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Biomedical subjects

P Ducrotte

Publications and source records attributed to P Ducrotte.

49 records · Page 3Linked to original sources
PubMed1987

[Controlled study of propranolol in the prevention of recurrent hemorrhage in cirrhotic patients].

The aim of this study was to assess, by a pragmatic controlled trial, the value of propranolol in the prevention of recurrent bleeding in patients with cirrhosis. From January 1982 to December 1984, 368 cirrhotic patients were admitted for bleeding episode due to portal hypertension. Ninety-nine patients were included in the trial 24 h after cessation of bleeding (5 days on the average after hospital admission) and were randomly assigned to 2 groups: 51 patients receiving propranolol at doses that reduced the resting heart rate by 25 p. 100 and 48 receiving neither treatment nor placebo. Ninety-one per cent presented a rupture of varices, and 9 p. 100 acute gastric erosions: 94 p. 100 had an alcoholic cirrhosis. The distribution according to Child Turcotte's classification was grade A: 45.5 p. 100, B: 45.5 p. 100, C: 100 p. 100. The two groups were not significantly different excepted for previous bleeding episodes. The cumulative percentages of recurrent bleeding were not significantly different: between the treated and untreated groups (60 p. 100 vs. 68 p. 100 at 18 months); between the compliant patients (n = 39) and untreated and not compliant patients altogether; between the treated and untreated patients of Child's grade A on the one hand, and patients grades B and C on the other hand. The curves of cumulative survival were not significantly different between treated and untreated patients (66 p. 100 vs. 78 p. 100 at 18 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Colonic transit time of radiopaque markers and rectoanal manometry in patients complaining of constipation.

Transit time, rectoanal manometry, and symptoms were studied in 61 patients complaining of constipation. A slow transit, in the colonic area of most of the patients, was found in 49. Rectoanal manometry was abnormal in 40. Both examinations were abnormal in 32 patients, colonic transit only in 17, and manometry only in eight. Finally, both examinations were normal in only four subjects. A transit delay was always associated with less than three stools per week, and straining at stool was constant when rectoanal manometric disturbances were shown. Objective abnormalities appear common in patients complaining of constipation and, correlated with symptoms, suggest that clinical study in constipation could be of more value than usually is believed.

Adolescent↗
PubMed1985

[Analysis of different factors affecting results of the surgical treatment of gastroesophageal reflux].

Gastric emptying, gastric secretion and esophageal pH were studied prospectively in 32 patients who had either a Lortat-Jacob type operation (n = 7) or a fundoplication with a 360 degrees (n = 4), 270 degrees (n = 5) or 180 degrees (n = 16) gastric fundic wrap. The goal was to determine the effects of various antireflux mechanisms on these functions as well as to try to explain abnormal postoperative esophageal pH scoring indexes. Esophageal pH was recorded during the 3 h period following a standard meal. Acid reflux was expressed using a scoring index taking into account the duration and magnitude of pH fall. Preoperatively, all patients had an abnormal pH scoring index. Postoperatively, the pH scoring index remained increased in 7 patients (group A) and returned to normal values in 25 (group B). Clinical data, esophageal pH parameters and gastric acid secretion measured preoperatively were not significantly different in the two groups of patients. Preoperative gastric emptying for liquids was shorter in group A than in group B patients (p less than 0.05). Postoperative gastric emptying of radiopaque markers was not different in the two groups of patients. Postoperative resting pressure of the lower esophageal sphincter was always less than 10 cm H2O in group A and more than 10 cm H2O in group B patients. Changes in lower esophageal pressure after surgery were higher in group B than in group A patients (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Coronary sinus lactate estimation and esophageal motor anomalies in angina with normal coronary angiogram.

Twenty-three patients (ages 44-82) with angina-like chest pain with a negative stress test and a normal coronary angiogram were studied for myocardial lactate metabolism during atrial pacing and for esophageal motor function with manometric measurements and acid infusion test. Eight patients had an abnormal myocardial lactate metabolism during maximal atrial pacing. Esophageal motor anomalies were observed in six of these eight patients and nine of the 15 subjects with normal myocardial lactate metabolism. The frequency and type of these anomalies were not different between the two groups of patients. Perfusion of acid into the esophagus reproduced the spontaneous pain syndrome in three patients, independent of any simultaneous motor dysfunction. These results suggest that esophageal motor anomalies must be interpreted with caution in patients with angina-like chest pain before affirming the exclusively esophageal origin of the pain.

Adult↗
PubMed1983

[Treatment of acid gastroesophageal reflux by posterior hemifundoplication. Clinical and pH-metric results].

The efficiency of posterior hemifundoplication (Toupet's procedure) in the treatment of gastroesophageal reflux was studied prospectively in 25 patients. Surgery was performed because of resistance to medical therapy and/or ulcerated esophagitis (12 cases). Clinical symptoms were evaluated three times: preoperatively, from 2 to 4 months after surgery and thirdly at a late post-operative interview (mean 21 months). Esophageal pH was recarded through a 3-h period after a standard meal and acid peptic reflux was expressed using a scoring index taking into account the duration and magnitude of pH fall. Esophageal pH was assessed in all the patients before and shortly after surgery and in 10 patients at the late postoperative control. Twenty-four of the 25 patients, had a dramatic improvement or were symptom-free, from 2 to 4 months after operation; the gastroesophageal reflux score decreased in all but 1 patient, but returned to physiological values in only 19 patients (group A), and remained above the normal range in 6 patients (group B). In the latter subjects, the preoperative score was significantly higher and the time elapsed below pH 3 significantly longer than those in group A. At the late postoperative control, clinical symptoms of gastroesophageal reflux were noted in 10 of the 23 patients interviewed. The incidence of late postoperative deterioration was more frequent in group B patients (4 among 6 subjects) than in group A (6 out of 17), and in patients presenting with severe esophagitis before surgery. In conclusion, while they confirm the immediate clinical efficiency of posterior hemifundoplication in gastroesophageal reflux, these results indicate that an abnormal esophageal pH test persists in 25 p. 100 of patients, and seems to carry an increased risk of further clinical deterioration.

