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Biomedical subjects

A Lavignolle

Publications and source records attributed to A Lavignolle.

16 recordsLinked to original sources
PubMed1991

[Prevention of recurrent hemorrhage in patients with cirrhosis. Results of a controlled trial of propranolol versus endoscopic sclerotherapy].

Between July 1984 and March 1986, we conducted a prospective randomized trial comparing propranolol and endoscopic sclerotherapy in the prevention of recurrent variceal hemorrhage in a group of non selected alcoholic cirrhotics. Seventy-six patients with variceal hemorrhage were randomized to receive propranolol (P) (34 patients), or sclerotherapy (S) (42 patients) approximately 12 days after initial bleeding. The 2 groups were similar as concern age, sex, etiology of cirrhosis, severity of liver failure, the number of previous hemorrhages, and the severity of initial hemorrhage. No side effects were observed in the P group; 20 patients (48 percent) in the group S had at least one side effect although minor. After an average follow-up of 36 months, 18 patients in group P (53 percent) and 23 in group S (55 percent) had hemorrhagic recurrence. Rebleeding occurred from other sources than esophageal varices in 5 patients, in the group S only. Five patients in group P and 8 patients in group S died of rebleeding. During the follow-up period, 8 patients in group P (23 percent) and 13 patients in group S (31 percent) died. No significant difference could be demonstrated between the 2 groups as regards the percentages of patients without variceal rebleeding or survival, calculated according to the Kaplan Meier method. In conclusion, in this trial, no significant difference could be demonstrated between propranolol and endoscopic sclerosis in the prevention of recurrent variceal hemorrhage in alcoholic cirrhotic patients.

Actuarial Analysis↗
PubMed1989

Rioprostil and ranitidine in the prevention of duodenal ulcer relapse.

One hundred and ninety duodenal ulcer patients who had relief of pain and endoscopically proven ulcer healing after a short treatment period are allocated at random to double-blind maintenance treatment with a synthetic dehydroprostaglandin-E1, rioprostil, 300 micrograms, or ranitidine, 150 mg, at bedtime for 6 months. Patients are monitored every two months and examined by endoscopy after six months of treatment, or more often if warranted. The cumulative relapse rate in the rioprostil group at six months is 32% (25/78) vs. 28% (20/72) in the ranitidine group. This difference is not significant. The percentage of side effects observed is 17% in the rioprostil group vs. 5% in the ranitidine group, but discontinuation of treatment is observed with the same frequency in the two groups.

Anti-Ulcer Agents↗
PubMed1989

Rioprostil vs. ranitidine in duodenal ulcer healing: a double-blind multicentre trial.

A total of 156 patients with endoscopically proven duodenal ulcers are randomized in a double-blind, multicentre trial comparing rioprostil, 300 micrograms b.d., with ranitidine, 150 mg b.d. With rioprostil, the cumulative healing rate by endoscopy is 73% at 4 weeks, and 87% at 6 weeks. With ranitidine it is 79% and 92%, respectively. There is no difference in the occurrence of pain after the two types of treatment, and the side effects are comparable in the two groups. These results show that rioprostil is probably as effective and safe as ranitidine in the treatment of duodenal ulcer.

Adult↗
PubMed1987

Low dose omeprazole effects on gastric acid secretion in normal man.

The pharmacological effects of low dose of omeprazole (Om) are not well known. This prompted us to investigate the effects of a 7-day treatment with a low dose of Om, 10 mg/d (Om10), on gastric acid secretion and serum gastrin levels and to compare the results with those obtained with an effective antisecretory dose of 20 mg/d (Om20). Twelve healthy volunteers received randomly and double-blind for three periods of 7 days, separated by at least 7 days, one capsule of placebo (P), Om10, Om20, given daily in the morning, in fasting condition. The last day of each period, 24 h pH was recorded using a glass electrode connected to a Digitrapper (Synectics). At the end of each pH-metry, acid secretion was measured in basal conditions (BAO), after sham-feeding (SAO) and after i.m. injection of 6 micrograms X kg-1 of pentagastrin (PAO). Whatever the threshold pH chosen, there was a statistically significant difference between P and Om10, P and Om20, and Om10 and Om20. Inhibition of acid concentrations was dose-dependent and prolonged, including nocturnal time. However, when considered on an individual basis, five subjects did not respond to Om10. More than 24 h after the last dose of Om has been administered, BAO, SAO and PAO were significantly reduced by either Om10 (respectively -52, -35 and -28 p. cent) and Om20 (respectively -60, -58 and -50 p. cent). Fasting serum gastrin concentration was significantly increased after Om20 treatment but not after Om10. We conclude that treatment with Om10 has a consistent and long lasting inhibitory action on gastric acidity without statistically significant effect on serum gastrin levels. These results suggest that 10 mg Om daily should be sufficient in some duodenal ulcer patients to effectively inhibit gastric acidity specially when long-term treatment seems to be indicated.

