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Biomedical subjects

P Zeitoun

Publications and source records attributed to P Zeitoun.

At least 19 recordsLinked to original sources
PubMed2004

Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial.

BACKGROUND: Helicobacter pylori gastritis may progress to glandular atrophy and intestinal metaplasia, conditions that predispose to gastric cancer. Profound suppression of gastric acid is associated with increased severity of H pylori gastritis. This prospective randomised study aimed to investigate whether H pylori eradication can influence gastritis and its sequelae during long term omeprazole therapy for gastro-oesophageal reflux disease (GORD). METHODS: A total of 231 H pylori positive GORD patients who had been treated for > or =12 months with omeprazole maintenance therapy (OM) were randomised to either continuation of OM (OM only; n = 120) or OM plus a one week course of omeprazole, amoxycillin, and clarithromycin (OM triple; n = 111). Endoscopy with standardised biopsy sampling as well as symptom evaluation were performed at baseline and after one and two years. Gastritis was assessed according to the Sydney classification system for activity, inflammation, atrophy, intestinal metaplasia, and H pylori density. RESULTS: Corpus gastritis activity at entry was moderate or severe in 50% and 55% of the OM only and OM triple groups, respectively. In the OM triple group, H pylori was eradicated in 90 (88%) patients, and activity and inflammation decreased substantially in both the antrum and corpus (p<0.001, baseline v two years). Atrophic gastritis also improved in the corpus (p<0.001) but not in the antrum. In the 83 OM only patients with continuing infection, there was no change in antral and corpus gastritis activity or atrophy, but inflammation increased (p<0.01). H pylori eradication did not alter the dose of omeprazole required, or reflux symptoms. CONCLUSIONS: Most H pylori positive GORD patients have a corpus predominant pangastritis during omeprazole maintenance therapy. Eradication of H pylori eliminates gastric mucosal inflammation and induces regression of corpus glandular atrophy. H pylori eradication did not worsen reflux disease or lead to a need for increased omeprazole maintenance dose. We therefore recommend eradication of H pylori in GORD patients receiving long term acid suppression.

Adult↗
PubMed2001

Neonlike iron x-ray laser: population kinetics and radiative transfer.

In this work, we present collisional-radiative calculations for neonlike iron x-ray lasers. These calculations show the importance of the interaction between the x-ray laser beam and the amplifying medium, which is taken into account in the paraxial Maxwell-Bloch approach. Our calculations are in better agreement with a recent experiment (a prepulse plus two main pulses) on the 3p-3s 0-1 line, than the code EHYBRID which ignores the above interaction. Saturation is attained for plasma lengths near 1 cm, and the calculated effective gain agrees with the experimental value, at least for the first main pulse.

Journal Article↗
PubMed2001

Bleeding reflux esophagitis: a prospective 1-year study in a university hospital.

OBJECTIVES: The prevalence of bleeding from reflux esophagitis has not been studied. The aim of the study was to evaluate the 1-yr prevalence of bleeding from reflux esophagitis, as well as the independent factors associated with bleeding. METHODS: All patients with reflux esophagitis diagnosed with upper digestive tract endoscopy in Reims Hospital in 1996 were included. Studied parameters were prospectively recorded and compared between patients with bleeding and nonbleeding reflux esophagitis. RESULTS: Endoscopy was performed in 1983 patients of whom 219 (11.0%) had overt upper digestive tract hemorrhage. Reflux esophagitis was the cause of bleeding in 32 patients (14.6%). Reflux esophagitis was diagnosed in 391 patients during the same period of time. Bleeding reflux esophagitis accounted for 8.2% of them. Independent factors associated with bleeding were grade 3 or 4 (Savary-Miller) esophagitis (odds ratio [OR]: 25.5, 95% confidence interval [CI]: 9.6-67.9), cirrhosis (OR: 5.7, 95% CI: 1.7-18.9), Eastern Cooperative Oncology Group performance status > or = 3 (OR: 4.6, 95% CI: 1.5-14.2), and anticoagulant therapy (OR: 3.9, 95% CI: 1.2-12.5). A history of reflux esophagitis or heartburn was noted in only 28.1% or 37.5% of the patients with bleeding reflux esophagitis, respectively. CONCLUSIONS: In this population of patients with reflux esophagitis, the prevalence of bleeding esophagitis was high (8.2%). Bleeding esophagitis occurred primarily in patients with severe esophagitis and was the revealing clinical form of gastroesophageal reflux disease in the majority of cases, suggesting that bleeding prevention would hardly be effective.

Adult↗
PubMed2001

[Protective effect of appendectomy on the development of ulcerative colitis. A case-control study].

AIMS: To examine by a case-control study the relationship between appendectomy and subsequent ulcerative colitis development in a French population. METHODS: A total of 150 patients with ulcerative colitis were matched for age (+/- 5 years) and sex, with 150 controls recruited in a preventive medicine center. The following data were collected from medical records and by standardised questionnaire in consultation or by phone: appendectomy and tonsillectomy before the onset of ulcerative colitis, smoking habits and area of residence. RESULTS: The rate of previous appendectomy in patients with ulcerative colitis was 8% (12/150) compared with 30.6% (46/150) in the control group (P=0.001). There was no significant association between ulcerative colitis and tonsillectomy (25.3 and 27.3% in the control and the ulcerative colitis groups, respectively). Smoking was more frequent in the control group (36%) than in the ulcerative colitis group (25.3%) but the difference was not significant (P=0.07). In multivariate analysis, the risk of developing ulcerative colitis was significantly lower after previous appendectomy (odds ratio=0.26; 95% confidence interval: 0.13-0.55; P=7 x 10(-4)). CONCLUSION: Our study confirms the inverse association between appendectomy and subsequent ulcerative colitis, in a French population, after adjusting on smoking.

