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Huber Y, Pfirrmann D, Gebhardt I, Labenz C, Gehrke N, Straub BK, Ruckes C, Bantel H, Belda E, Clément K, Leeming DJ, Karsdal MA, Galle PR, Simon P, Schattenberg JM. Improvement of non-invasive markers of NAFLD from an individualised, web-based exercise program. Aliment Pharmacol Ther 2019; 50:930-939. [PMID: 31342533 DOI: 10.1111/apt.15427] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/09/2019] [Accepted: 06/28/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Lifestyle modifications remain the cornerstone of treatment in non-alcoholic fatty liver disease (NAFLD). However, they requently fail related to the inability of patients to implement lasting changes. AIMS To evaluate the effects of a short, web-based, individualised exercise program on non-invasive markers of hepatic steatosis, inflammation and fibrosis. METHODS Patients with histologically confirmed NAFLD underwent an 8-week, web-based, individualised exercise program that contained bidirectional feedback. RESULTS Forty-four patients entered the study and 41 completed the assigned training goal (93.2%). In the completer population, 8 weeks of individualised exercise increased the VO2peak by 12.2% compared to baseline (P < .001). ALT and AST decreased by 14.3% (P = .002) and 18.2% (P < .001) and remained at this level until follow-up 12 weeks after the intervention. Markers of inflammation including hsCRP, ferritin, and M30 decreased. In parallel, gut microbiota exhibited increased metagenomic richness (P < .05) and at the taxonomic levels Bacteroidetes and Euryarchaeota increased whereas Actinobacteria phylum decreased. Surrogate scores of steatosis and fibrosis including the fatty liver index (FLI), FiB-4, APRI and transient elastography showed significant reductions. In parallel, a marker of procollagen-3 turnover (PRO-C3) decreased while C4M2, reflecting type IV collagen, degradation increased suggesting beneficial hepatic fibrosis remodelling from exercise. Also, an enhancement in health-related quality of life was reported. CONCLUSION The current study underlines the plausibility and potential of an 8 week individualised web-based exercise program in NAFLD. Clinical trial number: NCT02526732.
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Affiliation(s)
- Yvonne Huber
- Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Daniel Pfirrmann
- Department of Sports Medicine, Rehabilitation and Prevention, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ines Gebhardt
- Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christian Labenz
- Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Nadine Gehrke
- Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Beate K Straub
- Institute of Pathology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Trials (IZKS), University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Heike Bantel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Eugenio Belda
- Integromics team, Institute of cardiometabolism and Nutrition, Paris, France
| | - Karine Clément
- Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Sorbonne Université, INSERM, NutriOmics Research Team, Paris, France
| | - Diana J Leeming
- Nordic Bioscience Biomarkers and Research A/S, Herlev, Denmark
| | | | - Peter R Galle
- Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Prevention, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörn M Schattenberg
- Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Rodrigo-Mocholí D, Escudero E, Belda E, Laredo FG, Hernandis V, Marín P. Pharmacokinetics and effects of alfaxalone after intravenous and intramuscular administration to cats. N Z Vet J 2018; 66:172-177. [DOI: 10.1080/00480169.2018.1455541] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- D Rodrigo-Mocholí
- Faculty of Veterinary Medicine, Department of Veterinary Anaesthesia and Analgesia, University of Sydney, Camperdown, New South Wales, Australia
| | - E Escudero
- Faculty of Veterinary Medicine, Department of Pharmacology, University of Murcia, 30071 Espinardo, Murcia, Spain
| | - E Belda
- Faculty of Veterinary Medicine, Department of Animal Medicine and Surgery, University of Murcia, 30071 Espinardo, Murcia, Spain
| | - FG Laredo
- Faculty of Veterinary Medicine, Department of Animal Medicine and Surgery, University of Murcia, 30071 Espinardo, Murcia, Spain
| | - V Hernandis
