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Biomedical subjects

A Yousfi

Publications and source records attributed to A Yousfi.

11 recordsLinked to original sources
PubMed1997

[Subtotal colectomy with ceco-rectal anastomosis (Deloyers) for severe idiopathic constipation: an alternative to total colectomy reducing risks of digestive sequelae].

PURPOSE: Functional results of total colectomy (TC) and ileorectal anastomosis for colonic inertia are often impaired by postoperative obstruction and diarrhea. In order to avoid these postoperative complications, we propose a subtotal colectomy (STC) preserving the ileo-caecal junction. METHODS: Since 1989, 18 consecutive patients (17 F, 1 M; mean age: 54 years) with intractable constipation underwent TC (n = 6) or STC with caecorectal anastomosis (Deloyers Procedure) (n = 12). Mean preoperative bowel frequency was two movements every month. Colonic inertia was defined as diffuse marker delay during transit study without obstructed defecation on manometry or digitalised rectography. Rectocele (n = 10), rectal (n = 5) and genital prolapse (n = 6) were treated in the same operative time. RESULTS: Postoperative course was uneventful after STC but bowel obstruction, requiring laparotomy, occurred in 3 patients (50%) after TC: enterolysis (n = 2), bowel resection (n = 2). Mean postoperative day stool frequency of TC (4.2 +/- 1.2) was higher than STC (1.2 +/- 0.1). Half of patients after TC needed anti-diarrheal treatment and diet, 33% had rectal evacuation difficulties despite liquid stools, 17% had episodic incontinence, 66% had persistent abdominal pain. Compared to TC, the functional results of STC were significantly better: regular normal transit return without diet or treatment in 75% of cases, 25% had rectal emptying difficulties easily treated by mild laxatives, only 17% had persistent abdominal pain. Postoperative obstruction, diarrhea or fecal incontinence never occurred after STC. CONCLUSION: Compared to TC, STC with Deloyers procedure seems to reduce significantly the postoperative incidence of bowel obstruction, diarrhea and abdominal pain. Expected regular transit return after STC needs a careful selection of patients and simultaneous treatment of ano-rectal and pelvic floor abnormalities frequently associated with colonic inertia.

Adult↗
PubMed1991

[Corticoid therapy in the treatment of acute alcoholic hepatitis. Results of a meta-analysis].

A meta-analysis of 10 randomized trials comparing steroid therapy with placebo or abstention was performed. Trials were pooled for severity of acute alcoholic hepatitis and time of analysis. Papers with survival analyses at one and three months were included. The robustness of this meta-analysis was analysed after exclusion of trials analysing survival at three months only, trials including mild forms, or atypical trials. Comparisons were made use the Der Simonian-Laird and Mantel-Haenszel-Peto methods. All results were statistically significant. However, if only one medium size trial were to be added, the results would no longer be significant. Taking into account the complications of steroid therapy, we conclude that further clinical trials are necessary to confirm the effectiveness of steroid therapy, especially for the group of patients with severe alcoholic hepatitis.

Acute Disease↗
PubMed1990

[Solitary rectal ulcer syndrome: clinical features, clinical course and treatment. Apropos of 22 cases].

Rectopexy associated with anterior prolepsectomy was performed for 22 patients (19 females, 3 males), with solitary rectal ulcer syndrome (SRUS) surrounding internal rectal prolapse. The different lesions of SRUS were distributed among 3 main groups (G) according to the macroscopic appearance: G1: solitary ulcer (n = 7); G2: ulcerated proctitis (n = 7); G3: muco-hemorroidal prolapse (n = 3). A significant difference (P less than 0.05) was observed between each group, concerning mean age (G1: 34 years, G2 = 49, G3: 65) and the degree of perineal descent, which was more important in G3 and G2. Posterior intersphincteric rectopexy was performed for 6 patients in G3, with descending perineum and faecal incontinence, treated in the same time by perineoplasty (Parks). Abdominal rectopexy, mainly by the antero-posterior technique (Nicholls), was performed for the other patients (n = 6). Large anterior prolapsectomy reaching the top of the mucosal prolapse (4-7 cm), allowing ulcer resection in 3 cases, was combined with rectopexy. Associated operations were: sphincterotomy (n = 8) for narrow fibrous anal canal, sigmoidectomy (n = 4) for dolichocolon. Mean healing time for the solitary ulcer group (G1) was 2 months, 1 month for lesion of G2 and G3. Failures concerned 1 solitary ulcer after abdominal rectopexy and 1 ulcerative proctitis after rectopexy without prolapsectomy. Anorectal pain (81%), rectal bleeding (76%), faecal incontinence (27%), straining (81%), were cured or improved in 80% of cases. These results tend to confirm the efficacy of rectopexy, specially using the antero-posterior technique, for the treatment of SUSR with internal rectal prolapse. Nevertheless, rectopexy seems to be insufficient to correct the mucosal component of internal rectal prolapse, bearing the ulcerated lesion which needs to be treated by associated anterior prolapsectomy. Similarly all functional or organic disorders involving the perineum, anal canal or colon leading to anorectal dysfunction must also be considered to ensure complete treatment.

