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Biomedical subjects

R Colin

Publications and source records attributed to R Colin.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Syndromes of venous mesenteric ischemia: infarction and transient ischemia].

The reports of 8 patients with acute or subacute abdominal pain related to venous mesenteric ischemia were reviewed. None of the patients presented local or regional predisposing factors for venous thrombosis. In 4 patients, a localized segment of ischemic small bowel (median length 125 cm; range: 30-350) was resected without immediate anastomosis and postoperative anticoagulation therapy was given. Two of these patients developed recurrent ischemia involving the bowel adjacent to the stoma, treated successfully in 1 case by a repeat resection. The 4 other patients hospitalized with intestinal obstructive symptoms (1 case) or abdominal angina (3 cases) were treated by long term anticoagulation in 3 cases and artificial nutrition in 2 cases. None of them developed mesenteric infarction with a median follow up of 34 months. In 7 of the 8 patients, a coagulopathy was found: primary myeloproliferative disorder (1 case), hypercoagulation state (5 cases), autoimmune hemolytic anemia (1 case). These observations suggest that venous mesenteric ischemia included two different entities on the basis of clinical and morphological criteria: mesenteric infarction and subacute transient ischemia without bowel infarction. Most of apparently idiopathic cases of acute or subacute venous mesenteric ischemia are related to hypercoagulation states requiring a long term anticoagulation.

Abdominal Pain↗
PubMed1992

Effect of an effervescent citrate-cimetidine combination on intragastric pH in healthy subjects. A randomized, placebo-controlled three-period cross-over design.

Twelve healthy male volunteers participated in a randomized placebo-controlled, three-period cross-over study to assess the effect of a new effervescent citrate-cimetidine combination (200 mg cimetidine/tablet) (C) on intragastric pH in comparison with a liquid aluminium-magnesium hydroxide antacid (A) and placebo (P). The intragastric pH values were determined by an Ingold combined glass electrode and recorded by a "pH 60" portable unit. Each pH-metry lasted 5 hours and was performed on three separate occasions at one-week intervals. Each treatment was orally administrated at 09.00 h, following a 1-hour baseline intragastric pH recording. The effect of C was measurable almost immediately after drug intake with a median pH between 5-6.5 within 3 minutes, lasting for a mean of 110 minutes and median pH greater than 4 for at least 4 hours. The rise of gastric pH with C was higher (P less than 0.01) and longer (P less than 0.01) than that of A: median pH between 3.5 and 4.5 for 10 to 35 minutes, pH above the placebo curve for 140 minutes and above pH 3 for 50 minutes. In terms of percentage of time at or above each pH level, the differences between the three treatment groups were significantly in favor of C compared to A and A compared to P.

Adult↗
PubMed1991

[Digestive complications of non-steroidal anti-inflammatory drugs].

Gastrointestinal complications associated with non-steroidal antiinflammatory drugs (NSAID) represent a frequent and expensive drug side effect. Recent publications have shown that the deleterious effect of NSAID is not limited to the gastroduodenal tract but can involve all segments of the gut. Epidemiological and clinical studies have demonstrated that 20-30% of patients under NSAID develop digestive symptoms. The relative risk of gastric ulceration is 5 times higher and this risk increases in older patients and in those with peptic ulcer history. Bleeding and perforated gastroduodenal ulcer occur more frequently in patients who received NSAID and mortality in these complications seems to be higher than in control groups. Curative and preventive treatments are effective in gastropathy associated with NSAID use, but the indications for prophylactic therapy need to be more precise in the future. The risk of oesophageal stenosis is increased in patients with gastroesophageal reflux taking NSAID. Diarrhea occurs in 5-30% of patients under NSAID. Intestinal perforation and hemorrhage are more frequent in anti-inflammatory drug takers than in control groups. Mild intestinal inflammation had been recently reported under NSAID, marked by ileal dysfunction, blood and protein loss and occasionally diaphragm-like small intestinal stricture. The pathogenesis of the inflammation is uncertain but seems to be related to an increase in mucosal permeability.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1991

[Prolonged home enteral feeding].

Home enteral nutrition (HEN) is a method that will develop as an alternative to hospitalization. It is indicated mainly in patients who would normally be kept in neurology, ENT, gastroenterology, oncology, paediatrics or geriatrics hospital departments. The technicalities of HEN, such as route, periodicity and modalities of administration and choice of the diet, must be adjusted to the patient's condition and to the foreseeable duration of the procedure. HEN is best organized by a team of hospital specialists who will educate the patient prior to his discharge and follow him up at home in cooperation with the family doctor and district nurse. The extent of financial assistance provided by health insurance organizations is currently under evaluation.

Adult↗
PubMed1991

[Inflammatory bowel diseases in adults. Development and complications].