Adult↗
PubMed1981

Effect of ranitidine on resting pressure and pentagastrin response of human lower esophageal sphincter.

The effect on the lower esophageal sphincter pressure (LESP) of a new H2-receptor antagonist, ranitidine, has been tested during manometry in normal man. Basal tone and LES pentagastrin response were not significantly different after oral ranitidine administration in 10 healthy subjects. No significant variation of LESP was observed in six additional patients during 1 mg/kg body wt ranitidine infusion as compared to placebo. These results show that despite the difference in chemical structure and a greater inhibitory effect on gastric secretion, ranitidine, like cimetidine, does not alter resting pressure or LES response to pentagastrin in man. Ranitidine may therefore benefit patients with gastroesophageal reflux.

Administration, Oral↗
PubMed1981

Esophageal motility and pulmonary function in progressive systemic sclerosis.

In order to evaluate the influence of esophageal dysfunction on lung function abnormalities in progressive systemic sclerosis (PSS), we compared pulmonary function tests in 24 patients with PSS according to esophageal motility. We observed three groups of subjects with normal esophageal motility (8 cases), impaired peristalsis but normal lower esophageal sphincter (LES; 7 cases), and impaired peristalsis and LES function (9 cases). Dynamic lung compliance was significantly lower in patients with impaired peristalsis and LES function than in the two other groups, suggesting that a gastroesophageal reflux (GER) could enhance pulmonary fibrosis in PSS.

Adult↗
PubMedDate not supplied

Sexual and asexual development of Cryptosporidium parvum in five oocyst- or sporozoite-infected human enterocytic cell lines.

The human enterocytic cell lines Caco-2, HT29, HCT8 and the Caco-2 clones TC7 and PF11 were studied for their ability to support Cryptosporidium parvum development. Following the addition in cultures of either oocysts or excysted sporozoites, immunofluorescent and transmission electron microscopy revealed the presence of all stages of the parasite life cycle by both procedures, and no difference in the ratio of infected cells was found among cell lines. More oocysts were seen in cell monolayers infected with oocysts than with sporozoites (p < 0.0001). The number of meronts observed was the same after either oocysts or sporozoites inoculation. Data suggest that the two methods yield a same cell infection rate.

Animals↗
PubMedDate not supplied

Duodenojejunal motility after oral and enteral nutrition in humans: a comparative study.

BACKGROUND: Small bowel motility during enteral nutrition (EN) remains poorly known. Our aim was to compare, in six healthy volunteers, the duodenojejunal motor patterns after a 750-kcal meal either ingested or infused intraduodenally at two different infusion rates: 2 kcal/min for 6 hours (6-hour EN) or 1 kcal/min for 12 hours (12-hour EN). METHODS: In each volunteer, the three manometric studies were carried out in a random order with an interval of > or = 1 week between each recording. Number of phase III (PIIIs), their characteristics, number of waves (NW), and area under the curve (AUC) were determined. RESULTS: PIIIs were interrupted by each type of nutrition in every volunteer. In five of six during 6-hour EN and in six of six during 12-hour EN, the first PIII returned before the end of EN. The mean duration of the fed pattern was similar in the three studies. During the interruption of PIIIs after oral meal, duodenojejunal motility was characterized by uninterrupted random contractions. By contrast, in four of six during the 6-hour EN and in five of six during 12-hour EN, it was organized as regular short bursts of contractions separated by motor quiescence. In all studies during the disruption of PIIIs, NW and AUC values decreased progressively with time and were higher at the jejunum level than in the duodenum (p < .001). However, at each level of recording, NW and AUC values were similar in the three types of feeding. After the return of PIIIs, the number, duration, and propagation velocity of PIIIs, NW, and AUC values were similar in the three studies. CONCLUSIONS: EN interrupts PIIIs, but, in most cases, PIIIs reappear before the end of EN. During the interruption of PIIIs, the organization of the contractions is qualitatively different from the fed pattern observed after oral feeding. For the same caloric value of the meal, the quantitative duodenojejunal motor response is not affected by the infusion rate, and the more important jejunal, rather than duodenal motor response found after an oral meal, is observed during EN. During EN, after the return of PIIIs, despite the persistence of a nutrient infusion into the duodenum, the small bowel motor patterns are not qualitatively or quantitatively different from those recorded in fasting subjects.

Adult↗
PubMedDate not supplied

[Methods for studying the motility in the small intestine, colon and recto-anal area].

Small bowel and colonic motility can be studied either indirectly by the determination of the transit time or directly in recording bowel contractions. Small bowel transit time is usually assessed with the H2-breath test when colonic transit time is mainly determined fluoroscopically in studying the progression of radiopaque markers along the large bowel. Scintigraphic techniques are promising but not routinely used techniques. In the small bowel, gut contractions are recorded with manometric probes. To study colonic movements, electromyography is more usual than manometry. In both cases, whatever the technique employed, the large inter- and intra (topographic and nycthemeral) variability need to be considered for the interpretation of the motor patterns. Rectoanal studies led to consider two aspects: how the rectum acts as a reservoir and anal function. The ability of the rectum to be a reservoir is assessed either by the volume remaining in the rectum during the rectal perfusion with saline or by the determination of the maximal tolerable volume of distension. Manometry and/or electromyography test anal function at rest and during a rectal distension, straining or a voluntary contraction.

Anal Canal↗