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Biomedical subjects

E Lerebours

Publications and source records attributed to E Lerebours.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Syndromes of venous mesenteric ischemia: infarction and transient ischemia].

The reports of 8 patients with acute or subacute abdominal pain related to venous mesenteric ischemia were reviewed. None of the patients presented local or regional predisposing factors for venous thrombosis. In 4 patients, a localized segment of ischemic small bowel (median length 125 cm; range: 30-350) was resected without immediate anastomosis and postoperative anticoagulation therapy was given. Two of these patients developed recurrent ischemia involving the bowel adjacent to the stoma, treated successfully in 1 case by a repeat resection. The 4 other patients hospitalized with intestinal obstructive symptoms (1 case) or abdominal angina (3 cases) were treated by long term anticoagulation in 3 cases and artificial nutrition in 2 cases. None of them developed mesenteric infarction with a median follow up of 34 months. In 7 of the 8 patients, a coagulopathy was found: primary myeloproliferative disorder (1 case), hypercoagulation state (5 cases), autoimmune hemolytic anemia (1 case). These observations suggest that venous mesenteric ischemia included two different entities on the basis of clinical and morphological criteria: mesenteric infarction and subacute transient ischemia without bowel infarction. Most of apparently idiopathic cases of acute or subacute venous mesenteric ischemia are related to hypercoagulation states requiring a long term anticoagulation.

Abdominal Pain↗
PubMed1991

[Prolonged home enteral feeding].

Home enteral nutrition (HEN) is a method that will develop as an alternative to hospitalization. It is indicated mainly in patients who would normally be kept in neurology, ENT, gastroenterology, oncology, paediatrics or geriatrics hospital departments. The technicalities of HEN, such as route, periodicity and modalities of administration and choice of the diet, must be adjusted to the patient's condition and to the foreseeable duration of the procedure. HEN is best organized by a team of hospital specialists who will educate the patient prior to his discharge and follow him up at home in cooperation with the family doctor and district nurse. The extent of financial assistance provided by health insurance organizations is currently under evaluation.

Adult↗
PubMed1991

[Inflammatory bowel diseases in adults. Development and complications].

The courses of ulcerative colitis and Crohn's disease are marked by the unforeseeable occurrence of acute episodes of varying intensity during which complications may develop. Owing to the anatomical and topographical specificities of the colonic lesions, the evolutive profiles of these two diseases are very different. For the moment, there is no criterion at the onset of the diseases that can help in predicting their subsequent courses.

Adult↗
PubMed1991

Endoscopic injection of adrenaline for severe peptic ulcer haemorrhage in high surgical risk patients.

Endoscopic adrenaline-hypertonic injection was attempted in 40 patients admitted for oesophagogastroduodenal ulcer haemorrhage unresponsive to conventional medical treatment and presenting with severe underlying disease or advanced age (less than 80 years). The results were compared with our own historical controls (43 patients) treated by conventional therapy, meeting the same inclusion criteria. Permanent haemostasis was achieved in 32 patients in the injection group and 30 in the control group (NS) but emergency surgery was less frequent in the injection group (2 vs 25, p less than 0.001). Blood transfusion requirements were less in the injection group (8.5 +/- 6.2 vs 10.2 +/- 5.4, p less than 0.05) but length of hospital stay was not really different (15.7 days +/- 9.3 vs 20.9 +/- 14.4). Unfortunately, mortality was not reduced in the injection group (14/40 vs 17/43). Two lethal complications attributable to injection treatment occurred. This treatment could represent an alternative to conventional haemostatic treatment in high surgical risk patients with severe clinical bleeding, avoiding emergency surgery. In spite of the fact that we selected high-risk patients, endoscopic treatment was not able to lower the mortality (about 37%). Due to severe unpredictable side effects and potential risks of long-term massive rebleeding, this treatment should be performed electively in patients with severe clinical bleeding, as first line treatment when surgical risk factors exist or immediately before surgery in low risk patients.

Aged↗
PubMed1991

Effects of amoxicillin-clavulanate combination on the motility of the small intestine in human beings.

The amoxicillin-clavulanate combination (Augmentin) frequently induces gastric complaints and diarrhea by an unknown mechanism. The aim of this study was to assess the effects of two orally therapeutic regimens of amoxicillin-clavulanate on small bowel motility in human beings. Duodeno-jejunal manometric recordings were performed in six healthy subjects treated in a cross-over double-blind study with placebo; amoxicillin-clavulanate, 1 g plus 250 mg per os every 12 h for 3 days; or amoxicillin-clavulanate, 1 g plus 250 mg per os every 12 h on day 3 only (1-day regimen). Recordings were all performed on day 3 during a diurnal fasting period, a fed state after a standard dinner, and a nocturnal fasting period. Amoxicillin-clavulanate did not affect the motility of the small intestine during the diurnal fast or the fed state. During the nocturnal fast, amoxicillin-clavulanate significantly increased the motility index of the nonpropagated contractions and tended to increase the duration and the amplitude of the propagated contractions. The same digestive motor effect was already observed on the first day of treatment (1-day regimen). This study demonstrates that the oral administration of a therapeutic regimen of amoxicillin-clavulanate is associated, in most cases, with the occurrence of small intestinal motor disturbances.

