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Biomedical subjects

T Puy-Montbrun

Publications and source records attributed to T Puy-Montbrun.

11 recordsLinked to original sources

[Anal incontinence].

Contrary to a widespread opinion, anal incontinence is a frequent condition in men and women, and not only a disease of advanced age. This condition is so devastating socially and personally that the afflicted individual is often too embarrassed to bring it to the attention of his physician. An accurate history, a physical examination and additional anorectal physiology testing (anorectal manometry and anal endosonography) document the aetiology. The first line of treatment is medical including bowel management and neuromuscular reeducation. In case of failure, according to the cause, and with due regard to the impact on the quality of life, surgery can be performed. It is essential to know the preventive measures which are the only means for decreasing the incidence of anal incontinence.

Adult↗

Rare anorectal pathologic conditions.

Among the rare anorectal pathologic conditions published in the literature since 1992, except for malignant pathology, we have taken an interest in anal dermatology with Hailey-Hailey disease; infectious diseases, including tuberculosis, gangrene, actinomycosis, and cytomegalovirus ulcerations; vascular pathology with rectal varices and tumoral pathology with leiomyomas and lipomas; embryologic disorders, including gastric and salivary heterotopia; and a few exceptional lesions, such as spontaneous hematomas and certain traumatic lesions.

Anal Canal↗

Anorectal lesions in human immunodeficiency virus-infected patients.

In a prospective study, we analysed the anorectal lesions observed in 148 human immunodeficiency virus-infected patients and compared the data with those reported in the literature. The majority of the patients (97.3%) were homosexual or bisexual men. The mean age of the population was 34.2 years. A history of previous sexually transmitted diseases was found in 79.7% of the male patients. The stage of HIV-related disease, according to the Centers for Disease Control classification, could be determined in 141 patients: 54.6% were stage II, 3.5% stage III and 41.8% stage IV. Anal condylomata were the most frequent manifestation, affecting 29.7% of the patients, 7.1% of whom showed moderate to severe dysplasia. The types were mainly 6, 11, 16 and 18, but types 31, 35 and 39 were also observed. Ulcerations were the most frequent non-condylomatous lesions, occurring in 41 patients; most (60%) were due to herpes viruses, and a large minority (21%) to cytomegalovirus. The etiology could not be determined in five cases. Anal sepsis was present in 11.4%, haemorrhoidal disease in 16.8% and fissures in 6%. Six patients developed Kaposi's sarcoma and seven, non-Hodgkin's lymphoma. No anal cancers were observed. Finally, wound healing was slowed in the patients operated on for haemorrhoids, fissures and suppuration. No statistical analysis could be performed because of the small number of patients.

Adult↗

Kaposi's sarcoma of the colon in a young HIV-negative woman with Crohn's disease.

We report a case of isolated colonic Kaposi's sarcoma in a 36-year-old HIV-negative woman with refractory Crohn's disease of the colon and perineum following 11 months' treatment with azathioprine. The clinical features of this case are quite different from those classically described in Kaposi's sarcoma. Among the known risk factors, iatrogenic immunosuppression would appear to be the most probable.

Adult↗

Rectal stenosis due to Veganine suppositories.

A new case of rectal stenosis due to the chronic use of suppositories of associated analgesic drugs is reported. Surgical treatment was conservative. This observation outlines the dramatic consequences of chronic self-treatment and the difficulties of ensuring long-term withdrawal.

Acetaminophen↗

Anal ulcerations due to cytomegalovirus in patients with AIDS. Report of six cases.

Lesions due to cytomegalovirus (CMV) are frequent in the immunocompromised patient. This is particularly the case in patients with AIDS, where the colon and rectum are the regions most often involved. The authors report six cases of anal ulcerations due to CMV in patients with AIDS. These lesions, confirmed histologically, were either isolated or associated with other localizations. Treatment is based on specific antiviral agents but resistance and recurrence can occur. The current report underlines the importance of histologic examination of anal lesions in HIV-infected subjects.

Acquired Immunodeficiency Syndrome↗