Adult↗
PubMed1987

[Treatment of acute alcoholic hepatitis with prednisolone. 45 patients].

Whether or not prednisolone (or prednisone) should be used to treat alcoholic hepatitis remains controversial. This new controlled study performed on 45 patients with steatosis, fibrosis or cirrhosis of the liver suggests that prednisolone is not effective: after a 3-month follow-up clinical course, biochemical alterations, anatomical lesions and portal hypertension were the same in patients treated with prednisolone and in those who did not receive that drug.

Acute Disease↗
PubMed1979

[An ultrastructural study of the transformation of elementary bodies of Rickettsiella into initial bodies (author's transl)].

An intermediate stage between the elementary and the initial bodies of the Rickettsietta genus is defined as the beginning of an intracellular cycle. It is characterized by several structural changes in the dense elementary body: the cytoplasm becomes less electron-dense; thus, the nucleoid and the ribosomes are visible. The inner layer of the cell-wall becomes progressively clearer and the trilamellar structure of the inner and outer membranes appears distinctly. 'preinitial body' is proposed as name of this stage of development.

Alphaproteobacteria↗
PubMedDate not supplied

[Treatment of cancer of the pancreas (biliary-digestive bypass or excision?). Retrospective study of 164 patients].

The aim of this work was to study retrospectively the survival of 164 patients with cancer of the pancreas diagnosed in a gastroenterological unit from 1975 to 1984, according to the therapeutic procedure: 50 patients have not been operated, 12 have undergone an exploratory laparotomy, 72 patients a biliary bypass, 13 patients had undergone a pancreato-duodenectomy, 15 patients a total pancreatectomy, and 2 a caudal pancreatectomy; 9 patients inoperable had benefit from endoscopic biliary drainage. The survival was not statistically different in the 4 groups of patients. Today with a 2 year's follow-up, all patients have died. In the homogeneous group of 80 patients having a tumor of the head of the pancreas, the survival of the unoperated patients (72 +/- 19 days) is statistically lower than that of the patients having a biliary by-pass (187 +/- 28 days) (p less than 0.02). According to the Cox model, the variables age, sex, tumor localization and diagnosis delay did not influence the survival time. In conclusion, the results of this study confirm the severity of the cancer of the pancreas, whatever the therapeutic procedure used. Because of lack of controlled studies, it is impossible to codify the therapeutic procedure of cancer of pancreas.

Aged↗
PubMedDate not supplied

[Cytochemical and freeze-etching studies of the ultrastructure of a Rickettsiella in a crustacean (author's transl)].

Several characteristics of the intracellular cycle of Ricketsiella are elucidated, particularly regarding the envelope and the cytoplasm of dense forms (elementary bodies) as well as the proteinic inclusions of giant bodies. Cleavage faces have been displayed by freeze-etching, both at the level of cell wall and of plasma membrane. Their characteristics approach those of Gram-negative bacteria and are pratically common to all the stages. Appearance and significance of a polysaccharidic cement joining the outer membrane of the cell wall to the inner membrane (plasma membrane) in the dense forms are discussed. The arrangement of ribosomes and the structure of the nucleoid are described. A 6 nm lattice periodical structure is shown in the proteinic inclusion. Significance of these data for a classification of Rickettsiella and chlamydias is discussed.

Animals↗