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Abstract: The nasal septoplasty is a very current intervention in otorhinolaryngology surgery. The infectious complications of this intervention are rare and mostly mild. We report here the case of a patient hospitalized in ambulatory surgery within a fracture of the nose with luxation of the septum in the nasal fossa. This patient was operated for a reduction of this fracture with septoplasty. Twelve hours after the intervention the patient presented septic arthritis due to Streptococcus pyogenes. The tracks of prevention are presented. [ABSTRACT FROM AUTHOR]

Background It has been suggested that both anticardiolipin (aCL) and anti-β2 glycoprotein I (aβ2GPI) antibodies may play a critical role in the pathogenesis of systemic sclerosis (SSc)-related vascular impairment. Objectives To evaluate the prevalence of aCL and aβ2GPI antibodies and lupus-like anticoagulant (LAC) in patients with SSc and healthy controls. We also investigated a possible relationship between clinical and biological variables of patients with SSc and the presence of aCL/aβ2GPI antibodies and/or LAC. Methods Measurements of aCL and aβ2GPI antibodies, and LAC were performed in 69 consecutive patients with SSc and 69 age- and sex-matched controls. Clinical and biological findings were compared between patients with and without antiphospholipid antibodies. Results aCL and aβ2GPI antibodies and/or LAC were detected in 13 (19%) of 69 consecutive patients with SSc; in the healthy control group, aCL antibody was found in only one (2%) subject ( P = 0·0007). None of the healthy controls had aβ2GPI antibody and/or LAC. Moreover, pitting scars, pulmonary arterial hypertension, macrovascular involvement as well as severity of capillary impairment (using nailfold videocapillaroscopy) were more frequent in SSc patients with aCL/aβ2GPI antibodies and/or LAC compared with those without. Conclusions Our findings suggest that antiphospholipid antibodies may have a role in the genesis of vascular involvement related to SSc. Finally, the assessment of antiphospholipid antibodies (aCL and aβ2GPI antibodies, as well as LAC) may contribute to a better recognition of clinical features in patients with SSc; in essence, the patients with aCL/aβ2GPI antibodies and/or LAC may require close monitoring of vascular changes, including in particular pulmonary arterial hypertension and digital infarcts. [ABSTRACT FROM AUTHOR]

BACKGROUND: Self-expanding metallic stents (SEMS) are a first-line therapeutic procedure in the palliative treatment of dysphagia in patients with esophageal cancer. However, the impact of SEMS insertion on patient nutritional status has never been assessed. OBJECTIVE: To evaluate the nutritional status of patients after insertion of a SEMS and the impact of a preexisting undernutrition status on survival. DESIGN: Retrospective observational study. PATIENTS: A total of 120 patients treated in a single center by insertion of a SEMS for relief of dysphagia in the palliative treatment of esophageal cancer were retrospectively included. MAIN OUTCOME MEASUREMENTS: Efficacy of SEMS was assessed by the Ogilvie's dysphagia score. Patient nutritional and clinical statuses were evaluated at SEMS insertion, and patients were regularly followed until death. Independent predictive factors of early 30-day mortality were researched. RESULTS: Dysphagia scores decreased after SEMS insertion in 89.1% of patients, with median scores decreasing from 3.0 to 1.0 (P < .05). There was a significant decrease in body mass index (BMI) (P < .04), serum albumin level (P < .01), and World Health Organization (WHO) performance index (P < .02) at a 1-month evaluation. Serum albumin level, BMI <18 kg/m(2), and WHO performance index >2 at SEMS insertion were independent predictive factors of 30-day mortality. CONCLUSIONS: This study suggested that palliative stent placement in esophageal cancer was effective to relieve dysphagia but was not followed by an improvement of nutritional parameters. Moreover, it underlined the key role played by undernutrition on survival. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fiber supplementation during enteral nutrition has been recommended, but the effect of soluble compared with insoluble fiber supplements on antroduodenal motility is unknown. OBJECTIVE: The objective of this study was to compare antroduodenal motor patterns in 8 healthy volunteers during and after gastric infusion of 3 different diets: a fiber-free diet, an insoluble-fiber diet, and a mixed-fiber diet (50% soluble fiber and 50% insoluble fiber). DESIGN: Manometric studies with the 3 different diets (2100 kJ) were performed in random order. Antroduodenal motility was monitored continuously for 6 h by using a pneumohydraulic system to calculate the number, amplitude, and duration of the pressure waves; the area under the curve (AUC); and the percentage of time occupied by motor activity before, during, and after each type of infusion. Variations in antral areas were measured by ultrasonography. RESULTS: The gastric motor response was significantly higher, whatever the diet, in the distal antral recording site than in the 2 more proximal sites. In the proximal but not the distal antrum, the number of waves, the AUC, and the percentage of time occupied by motor activity were higher (P: < 0.04) with the mixed-fiber than with the insoluble-fiber diet. No significant differences in variations of antral area were observed among the 3 diets. In the duodenum, motor variables were not significantly different among the 3 diets. CONCLUSIONS: A gastric infusion induced a greater motor response in the distal than in the proximal antrum. A mixed-fiber diet was associated with significantly greater proximal antral motility than was an insoluble-fiber diet. There was no significant difference among the 3 formulas in duodenal motor variables or in variations in antral area as measured by ultrasound. Copyright © 2000 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

