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Biomedical subjects

E Louis

Publications and source records attributed to E Louis.

At least 145 records · Page 8Linked to original sources
PubMed1986

[Traumatic retroplacental hematomas].

In this study the authors present 4 observations of traumatic retroplacental hematomas recorded in the department of obstetrics and gynecology of the general hospital at Meaux between 1979 and 1984. The 4 cases are related to serious injury to the circulation as is shown by a detailed study of the observations. The frequency of these traumatic retroplacental hematomas seems clearly to be on the increase if comparison is made with earlier statistics. The problem of the security girdle is evoked again; the authors themselves think that it should be worn until pregnancy reaches its term. Emergency ultrasonography is the indispensable complement to the obstetric examination carried out on arrival of every pregnancy presenting a trauma enclosed in the abdomen; it may modify the order of the operations to be carried out by the various specialists who are responsible for the surveillance and treatment of these patients; together with monitoring it remains the best means of surveillance of the foetus following a road accident.

Abdominal Injuries↗
PubMedDate not supplied

Treatment of inflammatory bowel disease with azathioprine: how to use it in 1999.

Azathioprine and 6-mercaptopurine are effective drugs in the management of steroid dependent and chronic active inflammatory bowel diseases. They are also well tolerated on the long term. However, their use is still hampered by some drawbacks including delay before efficacy, 20-35% of non responders, relapse at withdrawal of the drugs, possible bone marrow toxicity and other side effects. During the last few years, these drawbacks have been challenged by important studies showing that a better knowledge of the metabolism of these drugs may help to improve their use.

Azathioprine↗
PubMedDate not supplied

Initial medical management of severe acute ulcerative colitis.

Severe colitis is life-threatening complication of ulcerative colitis. Early recognition of the severity of the colitis, intensive medical therapy and prompt surgery when necessary have all contributed to improved outcome. Initial medical treatment should be instituted as soon as the diagnosis is made with an intravenous corticosteroid associated with supportive treatment. If the patient fails to response to this intensive treatment after 5-7 days, cyclosporin should be initiated. If cyclosporin is not used then colectomy should be performed immediately. Moreover, significant deterioration at any point during medical therapy is an indication for colectomy. The gravity of the patient's condition require close interaction between physician an surgeon.

Acute Disease↗
PubMedDate not supplied

Genetics of Crohn's disease behaviour.

Crohn's disease is probably an heterogeneous entity. This heterogeneity may be linked to either genetics or environment. In particular the behaviour of the disease, i.e. the tendency to develop stricturing and/or penetrating lesions, may be linked to the genetic background. While epidemiological and clinical data suggest the relevance of these behavioural classifications, the progresses in the characterization of the immuno-inflammatory reaction in the bowel wall shed a new light on possible candidate genes for these genetic predispositions to various Crohn's disease behaviours. Association studies an linkage analysis focusing on growth factors, metalloproteinases and their tissue inhibitors as well as cytokines may bring new interesting data in this field.

Crohn Disease↗
PubMedDate not supplied

The immuno-inflammatory reaction in Crohn's disease and ulcerative colitis: characterisation, genetics and clinical application. Focus on TNF alpha.

Inflammatory bowel diseases are multifactorial polygenic diseases. The author has worked on the characterisation of the mucosal immuno-inflammatory reaction, on genetic predisposition and on potential clinical application of blood immuno-inflammatory markers in these diseases. This paper summarizes some aspects of this work, focusing on TNF. Following points are developed: production of TNF by inflamed mucosa, genetic control of TNF production, TNF gene polymorphim in inflammatory bowel disease, and evaluation of serum TNF as a marker of disease activity or evolutivity.

Biomarkers↗
PubMedDate not supplied

Ileo-caecal actinomycosis: report of a case simulating complicated inflammatory bowel disease.

Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans. Actinomyces israelii rarely cause abdominal infections or actinomycosis. Abdominal actinomysosis is characterised by fistulae and abscesses and may mimic cancer or inflammatory bowel disease. Abdominal actinomycosis is difficult to diagnose preoperatively, and often require surgical removal of the diseased tissue, allowing pathologists for giving the definitive diagnosis, revealed by characteristic "sulfur granules". The authors report herein the case of a 47-year-old man who presented with diarrhoea and abdominal pain. Abdominal computed tomography evoked complicated inflammatory bowel disease and surgical procedure was decided. Laparoscopic exploration did not provide further significant information, and laparotomy with diseased bowel resection was performed. Pathology demonstrated "sulfur granules" and allowed the diagnosis of abdominal actinomycosis. This case demonstrated that abdominal actinomycosis should be included in the differential diagnosis when computed tomography shows an infiltrative and inflammatory mass.