The courses of ulcerative colitis and Crohn's disease are marked by the unforeseeable occurrence of acute episodes of varying intensity during which complications may develop. Owing to the anatomical and topographical specificities of the colonic lesions, the evolutive profiles of these two diseases are very different. For the moment, there is no criterion at the onset of the diseases that can help in predicting their subsequent courses.

Adult↗
PubMed1991

Endoscopic injection of adrenaline for severe peptic ulcer haemorrhage in high surgical risk patients.

Endoscopic adrenaline-hypertonic injection was attempted in 40 patients admitted for oesophagogastroduodenal ulcer haemorrhage unresponsive to conventional medical treatment and presenting with severe underlying disease or advanced age (less than 80 years). The results were compared with our own historical controls (43 patients) treated by conventional therapy, meeting the same inclusion criteria. Permanent haemostasis was achieved in 32 patients in the injection group and 30 in the control group (NS) but emergency surgery was less frequent in the injection group (2 vs 25, p less than 0.001). Blood transfusion requirements were less in the injection group (8.5 +/- 6.2 vs 10.2 +/- 5.4, p less than 0.05) but length of hospital stay was not really different (15.7 days +/- 9.3 vs 20.9 +/- 14.4). Unfortunately, mortality was not reduced in the injection group (14/40 vs 17/43). Two lethal complications attributable to injection treatment occurred. This treatment could represent an alternative to conventional haemostatic treatment in high surgical risk patients with severe clinical bleeding, avoiding emergency surgery. In spite of the fact that we selected high-risk patients, endoscopic treatment was not able to lower the mortality (about 37%). Due to severe unpredictable side effects and potential risks of long-term massive rebleeding, this treatment should be performed electively in patients with severe clinical bleeding, as first line treatment when surgical risk factors exist or immediately before surgery in low risk patients.

Aged↗
PubMed1991

Liver glutathione and cytochrome P450 activity in experimental infection: study of the relative effects of infectious stress and malnutrition.

OBJECTIVE: To study the effects of infection and malnutrition on liver glutathione and cytochrome P450 (P450) in rats. DESIGN: Controlled experimental groups (12 groups). ANIMALS: Adult male Sprague-Dawley rats. INTERVENTIONS: Experimental endocarditis, pyelonephritis, or peritonitis were caused. Controls included free-fed rats and sham-operated rats, pair-fed to infected animals. Infection was verified by tissue culture. Rats were killed 3 days (acute infection) or 10 days (chronic infection, except endocarditis) after the induction of infection. RESULTS: Sham rats had lower liver weights, liver/body weight, and liver glutathione values than controls. Infected rats had larger liver weights and liver/body weight ratios and liver glutathione content than shams, and larger liver/body weight ratios than controls (acute infection). Infected rats had lower P450 values than both shams and controls. CONCLUSION: The malnutrition associated with infection caused decreased liver weight and glutathione content. Infection increased the liver weight, and liver glutathione content, but caused severe reduction in liver P450. If the same finding is true in infected patients, it could have consequences for the management of such patients.

Animals↗
PubMed1991

Effects of amoxicillin-clavulanate combination on the motility of the small intestine in human beings.

The amoxicillin-clavulanate combination (Augmentin) frequently induces gastric complaints and diarrhea by an unknown mechanism. The aim of this study was to assess the effects of two orally therapeutic regimens of amoxicillin-clavulanate on small bowel motility in human beings. Duodeno-jejunal manometric recordings were performed in six healthy subjects treated in a cross-over double-blind study with placebo; amoxicillin-clavulanate, 1 g plus 250 mg per os every 12 h for 3 days; or amoxicillin-clavulanate, 1 g plus 250 mg per os every 12 h on day 3 only (1-day regimen). Recordings were all performed on day 3 during a diurnal fasting period, a fed state after a standard dinner, and a nocturnal fasting period. Amoxicillin-clavulanate did not affect the motility of the small intestine during the diurnal fast or the fed state. During the nocturnal fast, amoxicillin-clavulanate significantly increased the motility index of the nonpropagated contractions and tended to increase the duration and the amplitude of the propagated contractions. The same digestive motor effect was already observed on the first day of treatment (1-day regimen). This study demonstrates that the oral administration of a therapeutic regimen of amoxicillin-clavulanate is associated, in most cases, with the occurrence of small intestinal motor disturbances.

Adult↗
PubMed1990

Effect of chemotherapy on resting energy expenditure in patients with non-Hodgkin's lymphoma. Results of a sequential study.

