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Biomedical subjects

M Deltenre

Publications and source records attributed to M Deltenre.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

An endoscopic Doppler probe: preliminary clinical evaluation.

A new pulsed Doppler catheter has been developed for use during gastrointestinal fiberendoscopy. Modern gastrointestinal endoscopy allows inspection of the wall of the entire esophagus, stomach, duodenum, and colon. Diagnosis is performed by inspecting the surface of the mucosa, biopsy, and cytology. However, it is not possible to determine the characteristics of the blood vessels of the wall beneath the mucosa with available techniques. We have developed a Doppler system which is miniature and can be passed down the biopsy channel of standard fiberendoscopes. This 8 MHz device incorporates range limiting to select the depth of interrogation by Doppler. The length of the probe is 2 m, and the diameter is 1.8 mm. This device has been tested in animal studies for efficacy and safety and is now being tested clinically in patients. The probe has been tested for two indications: the detection of the retroduodenal artery prior to endoscopic papillotomy for retained bile duct stones (90 patients); and the detection of flow in esophageal varices before and after endoscopic sclerotherapy (33 patients). Preliminary results are encouraging and suggest that this device can give information about submucosal blood vessels which cannot be detected using other methods.

Ampulla of Vater↗
PubMedDate not supplied

Evidence based medicine and extradigestive manifestations of Helicobacter pylori.

A putative pathogenetic role has been ascribed to Helicobacter pylori in several extradigestive diseases, including vascular (atherosclerosis and ischaemic heart disease, primary Raynaud phenomenon, primary headache), autoimmune (Sjögren's syndrome, Henoch-Schönlein purpura, autoimmune thyroiditis, idiopathic arrythmias, Parkinson's disease, nonarterial anterior optic ischemic neuropathy), and skin diseases (chronic idiopathic urticaria, rosacea, alopecia areata), sideropenic anemia, growth retardation, late menarche, extragastric MALT lymphoma, diabetes mellitus, hepatic encephalopathy, sudden infant death syndrome, and anorexia of aging. We examine critically the strength of the evidence linking these diseases to Helicobacter pylori, using ischaemic heart disease as an example of epidemiological techniques, and skin diseases as an example of treatment studies. By the standards of evidence-based medicine, studies have been often of low quality. The best evidence usually is not indicative of a role for Helicobacter pylori in these diseases.

Evidence-Based Medicine↗
PubMedDate not supplied

Severe acute pancreatitis associated with peliosis hepatis in a patient with systemic lupus erythematosus.

Acute pancreatitis is an unusual complication of systemic lupus erythematosus but can also stem from immunosuppressive therapy. Although abnormal liver tests are commonly seen in SLE, peliosis hepatis is very rarely described. We report here the first case of SLE associating a severe acute pancreatitis with peliosis hepatis who responded well to the immunosuppressive therapy. As suggested by the favourable outcome in this case, the presence of peliosis hepatis in SLE cannot not be held as a strong argument against an aggressive immunosuppressive therapy.

Acute Disease↗
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

Juxtapapillary duodenal diverticula and diverticula of the colon: is there a general "gastrointestinal diverticular disease"?

Both juxtapapillary duodenal diverticula and colon diverticula are acquired lesions, the pathogenesis of which is believed to involve the influence of high intraluminal pressure on loci minoris resistentiae in the gastrointestinal wall. We wanted to investigate whether juxtapapillary duodenal diverticula and colon diverticula occur independently, or whether they are part of a hypothetical general "gastrointestinal diverticular disease". 239 patients with juxtapapillary duodenal diverticula were identified in 2231 patients undergoing ERCP. Complete radiology data were available in 119/239 patients. Double contrast barium enema had been performed in 28/119 patients. In these patients, colon diverticula were present in 9/20 women and 1/8 men. The frequency of colon diverticula in these patients was compared with randomly chosen age- and sex-matched controls, for whom barium enema results were available. In these controls, 9/20 women and 1/8 men also had colon diverticula (n.s.). We conclude that after stratification for age and sex, the occurrence of colon diverticula is not higher in patients with juxtapapillary duodenal diverticula than in the general population. Juxtapapillary duodenal diverticula and colon diverticula thus occur independently. These data are not in favor of the existence of a general gastrointestinal diverticular disease.

Barium Sulfate↗
PubMedDate not supplied

Juxtapapillary duodenal diverticula: association with biliary stone disease.

In order to explore the relationship between duodenal diverticula and biliary stone disease, we reviewed 2231 endoscopic retrograde cholangio-pancreatography procedures. We found at least one juxtapapillary diverticulum per 239 patients (10.8%). The occurrence of duodenal diverticula increases with age. Patients with duodenal diverticula were older, had more gallbladder stones, more common bile duct stones, had undergone cholecystectomy more frequently, and experienced more frequently common bile duct stone recurrence after cholecystectomy. We thus confirm an association between the presence of diverticula of the second part of the duodenum, and biliary stone pathology, including gallbladder stones, common bile duct stones, and recurrent stones after cholecystectomy. We discuss the aetiopathogeny of this affection.

Adolescent↗
PubMedDate not supplied

Campylobacter pylori-associated gastritis: attempts to eradicate the bacteria by various antibiotics and anti-ulcer regimens.

The efficacy of various antimicrobial and anti-ulcer agents on the eradication of Campylobacter pylori in patients with antral gastritis or duodenal ulcers was investigated by several open studies or double-blind, placebo-controlled protocols. Among the anti-ulcer agents, ranitidine, cimetidine or sucraflate had no effect on C. pylori. Colloidal bismuth subcitrate achieved clearance of C. pylori in 40% of treated patients at the end of therapy but a high relapse rate (14/16 patients) was observed after a 6-month follow-up period. The antibacterial agents doxycycline, minocycline, ofloxacin, clindamycin, paromomycin and nifuroxazide failed to eradicate C. pylori in most patients. By contrast, short term elimination of C. pylori could be achieved in more than 90% of patients treated with amoxycillin. However, relapse occurred as a rule in all amoxycillin-treated patients within one month after therapy. Overall, we observed no correlation between the in-vitro activity of the different antibacterial agents and their in vivo efficacy. Development of resistance during therapy does not seem to account for this discrepancy since it occurred only with ofloxacin. On the basis of these results, we conclude that long term eradication of C. pylori from the gastric antrum cannot be achieved after monotherapy either with antibiotics or with bismuth salts.

Anti-Bacterial Agents↗