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Biomedical subjects

O Duhamel

Publications and source records attributed to O Duhamel.

At least 19 recordsLinked to original sources
PubMed1996

[Toxocariasis and functional intestinal disorders. Presentation of 4 cases].

We report 4 cases of adults patients, suffering from irritable bowel syndrome, which had been attributed late to toxocariasis and for whom the treatment led to recovery. Hypereosinophilia was present only in 3 cases. These cases show that toxocariasis is not limited anymore to its two classical expressions: visceral larva migrans and ocular toxocariasis. So it is useful to think of it to confirm and treat it in the case of patients suffering from irritable bowel syndrome. This enables shorter diagnosis delay (14 months in average for our patients) and this is essential for therapeutic efficiency.

Adult↗
PubMed1994

[Primary prevention of digestive hemorrhage, caused by rupture of esophageal varices, by endoscopic sclerotherapy in patients with liver cirrhosis. Multicenter randomized controlled study].

The severity of esophageal variceal bleeding in cirrhotic patients justifies prophylactic therapy. A multicenter controlled study was carried out in Languedoc in 116 cirrhotic patients with esophageal varices and no history of bleeding. Patients were randomly assigned to two groups: 60 control patients without therapy; 56 patients treated by endoscopic sclerotherapy (209 sessions). The mean follow-up was 20 +/- 11 months. Esophageal varices disappeared in 35 patients (62.5%) or became smaller in 10 other patients (18%). Varices reappeared in 9 of these 35 patients within 3 months. Minor (fever, dysphagia, stenosis) or major complications (variceal bleeding, bacterial peritonitis) were noted in 26 patients (46%). Esophageal variceal bleeding occurred in 13 of the treated patients and in 10 control patients. Actuarial curves of bleeding and survival were similar for both groups. Twenty controls and 21 treated patients died during the study. In conclusion, prophylactic sclerotherapy of esophageal varices should not be performed in cirrhotic patients, considering lack of efficacy and high rate of side effects.

Endoscopy, Gastrointestinal↗
PubMed1993

[Tetraplegia after colonoscopy: benzodiazepine withdrawal syndrome induced by flumazenil?].

A case is reported of a 68-year-old female patient who developed a flaccid tetraplegia on recovering from a colonoscopy, carried out under general anaesthesia (3 mg of midazolam, 20 mg of etomidate). During the preanaesthetic visit, she omitted to report a 15-year-addiction to lorazepam 2.5 mg every night. At the end of the procedure, 0.2 mg of flumazenil were injected. Recovery was immediate but followed by neurological signs associating general weakness, paraesthesia and tetraplegia. These symptoms discontinued spontaneously two hours later. She was discharged the same day but complained of myalgia and paraesthesia for a week. The physiopathology of this accident is unknown. The differential diagnosis and the influence of flumazenil on benzodiazepine withdrawal are discussed.

Aged↗
PubMed1991

Sulindac causes regression of rectal polyps in familial adenomatous polyposis.

In familial adenomatous polyposis, sulindac-induced polyp regression has been reported by several authors. In this study, the goal was to confirm these results by a randomized, placebo-controlled, double-blind crossover study in 10 patients with rectal polyps that had been previously treated by colectomy and ileorectal anastomosis. Patients received sulindac, 300 mg/day, or placebo during two 4-month periods separated by a 1-month wash-out phase. One patient was not compliant and was excluded. With sulindac, the authors observed a complete (6 patients) or almost complete (3 patients) regression of the polyps. With placebo, the authors observed an increase (5 patients), no change (2 patients), and a relative decrease (2 patients) in the number of polyps. The difference between sulindac and placebo was statistically significant (P less than 0.01). In biopsy specimens of polyps and normal rectal mucosa of 6 patients, the authors conducted an immunohistochemical study of the cellular proliferation index using the Ki 67 monoclonal antibody (Ki 67 index), at the beginning and at the end of each treatment period. They were not able to show a sulindac-induced modification of the Ki 67 index. The authors conclude that sulindac is effective in inducing the regression of rectal polyps in familial adenomatous polyposis.

Adenomatous Polyposis Coli↗
PubMed1985

[Latent myocardiopathy in chronic alcoholic patients with or without hepatic involvement].

Infraclinical myocardial lesions were searched for in patients with various types of liver disease due to chronic alcoholic intoxication. During a single procedure, a transjugular liver and right endoventricular biopsy and hemodynamic evaluation were performed in 26 patients without clinical evidence of cardiac involvement. Patients were classified into 5 groups: I, no liver disease (n = 4); II, fatty liver (n = 7); III, acute alcoholic hepatitis (n = 3); IV, cirrhosis (n = 7); V, cirrhosis with alcoholic hepatitis (n = 5). The study also included the determination of the serum thiamine level, a 24 h non-stop EKG recording and a M mode echocardiography. The cardiac-thoracic ratio, the EKG and Holter monitoring were normal. The serum thiamine levels decreased regularly from group I to group V, but there was no significant difference between patients with cirrhosis (group IV and V) and the others (group I to III). The same findings applied to the echocardiographic data. At rest, hemodynamic data were normal in all patients. Various degrees of myocardial lesions were present in 86 p. 100 of the cases. They included: cellular hypertrophy, contraction bands, interstitial fibrosis, fibroblastic infiltrate, perinuclear, cellular and or interstitial edema. Although frequent, these lesions were moderate and not specific. No correlation was found between the myocardial lesions and the type of liver disease. Myocardial lesions without cardiac manifestations have therefore been observed in vivo in nearly all patients with chronic alcoholic intoxication. These lesions were not correlated with the stage of alcoholic liver disease.

Cardiomyopathy, Alcoholic↗
PubMed1984

[Bacterial endocarditis of a mitral valve prolapse. Apropos of 2 cases].

We report on two observations of bacterial endocarditis complicating mitral valve prolapse. A review of the literature finds that endocarditis has complicated about 4 p. 100 of the cases of mitral valve prolapse that have been followed-up for 4 to 9 years. In one out of 4 such cases, a diagnostic delay has been held responsible for severe complications: arterial embolism, and cardiac failure with or without rupture of the chordae tendinae. Echocardiography, especially bidimensional, might lessen the diagnostic delay. Our analysis of the available reports indicates that young men with a late systolic murmur seem to be particularly prone do endocarditis, so that in this subgroup of patients antibiotic prophylaxis should be systematically prescribed when aggressive manipulations are considered.

Adult↗