Adult↗
PubMed1986

[Ogilvie's syndrome: results of endoscopic exsufflation in a series of 29 cases].

The aim of this study was to assess the value of endoscopic decompression of the colon in a series of 29 patients affected with Ogilvie's syndrome. During the first period (1980-1982), 14 patients were treated by colonoscopic decompression alone. During the second period (1982-1985), 15 endoscopic decompressions were systematically completed by intubation of the colon. The tube was removed after 2 to 13 days. Whatever the procedure, endoscopic decompression was successfully achieved in all cases. The death rate (8/29) and number of cecostomies (2/29) were similar in the two groups of patients. Only one death was directly related to Ogilvie's syndrome itself, whereas 7 patients died from other severe underlying diseases. However, colonic dilatation recurred in 6 patients in the first group and in one patient in the second group (p less than 0.05). No complications due to the endoscopic procedures occurred in this series. It may be concluded that endoscopic treatment of Ogilvie's syndrome is a safe and effective procedure. Our results also suggest that colonoscopic intubation should be used prophylactically in order to avoid recurrences, frequently observed after simple endoscopic decompression.

Acute Disease↗
PubMed1984

[Wirsung's duct hemorrhage in chronic pancreatitis. Report of 4 cases and study of the literature].

Hemorrhage from Wirsung's canal complicated chronic pancreatitis in 4 patients. Excision (2 cephalic and 1 corporeocaudal) in 3 cases provided successful results, the 4th patient dying from intraperitoneal rupture of the false cyst responsible for the hemorrhage, during recurrence of the latter after simple ligature. A literature review indicated pancreatic disease, mainly chronic, as the cause in 76.5% of the 64 cases documented. Diagnosis is difficult from clinical findings, and is dependent mainly on results of endoscopy and particularly retrograde catheterization of the papilla, while arteriography is essential for confirmation of the diagnosis and the site of the lesion, and for assisting choice of therapy. When a chronic pancreatitis exists, the only logical attitude is selective excision, mortality being minimal (5%). Embolization could be a valid method for ensuring hemostasis temporarily to allow delayed radical surgery.

Aged↗
PubMedDate not supplied

[Campylobacter pylori and gastric mucosa: histological and bacteriological study and preliminary results of an epidemiological survey in the area of Nantes].

The aims of this study were to: a) evaluate the prevalence of Campylobacter pylori (CP) in patients referred to a gastroenterology unit for upper digestive tract endoscopy, b) compare the results of histologic (Warthin-Starry method) and bacteriologic (direct and culture) examinations, c) correlate the presence and abundance of CP with the "activity" of chronic gastritis as assessed by antral and fundic specimens, and d) report the preliminary results of an epidemiological survey in the area of Nantes, France. CP was observed in 30 of the 64 patients studied (46 p. 100 of cases), and was significantly associated with chronic gastritis of either the superficial or interstitial (87 vs. 12 p. 100 of patients positive and negative, respectively for CP studies, p less than 10(-9], and preatrophic and/or atrophic types (40 vs. 12 p. 100 of patients positive and negative, respectively, for CP studies, p less than 0.01). CP was also present in 7 of 10 patients with duodenal ulcers and in 4 to 6 with gastric ulcers. Histologic and bacteriologic studies gave concordant results in 94 p. 100 of cases, and had the same sensitivity for diagnosis. Patients positive for CP studies had a statistically significant increased incidence of epigastric burns, and, at endoscopic examination, their fundic area appeared congestive more frequently. CP were dictated in both the antrum and fundus, but lesions of chronic gastritis were more prominent in the former. There was a statistically significant correlation between the degree of inflammation observed in the lamina propria and the number of CP present in the same area (antrum and fundus).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Severe jaundice with fatal outcome in pregnancy].

The authors report three cases of jaundice which developed during pregnancy and which rapidly resulted in the death of the patients. One case was a fulminant case of cytomegalovirus hepatitis and the other two were cases of acute steatosis of pregnancy. The clinical features are marked by the rapid development of a neurological syndrome resulting in coma and the association of blood dyscrasias due to major hepato-cellular failure resulting in DIC. The rapid progression of the disease generally results in the death of the mother and the child. However, there are some reports of survival with total cure after rapid extraction of the foetus, which justify an active therapeutic attitude.

Adult↗