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Biomedical subjects

H J Bertrand

Publications and source records attributed to H J Bertrand.

8 recordsLinked to original sources
PubMed1998

[Autoimmune hepatitis induced by fibrates].

AIM: Long term treatment by fibrates could induce chronic hepatitis associated with auto-antibodies. The aim of this study was to assess the features of this hepatitis. METHODS: Baseline clinical and biological features, and liver biopsy in 5 patients with fibrate-induced chronic hepatitis were studied, as well as their outcome. RESULTS: At enrollment, patients (4 men, mean age 65 years) had highly (n = 3) or mildly (n = 2) increased serum aminotransferase activity, hypergammaglobulinemia and high titers of anti-nuclear antibodies (with homogenous fluorescence in 3 cases). Liver biopsies demonstrated a lympho-plasmocytic infiltrate in all cases. Hepatocellular necrosis was multilobular in 2 cases, and mild to moderate, located in lobular and periportal areas in 3 cases. Cirrhosis was found at presentation in 3 cases and developed within a few months in the 2 other patients. After discontinuation of fibrates, aminotransferase activity normalized within 6 weeks either spontaneously (n = 3) or under immunosuppressive treatment (n = 2). Immunosuppression was rapidly withdrawn in 2 patients (< 18 months) without relapse, while one patient was treated for 4 years because of relapse after early withdrawal. A second liver biopsy performed 6 months after discontinuation of fibrates in an untreated-patient showed no inflammation or necrosis. CONCLUSION: These observations suggest that fibrates could trigger chronic liver disease resembling type I auto-immune chronic hepatitis, which resolves after drug withdrawal.

Aged↗
PubMed1990

[Percutaneous endoscopic gastrostomy. 174 cases].

Nutritional assistance was given by percutaneous endoscopic gastrostomy to 174 patients with neurological diseases (80 cases), tumours of the ear, nose and throat (ENT) region (70 cases) or malnutrition (24 elderly people). These patients had either deglutition disorders with inhalation or severe malnutrition, or could not tolerate a nasogastric tube. The endoscopic catheter (Bioser) was installed by the pull technique under general anaesthesia (26 percent), neuroleptanalgesia (16 percent), premedication (14 percent) or without sedation (44 percent). Installation was possible in 98 percent of the cases. Twenty-nine percent of the patients were treated in an outpatient clinic. The problems encountered (21 percent) were mainly due to blockade of the flange and rupture of the thread. Transoperative accidents, such as dyspnoea, bleeding or cardiac arrest, all without sequelae, were noted in 5 percent of the cases. The catheter remained in situ for a mean period of 3.9 +/- 0.3 months (range: 0.1 to 20 months). The following complications were observed: short-term (15 percent), hyperthermia (5), local infection (6), abscess of the abdominal wall (3), meteorism (9), pneumoperitoneum (1), subocclusion (2); long-term (25 percent), inflammatory reactions (13), leakage (19), catheter displacement (8) and catheter rupture (3). Local infections were more frequent in patients with ENT tumours than in the others. Percutaneous endoscopic gastrostomy is a fast and reliable technique preferable to surgical gastrostomy. Complications are frequent (46 percent) but usually minor (42 percent). Contra-indications must be respected, and the catheter must be introduced with the utmost care.

Administration, Cutaneous↗
PubMed1987

[Current indications of laparoscopy].

The authors illustrate the indications of laparoscopy by reporting their clinical experience in a Department of gastroenterology between 1982 and 1984. In addition to the clinical indications which remain valid, new indications of laparoscopy are described in cases of failure of ultrasonography and/or computerised tomography, and of direct opacification of the biliary and pancreatic ducts. Laparoscopy has been practically abandoned in the diagnosis of obstructive jaundice and pancreatic pathology. It is irreplaceable in peritoneal pathology. The role of laparoscopy in hepatic tumours, hepatitis, cirrhosis, certain abdominal emergencies, unexplained abdominal pain and pelvic disease is discussed. Some rare indications may be considered only when the technical possibilities of laparoscopy are understood.

Gastrointestinal Diseases↗
PubMed1985

[Application of an original technic in the evaluation of gastric emptying to the study of primperan].

The ingestion of radio-opaque granules during a meal enables the radiological study of gastric emptying under physiological conditions. The evacuation of the granules is well correlated with that of solids. After the development of a pharmaco-clinical model of hyposthenic dyspepsia, this technique was used by the authors to evaluate the influence of Primperan on gastric emptying after a dyspeptogenic meal in 12 volunteers. Following the randomised intravenous injection of either 20 mg of Primperan or a placebo, 5 to 7 minutes before the dyspeptogenic meal, the number of granules remaining in the stomach over time was used to measure the rate of gastric emptying. Primperan significantly accelerated the gastric emptying of the dyspeptogenic meal in comparison with the placebo (p less than 0.01).

Contrast Media↗
PubMed1983

[Acute interhemispheric subdural hematomas].

Three cases of acute interhemispheric subdural hematomas, one of which bilateral, are reported. These are secondary to cranial traumatism and/or to treatment by anticoagulants and have stereotyped clinical signs. Following a lucid period, intracranial hypertension appears, then a sudden predominantly crural hemiparesis or even paraplegia. The aspects shown by computerized tomography are characteristic. The literature and our experience suggest that the best treatment is complete evacuation of the hematoma by craniotomy performed before alteration of consciousness.

Aged↗