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See detailSandostatin, a new analogue of somatostatin, reduces the metabolic changes induced by the nocturnal interruption of continuous subcutaneous insulin infusion in type 1 (insulin-dependent) diabetic patients.
Scheen, André ULg; Gillet, J.; Rosenthaler, J. et al

in Diabetologia (1989), 32(11), 801-9

With the aim of assessing a new somatostatin analogue to prevent the metabolic changes induced by a 6-h nocturnal arrest of an insulin pump, nine C-peptide negative Type 1 (insulin-dependent) diabetic ... [more ▼]

With the aim of assessing a new somatostatin analogue to prevent the metabolic changes induced by a 6-h nocturnal arrest of an insulin pump, nine C-peptide negative Type 1 (insulin-dependent) diabetic patients were submitted blindly to two interruptions (from 23.00 to 05.00 hours) of their continuous s.c. insulin infusion, once after a single s.c. injection at 23.00 hours of 50 micrograms SMS 201-995 (Sandostatin, Sandoz) and once after 0.9% NaCl. Plasma SMS 201-995 levels peaked at 24.00 hours and then declined with an elimination half-life averaging 144 +/- 15 min. Plasma glucagon and growth hormone levels were significantly reduced after SMS 201-995 whereas the progressive fall in plasma-free insulin levels from 23.00 to 05.00 hours was unaffected. In the control test, blood glucose levels tended to decrease slightly from 23.00 to 02.00 hours and then increased markedly from 02.00 to 05.00 hours (+5.3 +/- 1.5 mmol/l) while after SMS 201-995 they decreased significantly from 23.00 to 02.00 hours (-2.6 +/- 0.5 mmol/l), resulting in values below 3 mmol/l in seven subjects, but showed a secondary increase until 05.00 hours (+3.5 +/- 1.5 mmol vs 23.00 h; p less than 0.05 vs 0.9% NaCl). While the rises in plasma non-esterified fatty acid and glycerol levels were not reduced by SMS 201-995, the increase in plasma 3-hydroxbutyrate levels, although similar from 23.00 to 02.00 hours, was significantly reduced from 02.00 to 05.00 hours (+77 +/- 20 vs +124 +/- 31 mumols.l-1.h-1; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailPurpura thrombotique thrombocytopénique
Dokekias, A. E.; Croisiaux, C.; Andrien, F. et al

in Revue Médicale de Liège (1989), 44

Deux patientes âgées respectivement de 58 et 24 ans ont été hospitalisées dans le Service d'Hématologie du CHU Sart Tilman pour PTT. Le diagnostic a été établi à partir de certains symptômes classiques à ... [more ▼]

Deux patientes âgées respectivement de 58 et 24 ans ont été hospitalisées dans le Service d'Hématologie du CHU Sart Tilman pour PTT. Le diagnostic a été établi à partir de certains symptômes classiques à savoir : hémolyse intravasculaire avec schizocytose (40/1000 dans le premier cas et 30/1000 dans le deuxième), élévation importante des LDH, thrombocytopénie majeure < 30.000/mm³, signes de souffrance du système nerveux central et insuffisance rénale aiguë dans le premier cas. Le scanner abdominal a permis d'observer dans le premier cas (admis à un stade avancé) un infarctus splénique massif et dans les deux cas une augmentation des indices de résistivité artérielle, témoignant d'une souffrance rénale. Le traitement par échanges plasmatiques a été instauré avec succès. Après obtention de la rémission complète, des infusions de plasma frais ont été poursuivies et le traitement d'entretien a été relayé par les antiagrégants plaquettaires. [less ▲]

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See detailDerivation of an Algorithm for Optimal Initial Cyclosporine Immunotherapy in Kidney Transplantation
Meurisse, Michel ULg; Albert, Adelin ULg; Defraigne, Jean-Olivier ULg et al

in Transplantation Proceedings (1988), 20(5 Suppl 6), 45-51

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See detailPrevention of metabolic alterations by insulin supplements administered either before or after 2-h nocturnal interruption of CSII.
Scheen, André ULg; Henrivaux, P.; Jandrain, Bernard ULg et al

in Diabetes Care (1987), 10(5), 567-72

To evaluate the efficacy of a bolus insulin injection to prevent the metabolic alterations induced by a 2-h nocturnal interruption of a continuous subcutaneous insulin infusion (CSII), nine type I ... [more ▼]

To evaluate the efficacy of a bolus insulin injection to prevent the metabolic alterations induced by a 2-h nocturnal interruption of a continuous subcutaneous insulin infusion (CSII), nine type I (insulin-dependent) C-peptide-negative diabetic patients were studied from 2200 to 0800 h during two randomized tests. An insulin bolus (2.1 +/- 0.2 U) was administered via the pump either at 2300 h, just before CSII interruption, or at 0100 h, after reactivating the pump at its usual basal rate (1.05 +/- 0.11 U/h). The insulin bolus at 2300 h induced a significant rise in plasma free-insulin levels at 2400 h (+6.9 +/- 1.8 mU/L, P less than .01), resulting in an early and marked fall in blood glucose concentrations between 2300 and 0100 h (-2.7 +/- 0.5 mM, P less than .001), with hypoglycemic values in five patients. The insulin bolus at 0100 h counteracted the fall in plasma free-insulin levels observed between 2300 and 0100 h and significantly increased plasma insulin at 0200 h (+3.2 +/- 0.8 mU/L, P less than .01). Blood glucose concentrations that remained stable during the 2-h arrest of the pump fell significantly between 0100 and 0400 h (-2.1 +/- 0.5 mM, P less than .005). This fall rate was significantly lower than that measured within the 3 h after the insulin bolus given before CSII interruption but significantly higher than that observed in a reference control group of patients whose pump was functioning normally throughout the night.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailU-100 insulin gives some protection against metabolic deterioration due to CSII interruption.
Scheen, André ULg; Henrivaux, P.; Jandrain, Bernard ULg et al

