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Biomedical subjects

J P Desechalliers

Publications and source records attributed to J P Desechalliers.

12 recordsLinked to original sources
PubMed1996

[Are early unforseen rehospitalizations inevitable?].

We randomly selected 198 readmissions to an acute-care hospital within the 3 months following the last discharge during the year 1993 to describe the reasons for planned readmissions and to assess whether unplanned readmissions were appropriate and/or avoidable. 49.5% of readmissions were planned: for medical investigations (45%), surgery (30%), or medical treatments (such as chemotherapy) (18%). Among the 100 unplanned readmissions, 13% were assessed as inappropriate, and 37% as potentially avoidable. Given this high rate of potentially avoidable readmissions, there is a need to identify preventive interventions.

Acute Disease↗
PubMed1993

[Disorders of the hypothalamo-hypophyseal-ovarian axis in chronic alcoholic women].

This paper deals with the physiology of menstrual cycle disturbances in alcoholic women. Nineteen women, aged from 25 to 45 years, were investigated for the quality of their menstrual cycle (amenorrhoea in 6, spanomenorrhoea in 5, normal cycle in 8) and for their clinical, biochemical and, when possible, histological hepatic status. In all these women, hormone levels were measured (in the early follicular phase for those with normal menses), including E2, E1, LHRH test, T, delta 4A, SBG, T4L, T3L, cortisol and prolactin. According to their hormonal profile, these women were classified as hypothalamo-pituitary amenorrhoea (n = 4), premature menopause (n = 2), ovarian dystrophy (n = 1) and normal hormone levels (n = 12). Although our results are too few for statistic value, it appears that the amount of alcohol consumed, the degree of malnutrition and the hepatic abnormalities observed are more important in women with abnormal hormonal profile.

Adult↗
PubMed1986

[Reflux esophagitis: respective roles of esophageal and gastric pathogenic factors].

Multiple factors contribute to the production of esophagitis in gastroesophageal reflux (GER), but the respective roles of esophageal (i. e. lower esophageal sphincter (LES) tone, peristalsis) and gastric factors (i. e. acid secretion and gastric emptying) are not well known. The aim of this work was to study the frequency and the severity of esophageal and gastric abnormalities observed in the same patients and to correlate these findings with the degree of esophagitis. Thirty-three consecutive patients with GER proven by esophageal pH recording (3-hr postprandial pH-test) were classified according to the presence (group A, n = 18) or absence (group B, n = 15) of severe esophagitis (i. e. erosions, ulcerations, or stenosis) at endoscopy. LES basal tone and esophageal peristalsis were studied by manometry. Gastric acid secretion and emptying of liquids were measured by intragastric titration coupled with the dye dilution technique. Results obtained in GER patients were compared with those found in twenty-three normal subjects. Hypotonia of LES (i. e. LES tone less than 7 cm H2O) was more frequent in group A (72 p. 100) than in group B patients (30 p. 100, p less than 0.05). Magnitude of esophageal peristaltic waves was lower in group A than in group B (p less than 0.10). When compared to values found in normal subjects, gastric emptying and acid secretion were not significantly different both in presence and in absence of esophagitis. There was no linear correlation between esophageal pH parameters and acid secretion values or gastric emptying rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Anorectal motility in idiopathic constipation. Study of 200 consecutive patients].

The aim of our work was to study anorectal motility and tension of the rectal wall in 200 constipated adult patients. Anorectal manometry was normal in 88 patients (group A), showed abnormal amplitude of the anorectal inhibitory reflex in 33 patients (group B) and hypertonia and ultraslow waves in 70 patients (group C). These anomalies were: a) reproducible in the 20 patients studied twice; b) observed in patients with enterocolitis, thus not specific of constipation; c) associated with an increased frequency of fecal evacuation difficulties. Despite normal values of tension of the rectal wall: a) the threshold of conscious perception of distension was increased in 14 p. 100 of patients; b) a paradoxical relationship between the anorectal inhibitory reflex and rectal tension was observed in group B patients. Our results support the concept of outlet obstruction due to anorectal dysfunction and suggest the possibility of neurologic and or ischemic mechanisms in group B patients.

Adolescent↗
PubMed1984

Ranitidine, cimetidine, antacids, and gastro-oesophageal reflux: results of a 20-hour oesophageal pH study.

