given, all subjects performed five all-out 10-s sprints separated by 60-s intervals of passive recovery, seated on a cycle ergometer. Power output, work done and heart rate data were recorded during each sprint. The elderly and the young sedentary subgroups given creatine showed significant (P < 0.05) improvements in maximal power (+3.7% and +2.0%, respectively) and work done (+4.1% and +5.1%, respectively) in the subsequent tests. In contrast, no significant change in pedalling performances was observed in the trained elderly subjects. The creatine did not change the exercise and recovery heart rate profiles, in any group. Our study suggested that creatine given by mouth increases the anaerobic power and work capacity of sedentary people of different ages during maximal pedalling tasks. However, the level of physical activity seems to be a determinant of the ergogenic effect of creatine in older subjects.

Administration, Oral↗
PubMed2001

Mesalazine 4 g daily given as prolonged-release granules twice daily and four times daily is at least as effective as prolonged-release tablets four times daily in patients with ulcerative colitis.

BACKGROUND: High doses of mesalazine usually result in an inconvenient dosage schedule and reduced compliance. The goal of this trial was to compare the effects of mesalazine 4 g daily given as prolonged-release granules in packets of 1 g with that of prolonged-release tablets of 0.5 g. METHODS: Two hundred twenty-seven patients with mild-to-moderate ulcerative colitis were randomized to treatment with two packets twice daily (Gr-b.i.d.), 1 packet four times daily (Gr-q.i.d.) or 2 tablets four times daily (Ta-q.i.d.) for 8 weeks. A disease activity index (ulcerative colitis disease activity index: UC-DAI) was calculated, and the granules were defined as noninferior to the tablets if the lower limit of the 95% CI for the differences was more than -1 UC-DAI score unit. RESULTS: Noninferiority of the granules compared with the tablets was demonstrated. The mean improvement in the UC-DAI in the treatment groups Gr-b.i.d., Gr-q.i.d., and Ta-q.i.d. were 3.2, 2.9, and 2.4, respectively; the proportion of complete responders in the three groups 39%, 37%, and 31%, respectively. There were no differences in side effects. CONCLUSION: Mesalazine 4 g daily given as prolonged-release granules twice and four times daily is at least as effective as prolonged-release tablets four times daily in patients with mild to moderate ulcerative colitis. The patients preferred the twice daily dosing.

Adolescent↗
PubMed2001

Ageing and muscle: the effects of malnutrition, re-nutrition, and physical exercise.

Because of the metabolic changes caused by ageing, malnutrition is accompanied by a preferential loss of fat-free mass in the elderly, and it exaggerates the physiological loss of body cell mass, muscle mass and muscle function observed in the aged. Exercise training has positive anabolic effects even in the frail elderly, and may improve the effect of re-nutrition in malnourished elderly patients.

Aged↗
PubMed2001

[Atrophic polychondritis associated with ulcerative colitis].

We report the case of a 46-year-old patient in whom ulcerative colitis had been diagnosed three years ago. He was admitted to the hospital for swelling of the nose. Clinical course and complementary exams led us to diagnose atrophic polychondritis. Twelve cases of such an association have been published so far.

Colitis, Ulcerative↗
PubMed2000

Acarbose and lymphocytic colitis.

We report a case of lymphocytic colitis induced by acarbose. Our immunopathological findings shown before and after rechallenge are consistent with a colonic immune-cell activation by the drug.

Acarbose↗
PubMed2000

Total artificial nutrition is associated with major changes in the fecal flora.

BACKGROUND: Animal studies have demonstrated dramatic changes in the intestinal flora during total enteral (TEN) or parenteral (TPN) nutrition. AIM OF THE STUDY: To assess the impact of TEN and TPN on human intestinal microflora. METHODS: Eight patients on fiber-free TEN, five patients on TPN, and ten controls were studied. Fecal bacteria were identified and numbered (logCFU/g feces), and fecal short-chain fatty acids (SCFAs) were measured in stool samples, by gas-liquid chromatography. RESULTS: In TEN patients, compared to controls (P < 0.01), aerobes were increased (8.46 +/- 0.24) while anaerobes were decreased (5.79 +/- 0.84). In TPN patients, both aerobes and anaerobes were decreased compared to controls (5.64 +/- 0.27 and 5.31 +/- 1.09 respectively, P < 0.01). Total SCFAs were lower in TPN patients than in TEN patients (48.3 +/- 16.6 vs 118.6 +/- 24.1 mmol/kg, P < 0.05). CONCLUSIONS: Both TPN and TEN induce modifications in the intestinal microflora. During TPN, a homogeneous decrease occurs in both aerobic and anaerobic bacteria. TEN decreases only anaerobic bacteria, while aerobic bacteria are increased. This imbalance may play a role in the pathophysiology of TEN-induced diarrhea.

Bacteria, Aerobic↗
PubMed2000

Energy metabolism and substrate oxidation in patients with Crohn's disease.

