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Biomedical subjects

P Zeitoun

Publications and source records attributed to P Zeitoun.

At least 55 records · Page 3Linked to original sources
PubMed1989

Protective effect of low dose of enprostil against gastric blood loss induced by aspirin in man.

This study tested the efficacy of enprostil given both at potent antisecretory (35 micrograms twice daily) and weak antisecretory (7 micrograms twice daily) doses in preventing aspirin-induced gastric blood loss measured chemically in gastric washings in 10 volunteers. Aspirin (500 mg four times a day) increased gastric blood loss compared with placebo (p less than 0.001). When enprostil was given in addition to aspirin, gastric blood loss was not significantly different from basal value. The pH of gastric washings was significantly increased by the large but not by the low dose of enprostil compared with placebo. The two doses of enprostil were equally efficacious, suggesting a mucosal protective effect of enprostil independent of acid inhibition.

Adult↗
PubMed1989

Comparison of omeprazole with ranitidine in the treatment of reflux oesophagitis.

The amount and concentration of acid in the refluxed gastric contents are considered to be the major factors in the development and progression of reflux oesophagitis. Omeprazole, with its pronounced inhibition of gastric acid secretion, should therefore be a most effective drug for the treatment of patients with this disease. In an international clinical programme, the effects of treatment with placebo, ranitidine, 150 mg b.d. and omeprazole in doses ranging from 20 mg to 60 mg once daily, have been compared in patients with erosive and/or ulcerative oesophagitis. One placebo-controlled study and five comparative studies with ranitidine have been performed. Similar inclusion criteria, definition of oesophagitis on endoscopic evidence of mucosal defects, and assessment of symptoms were used in all the trials. It is evident from the placebo-controlled study that spontaneous healing of erosions and/or ulcers in the oesophageal mucosa seldom occurs. After 4 weeks of treatment, 6% (2/32) of patients randomized to the placebo group had healed, compared to 81% (25/31) treated with omeprazole, 20 mg or 40 mg once daily. In the five studies comparing omeprazole and ranitidine, nearly twice as many patients healed in the omeprazole-treated groups compared with those receiving ranitidine. The overall healing rate was 76% after 4 weeks on omeprazole (range 67-85%) and 37% on ranitidine (range 28-45%), and after 8 weeks the corresponding figures were 90% (85-95%) and 56% (43-66%), respectively. Apart from choice of treatment, only severity of the oesophagitis influenced the rate of healing.(ABSTRACT TRUNCATED AT 250 WORDS)

Dose-Response Relationship, Drug↗
PubMed1989

[Cancer of the esophagus after mediastinal radiotherapy for Hodgkin's disease. Apropos of a case].

Malignant solid tumors induced by radiotherapy for Hodgkin's disease are uncommon. We report one case of thoracic esophageal squamous carcinoma diagnosed 19 years after mediastinal irradiation. The criteria usually accepted for the diagnosis of radiation cancer were all present in this case. An oesophagectomy was performed and the patient made a good recovery from the operation.

Carcinoma, Squamous Cell↗
PubMed1989

[Omeprazole (20 mg daily) compared to ranitidine (150 mg twice daily) in the treatment of esophagitis caused by reflux. Results of a double-blind randomized multicenter trial in France and Belgium].

We report the results of a trial of omeprazole 20 mg daily versus ranitidine 150 mg b.i.d. in the short-term management of erosive or ulcerative esophagitis. The principal aim of the trial was to assess the healing rates of the esophageal lesions. The trial was conducted in 19 centers (16 in France and 3 in Belgium). The lesions of the esophageal mucosa were defined as follows: grade 2 (n = 112), round or linear erosions; grade 3 (n = 33), confluent erosions affecting the total esophageal circumference; or grade 4 (n = 11), erosions as described above plus deep ulcerations or peptic stenosis which did not need endoscopic dilatation. The main criterion was the complete healing of esophageal lesions after 4 weeks of treatment. Patients were randomly allocated to double-blind treatment with omeprazole or ranitidine. Clinical and endoscopic examinations were done on inclusion in the trial and at day 29 +/- 6, and again at day 57 +/- 6 if esophagitis was unhealed. No patient was excluded from the analysis on an "intention-to-treat" basis, and 25 patients were excluded from the "per protocol" analysis, mainly because of poor compliance with the trial protocol. The healing rate at weak 4 was 50 of 62 patients (81 p. 100) treated with omeprazole and 31 of 69 patients (45 p. 100) with ranitidine (p less than 0.001). The corresponding figures at week 8 were 58 of 61 (95 p. 100) and 40 of 61 (65 p. 100) (p less than 0.001).

Belgium↗
PubMed1989

[A case of chronic ischemic erosive gastropathy healed after surgical revascularization].

