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Biomedical subjects

M Gaudric

Publications and source records attributed to M Gaudric.

At least 37 records · Page 2Linked to original sources

The effect of cisapride on gastro-oesophageal dysfunction in systemic sclerosis: a controlled manometric study.

1. Cisapride is a novel prokinetic drug which facilitates or restores motility throughout the gastrointestinal tract. Its mechanism of action is thought to involve enhancement of acetylcholine release in the myenteric plexus of the gut. 2. The effect of intravenous cisapride 10 mg on gastro-oesophageal dysfunction was investigated in 20 patients with systemic sclerosis, using a double-blind, randomised, cross-over, placebo-controlled manometric study design. 3. The increase in lower oesophageal sphincter pressure was significantly higher after cisapride (mean +/- s.e. mean, 8.3 +/- 2.1 cm H2O) than after placebo (mean +/- s.e. mean. 0.1 +/- 0.3 cm H2O) (P less than 0.001). The increase in the number of fundic gastric contractions during the 30 min study period was significantly higher after cisapride (mean +/- s.e. mean, 7.7 +/- 2.3) than after placebo (mean +/- s.e. mean, 0.9 +/- 0.6) (P less than 0.01). 4. No serious clinical adverse effects were observed. 5. The study demonstrates that intravenous cisapride induces a significant increase in lower oesophageal sphincter pressure and in the number of fundic gastric contractions, which may be beneficial in the treatment of scleroderma gastro-oesophageal dysfunction. Further long-term studies of the effect of oral cisapride in patients with systemic sclerosis are warranted.

Cisapride↗

[Helicobacter pylori infection and the surgically treated stomach].

In 38 patients who had been operated for peptic ulcer (32) or gastric cancer (6), we performed upper GI endoscopy with biopsies. HP was found in the mucosa in 8 out of 10 patients with highly selective vagotomy, 5 out of 11 patients with gastrectomy for ulcer, 6 out of 11 patients with vagotomy-pyloroplasty and in only 1 case out of 6 with gastrectomy for cancer. These results are in agreement with other publications. Bilio-pancreatic reflux into the stump probably explains why HP was found in only 50% of cases with suppression of pyloric function, compared with 80% after highly selective vagotomy. Interstitial gastritis was present in every case infected with HP, but the same gastritis was present in one half of mucosas, without infection by HP. This particular gastritis in probably caused by reflux. The role of HP in the relapse of ulcers therefore remains to be demonstrated.

Adult↗

[Ectasing cholangitis and secondary biliary cirrhosis following intra-arterial hepatic chemotherapy. Treatment by liver transplantation].

A case of ectasing cholangitis, following intra-arterial chemotherapy with discontinuous infusion of fluorouracile, is described. The severe destruction of the intra-hepatic biliary ducts led to the constitution of large cavities in continuity with the biliary tree. These cavities were responsible for images which were mistakenly thought to be metastases. Consequently, secondary biliary cirrhosis developed, requiring orthotopic liver transplantation.

Adenocarcinoma↗

Determination of total and segmental colonic transit time in constipated patients. Results in 91 patients with a new simplified method.

Ninety-one patients with idiopathic constipation had segmental colonic transit studied with radiopaque markers using a new simplified technique to determine frequency and type of colonic transit time (CTT) abnormalities and to determine the utility of this test in planning therapy. Colonic transit studies defined four groups: normal CTT (N = 49), right colonic stasis (N = 16), outlet obstruction (N = 12), and isolated left colonic stasis (N = 14). Right colonic stasis and outlet obstruction were associated with frequent use of digital pressure to assist defecation. Right colonic stasis was characterized by a low stool frequency (less than 3 per week) in 93% of cases and failure to respond to bran therapy. Outlet obstruction also showed a poor response to bran therapy but weekly stool frequency was higher than 3 in 46% of cases. Normal colonic transit time and isolated left colonic stasis were characterized by a normal stool frequency (5.8 +/- 0.05 and 4.2 +/- 0.1, respectively) and clinical help with the use of bran treatment (72 and 64%, respectively). Our study suggested that patients who complain of idiopathic constipation represent a heterogenous group of disorders. Segmental CTT determination is a simple, useful, and noninvasive test of patients with constipation.

Adolescent↗

Effect of theophylline on gastroesophageal reflux in patients with asthma.