- Faculty of Veterinary Medicine, Department of Pharmacology, University of Murcia, 30071 Espinardo, Murcia, Spain
| | - P Marín
- Faculty of Veterinary Medicine, Department of Pharmacology, University of Murcia, 30071 Espinardo, Murcia, Spain
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3
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Laredo FG, Belda E, Escobar M. Mechanical ventilation of six dogs anaesthetised with isoflurane or sevoflurane delivered by a Komesaroff anaesthetic machine. Vet rec case rep 2013. [DOI: 10.1136/vetreccr.164.24.751rep] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- F. G. Laredo
- Departamento de Medicina y Cirugía AnimalUniversidad de MurciaCampus de Espinardo30100EspinadoMurciaSpain
| | - E. Belda
- Departamento de Medicina y Cirugía AnimalUniversidad de MurciaCampus de Espinardo30100EspinadoMurciaSpain
| | - M. Escobar
- Departamento de Medicina y Cirugía AnimalUniversidad de MurciaCampus de Espinardo30100EspinadoMurciaSpain
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Abstract
Unilateral enlargement of left testicle and scrotum was detected in an 8-year-old West Highland White Terrier. The histopathological diagnosis after surgery was a seminoma (SEM) tumour, and a diagnosis of metastatic foci was also detected in vaginal tunic and scrotum. Two months later, new metastatic SEM foci in the skin were diagnosed. Twenty-two months after the initial orchiectomy new multiple cutaneous nodules and a swelling of periesophageal structures were observed. Finally, the necropsy revealed multiple malignant metastatic SEM focus. To the author's knowledge, this is the first description of a canine SEM with unusual widespread metastasis on the base of tongue, soft palate, trachea and pericardium.
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Affiliation(s)
- X Lucas
- Animal Surgery and Medicine Department, Veterinary Hospital Teaching, University of Murcia, Espinardo, Murcia, Spain.
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O'Toole PW, Snelling WJ, Canchaya C, Forde BM, Hardie KR, Josenhans C, Graham RL, McMullan G, Parkhill J, Belda E, Bentley SD. Comparative genomics and proteomics of Helicobacter mustelae, an ulcerogenic and carcinogenic gastric pathogen. BMC Genomics 2010; 11:164. [PMID: 20219135 PMCID: PMC2846917 DOI: 10.1186/1471-2164-11-164] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 03/10/2010] [Indexed: 12/11/2022] Open
Abstract
Background Helicobacter mustelae causes gastritis, ulcers and gastric cancer in ferrets and other mustelids. H. mustelae remains the only helicobacter other than H. pylori that causes gastric ulceration and cancer in its natural host. To improve understanding of H. mustelae pathogenesis, and the ulcerogenic and carcinogenic potential of helicobacters in general, we sequenced the H. mustelae genome, and identified 425 expressed proteins in the envelope and cytosolic proteome. Results The H. mustelae genome lacks orthologs of major H. pylori virulence factors including CagA, VacA, BabA, SabA and OipA. However, it encodes ten autotransporter surface proteins, seven of which were detected in the expressed proteome, and which, except for the Hsr protein, are of unknown function. There are 26 putative outer membrane proteins in H. mustelae, some of which are most similar to the Hof proteins of H. pylori. Although homologs of putative virulence determinants of H. pylori (NapA, plasminogen adhesin, collagenase) and Campylobacter jejuni (CiaB, Peb4a) are present in the H. mustelae genome, it also includes a distinct complement of virulence-related genes including a haemagglutinin/haemolysin protein, and a glycosyl transferase for producing blood group A/B on its lipopolysaccharide. The most highly expressed 264 proteins in the cytosolic proteome included many corresponding proteins from H. pylori, but the rank profile in H. mustelae was distinctive. Of 27 genes shown to be essential for H. pylori colonization of the gerbil, all but three had orthologs in H. mustelae, identifying a shared set of core proteins for gastric persistence. Conclusions The determination of the genome sequence and expressed proteome of the ulcerogenic species H mustelae provides a comparative model for H. pylori to investigate bacterial gastric carcinogenesis in mammals, and to suggest ways whereby cag minus H. pylori strains might cause ulceration and cancer. The genome sequence was deposited in EMBL/GenBank/DDBJ under accession number FN555004.
