Search PubMed⌕ Search

Biomedical subjects

J F Rey

Publications and source records attributed to J F Rey.

At least 37 records · Page 2Linked to original sources
PubMed1999

Endoscopic disinfection: a worldwide problem.

Safety of endoscopic procedures has been a major issue over the last 10 years. Outbreak of new infectious diseases (type C) hepatitis, Creutzfeldt-Jakob disease) underlines the necessity for strengthening cleaning and disinfection guidelines. Patients should be ensured that all endoscopic procedures are carried out with high-level disinfection endoscopes and with sterile or single-use accessories. Improvements from a hygienic point of view of both endoscopes and washer-disinfectors are important goals for manufacturers. Adequate training of endoscopic staff is one of the most crucial points to achieve the highest quality control standards in digestive endoscopy.

Bacterial Infections↗
PubMed1995

Metal stents for palliation of rectal carcinoma: a preliminary report on 12 patients.

BACKGROUND AND STUDY AIMS: Laser therapy is often the only alternative to palliative surgery for elderly patients with advanced rectal carcinoma. In order to reduce the number of laser sessions required, we tried to insert metal stents after initial relief of the obstruction. PATIENTS AND METHODS: In 12 patients (seven female, five male, aged 77-91 years) with rectal or rectosigmoid carcinomas, metallic self-expanding stents (length 5-10 cm, internal diameter 1-2 cm) were introduced. Initial treatments were performed with Nd:YAG laser (mean number of sessions 3.1) in order to allow free passage of an adult colonoscope. Endoscopic and clinical follow-up was carried out at regular intervals. RESULTS: Stent insertion was possible in 11 of the 12 patients. Failure occurred in one patient with sigmoid carcinoma with a distorted loop and diverticulosis. In three patients, the prostheses migrated due to the opening of the lumen being too large; after stent removal, a second stent was successfully placed. Seven patients have died since the beginning of the study, all from the initial disease, without symptoms of stent occlusion. Stenting allowed the number of laser sessions to be reduced. The interval between the laser sessions was extended from 5.1 weeks in a historical control group of 65 patients to the 9.7 weeks in these 11 patients with additional stenting. CONCLUSION: Stenting for rectal carcinoma is technically feasible and safe, and probably reduces the number of laser sessions required. However, better materials are required.

Aged↗
PubMed1995

[Risk of transmission of hepatitis C virus by digestive endoscopy].

OBJECTIVE: In 30 to 50% of cases, the route of transmission of virus C remains unknown. The aim of this study was to investigate the effectiveness of manual cleaning and disinfection procedures after endoscopic examinations in highly infected patients. METHODS: In 39 patients with chronic hepatitis C and a high level of replication, a gastroscopy with biopsy was performed with a fully submersible endoscope. Cleaning and disinfection were carried out with the following protocol: cleaning with detergent solution (Sekulyse), rinsing, 3 to 5 min immersion into a glutaraldehyde disinfectant solution (Sekucid) and final rinsing. One hundred mL of sterile water was flushed through the biopsy channel immediately after removal of the endoscope (T1), after cleaning (T2), and after final disinfection (T3). These 100 mL were collected in aliquots for viral and bacterial screening. Virus C particles were searched for in the effluent of the biopsy channel using two methods of polymerase chain reaction. RESULTS: Virus C particles were found in 2 of 39 patients in T1 aliquots collected before washing. Routine cleaning with a detergent eliminated all viral particles, as tests were negative at T2 and T3. The usual bacteria (Pseudomonas, Streptococcus, Neisseria...) were detected at T1 and had disappeared after total disinfection at T3. CONCLUSION: Virus C hepatitis could be transmitted during endoscopic examination, but cleaning and disinfection procedures effectively eliminated all viral particles.

Disinfection↗
PubMed1993

[Is your scalpel correctly adjusted? The correct use of electric scalpels in digestive system endoscopy].

Progress has been made in electric scalpel technology, as applied to endoscopy, over recent years. Lamp or spark gap scalpels have been replaced by more reliable transistor scalpels fitted with a return electrode avoiding any defective circuits. Before using an electric scalpel, it is essential to understand the basic physical laws governing their use with section, coagulation or mixed currents. Any interference with other electrical apparatuses in the surgical endoscopy room must be avoided and precautions must also be taken in patients with cardiac pacemakers. Different settings are required for colonic polypectomy and endoscopic sphincterotomy in order to ensure a clean cut without oedema and with perfect haemostasis. Although monopolar currents are generally used, some haemostatic or tumour destruction electrodes use a bipolar current which avoids deep necrosis. Diathermy is a precise technique in interventional endoscopy, but surgeons must adapt their knowledge to the equipment used.

Electrocoagulation↗
PubMed1991

[Preparation for digestive endoscopies].

Endoscopic examinations are extremely valuable methods of exploration or even treatment in hepato-gastroenterology. Preparation for these examinations may be very simple in the case of oesophago-gastroduodenoscopy, since all that is required of the patients is to be fasting. In exploration of the colon, preparation is longer and more meticulous, and its quality will to a great extent condition the quality of the diagnosis obtained. Whenever endoscopic examinations are complemented by treatment, the precautions to be taken are sometimes more important and may amount to preoperative evaluation, including prophylactic antibiotic therapy. Pre-endoscopic preparation must also take into account some particular cases, such as patients with cardiac valve or children. The general practitioner plays a very important role in informing his patients about to undergo an endoscopic exploration or treatment. He must also tell them that precautions must be taken after endoscopy, notably in case of non-general anaesthesia.

Endoscopy, Digestive System↗
PubMed1989

Comparative study of sucralfate versus cimetidine in the treatment of acute gastroduodenal ulcer. Randomized trial with 667 patients.

Six-hundred sixty-seven patients with endoscopically proven peptic ulcer were included in a randomized, multicenter trial to assess the comparative efficacy of sucralfate and cimetidine. One hundred eighty-seven patients with gastric ulcer and 480 patients with duodenal ulcer completed the study. Ulcer healing was evaluated endoscopically at six weeks for duodenal ulcer and at eight weeks for gastric ulcer. Patients with unhealed ulcer at this time were assigned to the other therapy for a second period of six or eight weeks of treatment (crossover). In patients with duodenal gastric ulcer, pain relief and healing were not significantly different in the two groups. Eighty-eight percent of duodenal ulcers and 73 percent of gastric ulcers healed with six weeks of sucralfate treatment. Reported side effects and symptoms, pooled together for duodenal and gastric ulcer, were more significant in the sucralfate group (7.5 percent) than in the cimetidine group (3.7 percent). Constipation was the most frequent symptom recorded. In conclusion, sucralfate and cimetidine are both excellent healing agents for short-term treatment of duodenal and gastric ulcer. Both give rapid relief of symptoms without severe side effects.

Acute Disease↗
PubMed1989

[Contribution of electronic imaging. Possibilities of quantification in digestive endoscopy].

The authors report two preliminary studies on image analysis. Using carto-PC software, they compared an automated analysis picture to the Blackstone classification in cases of esophagitis. In the next decade the improvement of electronic video in digestive endoscopy will permit a direct analysis of the details of the digestive mucosa thanks to electronic video endoscopes linked to a computer.

Endoscopy↗