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Biomedical subjects

P Hecketsweiler

Publications and source records attributed to P Hecketsweiler.

At least 55 records · Page 3Linked to original sources
PubMed1976

[Insight into Crohn's disease].

After noting that Cohn's disease has a long history behind it, the authors show a real increase in the frequency of the disease, apparently more marked in the Anglo-Saxon countries than in France. The etiopathogenesis of the disease is completely unknown. It seems that subjects suffering from Crohn's disease present an exacerbated xenic reaction. There are strong arguments in favour of a genetic contribution. The association with ankylosing spondylarthritis and thus the HLA system is particularly interesting. Following a breif review of the clinical signs and of the complications of the disease, the authors emphasize the diagnostic value of a scoring system. The evolution is very variable: quiescence which does not mean cure, progressive and continuous aggravation, alternation of outbreaks and remissions. Symptomatic, medical therapy is certainly effective but is efficacy is limited. Medical therapy aimed at the etiopathogenic factors is without foundation. Surgical intervention, sometimes immediately beneficial, is accompanied by a 50% frequency of recurrences in a ten-year period. Crohn's disease, fatal in 5% of cases, sometimes handicapping severely the development of the individual, is worthy of further rheumatological study.

Consanguinity↗
PubMed1976

[Rheumatic manifestations of Crohn's disease. A national survey].

The authors analyse the results of a national survey, by questionnaire, in which 44 rheumatologists participated: the 102 cases of Crohn's disease discovered are divided as follow - 47 cases of peripheral rheumatism, and 55 cases of axial rheumatism, spondylarthritis and sacro-ileitis. The cases of peripheral rheumatism were closely related to the enteritis: appearing after the first digestive symptoms, they follow closely the development of, and recede with intestinal resection of the lesion; mono, oligo, or polyarticular, they develop in brief episodes, in an immune context and are only one symptom among the others of Crohn's disease. In contrast, preceding or following the first digestive symptoms, pelvispondylitis (34 cases) developed quite independently of the enteritis and was modified neither by medical treatment nor surgical treatment; these cases were characterized by equal distribution between the two sexes, inconstancy of syndesmosis, and frequent peripheral involvement. As regards the cases of sacro-ileitis, whether discovered by chance or because of rachialgia and arthralgia, these appear to be similar to the cases of pelvispondylitis and their appearance is probably conditioned by a polygenic transmission factor different from the HL-A B 27 marker.

Adolescent↗
PubMedDate not supplied

[Effect of levamisole on the prevention of developmental flare-ups in quiescent Crohn's disease: a prospective multicenter controlled trial in 155 patients].

The prevention of relapse in quiescent Crohn's disease remains a major therapeutic challenge. The present study is a double blind placebo (P)-controlled, randomized, multicentre cooperative trial designed to test the effectiveness of levamisole (L) in the prophylaxis against flare up in patients with quiescent Crohn's disease. The trial included 2 successive phases: a) phase I:167 patients with inactive disease (but who had not had previous resection of all diseased tissue) were randomly and double blindly assigned to receive either L (150 mg orally once weekly) or P; patients were randomized in 2 strata: those having experienced a recent flare up (within the 3 months preceding their entry into the trial: red strata) versus others (blue strata). Patients were followed up at 3 monthly intervals during 2 years. Initially there was no significant difference between L and P groups as regard to age, sex ratio, duration of disease at the time of randomization, incidence of prior intestinal resection, Crohn's disease topography, clinical activity; biological activity was slightly but significantly higher (P less than 0.05) in the P group. Twelve patients were withdrawn from analysis (lost to follow-up: 2; inadequate respect of the protocol: 10), leaving 155 patients (78 L, 77 P) who completed the study. L did not significantly influence any of the following parameters: incidence of attacks (L: 37 p. 100; P: 35 p. 100), lag time between the entry into the trial and the occurrence of the attack (L: 32.7 +/- 5.2; P: 41.8 +/- 5.8; m +/- SEM; weeks), curves of maintenance in remission (Kaplan-Meier method), outcome rank, severity of attacks. Attempts to analyse separately certain subgroups--subjects with purely colonic (+/- anal) disease, subjects with small bowel localization (+/- anus), patients of the red or blue strata--did not show any statistical difference between L and P. Thirteen patients left the trial for minor intolerance (10 L, 3 P). b) Phase II lasted one further year and involved the patients still in remission and in the trial at the end of phase I (n = 57). Those who had received L during phase I were randomized between continuance of L (L leads to L) vs. a change to P (L leads to P); those who had been on P during phase I were randomized between continuance of P vs. a switch to L.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical Trials as Topic↗