A possible role of methylxanthines in the high incidence of gastroesophageal reflux (GER) in patients with asthma has been suggested. Therefore, we used a randomized, double-blind, crossover design to compare the effects of a 1-week conventional theophylline treatment and a 1-week placebo treatment in 16 adult patients with asthma. No oral or parenteral glucocorticoids were administered, but seven patients were taking inhaled corticoids. All patients needed inhaled adrenergic drugs. At the end of each period of theophylline or placebo treatment, the patients were carefully questioned with respect to respiratory and digestive symptoms, forced expiratory flows were measured, and GER was assessed by prolonged nocturnal intraesophageal pH monitoring. Peak expiratory flow was measured three times a day throughout the study. No significant increase in GER was found with theophylline compared to placebo, and forced expiratory flows improved with theophylline (p less than 0.05 for FEV1 and p less than 0.01 for peak expiratory flow rate). There was no correlation between GER, the duration of asthma, and forced expiratory flows. Thus, our study failed to demonstrate any adverse effect of a slow-release theophylline preparation on GER in patients with asthma. These results further suggest that the presence of GER is not a contraindication to the use of a slow-release theophylline in subjects with asthma.

Adrenergic beta-Agonists↗

[Campylobacter pyloridis and gastroduodenal pathology].

After the first report by Marshall and Warren of the presence of gastritis associated Campylobacter pyloridis in antral mucosa, many groups have found the same association in many countries of Europe, USA, Japan. In France, too C.P. is found in antral mucosa. We have studied 119 dyspeptic patients; during endoscopy 3 biopsy specimens were taken, one for microaerophilic culture and 2 for pathologic examination. We found the germ in 27 p. 100 of 22 normal subjects but no culture was positive. In chronic interstitial gastritis it is found in 90 p. 100 of cases and in 98 p. 100 if a duodenal ulcer is associated. Ten patients with healed duodenal ulcer have been treated by V Penicillin: 3 millions unit/day during 2 weeks. In five cases C.P. disappeared but 2 of them relapse 2 months later.

Adult↗

[Bacterial flora in gastric juice taken at endoscopy in 93 normal subjects].

Bacteriologic examination of gastric juice samples taken during endoscopy in ninety-three subjects free of endoscopically-detectable disease was performed. Mucosal pH was determined using bromocresol green dye. Among the 17 subjects with a mucosal pH exceeding 4, 11 (64%) had more than 10(5) organisms/ml. In contrast, similar counts were found in only 10 of the 76 subjects with a normal mucosal pH. The pathogens recovered were normal hosts of the upper digestive tract and a few nitrate reductase + Enterobacteriaceae. Questions still to be resolved are whether these pathogens can induce disease and whether bacterial colonization correlates with the increased gastric nitrosamine levels and microscopic mucosal lesions previously described in patients with a gastric pH above 4.

Adult↗

[Adenine arabinoside: hope in the treatment of chronic virus B hepatitis].

Five patients presenting with HBs Ag and HBe Ag-positive chronic hepatitis were treated with adenosine arabinoside (Vidarabine) in doses of 15 mg/kg/day. The drug was administered by intravenous infusion in 2 series of 5 infusions each separated by 2-day intervals. Two patients had a second course 4 months after the first one. There were no clinical or biochemical adverse reactions. Following treatment, serum transaminase levels returned to normal. All patients became HB Ag-negative, with presence of anti-HBe antibody in three; two patients became HBs Ag-negative, with presence of anti-HBs antibody in one. Although very short, this series should encourage further therapeutic studies, including a controlled, randomized trial in a large number of patients.

Adult↗

[Local pseudocancerous inflammatory polyposis in Crohn's disease of the colon. Usefulness of coloscopy (author's transl)].

In Crohn's granulomatous colitis large pseudopolyps may produce local lesions with radiological images resembling cancer. In the case reported here, three successive lesions of similar radiological appearance located on different sites were found on post-operative examination to be proliferative pseudopolyps adjacent to typical granulomas. In all previously published cases, even when the patient was known to have Crohn's disease colectomy was invariably performed, probably for fear of a malignant tumour. Coloscopy, and particularly biopsies showing non-malignant lesions, could result in conservative treatment. Granulomas are more exceptionally found.

Colonoscopy↗