Actinomycosis↗
PubMedDate not supplied

Observational survey of NSAID-related upper gastro-intestinal adverse events in Belgium.

OBJECTIVES: To evaluate the impact of NSAID use on current routine upper GI endoscopy (UGIE) and to compare the lesions found in NSAID users and non-users. METHODS: Participating gastroenterologists consecutively documented outpatients with and without suspicion of bleeding, referred for upper gastrointestinal endoscopy. Patient characteristics, presence of risk factors, NSAID use and endoscopic findings were reported on standard data collection forms. MAIN RESULTS: A total of 2685 non-bleeding and 159 bleeding patients were enrolled within a time period of 2 months. NSAID therapy was present in 20% of the non-bleeding patients and at least 9% of referrals for endoscopy were directly related to suspected NSAID adverse events. Nearly half of acute bleeding patients (42%) were NSAID users, including aspirin for cardioprevention. Warning digestive symptoms prior to acute bleeding were frequently absent (56%). Oesophagitis was the main endoscopic diagnosis (51% of patients). Gastroduodenal (GD) ulcer was significantly more frequent in NSAID users, whereas oesophagitis and bleeding oesophageal varices were more frequent among non-users. Analysis of odds ratio's demonstrated NSAID use to significantly increase the risk for gastric ulcer in the whole patient group (OR = 2.73; 95% confidence interval (CI): 1.98-3.77; p < 0.001) and, in addition, for duodenal ulcer in the elderly (> 65 y) subgroup (OR = 2.91; 95% CI: 1.52-5.59; p < 0.05). CONCLUSIONS: This survey confirms the high incidence of GD ulcers in NSAID users and the risk for serious gastrointestinal complications, often occurring without warning symptoms. It underlines the impact of NSAID use on the routine endoscopy load, the necessity of careful selection of patients for NSAID prescriptions and the need for gastropreventive measures, particularly in elderly patients and patients associating multiple risk factors.

Adult↗
PubMedDate not supplied

Pregnancy and inflammatory bowel disease.

Overall, around 25% of women with inflammatory bowel disease will conceive during their disease. Most of the women with inflammatory bowel disease will have a normal pregnancy and healthy children. However, specific problems may arise related to these pregnancies. This paper reviews what is known on fertility, risk of disease transmission, effect of the disease on the pregnancy and the reverse, delivery, medical follow up and treatment as well as breastfeeding in the setting of inflammatory bowel disease.

Disease Transmission, Infectious↗
PubMedDate not supplied

Negative association between smoking and anti-saccharomyces cerevisiae antibodies in Crohn's disease.

BACKGROUND: Crohn's disease (CD) is a polygenic multifactorial heterogeneous disease. Anti-Saccharomyces Cerevisiae antibodies (ASCA) correlate highly with CD and are present in 50-80% of patients. The reason for ASCA positivity or negativity in CD is unknown. The aim of our work was to analyse clinical, epidemiological and genetic characteristics in ASCA+ or ASCA- CD patients. METHODS: 113 patients with CD were tested for ASCA (IgA and IgG) by using a commercial kit (Medipan Diagnostica). Age, gender, systemic manifestations, familial form of disease, age at diagnosis, location and behaviour of the disease, smoking habit as well as genotyping for -308 TNF gene polymorphisms were determined. RESULTS: 38.9% CD patients were negative for both IgA and IgG ASCA while 61.1% were ASCA positive (respectively IgA and IgG: 31.9%; IgA only: 9.7%; IgG only: 19.5%). The only significant difference between ASCA+ and ASCA- patients was for smoking habit: there were 29% smokers in ASCA+ versus 50% in ASCA- CD patients (P = 0.03). This low proportion of smokers was more prominent in ASCA IgA+ patients than in isolated ASCA IgG+ patients (25.6% versus 45.5%) and was minimal in patients with high titers of ASCA IgA (0/8). Logistic regression showed smoking habit still borderline for significance (P = 0.057). CONCLUSIONS: Our results suggest a negative association between smoking and ASCA positivity in CD. This association was more prominent for ASCA IgA+. It indicates that smoking habit should be taken into account when analysing ASCA status in CD patients and may suggest an influence of smoking on immunization against intestinal material.

Adult↗
PubMedDate not supplied

[Video-capsule endoscopy for small bowel investigation].

Capsule endoscopy is a new technique of exploration which enables to visualize the entire small bowel. Occult or unexplained digestive bleeding currently constitutes on major indication of this technique. The aim of this study is to report the results obtained among 15 patients investigated by capsule endoscopy and to discuss the place of this new technique in the small bowel exploration.

Adolescent↗