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Biomedical subjects

R Fiasse

Publications and source records attributed to R Fiasse.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Ileo-anal anastomosis in hemorrhagic-ulcerative rectocolitis and familial adenomatous polyposis: is it mandatory to perform resection of the endo-anal mucosa?].

The aim of this study was to assess the clinical outcome after ileal pouch-anal anastomosis with mucosectomy for ulcerative colitis and for familial adenomatous polyposis, and to characterize the histology of the stripped endoanal mucosa with particular reference to the ulcerative colitis activity, adenomatous polyps and dysplasia. Twenty-eight patients were operated, 16 for ulcerative colitis (group I) and 12 for familial adenomatous polyposis (group II). In group I, there were no intraoperative complications, but mucosectomy was tedious in 10 patients (62%) and the anastomosis was performed under some degree of tension in 10 patients (62%). In group II, there was a direct injury of the internal sphincter by a posterior tear during the mucosal stripping in one case. Mucosectomy was easy to perform in 8 patients (67%) and 10 anastomoses (84%) were performed under tension. In both groups, there were no postoperative complications related to the mucosectomy or to the anastomosis itself. Functional results were good, with a normal continence in 80% of ulcerative colitis patients and 92% of familial adenomatous polyposis patients. Review of histological sections of the stripped anal mucosa in group I showed chronic active ulcerative colitis in 8 patients (50%), chronic non-active ulcerative colitis in 4 (25%) and quiescent ulcerative colitis in 4 (25%). There was only one case of moderate dysplasia in a patient with a Dukes A carcinoma. In group II, anal mucosa showed micropolyps in all cases with mild dysplasia in 3 cases (25%) and moderate dysplasia in 9 (75%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenomatous Polyposis Coli↗
PubMed1988

Effect of a 2 g cimetidine infusion on twenty-four-hour intragastric pH in critically ill patients.

We evaluated the effect of a cimetidine continuous infusion (2 g in 24 h) on the intragastric pH of 16 critically ill patients (11 men, 5 women, mean age 45 years). During the 24 h pre-trial period and the subsequent 24 h cimetidine infusion, an intragastric combined electrode was placed in the fundus and the pH recorded with a portable pH module and data collection unit. In each patient, the cimetidine infusion induced a prolonged rise of intragastric pH. For all patients the mean percentage of readings above pH 4.0 was 11% pre-trial and 75% during the cimetidine 24 h infusion (p less than 0.001). The percentages of readings above 5.0, 6.0, 7.0 were also significantly higher during infusion than pre-trial in the 16 patients. After starting the cimetidine infusion, there was a concomitant rise of median plasma cimetidine and median intragastric pH in the 7 patients studied. After 6 h, median plasma cimetidine remained above 1 mcg/ml. These results and recent data from the literature suggest that in critically ill patients a continuous infusion of cimetidine might prevent stress ulcerations better than bolus injections by maintaining intragastric pH above 4.0 during longer time intervals.

Adult↗
PubMed1986

[Anal surgery in Crohn's disease. Clinical and functional results].

The aim of this study was to evaluate the results of anal surgery performed in 105 patients for perianal symptomatic complications of Crohn's disease. The patients were divided into 3 groups: group I: 45 patients with simple fistulae; group II: 53 patients with complex fistulae; group III: 7 patients with other symptomatic perianal lesions. All patients underwent a resection of their perianal lesions. Complete wound healing was obtained in 95 patients after a mean interval of 11 weeks. Satisfactory results persisted during a mean follow-up of 5 years. The functional results were clinically evaluated in 100 patients: 90 patients were asymptomatic, 6 patients complained of soiling and 4 patients noticed occasional incontinence for flatus and liquid stools. Anorectal function was studied by manometry in the last 31 patients who underwent surgery. Before surgery, the resting anal pressure and the maximal voluntary squeezing pressure were significantly lower than in control subjects. After surgery, there was no statistical difference between the pre- and postoperative results for both parameters. In conclusion, anal surgery in Crohn's disease is hazardous because of the complexity of lesions and preoperative anorectal dysfunction. However, the clinical and functional results obtained in our patients were satisfactory.

Adult↗
PubMed1980

Controlled trial of cimetidine in reflux esophagitis.

In an eight-week double-blind trial, the effectiveness of cimetidine (1.6 g/day) was compared to placebo in 34 patients with symptomatic esophagitis confirmed by endoscopy with biopsies and/or by acid infusion test. Patients treated with cimetidine had significantly less symptomatic days during the first six weeks and less symptomatic nights during the first two weeks, and they consumed less antacids during the whole trial period. Endoscopic evaluation of 17 patients on cimetidine and of 15 patients on placebo did not show any significant difference in severity and extent of esophageal lesions after eight weeks, but histological assessment of 16 patients on cimetidine and 13 patients on placebo showed a significant improvement after eight weeks of cimetidine (P < 0.025). These results show that cimetidine has a rapid effect on symptoms of reflux esophagitis and that, in some cases, it may reduce the esophageal lesions after eight weeks.

Administration, Oral↗
PubMed1978

Circulating immune complexes and disease activity in Crohn's disease.

Circulating immune complexes were determined in 59 consecutive patients with Crohn's disease and 100 blood donors by a double method based on the inhibition of the agglutinating activity of CIq and/or rheumatoid factor on the IgG-coated polystyrene particles. In patients, the incidence of positive immune complexes was 63% and 61% at first testing, 85% and 78% at subsequent determinations; there was a good correlation between the inhibition titres of CIq and those of rheumatoid factor (p less than 0.001). In blood donors, the incidence was 22% and 14% at low titre. The incidence of immune complexes was the lowest (36%) in the group of resected patients without signs of relapse; repeat determinations showed absence of immune complexes three months postoperatively. In patients medically treated for primary disease or relapse, rheumatoid factor titre higher than 1/1 was less frequent than in medically untreated patients with active disease (p less than 0.01). A significantly higher concentration of serum alpha-1-antitrypsin and orosomucoid, and a significantly lower level of serum iron were found in patients with an IC titre exceeding 1/1; longitudinal studies showed in most cases a concordance between the evolution of immune complex titres, inflammatory parameters and clinical status.

Adolescent↗
PubMed1977

Double-blind placebo-controlled study of loperamide (Imodium) in chronic diarrhoea caused by ileocolic disease or resection.

Loperamide (R 18 553) was compared with placebo in a double-blind crossover study of 21 patients with chronic diarrhoea caused by ileocolic disease or resection. Eighteen patients completed the trial. At a median daily dose of 6 mg the new antidiarrhoeal preparation was found to be superior to placebo in controlling chronic diarrhoea. The frequency and weight of stools significantly decreased, the stools became more solid, and carmine transit time was prolonged during loperamide therapy. Loperamide was consistently preferred to placebo by the patients. Gastrointestinal side-effects were few and comparable during both treatment periods.

Adult↗
PubMed1977

Long-term survey of the treatment of diarrhoea with loperamide.

42 outpatients with chronic diarrhoea of varying origin received individually adapted doses (2--12 mg) of loperamide for a median time of 543 days (range 140--1,159 days). In most cases, the mean daily stool frequency dropped significantly and stool consistency improved clearly; the beneficial effects of the drug were maintained over the entire treatment period. Also, patients with diarrhoea of organic origin tended to react more favourably to loperamide than patients with functional diarrhoea. No drug-related changes in laboratory parameters could be detected and clinical side effects were virtually nil. No morphine-like effect of loperamide could be evidence by means of the pupil diameter changes after naloxone administration.

Adult↗