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Affiliation(s)
- Paul W O'Toole
- Department of Microbiology, & Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland.
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Laredo FG, Belda E, Escobar M. Mechanical ventilation of six dogs anaesthetised with isoflurane or sevoflurane delivered by a Komesaroff anaesthetic machine. Vet Rec 2009; 164:751-4. [PMID: 19525524 DOI: 10.1136/vr.164.24.751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
After intravenous induction, six beagles were connected to a Komesaroff machine provided with a single in-circuit vaporiser and ventilated mechanically at either nine or 14 breaths/minute while anaesthetised with either isoflurane or sevoflurane. The vaporiser was initially set at position 4/4 (fully open) and the anaesthetic concentrations were measured after one and five minutes; the vaporiser was then set at the lowest setting able to maintain anaesthesia. Cardiorespiratory variables were measured throughout the study. In most cases anaesthesia was maintained at setting 1/4 with isoflurane and at setting 1.5/4 or 2/4 with sevoflurane.
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Affiliation(s)
- F G Laredo
- Departamento de Medicina y Cirugía Animal, Universidad de Murcia, Campus de Espinardo, 30100 Espinado, Murcia, Spain.
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Abstract
A 5-year-old female cross-breed dog was presented for a one-month history of lethargy, poor appetite and weight loss. A hysterectomy had been performed 2 years ago. Abdominal palpation revealed a mid-abdominal mass and haematological analysis showed leucocytosis with left shift. On abdominal radiographs, a 9 cm in diameter soft tissue opacity mass ventral to the colon and caudal to the left kidney was observed. The abdominal ultrasonography revealed a mass well circumscribed, with a hyperechoic capsule and hypoechoic center with echoic debris. The presumptive diagnosis was an abscess due to foreign body granuloma. Laparotomy was performed and a mass close to the left ovary was found. Adhesions and residues of the suture material were observed close to the right ovary and the uterine body stump. The mass, both ovaries and adhesions were removed. On cut section of the mass two cavities were observed. The small one contained three embedded silk suture residues. Histopathological examination confirmed the diagnosis of a chronic abscess caused by silk suture.
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Affiliation(s)
- S Boza
- Departamento de Medicina y Cirugía Animal, Hospital Clínico Veterinario, Universidad de Murcia, Campus Universitario de Espinardo, Murcia, Spain
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Belda E, Laredo FG, Escobar M, Soler M, Lucas X, Agut A. Sedative and cardiorespiratory effects of three doses of romifidine in comparison with medetomidine in five cats. Vet Rec 2008; 162:82-7. [PMID: 18204032 DOI: 10.1136/vr.162.3.82] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study was designed to compare the effects of three doses of romifidine (200, 400 and 600 microg/kg) with medetomidine (80 microg/kg) administered intramuscularly to five cats. The quality of sedation and the cardiovascular and respiratory effects of each treatment were evaluated, and the onset and duration of the sedation, and the cats' recovery times, were measured. Cardiorespiratory variables were also analysed. The dose of 200 microg/kg romifidine was clinically superior to the other doses of romifidine, providing moderate sedation, with minor cardiorespiratory and other adverse effects. However none of the doses of romifidine induced as deep and reliable sedation as the dose of medetomidine.
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Affiliation(s)
- E Belda
- Departamento de Medicina y Cirugía Animal, Universidad de Murcia, Campus de Espinardo, 30100 Espinardo, Murcia, Spain
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Abstract
An 8-year-old, entire male crossbreed dog had a 2-day history of abdominal pain and straining to urinate and defecate. A diagnosis of urolithiasis with urinary retention, and probable prostatitis was made. The dog was treated with fluids and enrofloxacin. Five days later, ultrasonography of the prostate showed two hypoechoic areas compatible with abscesses. Twelve hours later, the patient started to urinate from the rectum during micturition and urethrorectal fistula was diagnosed. The omentalization of the prostatic abscesses and castration were performed and calculi were removed. The urethrorectal fistula was treated conservatively with an indwelling urinary catheter, a low residue diet and antibiotics. The dog recovered uneventfully without recurrence of the fistula.
