PubMed Health⌕ Search

Biomedical subjects

M Deltenre

Publications and source records attributed to M Deltenre.

At least 19 recordsLinked to original sources
PubMed1994

Helicobacter pylori: the link with gastric cancer.

Gastric cancer is the world's overall second most common cancer, and carries a bad prognosis. In the Correa model of gastric carcinogenesis, environmental factors (salt, nitrate, a lack of vitamin C and beta-carotene, bile reflux, bacterial overgrowth in atrophic gastritis with nitrosamine formation) are related to the evolution from normal gastric tissue through superficial gastritis, multifocal atrophic gastritis, intestinal metaplasia and dysplasia to carcinoma. The incidence of H. pylori decreases with progressing preneoplastic lesions. In several studies, the prevalence of H. pylori was elevated in patients with gastric cancer, with a trend for a higher prevalence in intestinal type gastric cancer vs diffuse type. Family members of patients with gastric adenocarcinoma have a higher H. pylori prevalence than controls; patients infected with H. pylori have more family members with gastric cancer. Several epidemiological studies showed a higher H. pylori prevalence in regions or populations with high gastric cancer risk vs low-risk populations. Large-scale studies in China and Europe showed a correlation between H. pylori seroprevalence and gastric cancer incidence and mortality. Three prospective nested case-control studies showed that infection with H. pylori increased the risk of further development of gastric adenocarcinoma, showing that H. pylori infection precedes the development of gastric cancer. Several pathways can be identified explaining the association between H. pylori and gastric adenocarcinoma. We showed that gastric cell proliferation is increased in parallel with inflammation. The ascorbic acid concentrating mechanism is abolished in gastritis. Ammonia, generated by H. pylori's urease, gives rise to gastric mucosal atrophy. We showed that salt increases the gastric cell proliferation only in H. pylori-infected individuals. The organism's toxin may play a role in gastric cancer. Besides H. pylori, other environmental factors are important in determining the gastric cancer risk. For instance, we showed that in Belgium, Maghreb immigrants have a high prevalence of H. pylori infection but a low prevalence of intestinal metaplasia and gastric cancer. Gastric lymphoma is rare (about 5% of all gastric tumours), but its incidence is steadily increasing. It was shown that H. pylori also increases the risk for low-grade as well as high-grade gastric lymphoma. Eradication of H. pylori has been shown to cure several cases of unequivocally proven gastric low-grade lymphoma.(ABSTRACT TRUNCATED AT 400 WORDS)

Helicobacter Infections↗
PubMed1991

Management of dysphagia in suspected esophageal motor disorders.

Fifty-three patients suffering from dysphagia because of suspected esophageal motor disorders were treated by pneumatic dilatation using the Rider-Moeller technique. Fifteen had achalasia demonstrated by manometric studies. Forty-nine of them had remarkable clinical improvement after the procedure. During the mean period of follow-up (average 5 years, range 1-11), 75% of the patients needed a new dilatation, with a delay of two years. The results of the dilatation were excellent or good in 80% of the cases. Early complications consisted in two esophageal perforations surgically treated. There was no mortality. We did not observe late complications of the procedure. We conclude that pneumatic dilatation should be the initial procedure in the treatment of dysphagia in suspected esophageal motor disorders.

Aged↗
PubMed1990

A randomized, multi-observer, comparative evaluation of conventional fiberendoscopy and videoendoscopy in the upper GI tract.

In a comparative, histologically controlled study, no significant difference was found in the accuracy of conventional fiberendoscopy and videoendoscopy in the diagnosis of upper gastrointestinal tract lesions. Both techniques permitted accurate description of focal and/or ulcerative lesions, but videoendoscopy did not provide better sensitivity than fiberendoscopy in the diagnosis of superficial, non-ulcerative, inflammatory changes. The same results were obtained on checking the reproducibility of the macroscopic diagnosis by a delayed review of recorded videotapes.

Duodenal Diseases↗
PubMed1989

The reliability of urease tests, histology and culture in the diagnosis of Campylobacter pylori infection.

The accuracy of various staining techniques for immersion microscopy, of five media for culture and five urease test modalities for the detection of Campylobacter pylori infection is reported. It was found that 2% urea unbuffered gel preparation is the most accurate urease test (sensitivity: 89%, specificity: 98%) but a minimal amount of 10,000 CFU/ml is necessary to observe positivity and the sensitivity of urease tests drops to 52% in patients under antimicrobial treatment. For histological diagnosis, modified Giemsa staining was shown to be slightly superior to H&E. The most valuable diagnosis technique is culture when the biopsy specimen is transported and processed under appropriate conditions. A 94% sensitivity rate was observed with 'BCC agar', a new medium containing brain heart infusion, activated charcoal and horse serum.

