Biomedical subjects

Annick Chavaillon

Publications and source records attributed to Annick Chavaillon.

4 recordsLinked to original sources

PubMed2004

Surveillance of duodenal adenomas in familial adenomatous polyposis reveals high cumulative risk of advanced disease.

PURPOSE: The development of high-grade dysplasia (HGD) on duodenal or jejunal adenomas and of late-stage (stage IV) duodenal polyposis are major clinical events for familial adenomatous polyposis (FAP) patients. Our aim was to determine their respective frequency, risk factors, and cumulative risk. PATIENTS AND METHODS: A prospective, optimized, endoscopic surveillance protocol was applied to 58 FAP patients in a university hospital. The number, size, and histology of duodenojejunal polyps were assessed, and the Spigelman's score was calculated at each endoscopy. Cox regression and linear regression analysis were used to determine risk factors for HGD development and the cumulative risk of stage IV duodenal polyposis, respectively. RESULTS: During a median (+/- standard deviation) follow-up of 47.9 +/- 15.6 months, 35 patients with at least two consecutive examinations had 107 duodenojejunal examinations. The Spigelman's score increased in 21 patients (60.0%), and HGD developed in 12 patients (34.2%). High initial Spigelman's score (> 7 points), but not age or APC mutation site, was a risk factor for HGD development. Estimated cumulative risk of developing stage IV duodenal polyposis was of 42.9% at age 60 (95% CI, 35.7% to 50.0%) and 50.0% at age 70 (95% CI, 42.9% to 57.1%). CONCLUSION: This prospective series shows a higher duodenal polyposis progression rate and cumulative risk of late-stage (stage IV) duodenal polyposis in FAP patients compared with previous series. These results suggest that current modalities for surveillance and management of these patients need revision.

Adenoma↗

PubMed2004

Unsedated transnasal PEG placement.

BACKGROUND: By using a small-diameter endoscope, EGD can be performed transnasally in adults. A prospective study was conducted to evaluate the feasibility of transnasal PEG placement without conscious sedation. METHODS: Unsedated transnasal PEG was attempted in 23 patients by using a 5.9-mm-diameter videoendoscope. The indication for PEG insertion, success or failure, reason(s) for failure, and adverse effects of the procedure were recorded. During the first month, all patients were monitored by telephone contact for complications and to verify functionality of the PEG. RESULTS: Transnasal PEG insertion was successful in 21 (91%) patients. The cause for failure was the inability to transilluminate the abdominal wall. Complications included epistaxis (n=1), minor wound infection (n=1), and soiling around the stoma (n=1). Of the 21 patients in whom transnasal PEG placement was successful, all were alive, with a functional gastrostomy at the 1-month follow-up. CONCLUSIONS: Unsedated transnasal PEG tube insertion is minimally invasive, is feasible in daily practice in selected patients, and rarely is associated with complications.

Aged↗

PubMed2002

The influence of mutation site and age on the severity of duodenal polyposis in patients with familial adenomatous polyposis.

BACKGROUND: The present study was undertaken to identify factors affecting the severity of the duodenojejunal polyposis in patients with familial adenomatous polyposis. METHODS: Duodenojejunal polyposis was evaluated in 41 consecutive patients with familial adenomatous polyposis (mean age 41 years, range 21-63 years), 33 (80%) with known APC mutation, by using a standardized endoscopic protocol. The severity of the polyposis was graded with the Spigelman scoring system (0-12 points), the Spigelman score/age ratio, and the presence or absence of advanced adenomas (>1 cm in diameter and/or high-grade dysplasia). RESULTS: The Spigelman score (median 8, range 3-12) was higher in patients older than 50 years (median 10, range 3-12) as compared with younger patients (median 7.5, range 3-11; p = 0.043). A significant association between age and the presence of advanced adenomas was also observed. Patients with a mutation in the central part of the APC gene (codons 279-1309) had a higher Spigelman score and Spigelman score/age ratio as compared with patients with other mutations: median Spigelman score/age ratio 0.21 (range 0.14-0.40) versus 0.10 (range 0.06-0.20) (p < 0.001). CONCLUSIONS: Older age and APC mutation in the central part of the gene are risk factors for the development of severe duodenojejunal polyposis.

Adenomatous Polyposis Coli↗

PubMedDate not supplied

[Autoimmune pancreatitis: beneficial effects of corticosteroid therapy on biliary and metabolic complications].

Auto-immune pancreatitis is rare and its evolution includes both the usual complications of chronic pancreatites, such as diabetes and specific consequences and complications including extension of inflammatory lesions of the extra or intrahepatic biliary tract. One particular characteristic of these complications is that they are sensitive to cortisone therapy, as illustrated by the case we report here.

Aged↗