Search

Your search keyword '"Degoutte E"' showing total 5 results
Start Over Author "Degoutte E"
5 results on '"Degoutte E"'

1. Systemic antibiotic prophylaxis after gastrointestinal hemorrhage in cirrhotic patients with a high risk of infection

Author

B. Debenes, Degoutte E, V. G. Levy, Arnaud Pauwels, and N. Mostefa-Kara

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, medicine.drug_class, Antibiotics, Bacteremia, Gastroenterology, Internal medicine, Clavulanic acid, medicine, Humans, Antibiotic prophylaxis, Hepatology, business.industry, Septic shock, Incidence (epidemiology), Bacterial Infections, Antibiotic Prophylaxis, Middle Aged, Amoxicillin, medicine.disease, Surgery, Ciprofloxacin, Female, Gastrointestinal Hemorrhage, business, medicine.drug
Abstract

In cirrhotic patients with gastrointestinal hemorrhage, bacterial infections are frequent and play a significant role in mortality. We have previously found that patients with a Child-Pugh's class C or a rebleeding are a subgroup of cirrhotic patients with a high risk of infection. The aims of the study were (1) to validate these indicators and (2) to assess the effectiveness of a systemic antibiotic treatment in preventing bacterial infections in bleeding cirrhotics with a high risk of infection. One hundred and nineteen bleeding cirrhotic patients were divided into 3 groups. Patients with a Child-Pugh's class A-B and no rebleeding (i.e., with a low risk of infection) constituted group 1 (n = 55). Patients with a high risk of infection were randomly allocated to serve as controls (group 2, n = 34) or to receive the ciprofloxacin and a combination of amoxicillin and clavulanic acid for 3 days after hemorrhage (group 3, n = 30). This antibiotic prophylaxis was administered first intravenously and then orally when the bleeding was controlled. The study period was defined as 10 days after hemorrhage. Incidence of bacterial infections was significantly higher in patients from group 2 than in patients from group 1 (52.9% vs. 18.2%; P < .001). Moreover, infections were more severe in group 2: a sepsis syndrome or a septic shock developed in 66.7% of infected patients from this group, but in only 20% of infected patients from group 1. Incidence of bacterial infections was much lower in patients from group 3 than in those from group 2 (13.3% vs. 52.9%; P < .001). Eight patients from group 2 (23.5%) and 4 patients from group 3 (13.3%) died during the first four weeks (P-not significant). Septic shock was the cause of death in 3 patients from group 2 and in only 1 patient from group 3. The cost of antibiotic therapy, including antibiotic prophylaxis in group 3, was $208 +/- $63 per patient in group 2 and $167 +/- $42 per patient in group 3 (P < .05). We conclude that (1) patients with a Child-Pugh's class C and/or a rebleeding are a subgroup of cirrhotic patients with a high risk of infection after gastrointestinal hemorrhage and that (2) in these patients, a prophylactic treatment with systemic antibiotics is very effective in preventing bacterial infections.

Published
1996
Full Text
View/download PDF

3. Mesalamine foam enema versus mesalamine liquid enema in active left-sided ulcerative colitis.

Author

Cortot A, Maetz D, Degoutte E, Delette O, Meunier P, Tan G, Cazals JB, Dewit O, Hebuterne X, Beorchia S, Grunberg B, Leprince E, D'Haens G, Forestier S, Idier I, and Lémann M

Subjects
Administration, Rectal, Adolescent, Adult, Aged, Aged, 80 and over, Colitis, Ulcerative complications, Dosage Forms, Female, Humans, Male, Middle Aged, Proctitis etiology, Proctocolitis drug therapy, Proctocolitis etiology, Single-Blind Method, Treatment Outcome, Young Adult, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Colitis, Ulcerative drug therapy, Enema methods, Mesalamine administration & dosage, Proctitis drug therapy
Abstract

Aim: To determine in a noninferiority study whether mesalamine foam is as effective as mesalamine liquid enema for inducing clinical remission in patients with active left-sided ulcerative colitis (UC)., Methods: In a multicenter investigator-blind trial, 375 patients with mild-to-moderate UC were randomized to receive mesalamine foam 1 g/80 mL/day or mesalamine liquid enema 1 g/100 mL/day for 4 wk (W). Inclusion criteria were: disease extension at least 5 cm from anorectal junction and not above splenic flexure and Clinical Activity Index (CAI) 1-4 > or = 4. Primary end point was clinical remission at W4 defined as a CAI 1-4 < or = 2. Noninferiority of the foam to liquid enema was declared if the lower limit of the 97.5% unilateral confidence interval (97.5% CI) of the difference in remission rates between foam and liquid enema groups was greater than -15% ., Results: Remission rates at W4 in foam versus liquid were 68.3%versus 73.6% in per protocol (PP) population (lower limit of 97.5% CI -15.1%) and 66.7%versus 70.5% in intention-to-treat (ITT) population (97.5% CI -13.4%). Remission rates at W2 were 48.1 %versus 50.6% in ITT (97.5% CI -12.8%) and 49.1%versus 52.1% in PP (97.5% CI -13.8%) in foam versus liquid, respectively. Both treatments were well tolerated., Conclusions: A 4-wk treatment of 1 g mesalamine foam induced a clinical remission in 68% patients versus 73% with 1 g mesalamine liquid enema. Although the noninferiority of mesalamine foam could not be strictly demonstrated at W4 in the PP analysis, it was achieved in the ITT population and at W2 in both populations. Mesalamine foam represents a therapeutic alternative to mesalamine liquid enema in patients with mild-to-moderate active proctitis and proctosigmoiditis.

Published
2008
Full Text
View/download PDF

4. [Gastric protein loss and alcoholic cirrhosis. Study by measurement of gastric clearance of alpha 1-antitrypsin].

Author

Becheur H, Pauwels A, Mostefa-Kara N, Degoutte E, Fourdan O, Akrour O, Lévy VG, and Florent C

Subjects
Adult, Aged, Ascites etiology, Female, Humans, Liver Cirrhosis, Alcoholic blood, Liver Cirrhosis, Alcoholic complications, Male, Middle Aged, Serum Albumin analysis, alpha 1-Antitrypsin physiology, Gastric Mucosa metabolism, Liver Cirrhosis, Alcoholic metabolism, alpha 1-Antitrypsin metabolism
Abstract

Objective: The aim of the study was to assess gastric protein loss in alcoholic cirrhotic patients, and to determine its role in the low serum albumin levels frequently observed in these patients., Methods: Twenty-six alcoholic cirrhotic patients with ascites and serum albumin levels < 30 g/L were studied and compared to 6 healthy volunteers. Gastric protein loss was determined by measuring gastric clearance of alpha 1-antitrypsin., Results: Gastric clearance of alpha 1-antitrypsin was 0.96 +/- 1.42 mL/h (median : 0.52; range: 0.11-6.54) in cirrhotic patients and 0.48 +/- 0.20 mL/h (median: 0.51) in healthy volunteers. Values in cirrhotic patients were not significantly different from healthy volunteers. However, 3 cirrhotic patients had high values of gastric clearance of alpha 1-antitrypsin (2.84, 3.99 and 6.54 mL/h). Their serum albumin and protein levels were significantly lower than those in the 23 other patients (P < 0.05 and < 0.03, respectively). Severe portal hypertensive gastropathy was present in two out of these 3 patients and in two out of the 23 other patients., Conclusion: Gastric protein loss is not significantly increased in liver cirrhosis. However, in a few patients, this loss is high and may play a role in low serum albumin levels.

Published
1996

Catalog

Books, media, physical & digital resources
See catalog results