in Diabetes Care (1987), 10(6), 707-11

We investigated the influence of insulin concentration within the insulin pump on the metabolic and plasma free-insulin changes induced by a 6-h nocturnal interruption of continuous subcutaneous insulin ... [more ▼]

We investigated the influence of insulin concentration within the insulin pump on the metabolic and plasma free-insulin changes induced by a 6-h nocturnal interruption of continuous subcutaneous insulin infusion (CSII) in five C-peptide-negative insulin-dependent diabetic patients with low circulating levels of anti-insulin antibodies. We compared the changes in blood glucose, plasma free fatty acids, 3-hydroxybutyrate, and free insulin during the interruption from 2300 to 0500 h of the Nordisk Infuser loaded with either U-100 or U-20 regular insulin. The decrease in plasma free-insulin levels was slower, resulting in a significantly delayed and smaller increase in blood glucose levels (2.4 +/- 1.6 vs. 7.6 +/- 2.9 mM, P less than .025) when the pump contained U-100 instead of U-20 insulin. Although the increases in levels of plasma free fatty acids were similar in both tests, the rise in plasma 3-hydroxybutyrate levels tended to be reduced with U-100 insulin (414 +/- 139 vs. 639 +/- 67 microM, P less than .10). Thus, our observations indicate that U-100 insulin gives some protection against the metabolic deterioration due to the interruption of CSII so that diabetic patients may be able to remain without the pump for longer periods with concentrated rather than diluted insulin. [less ▲]

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See detailMetabolic alterations after a two-hour nocturnal interruption of a continuous subcutaneous insulin infusion.
Scheen, André ULg; Castillo, M.; Jandrain, Bernard ULg et al

in Diabetes Care (1984), 7(4), 338-42

In order to evaluate the metabolic consequences of a 2-h nocturnal interruption of continuous subcutaneous insulin infusion (CSII), seven insulin-dependent diabetic patients without residual insulin ... [more ▼]

In order to evaluate the metabolic consequences of a 2-h nocturnal interruption of continuous subcutaneous insulin infusion (CSII), seven insulin-dependent diabetic patients without residual insulin secretion were investigated. The changes in blood glucose, plasma free insulin, glucagon, free fatty acids, and 3-hydroxybutyrate (3 OH-B) concentrations have been compared during two randomized tests carried out either during the normal functioning of a Mill-Hill pump from 10 p.m. to 8 a.m. (1.00 +/- 0.06 U insulin/h, keeping adequate metabolic control) or during the same conditions but with a deliberate arrest of the pump between 11 p.m. and 1 a.m. Considering the value recorded at 11 p.m. as reference, interruption of the insulin infusion resulted in: (1) a rapid (already significant after 1 h) and sustained (maximal fall: --12.5 +/- 2.5 mU/L at 3 a.m.) decrease in plasma free insulin; (2) a delayed (significant after 4 h) and linear rise in blood glucose (maximal increase: + 4.0 +/- 1.3 mmol/L at 5 a.m.); (3) an early (significant at midnight) and prolonged rise in plasma free fatty acids (+ 387 +/- 148 mumol/L at 3 a.m.); (4) a delayed (significant after 3 h) and sustained increase in plasma 3 OH-B (+ 347 +/- 88 mumol/L at 3 a.m.); and (5) no significant changes in plasma glucagon. Thus, a 2-h interruption of CSII in resting nocturnal conditions is sufficient to induce significant, delayed, and sustained metabolic alterations in C-peptide-negative patients despite good baseline blood glucose control. Resetting the pump at its basal rate is insufficient to quickly restore adequate circulating insulin levels and effectively counteract the metabolic disturbances. The efficacy of a bolus insulin injection in these conditions should be evaluated. [less ▲]

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See detailLe syndrome d'immunodéficience acquise : espoirs et limites thérapeutiques
Henrivaux, P.; Bury, Jean; Demonty, J. et al

in Médecine et Hygiène (1983), 41

Le SIDA reste une affection mortelle survenant dans certains groupes humains à haut risque qui sont actuellement bien connus. L'agent responsable pourrait être un rétrovirus. L'évolution se caractérise ... [more ▼]

Le SIDA reste une affection mortelle survenant dans certains groupes humains à haut risque qui sont actuellement bien connus. L'agent responsable pourrait être un rétrovirus. L'évolution se caractérise par des infections opportunistes graves (P. Carinii, T. Gondii, C. Neoformans) et/ou l'apparition d'un sarcome de Kaposi de haut degré de malignité. Au-del) du traitement des infections et du sarcome de Kaposi, la restauration de l'immunité cellulaire reste l'objectif prinicpal. Dans cette perspective, des essais sont actuellement en cours utilisant l'interféron, les hormones thymiques ou l'interleukine 2. [less ▲]

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