This study was undertaken to investigate the day-to-day pharmacokinetic variability of 5-fluorouracil (5FU) given as a continuous i.v. infusion concomitantly with cisplatin. Ten lung cancer patients were investigated during the first course of chemotherapy. All patients had advanced, previously untreated, inoperable non-small-cell lung cancer. They received continuous infusions of cisplatin given at 100 mg/m2 over 5 days and of 5FU given at 1 g/m2 daily from day 2 to day 5. Both drugs were infused i.v. for 24 h/day at a constant rate with a volumetric pump. Blood samples were drawn from day 2 to day 5, every 4 h from 8 a.m. to 8 p.m. and every 2 h during the night (8 p.m. to 8 a.m.). Plasma 5FU and FBAL concentrations were determined simultaneously by gas chromatography-mass spectrometry. Plasma 5FU concentrations varied widely over the 4-day treatment course for each patient. Despite continuous constant-rate 5FU administration, plasma 5FU concentrations were significantly lower between 8 a.m. and 8 p.m. than during the night. Mean plasma concentrations of 5FU and FBAL increased significantly from the 1st day (0.42 and 1.19 micrograms/ml for 5FU and FBAL, respectively) to the 4th day of 5FU infusion (0.67 and 1.78 micrograms/ml for 5FU and FBAL, respectively). Further study is warranted to elucidate the mechanisms of the observed increase in plasma 5FU concentrations as well as its relationship with cisplatin coadministration and to assess the clinical relevance of this plasma 5FU accumulation. [ABSTRACT FROM AUTHOR]

Lactase-deficient subjects absorb lactose in yogurt more effectively than lactose in other dairy products. However, as all previous studies were performed without a double-blind design and only after a single ingestion of the test product, the mechanism of this enhanced absorption remains unclear. The aims of this double-blind study were 1) to evaluate lactose absorption after prolonged ingestion of yogurt and fermented-then-pasteurized milk (FPM) and 2) to assess the modification of the lactase activity of the duodenal mucosa. In 16 lactase-deficient subjects we confirmed that yogurt enhances lactose digestion, this beneficial effect being destroyed by pasteurization. Moreover, the long-term (8 d) ingestion of either yogurt or FPM does not modify the results of hydrogen breath tests in comparison with a 24-h ingestion. The mucosal lactase (Dahlquist method) and β-galactosidase (ONPG method) activities were not significantly modified by yogurt or FPM ingestion. These results suggest that in lactase-deficient subjects no adaptation occurs after eating yogurt or FPM and that the increased lactose absorption in yogurt must be mainly related to an intraluminal process. [ABSTRACT FROM AUTHOR]