Weight loss and malnutrition are common features in patients with Crohn's disease. This study was designed to evaluate diet-induced thermogenesis and substrate oxidation in patients with Crohn's disease. Twenty-three patients (17 women, 6 men; age 34 +/- 2 y) and 17 healthy control subjects (13 women, 4 men; age 36 +/- 3 y) were studied. Resting energy expenditure and fasting substrate oxidation were measured by indirect calorimetry in the morning after an overnight fast. After a standard homogenized test meal (10 kcal/kg), indirect calorimetry was performed every 30 min for 3 h to measure the diet-induced thermogenesis and the postprandial substrate oxidation. In the fasting state, resting energy expenditure was significantly higher in patients than in control subjects (1433 +/- 43 versus 1279 +/- 53 kcal/24 h). Lipid oxidation was higher in patients with Crohn's disease than in control subjects (1.17 +/- 0. 07 versus 0.61 +/- 0.11 mg. kg(-1). min(-1), P < 0.01). Postprandially, diet-induced thermogenesis was significantly lower in patients with Crohn's disease than in control subjects (4.6% +/- 0.5 versus 6.3% +/- 0.5 of energy intake, P < 0.01). Lipid oxidation was significantly higher in patients with Crohn's disease than in control subjects (0.78 +/- 0.05 versus 0.56 +/- 0.08 mg. kg(-1). min(-1), P < 0.05), and glucose oxidation was lower in patients with Crohn's disease than in control subjects. In patients with Crohn's disease, lipid oxidation positively correlates with the disease activity evaluated by the Crohn's Disease Activity Index (r = 0.48, P150), fasting and postprandial lipid oxidation was significantly higher than in patients with inactive Crohn's disease (P < 0.05). In conclusion, patients with Crohn's disease have increased fat oxidation, which correlates with disease activity and this may explain the reduced fat stores in patients with Crohn's disease.

Adult↗
PubMed2000

Resting energy expenditure in chronic hepatitis C.

BACKGROUND/AIMS: Hypermetabolism is considered to be of clinical interest in liver disease and in several chronic viral infections. Whether resting energy expenditure (REE) increases during chronic hepatitis C is not known. Our aims were: (a) to determine the metabolic state of patients with chronic hepatitis C, and (b) to evaluate the effects of interferon therapy on REE. METHODS: Forty-seven patients and 20 controls were studied. Sixteen patients failed to respond to interferon and 12 patients stopped the treatment during the first 2 months for various reasons. The 19 responders all received 1 year of interferon. REE (indirect calorimetry) and fat-free mass (FFM, bioelectric impedance analysis) were evaluated before (day 0) and after 90, 180, and 360 days of interferon. The virus load was evaluated in patients before treatment. RESULTS: On day 0, REE expressed as a ratio of FFM (REE/FFM) was higher in patients than in controls (129.2 +/- 14.7 vs 117.9 +/- 9.6 kJ kg FFM(-1) 24 h(-1), p<0.01), and was positively correlated with the viral load (r=0.45, p=0.01). On day 90, REE/FFM had significantly decreased in responders but it did not decrease in non-responders (p<0.01). In responders, REE/FFM on days 180 and 360 was similar to that of the controls. CONCLUSIONS: Chronic hepatitis C induces hypermetabolism that is normalized by interferon therapy in responders. The underlying mechanisms of chronic hepatitis C-induced hypermetabolism and its clinical relevance remain to be determined.

Adult↗
PubMed1999

Correction of malnutrition following gastrectomy with cyclic enteral nutrition.

This study was designed to evaluate the efficacy and tolerance of cyclic enteral nutrition (CyEN) in gastrectomized patients and to compare the nutritional response to refeeding of 28 gastrectomized patients and 38 nongastrectomized undernourished patients. Total (enteral + oral) energy intake (292% and 284% of resting energy expenditure in gastrectomized and nongastrectomized patients, respectively) and the duration of CyEN (27 days) were similar in both groups. Tolerance was good and not different in the two groups. In the gastrectomized patients, a global nutritional deficiency score based on 10 biological and anthropometric parameters significantly improved (P < 0.0001) with six of the 10 nutritional parameters studied being improved by renutrition. Comparison of the two groups revealed similar efficacy of refeeding; the global nutritional deficiency score improved by 42.7 +/- 17.3% in group 1 and 40.0 +/- 17.4% in group 2. After one year, the probability of being alive without relapse was 77.8% in the gastrectomized and 72.2% in the nongastrectomized patients (P = 0.70). The efficacy of renutrition was similar regardless of the type of gastrectomy (eg, partial or total). CyEN is a safe, effective and durable treatment for undernutrition in gastrectomized patients.

Adult↗
PubMed1999

[Multifocal MALT lymphoma and acute cytomegalovirus gastritis revealing CD4 lymphopenia without HIV infection].

We report the case of a 63 year-old female who presented with a seven-year history of epigastric pain and a sudden overall deterioration. Gastroscopy demonstrated inflammatory aspect and ulceration in the antrum and fundus. Histology showed a lymphocytic infiltrate consistent with low grade mucosa-associated lymphoid tissue lymphoma and cytomegalovirus gastritis. There was no evidence of Helicobacter pylori infection. Other investigations demonstrated two pulmonary foci consistent with lymphomatous infiltration and a reduced CD4 + T-lymphocyte count (85/mm3). Other screening tests including HIV serology were negative. This case of idiopathic CD4 lymphopenia, in conjunction with the other rare cases in the literature, allows us to reevaluate this condition and its unusual clinical presentation with two opportunistic pathologies.

Acute Disease↗
PubMed1998

[Mesenteric arterial thrombosis in protein S deficiency].

Arterial thrombosis is very rarely described in patients with coagulation factors deficiency. We report the first case of superior mesenteric artery thrombosis of a normal mesenteric artery associated with protein S deficiency, causing massive mesenteric infarction with short bowel syndrome. Eight-month parenteral nutrition and definitive antivitamin K anticoagulation were required in this 72 year-old patient. The initial oral anticoagulant malabsorption disappeared a few months later as clinical and biological course improved. Rapid intestinal adaptation was probably consecutive to early enteral refeeding. The possibility of reintroducing antivitamin K despite initial inefficacy should be stressed, as well as the necessity of an exhaustive coagulation work-up in patients with mesenteric infarction.

Aged↗