A case of chronic ischemic erosive gastropathy secondary to chronic abdominal vascular insufficiency is reported. This gastropathy healed after revascularization procedure but then recurred after stenosis of the aortomesenteric graft. The clinical picture was characterized by post-prandial abdominal pain, weight loss and an abdominal bruit. The upper gastrointestinal endoscopy showed multiple non hemorrhagic antral erosions with irregular outlines and a pseudomembranous floor. Reduction of the resistance of the gastric mucosal barrier by a chronic decrease of mucosal blood flow probably accounted for the gastric erosions. Although the prevalence is unknown, ischemic injury to the stomach is unexpected, because of the rich collateral circulation of this organ. Increased awareness of the disease and its prognostic implications should lead to suggest abdominal vascular insufficiency based on their clinical and gastroscopic aspects, thus leading to operation before acute mesenteric infarction occurs.

Celiac Artery↗
PubMed1987

Effects of propranolol and sucralfate on ethanol-induced gastric mucosal damage in chronic portal hypertensive rats.

In a rat model of chronic portal hypertension we studied ethanol-induced gastric mucosal damage and the effects of pretreatment by propranolol and sucralfate. Susceptibility to ethanol was increased in chronic portal hypertensive rats compared with sham-operated rats (55 +/- 8% vs. 25 +/- 4%). Both acute pretreatment (10 min) and chronic pretreatment (3 weeks) with propranolol reduced gastric mucosal injury induced by ethanol in portal hypertensive rats, compared with saline-treated rats. Acute and chronic pretreatment with propranolol had no protective effect in sham-operated rats. In portal hypertensive rats, sucralfate in two different doses (500 and 125 mg/kg) protected the gastric mucosa against ethanol-induced gastric injury compared with animals receiving saline (2 +/- 1% and 3 +/- 2% vs. 25 +/- 3%). Sucralfate at the higher dose did not reduce portal pressure in portal hypertensive rats. We conclude that: (1) chronic portal hypertension increases ethanol-induced gastric damage; (2) acute and chronic propranolol treatment reduces ethanol-induced gastric injury in portal hypertensive rats, probably by decreasing portal hypertension; (3) sucralfate has a cytoprotective effect in portal hypertensive rats without reducing portal pressure. These results suggest a potential application of sucralfate in patients otherwise treated by sclerotherapy.

Animals↗
PubMed1987

[Evaluation by endoscopic biopsies, of the histological criteria of reflux esophagitis].

Histologic criteria of esophagitis and/or gastroesophageal reflux have been described in suction biopsy specimens which are easy to orient for perpendicular section of the mucosal surface. The aim of this study was to reassess the currently accepted criteria in guided endoscopic pinch biopsy specimens obtained from esophageal erosions. Epithelium of each sample was stained by Lugol's solution in order to be able to spread the specimen out flat and orient it before fixation. Of 92 biopsies nine were composed of granulation tissue and were excluded from the study. Of the remaining 83 biopsy specimens, 74 (89.2 p. 100) from 66 patients were properly oriented. Of these 74.65 (87.8 p. 100) from 57 patients contained lamina propria. Combination of the 2 epithelial criteria, i.e. papillary height and basal cell zone thickness greater than 50 p. 100 and 14 p. 100 of total epithelial thickness, respectively, were recorded in only 58 p. 100 of 66 patients. Nevertheless, the mean papillary height and the mean basal cell layer thickness were 64 p. 100 and 19 p. 100 of total epithelial thickness, respectively. Infiltration of the lamina propria by neutrophilic and/or eosinophilic granulocytes were recorded in 32 of 57 patients (56 p. 100) and only in 48 p. 100 of biopsy specimens which did not display any epithelial defect. Combination of pathologic changes in epithelium and lamina propria were observed in only 32 p. 100 of the patients and were not more frequent than expected on the basis of a chance association. We conclude that histologic criteria have a low sensitivity even in patients with erosive esophagitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Role of chemotherapy in the treatment of gastric adenocarcinoma].

In spite of the progress achieved in endoscopic detection and surgical techniques, the prognosis of gastric adenocarcinomas remains poor. To improve the results obtained, one of the most important lines of research is chemotherapy, but its place in the management of these tumours is still controverted. Apart from 5-fluorouracil, other active drugs recently developed (e.g. adriamycin, mitomycin, nitroso-ureas and cis-platinum) have been entered into new protocols and tested. The results at present available in patients with metastases are 40 to 50% complete or partial objective responses lasting for 4 to 16 months. They justify the use of these drugs, provided the patients' comfort is improved after the first two cycles. The place of adjuvant chemotherapy after complete surgical resection of gastric adenocarcinomas is still debated. Only 3 out of 13 randomized trials have demonstrated a longer survival in the treated group. Further controlled trials are required, using the most effective protocols, to determine their advantages and to find out which subgroups of patients are likely to benefit from chemotherapy.