This study compared the resting energy expenditure (REE) modifications observed during successive intensive identical chemotherapy courses in non-Hodgkin's lymphoma patients to assess indirectly the metabolic changes induced by the cytotoxic effect of drugs on the tumor. With this therapeutic regimen, reduction of tumor mass is mostly achieved during the first course of chemotherapy. The study included 10 non-Hodgkin's lymphoma adult patients receiving three intensive 5-day courses of Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), cyclophosphamide, vindesine, and bleomycin. Resting energy expenditure was evaluated by indirect calorimetry during each course, first within the first 2 days before chemotherapy and then on days 2, 3 and 5. Initial REE (day 0) on entry into the study (21.8 +/- 1.2 kcal/kg.d-1) represented 99 +/- 6.7% of theoretical REE. Resting energy expenditure on day 0 was lower during course 2 and 3 (19.1 +/- 0.7 and 18.4 +/- 1.8 kcal/kg/d) than during course 1 (21.8 +/- 1.2 kcal/kg/d). The REE profile was different among the 3 courses: course 1 induced a significant REE decrease on days 3 and 5 (P less than 0.01); during course 2, REE remained stable and was lower than during course 1; during course 3, REE increased on days 2, 3, and 5 (P less than 0.05). Energy balance was positive during the three courses and nutritional status remained stable. The REE decrease observed during course 1 may be regarded as the metabolic effect of chemotherapy on the tumor metabolism.

Adult↗
PubMed1990

The effect of enprostil on duodeno-jejunal motility in man.

Motor changes could be involved in the pathogenesis of diarrhoea that complicates the treatment of ulcer disease by prostaglandins. Our aim was to assess the effect of enprostil, a synthetic analogue of PGE2, on duodeno-jejunal motility. During this randomized double-blind crossover study, two manometric recordings, each lasting 20 h (12.00-08.00 hours), were carried out during dosing with 35 micrograms enprostil b.d. or placebo (eight volunteers: part 1), or during dosing with 35 or 70 micrograms enprostil b.d. (nine volunteers: part 2). Subjects were only allowed a standard dinner at 18.00 hours. During fasting, in part 1, the number of phase 3 activity patterns (PIIIs) was higher with enprostil than with placebo (P less than 0.01), without any difference in their characteristics; the overall duration of phase 1 activity was longer with enprostil than with placebo (P less than 0.01). In part 2, during fasting the number and characteristics of the PIIIs were not different, but there was a dose-related increase in PI, and decrease in PII activity. Fed motor patterns did not differ between the two doses of enprostil.

Adult↗
PubMed1990

["Ambulatory" ischemic colitis. Clinical course and etiologic features in 88 cases].

From January 1983 to December 1988, 88 consecutive patients with ambulatory ischemic colitis without severe disease or surgical operation were observed. The diagnosis was established in all cases by endoscopy, and in 64 cases by histologic examination. The study included 55 women and 33 men with a mean age of 65.4 years (22-90). Symptoms included: abdominal pain (73 percent), diarrhea (60 percent) and bloody stools (85 percent). The sequence abdominal pain-diarrhea-bloody stools was noted in 41 percent of cases. Most cases of colitis were located in the sigmoid and left colon. The immediate course was uneventful in 81 patients. Six patients underwent surgery and of these, three died. The mortality rate was 4.5 percent (4 cases). Long-term outcome was known in 41 cases. None of the patients were symptomatic, but a moderate secondary stenosis was noted in 4 of 31 patients who underwent endoscopic or radiological follow-up examination. In 80 cases, one or more potentially etiological factors were observed including vascular obstruction (32 cases), low-flow states (27 cases), and drugs (78 cases). Twenty patients were taking non steroidal anti-inflammatory drugs (23 percent). Drug treatment was recent in 10 cases, and in four, it was the only possible etiological factor. This suggests the responsibility of anti-inflammatory drugs in the onset of certain cases of ischemic colitis.

Adult↗
PubMed1990

[Constipation symptoms studied by a standard questionnaire and anorectal manometry before and after promontory rectopexy (Orr-Loygue technic) in 25 female patients].

Intractable constipation is frequently observed after rectopexy. The aim of our study was to look for clinical and manometric data, which could help to predict postoperative constipation. Twenty-five consecutive female patients treated by Orr-Loygue rectopexy were asked to answer a standard questionnaire and underwent anorectal manometry pre- and postoperatively. Nineteen patients complained of constipation after surgery. Preoperative constipation was significantly more frequent in patients who complained of postoperative constipation, than in patients who did not. Preoperative colonic transit time study in 8 patients was not useful in predicting postoperative constipation. Moreover, symptoms of constipation were quite similar pre- and postoperatively in the 19 patients complaining of postoperative constipation. Anorectal manometric data were not different between patients who complained of postoperative constipation and patients who did not. Therefore preoperative complaints of constipation are most important to consider before rectopexy.

Adult↗