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Affiliation(s)
- A Agut
- Departamento de Medicina y Cirugía Animal, Hospital Clínico Veterinario, Universidad de Murcia, Campus de Espinardo, Murcia, Spain.
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Laredo FG, Belda E, Murciano J, Escobar M, Navarro A, Robinson KJ, Jones RS. Comparison of the analgesic effects of meloxicam and carprofen administered preoperatively to dogs undergoing orthopaedic surgery. Vet Rec 2004; 155:667-71. [PMID: 15581141 DOI: 10.1136/vr.155.21.667] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Thirty-two dogs undergoing operations to repair a torn cranial cruciate ligament or a fractured long bone were randomly allocated to one of two treatment groups in a study on postoperative pain. Sixteen of the dogs were given 4 mg/kg carprofen and the other 16 were given 0.2 mg/kg meloxicam subcutaneously before the operation. The signs of pain shown by the animals were assessed for 24 hours on a visual analogue scale, a discontinuous scoring system, and a score based on five behavioural and physiological variables. The dogs' heart and respiratory rates and their mean arterial blood pressures were also measured non-invasively at each assessment. Blood samples were taken before the surgery and 24 hours after it, and the concentrations of urea and creatinine were measured in plasma. Both drugs were effective in relieving the signs of pain for up to 24 hours in all the dogs. There were no significant changes in the concentrations of urea and creatinine, and no adverse effects were reported during the postoperative period.
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Affiliation(s)
- F G Laredo
- Departamento de Medicina y Cirugía Animal, Universidad de Murcia, Campus de Espinardo, 30.100 Espinardo (Murcia), Spain
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Abstract
An eight-year-old, entire female Pekingese cross, weighing 3.8 kg, had been inappetent with fever, depression, abdominal pain, vomiting and diarrhoea for seven days. The radiographic and ultrasonographic findings were consistent with glomerulonephritis, nephrolithiasis in both kidneys, bladder calculi and an accumulation of fluid in the left perinephric space. The clinical signs, together with the results of the diagnostic imaging, suggested that this fluid could be pus. A definitive diagnosis of a subcapsular abscess in the left kidney was established when this kidney was removed surgically. A histopathological examination of the kidney revealed a diffuse suppurative interstitial nephritis, membranous glomerulonephritis and an abscess invading the perinephric adipose tissue from the renal cortex. Twelve months after surgery the dog remains clinically stable, but owing to the disease of its remaining kidney its long-term prognosis is poor.
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Affiliation(s)
- A Agut
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, Campus de Espinardo, 30071 Murcia, Spain
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Affiliation(s)
- X Lucas
- Veterinary Teaching Hospital, Department of Animal Pathology, University of Murcia, 30100 Murcia, Spain
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Agut A, Soler M, Sevas J, Belda E. What is your diagnosis? Small intestinal mechanical obstruction. J Small Anim Pract 2003; 44:99, 143-4. [PMID: 12653321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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Giraud V, Naveau S, Balian A, Belda E, Capron F, Lemaigre G, Chaput JC. [Predictive risk factors for progression to cirrhosis in early stage alcoholic liver disease]. Gastroenterol Clin Biol 1998; 22:997-1002. [PMID: 10051977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To assess the risk factors of cirrhosis in early stage alcoholic liver disease. PATIENTS We investigated 83 heavy drinkers (60 males and 23 females) in whom the first of two liver biopsies showed normal or pure alcoholic fatty liver. RESULTS When the six following variables: sex, age, delay between the first and last biopsy, total duration of alcohol consumption before the first biopsy, daily alcohol consumption for the last 5 years before the first biopsy and the extent of fatty liver in the first biopsy, were considered together in stepwise regression analysis, the delay between the first and last biopsy (p < 0.0001), sex (P < 0.004) and the extent of fatty liver in the first biopsy (P < 0.06) significantly improved the prediction of cirrhosis. The odds ratio of cirrhosis for a women was 19.1 (confidence interval 95% [1.85-197]). The odds ratio for cirrhosis for a percentage of fatty liver > or = 5/10 was 7.4 (confidence interval 95% [1-92]). CONCLUSION With the same delay between two liver biopsies, the female sex and the extent of fatty liver are two independent risk factors for the development of cirrhosis in heavy drinkers.