This study compared the effects of cimetidine, ranitidine, and antacids on oesophageal pH levels. Forty-five patients were confirmed as having a gastro-oesophageal acid reflux by 3-hour postprandial metered pH measurements. The 45 patients were randomly placed into three treatment groups; one group received cimetidine 1 g/day, the second received ranitidine 300 mg/day, and the third received 60 ml/day of an antacid. The patients were retested under treatment (3-hour postprandial metered pH and prolonged 20-hour metered pH). The 3-hour postprandial metered pH was then compared to the pretreatment tests. The 20-hour postprandial metered pH test was compared with the results from 43 control (untreated) subjects with gastro-oesophageal acid refluxes. The 3-hour postprandial comparison showed a significant decrease in acid reflux with all three treatment drugs. The 20-hour measurement demonstrated a significant decrease with all three drugs in the number of acid reflux incidences compared to the untreated control patients; the ranitidine group had a significant decrease in the percentage of time with acid pH. No significant differences appeared in the comparison of the records of the 45 treated patients except for the percentage of time below pH 2 for 20 hours which was significantly lower for ranitidine. All three treatments were effective with a clear advantage in favour of ranitidine.

Adult↗
PubMed1984

[Digestive hemorrhage under anticoagulant treatment. Retrospective analysis of a series of 178 consecutive cases].

The aim of this study was to describe the clinical characteristics, prognosis and epidemiological pattern of gastrointestinal bleeding occurring in patients receiving anticoagulant therapy. From 1971 to 1981, among 3,194 consecutive patients admitted to a gastrointestinal unit because of acute gastrointestinal bleeding, 178 were under anticoagulant therapy (i.e. antivitamin K and heparin or heparin derivative in respectively 85 and 13 p. 100 of the cases). Fourteen percent of these 178 patients had also taken gastrotoxic drugs before the bleeding occurred. Indications for anticoagulant therapy were as follows: ischemic heart disease (21 p. 100), arrhythmias (20.3 p. 100), venous thrombosis and pulmonary embolism (15.8 p. 100), arteritis (10.8 p. 100), aortic, coronary or peripheral arterial grafts (8.4 p. 100), prophylaxis of venous thrombosis (8.4 p. 100), valve prosthesis (7.3 p. 100). The lesion responsible for bleeding was found in 80 p. 100 of the cases. Surgical hemostasis was required in only 4 patients. Ten patients died (2 postoperatively). During the study period, the incidence of bleeding associated with anticoagulant therapy in the group of patients admitted to the unit with gastrointestinal hemorrhage increased from 1.5 p. 100 to 8.0 p. 100. This fact appeared to be closely related to new indications (valve prosthesis, arterial grafts, prophylaxis of venous thrombosis) and to an increased incidence of gastrointestinal bleeding especially in association with acenocoumarol treatment. These results show that, although occurring in a high risk population, gastrointestinal bleeding related to anticoagulant therapy generally has a favorable outcome. They also suggest that a prospective epidemiological study may be of interest to determine the reasons for the increasing incidence and to propose preventive measures.

Adult↗
PubMed1981

Diverticulitis in a patient with a 47-year defunctionalized colon.

A patient who had a cecostomy because of a complicated appendicitis at the age of 17 functioned with an excluded colon for 47 years. He was then hospitalized for diverticulitis and left pericolic abscess. After treatment of the abscess by left segmental colectomy and reanastomosis, the cecostomy was closed. Two years later, he presented a normal bowel habit and improvement of his diverticulosis. Rectal manometric study showed that the rectal was normal both before and two years after surgery. Occurrence of diverticular disease in a normally innervated and vascularized, but almost empty, colon presenting with normal mechanical properties is consistent with Burkitt's hypothesis concerning long-term effects of a low residue diet on the gastrointestinal tract.

Colectomy↗
PubMedDate not supplied

[Systemic hypertension in black African in Niamey: a study from 180 in-patients (author's transl)].

In Niger, systemic hypertension is responsible for almost 10 p. 100 of the hospital admittances, and for 1 out of 2 or 3 cases of cardiovascular disease. There is no patent correlation with sex, except that the age of maximal frequency is between 40 and 50 for females and after 50 for males. Clinical and etiological features are conventional but present two original points: the young age of many patients, and the frequency of intestinal nephropathies. As Nigerian patients are often middle-class people or civil-servants, one may suspect a correlation between frequency of systemic hypertension and social evolution.

Adult↗