PubMed Health⌕ Search

Biomedical subjects

C Seigneuric

Publications and source records attributed to C Seigneuric.

At least 19 recordsLinked to original sources

[Conditions of practice and results of colonoscopy in non-university hospitals. Results of a cross sectional, multicenter ANGH study (1)].

OBJECTIVES: The aim of the study was to describe the conditions of practice and results of colonoscopies performed in non university hospital endoscopy units. METHODS: A study was suggested to all members of the National Association of non university Hospital Gastroenterologists (ANGH). During one week a questionnaire was filled out by the gastroenterologists for each colonoscopy. RESULTS: Eighty six hospitals (229 gastroenterologists) took part in this study including 840 explorations. Ninety one percent of them were complete and the result was abnormal in 49%: cancers (3%), polyps > or =1 cm (8%), polyps < 1 cm (20%) and colitis (5%). Colonoscopies were ambulatory in half of the cases. Sedation was used in 95% of the patients, 80% by the anesthesist and 15% by the gastroenterologist (conscious sedation). The recommendations of the French Society of Anesthesia and Intensive Care for ambulatory sedation were not totally respected (15% of patients left the endoscopy unit without assistance). Only 6% of colonoscopies were not well tolerated, because of pain or incidents rarely necessitating intensive care monitoring (5 cases) or prolonged hospitalization (2 cases). CONCLUSION: Colonoscopy provides good diagnostic yield although conditions of use can be improved.

Aged↗

[Patient opinions after colonoscopy. Results of a cross sectional, multicenter ANGH study (2)].

OBJECTIVES: The aims of this study were to evaluate patient opinions following colonoscopy and to analyze the role of conditions of practice on patients' opinions. METHODS: A study was suggested to all members of the ANGH. During one week of practice, a questionnaire was filled out by the gastroenterologist and a second one by the patient, alone, one day after colonoscopy. RESULTS: Eighty six hospitals (229 gastroenterologists) took part in the study which included 815 patients; 752 of them (92%) filled out the satisfaction questionnaire. Five hundred and eighty four patients (78%) would accept a new endoscopy in the same conditions; 168 patients (22%) would accept if the conditions were different or would refuse a new endoscopy. The main factors associated with acceptance under the same conditions were: good tolerance (odds-ratio (OR): 5.08), old age (OR: 5), anesthesia (OR: 2.67) or conscious sedation (OR: 2.29), male gender (OR: 2.39) and ambulatory care (OR: 2). CONCLUSION: This study of clinical practice underscored the different factors associated with better acceptance of colonoscopy. Individual gastroenterologists could use these data to guide practice.

Age Factors↗

A prospective, multicenter, randomized trial comparing steroids and pulse cyclophosphamide versus steroids and oral cyclophosphamide in the treatment of generalized Wegener's granulomatosis.

OBJECTIVE: To investigate the effectiveness and side effects of oral versus pulse cyclophosphamide (CYC) in combination with corticosteroids (CS) in the treatment of systemic Wegener's granulomatosis (WG). METHODS: Patients with newly diagnosed systemic WG were enrolled in a prospective, randomized trial. At the time of diagnosis, prior to randomization, every patient received a daily injection of methylprednisolone for 3 days, followed by daily oral prednisone (1 mg/kg/day) and a 0.7-gm/m2 pulse of CYC. Patients were then randomly assigned to receive either prednisone plus intravenous pulse CYC (group A) or prednisone plus oral CYC (group B) as first-line treatment. CYC was given for at least 1 year and was then progressively tapered and discontinued. RESULTS: Fifty patients were included in the study: 27 in group A and 23 in group B. At 6 months, 24 group A patients (88.9%) were in remission, versus 18 group B patients (78.3%). At the end of the trial, 18 group A patients (66.7%) and 13 group B patients (56.5%) were in remission. In group A, 66.7% of the patients experienced side effects, versus 69.6% in group B. Infectious side effects were significantly more frequent in group B (69.6%) than in group A (40.7%) (P < 0.05). The incidence of Pneumocystis carinii pneumonia was higher in oral CYC-treated patients (30.4%) than in pulse CYC-treated patients (11.1%). Nine group A patients (33.3%) and 10 group B patients (43.5%) died. Actuarial curves showed that relapses were significantly more frequent in group A (59.2%) than in group B (13%) (P = 0.02). CONCLUSION: Our results indicate that pulse CYC is as effective as oral CYC in achieving initial remission of WG and is associated with fewer side effects and lower mortality. However, in the long term, treatment with pulse CYC does not maintain remission or prevent relapses as well as oral CYC.

Administration, Oral↗

[The neurosurgical treatment of the cerebral localisations of the alveolaris (multilocularis) echinococcosis (author's transl)].

A case of adult woman surgically treated for hepatic alveolaris ecchinococcosis on 1975 is presented. On 1976, a hypertensive intracranial syndrome is treated by removal of a right temporal kystic localisation. On 1977, a new localisation is successfully raised. The authors, in a short review of the literature note that these cerebral localisations are not always terminal. The alveolaris ecchinococcosis is now autochthonous in France.

Brain Diseases↗