Adult↗
PubMed1990

Effect of chemotherapy on resting energy expenditure in patients with non-Hodgkin's lymphoma. Results of a sequential study.

This study compared the resting energy expenditure (REE) modifications observed during successive intensive identical chemotherapy courses in non-Hodgkin's lymphoma patients to assess indirectly the metabolic changes induced by the cytotoxic effect of drugs on the tumor. With this therapeutic regimen, reduction of tumor mass is mostly achieved during the first course of chemotherapy. The study included 10 non-Hodgkin's lymphoma adult patients receiving three intensive 5-day courses of Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), cyclophosphamide, vindesine, and bleomycin. Resting energy expenditure was evaluated by indirect calorimetry during each course, first within the first 2 days before chemotherapy and then on days 2, 3 and 5. Initial REE (day 0) on entry into the study (21.8 +/- 1.2 kcal/kg.d-1) represented 99 +/- 6.7% of theoretical REE. Resting energy expenditure on day 0 was lower during course 2 and 3 (19.1 +/- 0.7 and 18.4 +/- 1.8 kcal/kg/d) than during course 1 (21.8 +/- 1.2 kcal/kg/d). The REE profile was different among the 3 courses: course 1 induced a significant REE decrease on days 3 and 5 (P less than 0.01); during course 2, REE remained stable and was lower than during course 1; during course 3, REE increased on days 2, 3, and 5 (P less than 0.05). Energy balance was positive during the three courses and nutritional status remained stable. The REE decrease observed during course 1 may be regarded as the metabolic effect of chemotherapy on the tumor metabolism.

Adult↗
PubMed1990

[Incidence of inflammatory bowel disease in the Nord-Pas-de-Calais region and the Somme area of France in 1988].

No epidemiological data on inflammatory bowel disease (IBD) are available in France. We therefore conducted a prospective epidemiologic study of IBD in the Nord-Pas de Calais region and the Somme department of France (4.5 million inhabitants). Each suspected new case was reported by all (private and public) gastroenterologists (n = 120) and a questionnaire was filled out at the gastroenterologist office by an epidemiologist. The final diagnosis of Crohn's disease (CD), ulcerative colitis (UC), or proctitis (UP) was made in a blind manner by two gastroenterologists. During 1988, 576 IBD patients were identified; 281 (49 percent) had CD, 207 (36 percent) had UC including 75 UP; and 88 (15 percent) had unclassified colitis. The incidence rate per 10(5) was 6.3 for CD and 4.6 for UC. The female/male ratio was 1.4 for CD and 0.9 for UC. The mean age at the time of diagnosis was 31 years for CD and 40.5 years for UC. The mean time between onset of symptoms and diagnosis was longer for CD (15 months) than for UC (6.8 months). These preliminary data suggest that the incidence of IBD is high in Northwestern France and comparable, for CD, to the highest incidence of Northern Europe.

Adolescent↗
PubMed1990

["Ambulatory" ischemic colitis. Clinical course and etiologic features in 88 cases].

From January 1983 to December 1988, 88 consecutive patients with ambulatory ischemic colitis without severe disease or surgical operation were observed. The diagnosis was established in all cases by endoscopy, and in 64 cases by histologic examination. The study included 55 women and 33 men with a mean age of 65.4 years (22-90). Symptoms included: abdominal pain (73 percent), diarrhea (60 percent) and bloody stools (85 percent). The sequence abdominal pain-diarrhea-bloody stools was noted in 41 percent of cases. Most cases of colitis were located in the sigmoid and left colon. The immediate course was uneventful in 81 patients. Six patients underwent surgery and of these, three died. The mortality rate was 4.5 percent (4 cases). Long-term outcome was known in 41 cases. None of the patients were symptomatic, but a moderate secondary stenosis was noted in 4 of 31 patients who underwent endoscopic or radiological follow-up examination. In 80 cases, one or more potentially etiological factors were observed including vascular obstruction (32 cases), low-flow states (27 cases), and drugs (78 cases). Twenty patients were taking non steroidal anti-inflammatory drugs (23 percent). Drug treatment was recent in 10 cases, and in four, it was the only possible etiological factor. This suggests the responsibility of anti-inflammatory drugs in the onset of certain cases of ischemic colitis.

Adult↗
PubMed1989

Rehabilitation of microsomal enzymes in malnourished rats: comparison of parenteral versus oral refeeding.

Protein malnutrition decreases the activity of drug-metabolizing liver microsomal enzymes. In the first part of our study, we evaluated those enzymes during malnutrition and refeeding. Then we compared the effects of different nutritional patterns on these parameters. During malnutrition (M), rats were fed a 5% casein diet. During refeeding, they were randomized in 3 groups: oral refeeding (20% casein diet: A), continuous total parenteral nutrition (TPN: B) and oral energy refeeding (glucose + lipids) + continuous amino-acid infusion (C). Rats were sacrificed before and at various times during malnutrition and refeeding (2 to 28 days). There was no difference in caloric intake between the 3 groups. Nitrogen balance was not different in A and B. It was lower in C, though nitrogen intake was not different. Body and liver weights were not different between the 3 groups. Microsomal proteins and cytochrome P-450 were improved in A and B but not in C compared to M. Our results suggest that TPN (but not continuous amino-acids infusion + oral energy intake) is as effective as oral nutrition on rehabilitation of microsomal enzymes in malnourished rats.

Journal Article↗