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J C Delchier

Publications and source records attributed to J C Delchier.

101 records · Page 6Linked to original sources
PubMed1979

[Oxyphenisatin, a laxative responsible for chronic hepatitis and cirrhosis, still marketed in France (author's transl)].

Six patients suffering from chronic liver disease attributed to oxyphenisatin ingestion are presented. They seem to be the first such cases reported in France. These patients were between 22 and 69 years old, 5 of them were female. Three patients had a chronic active hepatitis (CAH). In these three subjects the onset of the illness was a jaundice ; alanine transaminase (ALAT) exceeded 5 times the upper limit of the normal value ; smooth muscle antibodies were present in 2 patients and antinuclear antibodies in the third. Two other patients had cirrhosis, without chronic active hepatitis ; none presented autoantibodies. The sixth patient suffered from a subacute hepatitis, suggested by the presence of jaundice and ascites, high levels of serum ALAT and a very prolonged prothrombin time ; smooth muscle antibodies were present. In all cases, HBs Ag was absent from serum. Each patient had ingested laxative pills containing oxyphenisatin for 4 to 25 years ; the total amount ingested was comprised between 12.5 and 350 g. The chronic liver diseases reported in this series closely resemble those published in the literature. The lesions observed make it necessary to look for oxyphenisatin ingestion in every patient having CAH or cirrhosis without known etiology. These chronic liver diseases imply the rapid withdrawal of oxyphenisatin from french market, as already enforced in Australia and the United States.

Adult↗
PubMed1978

[Cimetidine. Clinical pharmacology and toxicity (author's transl)].

Cimetidine, a new histamine H2-receptor antagonist (H.H2.R.A.) is a potent inhibitor of basal and stimulated gastric acid secretion. Contrary to anticholinergics, it does not affect gastric emptying nor does it decrease lower oesophageal sphincter pressure; cimetidine may therefore be used as the treatment of reflux oesophagitis. After prolonged administration of currently used therapeutic doses, basal and post-prandial serum gastrin levels remain unchanged and the parietal cell mass is not increases. Cimetidine toxicity is very low. Cimetidine is effective in promoting healing and pain relief of gastric and duodenal ulcer. In the latter long-term treatment for prevention of relapse is efficient, but the appraisal of its safety remains debated. Efficiency of H.H2.R.A. in the prophylaxis of gastrointestinal haemorrhage in patients with fulminant hepatic failure has been proven. Furthermore, cimetidine has a dramatic ability to control haemorrhage from acute erosive lesions in any seriously-ill patient. It may also be of benefit in the treatment of bleeding from gastric or duodenal ulcer and, whatewer the lesion, in the prevention of bleeding recurrence. In the Zollinger-Ellison syndrome, good results have been obtained but cimetidine treatment must be decided and supervised only by well-informed specialists. Lastly, in patients with severe exocrine pancreatic insufficiency, cimetidine prevents gastric degradation of orally administered pancreatic extracts and decreases steatorrhea.

Cimetidine↗
PubMedDate not supplied

The usefulness of microscopic bile examination in patients with suspected microlithiasis: a prospective evaluation.

Gallbladder bile collected by duodenal intubation or during surgery was examined microscopically in patients who were free of stones and in patients with proven stones. None of the 16 patients free of stones had cholesterol monohydrate crystals or calcium bilirubinate granules in bile. Among the 17 patients with proven cholelithiasis, 13 with cholesterol stones had cholesterol monohydrate crystals in their bile, but only 2 of the 4 patients with pigment stones had calcium bilirubinate granules. These data confirm that cholesterol monohydrate crystals are sensitive and specific for cholesterol stones, whereas calcium bilirubinate granules lack sensitivity for the diagnosis of pigment stones. From these results, the diagnostic usefulness of microscopic examination of bile collected from the duodenum was studied prospectively in 46 patients with symptoms suggestive of cholelithiasis but in whom stones had not been visualized at cholecystography and ultrasonography. In 15 of them, bile was found to be abnormal: cholesterol monohydrate crystals were seen in 11, cholesterol crystals + calcium bilirubinate granules in 2 and calcium bilirubinate granules in 2. To date, nine of these patients have been operated on: 6 (all with cholesterol monohydrate crystals) had small cholesterol gallstones and 3 (2 with cholesterol monohydrate crystals and 1 with calcium bilirubinate granules) had signs strongly suggestive of the recent migration of gallstones. One patient refused operation, but minute pigment stones were found to be associated with calcium bilirubinate granules at duodenal intubation. In the other 31 patients, bile contained neither cholesterol monohydrate crystals nor calcium bilirubinate granules. They were not operated on and were followed up with repeated investigations for 12 to 24 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Long-term efficacy and tolerability of omeprazole in 20 patients with severe Zollinger-Ellison syndrome].

Omeprazole efficacy and tolerance were evaluated in 20 patients with longstanding Zollinger-Ellison syndrome (ZES) committed to long-term antisecretory therapy. The study included 13 men and 7 women, aged 53 (30-74) years (median and range). Nineteen patients presented with epigastric pain, 14 with vomiting, and 9 with diarrhea. All patients had gastroduodenal ulcerations, associated with esophagitis in 9 cases. Median and extreme values for basal acid output (BAO) and serum gastrin (SG) levels before omeprazole treatment were 41 (3.7-80) mmol H+/h and 413 (111-11,490) pg/ml, respectively. In 18 patients, omeprazole treatment was initiated because of resistance to H2-antagonists, and in 2 patients because of carbothioamide RP 40749 discontinuation. Initial doses of omeprazole were 60 mg per day in 10 patients and ranged from 80 to 160 mg per day in the others. Esophagogastrectomy was performed in one patient at day 15 because of esophageal stenosis. In the remaining 19 patients, median duration of treatment was 16 (7-54) months and median doses of omeprazole were 70 (20-160) mg per day during the survey. Omeprazole therapy was highly effective in inducing rapid disappearance of clinical abnormalities in 18 of 19 patients. Twenty-two days after initiation of treatment, median BAO was 4 (0-14) mmol/h and ulcerations had healed in 17 of 19 patients. Median BAO was less than 5 mmol/h during follow-up. However, asymptomatic ulcer recurrence was noted in 4 patients, but disappeared quickly after omeprazole doses were increased. Median basal gastrin level was 700 (116-36.625) pg/ml at the least determination and was statistically higher than pretreatment values (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMedDate not supplied

[Presence of anti-Yersinia pseudotuberculosis agglutinins during a flare-up of ileal Crohn's disease. Apropos of 3 cases].

Sera of 19 patients who had been admitted with an attack of Crohn's disease were tested for agglutinins against Yersinia. The localization and the extent of the disease were highly variable. Only three patients with a subacute obstruction syndrome due to ileitis had a high circulating antibody titer directed against Yersinia pseudotuberculosis type IV (greater than or equal to 1/500). Culture of the stools did not isolate any pathogenic organisms; particularly, Yersinia pseudotuberculosis failed to grow even though specific methods were used. In one case, a strain of Yersinia enterocolitica was identified which did not prove to be pathogenic. Under corticoid and antibiotic treatment, the course was favorable in every patient. Agglutinin titers progressively decreased and serology became negative within seven to ten months. A patient had a relapse of ileitis but agglutinin titers failed to rise again. In these three patients with unquestionable Crohn's disease, it may be concluded that there was serological evidence of superinfection with Yersinia pseudotuberculosis type IV. This organism might be responsible for acute ileitis mimicking an attack of Crohn's disease.

Adult↗