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Affiliation(s)
- V Giraud
- Service d'Hépato-Gastroentérologie, Hôpital Antoine-Béclère Clamart
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Durand-Zaleski I, Delaunay L, Langeron O, Belda E, Astier A, Brun-Buisson C. Infection risk and cost-effectiveness of commercial bags or glass bottles for total parenteral nutrition. Infect Control Hosp Epidemiol 1997; 18:183-8. [PMID: 9090546 DOI: 10.1086/647584] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine whether the greater daily expense of administering total parenteral nutrition (TPN) via plastic bags changed once daily, compared to glass bottles changed thrice daily, could be offset by savings from a reduction in nosocomial infections. DESIGN The costs and potential benefits of commercially available TPN bags and TPN in glass containers were compared. Costs were computed from the viewpoint of the hospital, first in a general model and then for two specific examples, Crohn's disease and intensive-care unit (ICU) patients. The extra cost of using bags was $20 per day. The total cost of nosocomial bacteremia was estimated at $6,000. The monetary benefits of using TPN bags were $6,000XT, where XT was the percentage of nosocomial infections averted. We also considered that reduction in intravenous (IV)-line manipulation could reduce bacteremia-related mortality and computed a cost-per-life-saved ratio. RESULTS Modeling showed that TPN in bags could yield a net benefit when the absolute reduction in the daily risk of nosocomial bacteremia reached the threshold value of 0.3%. Such a reduction could not be attained in patients with Crohn's disease, and corresponded to a 50% to 60% reduction of infection rates in ICU patients. Varying the risk of mortality attributable to IV-line-related infection from 1% to 13% resulted in a cost effectiveness of using TPN bags ranging from $90,000 to $7,000 per life saved in ICU, assuming a two-thirds reduction in IV-line infections, and from $180,000 to $14,000 if the infection rate was reduced by one third. CONCLUSION The baseline cost-minimization analysis concluded that the extra cost of TPN bags was not justified by the extra savings. The cost-effectiveness analysis, however, found that the cost per life saved fell within the accepted range of public health interventions, provided a large fraction of infections are averted using TPN bags.
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Affiliation(s)
- I Durand-Zaleski
- Department of Public Health, Hôpital Henri Mondor, Créteil, France
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Naveau S, Belda E, Borotto E, Genuist F, Chaput JC. Comparison of clinical judgment and anthropometric parameters for evaluating nutritional status in patients with alcoholic liver disease. J Hepatol 1995; 23:234-5. [PMID: 7499801 DOI: 10.1016/0168-8278(95)80344-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Delchier JC, Belda E. [Risks of severe digestive adverse effects of NSAIDs. Evaluation methods of mucoprotective drugs]. Rev Rhum Ed Fr 1993; 60:87S-89S. [PMID: 8118458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Frequency and severity of digestive adverse events due to NSAIDs are not similarly estimated by rheumatologists and gastroenterologists. A recent meta-analysis showed that NSAIDs users were at approximately three times greater relative risk for developing serious adverse gastrointestinal events than nonusers. Additional risk factors included age greater than 60 years, previous history of gastrointestinal events and concomitant corticosteroid use. Serious adverse gastrointestinal events are rare and preventive treatments cannot be evaluated with prospective trials. Therefore, the model of acute lesions induced by a 7 days treatment with NSAIDs is used. Most of patients given NSAIDs for a few days have gastric lesions (erosions or submucosal hemorrhage) which do not cause symptoms and spontaneously disappear despite the treatment continues. Evaluation of severity of lesions at day 7 after starting treatment proved to be adequate to compare gastrotoxicity of different NSAIDs and to assess efficiency of gastroprotection drugs. This model is appropriate to evaluate the protective effect of diacerheine.
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Affiliation(s)
- J C Delchier
- Service d'Hépathologie et de Gastroentérologie, Hôpital Henri Mondor, Créteil
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