Adult↗
PubMed1999

[Time required for training in colonoscopy. Prospective study of 362 consecutive tests].

OBJECTIVES: To assess the time required for training in colonoscopy during one year. MATERIAL AND METHODS: All complete colonoscopies performed under general anesthesia in patients having an intact colon were included. RESULTS: The mean duration of 362 colonoscopies was 23 +/- 12 min. The time required by a senior alone was 19 +/- 9 min (n = 129). There was a significant increase in procedural time (P = 0.001) if a trainee was involved in the case (n = 68) (28 +/- 12 min) and if an assistant carried out the procedure (n = 165) alone (25 +/- 14 min) or with a trainee (27 +/- 9 min). We estimated the time which would have been required for the seniors to perform all the colonoscopies. This time was increased by 24.4% by education of trainees and self-training of assistants. CONCLUSION: The duration of colonoscopy is increased by education, the cost of which should be assessed.

Anesthesia, General↗
PubMed1998

Factors influencing corpus argyrophil cell density and hyperplasia in reflux esophagitis patients treated with antisecretory drugs and controls.

A cross sectional study was designed to elucidate the factors influencing the argyrophil cell population in patients with gastroesophageal reflux disease treated with omeprazole (N = 201) or H2-receptor antagonists (N = 118) and in control patients (N = 215). Fasting gastrinemia and Helicobacter pylori serology were determined. Gastritis, Helicobacter pylori infection, and argyrophil cell density and hyperplasia were evaluated in gastric biopsies. The argyrophil cell density was higher in both treatment groups than in controls (P = 0.002 and P = 0.051), whereas argyrophil cell hyperplasia was similar in the three groups. According to multivariate analysis, positive Helicobacter pylori serology was an independent parameter that decreased both density and grade of hyperplasia of argyrophil cells. Female gender and hypergastrinemia were independent factors increasing argyrophil cell density and hyperplasia, whereas antisecretory therapy, age and active gastritis were not. In addition, atrophic gastritis independently increased argyrophil cell hyperplasia. The prevalence of atrophic gastritis was significantly higher in Helicobacter pylori-positive than in negative patients and lower in the patients treated long-term with omeprazole than in the other groups.

Adult↗
PubMed1998

Outcome of erosive/ulcerative reflux oesophagitis in 181 consecutive patients 5 years after diagnosis.

BACKGROUND: Controversy exists as to whether oesophagitis worsens over the long-run and long-term follow-up studies of homogeneous series are scarce. AIMS: This study assessed the level of symptoms and the proportions of patients who underwent anti reflux surgery or were on antisecretory therapy. PATIENTS AND METHODS: Files from 286 patients with a first time diagnosis were retrieved. Outcome data was obtained over the phone from the general practitioners and from the patients. RESULTS: Seventy-five patients had died (26.2%), 2 of whom from anti reflux surgery, and 30 (14.2%) could not be contacted. Of the 181 patients contacted, 18 (9.9%) had undergone anti reflux surgery. Of the 163 remaining patients, 57.7% were no longer on medication (group 1), 31.9% were using antacids, alginate or cisapride (group 2) and 10.4% were on antisecretory therapy (group 3). High initial grades of oesophagitis and older age were linked to antisecretory drug consumption. There were no new cases of haemorrhage or stricture. CONCLUSIONS: Patients in this study showed a low rate of symptomatic relapse and of antisecretory drug requirements and no complications despite having had oesophageal breaks.

Adolescent↗
PubMed1996

[Primary leiomyosarcoma of the liver 37 years after successful treatment of hereditary retinoblastoma].

In patients successfully treated for hereditary retinoblastoma, the risk of developing a second non-ocular tumor has been reported. We report the first case of primary hepatic leiomyosarcoma in a 39 year-old woman who has been treated 37 years before for hereditary retinoblastoma of the left eye. The patient presented with right upper quadrant abdominal pain and fever. Histological diagnosis was made by liver biopsy. As surgical resection was impossible, chemotherapy with epirubicin, then ifosfamide, etoposide and cisplatin was performed. The patient died 22 months after diagnosis. Genetic abnormalities observed in hereditary retinoblastoma, which probably resulted in a predisposition to the development of hepatic cancer in this patient, were not investigated.

Adult↗
PubMed1996

[Crohn's disease and pregnancy. Two case reports].

We report two cases of pregnancy in patients with Crohn's disease. For the first woman, non-exclusive ambulatory parenteral nutrition was given during the entire duration of gestation in a patient with short bowel syndrome, maintaining good nutritional status and normal delivery at term of an eutrophic infant; Crohn's disease relapsed one month post partum. In the second patient, Crohn's disease was less severe and remission occurred without treatment. Prophylactic cesarean was required due to multiple perineal scars resulting from surgical treatment of Crohn-related fistulae. The main problems with pregnancy in patients with Crohn's disease are discussed.

Adult↗