Bacteriological Techniques↗
PubMed1989

[Clinical, endoscopic and histologic findings in 1,100 patients of whom 574 were colonized by Campylobacter pylori].

Of 1,100 patients checked by at least two diagnostic tests (urease, histology, culture) 574 (52.1 p. 100) were found to have Campylobacter pylori (C. pylori) in their antral mucosa. Significantly different frequencies of C. pylori (p less than 0.005) were evidenced in the group of patients with active gastroduodenal ulcer (212/298, 71 p. 100), in non-ulcer dyspepsia (NUD) with a previous history of GD ulcer (108/177, 61 p. 100) and NUD without antecedent history of GD ulcer (254/625, 41 p. 100). Whatever the group, males and immigrants were significantly at risk. Chronic alcoholism (greater than 60 g/day) and non-steroid anti-inflammatory drug (NSAID) intake were not predictive for the presence of C. pylori but smokers were significantly at risk when the total (n = 1,100) population was taken into consideration. C. pylori was found in 29 p. 100 of asymptomatic controls (n = 31). There was no significant difference in the frequency and intensity of symptoms when comparing C. pylori+ and C. pylori- patients. The macroscopic aspect of the antral mucosa was not predictive since 51 p. 100 of patients with normal endoscopy were C. pylori+. A strong correlation was observed between the incidence of C. pylori and the severity of gastritis at histology (p less than 0.001) and C. pylori was found in 7 p. 100 of patients with normal histology.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗
PubMed1988

Campylobacter pylori-associated gastritis: a double-blind placebo-controlled trial with amoxycillin.

We randomly assigned 45 adult patients with Campylobacter pylori-confirmed antral gastritis to 8 days of treatment with 1 g amoxycillin suspension twice a day, or placebo, according to a double-blind study design. At the end of therapy, 91% of patients treated with amoxycillin demonstrated clearance of the organism from the antrum, compared with 16% in the placebo group (p less than 0.001). Active antral gastritis resolved in 68% of patients in the amoxycillin group versus only 9% in the placebo group (p less than 0.001). No significant difference was observed when looking at the evolution of chronic only gastritis. No significant improvement was observed in the assessment of clinical symptoms and endoscopic appearance. Reappearance of C. pylori and significant worsening of the histological score of active gastritis was observed after 2 wk in all patients. In a second study phase, 18 patients initially not cleared of their bacteria received amoxycillin single blind for 14 days. Clearance of bacteria associated with improvement or resolution of active gastritis was observed in 72% of the cases. In this subgroup, all patients investigated after 1 month were recolonized with C. pylori and, again, had histological active gastritis. We conclude that amoxycillin is effective in treating active antral gastritis associated with C. pylori, but not in preventing relapses, which occur in all cases within 1 month after therapy.

Adult↗
PubMed1984

Acute hepatic injury associated with minocycline.

Minocycline hydrochloride hepatotoxic effect occurred in one patient. Unlike the usual histologic features of tetracycline-induced hepatic injury, fatty metamorphosis was predominantly macrovesicular . The patient recovered when drug therapy was withdrawn. Close observation of liver function variables is recommended in patients treated with high parenteral doses of minocycline, particularly in cases of pregnancy or renal disease.

Acute Disease↗
PubMed1983

Comparative study of ultrasound and ERCP in the diagnosis of hepatic, biliary and pancreatic diseases: a prospective study based on a continuous series of 424 patients.

A prospective study of the diagnostic yield of ultrasound (US) and ERCP was made on a continuous series of 424 patients. Technical failures were slightly more frequent with US (11%) than with ERCP (8%), while US proved more accurate than ERCP in the diagnosis of focal hepatic disease--94% of correct diagnosis versus 41% (n = 17). In diffuse hepatic disease (n = 63) the accuracy of both methods was the same--87% of correct diagnosis with US, 83% with ERCP. US had better performances (91%), while ERCP was more accurate in the diagnosis of common duct lithiasis or tumour (98% for ERCP, 36% for US). Although ERCP has a better diagnostic yield for pancreatic diseases (92% to 100% of correct diagnosis according to the lesions) associate complications, such as pseudo-cysts, abscess formation and extravasations are better demonstrated by US (95% of correct diagnosis versus 73%). The two methods thus prove to be complementary.

Acute Disease↗