Adenocarcinoma↗
PubMed1985

[Maintenance therapy of ulcer disease. Comparative multicenter study of sucralfate, cimetidine and a placebo].

Relapse rates were studied in one hundred patients in a multicentric, randomized trial during and after maintenance therapy comparing sucralfate, cimetidine and placebo. These patients were previously treated by cimetidine for peptic ulcer and were considered cured after endoscopic examination. Outpatients were randomly assigned to a 6 month maintenance treatment with either cimetidine (600 mg daily), sucralfate (300 mg daily) or a placebo. All patients underwent endoscopic evaluation after 3 and 6 months of therapy. A clinical évaluation was performed 6 months after all treatment had ceased. Clinical and endoscopic results proved the significant superiority of both sucralfate and cimetidine over the placebo. Remission rates with sucralfate were respectively 80,4 p. 100 after 6 months and 68,5 p. 100 after 12 months. These results were slightly superior to those observed with cimetidine (69,3 p. 100 and 61,3 p. 100). However, this difference is not statistically significant. Results for the placebo group were 47,9 p. 100 and 37,7 p. 100. Sucralfate is an effective medication in preventing the recurrence of peptic ulcer. Its pharmacological action, its few side effects and its effectiveness seem to make this medication very interesting in treating the ulcerous disease.

Aluminum↗
PubMed1984

[Carcinoembryonic antigen in ascites and pleural effusions].

The purpose of this prospective study was to evaluate the usefulness of carcinoembryonic antigen (CEA) assays in effusion fluids for the diagnosis of cancer. From 1978 to 1981, 63 patients totaling 67 effusions were investigated for malignant cells and CEA concentrations. There were 62 cases of ascites and 5 cases of pleural effusion resulting from 35 cirrhoses and 28 cancers, including 17 adenocarcinomas. Macroscopic examination of serous membranes was possible in 24 patients. CEA concentrations at least 4 times higher than the upper limit of normal laboratory values were required to diagnose malignancy in effusions. The specificity of both cytology and CEA assays was 100 p. 100 in cirrhotic ascites. Malignant cells were present in 14 cases and positive CEA levels in 19 cases. CEA concentrations were highly significant (p less than 0.001) of cancerous effusions due to adenocarcinomas. In cancers other than adenocarcinoma and in hepatocarcinoma, CEA assays did not prove useful, and cytological examination remained the best diagnostic method. Both cytology and CEA levels were positive for malignancy in 11 effusions, and a diagnosis of cancer could be made on these grounds in 22 out 28 cases. Lack of correlation between CEA concentrations in sera and in effusion fluids suggests local production consecutive to invasion of the serous membranes. All 8 adenocarcinoma patients with grossly detectable extension to the peritoneum had high CEA concentrations, but malignant cells were absent in 4 cases. This discrepancy might tentatively be explained by local dissemination via the lymphatic system without disruption of the membrane but resulting in reflux of CEA into the effusion fluid.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1984

Cavitation of mesenteric lymph nodes, splenic atrophy, and a flat small intestinal mucosa. Report of six cases.

This study describes, in 6 patients with a flat small intestinal mucosa and splenic atrophy, a particular lesion of the mesenteric lymph nodes termed "cavitation." In 4 women and 2 men with abdominal mass, intestinal obstruction, or suspected celiac disease-associated lymphoma, unusual pseudocystic lymph node lesions were found in the jejunal or jejunoileal mesentery. These lesions consisted histologically of a large central cavity occupied by hyaline-type material and surrounded by fibrous tissue and remnants of lymph node structures. There was no histologic evidence of malignant lymphoma or mesenteric panniculitis. Diffuse subtotal villous atrophy involving at least the jejunum was found in each case, together with unequivocal biological and morphological evidence of splenic atrophy, severe malabsorption, and a history of chronic or childhood diarrhea. HLA B8 or DR3, or both, was present in 4 of 4 cases; dermatitis herpetiformis was present in 1 case. An unequivocal mucosal response to a gluten-free diet was observed in 2 cases. Four patients died of cachexia or hyposplenism-related infections. We conclude that cavitation of mesenteric lymph nodes is an original feature which may be associated with splenic atrophy and a flat small intestinal mucosa; some of these patients may have celiac disease. Pathogenesis is unknown.

Adult↗
PubMed1983

Parietal cell autoantibodies: localization of their binding sites on isolated gastric glands.

The localization of antigens reacting with parietal cell antibodies found in the sera of some patients with pernicious anaemia was studied by the indirect immunoperoxidase method on viable gastric glands isolated from the mouse or human fundus by collagenase digestion. We observed that only the luminal surface of parietal cell bound antibodies, whereas their lateral and basal surfaces were not stained. From this data it is concluded that parietal cell antibodies are unlikely to be cytotoxic in vivo.

Animals↗