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Biomedical subjects

R Colin

Publications and source records attributed to R Colin.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Diarrhea in intestinal inflammatory diseases].

Diarrhoea is a frequent symptom in ulcerative colitis (UC) and Crohn's disease (CD) which it often reveals. Its clinical features, course, physiopathology and treatment are different in these two diseases. UC is accompanied by an imperative, blood-stained, diurnal and often noctural diarrhoea the intensity of which fluctuates with the course of the disease, usually regressing under medical treatment but capable of becoming severe. This diarrhoea is due to several physiopathological mechanisms such as loss of colonic absorption function, exudative enteropathy and disorders of motility. Contrary to the lesions of UC, those of CD involve the whole digestive tract; they are multisegmental, ileal, colonic, ileocolonic or diffuse. Diarrhoea takes different forms depending on the site and evolutive stage of the lesions: malabsorption of bile salts and/or fatty acids in ileal lesions or after surgical resections, bacterial proliferation above stenoses, intestinal shunts due to internal fistulae, reduced absorbing area, exudative enteropathy and motor disorders in colonic lesions. In UC, treatment of the diarrhoea is that of exacerbations: systemic or topical corticosteroids or 5-aminosalicylic acid. In CD, side by side whit the maintenance treatment of the disease with anti-inflammatory drugs, the symptomatic treatments of diarrhoea play an important role and must be tailored to the responsible physiopathological mechanisms; some patients need artificial feeding.

Anti-Inflammatory Agents↗
PubMed1989

[Effects of food on motility of the small intestine].

It is now well-known that feeding suppresses the phase 3 propagated waves for 2.30 to 10 hours in the small intestine. This finding can be influenced by subject's age, ingestion time and nature of food. The influence of extraluminal factors, i.e. nervous or hormonal, is probable. First, a reduction of jejunal contractions frequency without alteration of their amplitude can be found in the elderly. Second, a late dinner can shorten by 50 per cent the duration of the post-prandial motor profile, which is followed by an irregular activity normally nearly absent and without reappearance of a reduced periodicity of phase 3. In man as in animal, the duration of the post-prandial inhibition is correlated with the caloric content of the meal. At equal colonic content a lipidic meal induces a stronger effect than a glucidic meal which has itself a stronger effect than a protidic one. Fibres eventually increase by 40 to 50 per cent the duration of the post-prandial continuous motor activity in the duodenum, and have, depending on their nature, a variable effect on the jejunum. Digestion and absorption of nutrients also appear to be involved through probable nervous and/or hormonal pathways. In animals, an increased absorption of lipids by addition of bile lengthens the inhibition duration; in man intravenous infusion of a lipidic emulsion can induce a typical post-prandial motor profile. Clinical implications of these results involve at the moment a hypothesis on the physiopathology of diarrhea and artificial, enteral or parenteral, nutrition. On the model of vagotomised patients, it was shown that diarrheic patients exhibited a shorter post-prandial activity. Enteral feeding can interrupt phase 3 on the one hand temporarily and on the other under the conditions of a minimal caloric flow and molecular weight of peptides in case of protidic infusion. Preliminary results with parenteral alimentation were found to be similar, with in particular a strong inhibitory effect of perfusion of lipids.

Adolescent↗
PubMed1989

Yogurt and fermented-then-pasteurized milk: effects of short-term and long-term ingestion on lactose absorption and mucosal lactase activity in lactase-deficient subjects.

Lactase-deficient subjects absorb lactose in yogurt more effectively than lactose in other dairy products. However, as all previous studies were performed without a double-blind design and only after a single ingestion of the test product, the mechanism of this enhanced absorption remains unclear. The aims of this double-blind study were 1) to evaluate lactose absorption after prolonged ingestion of yogurt and fermented-then-pasteurized milk (FPM) and 2) to assess the modification of the lactase activity of the duodenal mucosa. In 16 lactase-deficient subjects we confirmed that yogurt enhances lactose digestion, this beneficial effect being destroyed by pasteurization. Moreover, the long-term (8 d) ingestion of either yogurt or FPM does not modify the results of hydrogen breath tests in comparison with a 24-h ingestion. The mucosal lactase (Dahlquist method) and beta-galactosidase (ONPG method) activities were not significantly modified by yogurt or FPM ingestion. These results suggest that in lactase-deficient subjects no adaptation occurs after eating yogurt or FPM and that the increased lactose absorption in yogurt must be mainly related to an intraluminal process.

Adolescent↗
PubMed1989

Jejunal motility during cyclic total parenteral nutrition in patients with Crohn's disease.

Our aim was to study the jejunal motility (a) in seven patients receiving longterm (median: 24 days) cyclic total parenteral nutrition (CTPN) for an acute exacerbation of Crohn's disease involving the ileum and/or the colon without any sign of occlusion and (b) in six healthy volunteers undergoing the same parenteral nutrition for one day after an overnight fast. Continuous recordings, lasting 20 hours, were carried out in patients after correction of their nutritional status and significant improvement of the Crohn's disease activity index. In five of the seven patients, we recorded seven to 14 phase III episodes (PIII) (median: 10), both more frequent and slower during the nocturnal part of the recording time as compared with diurnal. Seven to 18 PIIIs (median: 12) were found in controls. The overall duration of the motor activity was not different between these five patients and controls. In the remaining two patients, no PIII episode was recorded and 79% and 57% respectively of the whole recording time consisted of irregular motor activity. Our work therefore, shows that: (a) PIIIs remain and have a circadian variation in their periodicity and propagation velocity, in most of our patients undergoing longterm CTPN (b) CTPN does not determine a longer duration of motor rest of the small bowel in patients than in controls submitted for a short period of time to the same parenteral intake.

Adult↗
PubMed1989

Effects of ketoacids on liver glutathione and microsomal enzymes in malnourished rats.

The progression of chronic renal failure is delayed by the use of low protein diets, but such diets are deficient in essential amino acids. In order to maintain good nutritional status, branched-chain ketoacids (BCKA) can be added to these diets. The effects of BCKA on protein metabolism in skeletal muscle is well established, but there is little information about their effects on liver metabolism. Protein deprivation affects some aspects of liver function such as drug metabolism (glutathione, cytochrome P-450 and enzymes). In a chronic protein malnutrition model, we have tested the efficacy of BCKA to correct these abnormalities when they are added to a low protein diet. RNA/DNA, liver proteins, microsomal proteins and glutathione were markedly improved; cytochrome P-450 was only partly improved, and aminopyrine demethylase was not affected. In conclusion, this study suggests that BCKA have a beneficial effect and may prevent the deterioration in the nutritional state of the liver in uremic patients.

Animals↗
PubMed1989

[Severe diarrhea caused by Ticlid associated with disorders of small intestine motility].

Ticlopidine is a potent inhibitor of platelet aggregation whose mechanism of action remains unknown. It might act through an increase of intraplatelet PGE1 and PGD2. Benign diarrhea is the most common side effect during ticlopidine treatment. We report four cases of severe chronic diarrhea with fecal incontinence in patients treated by ticlopidine. In two patients manometric recording of jejunal motility was performed. Abnormal motility patterns were observed in both cases: bursts of 3-11 propagated contractions occurring every 2 min and migrating at a rate of 0.6 cm/s, preceded and followed by a brief period of quiescence. Migrating motor complexes and a low percentage of time of quiescence were noted on both recordings. These disorders in intestinal motility may play a role in the pathogenesis of diarrhea observed with ticlopidine.

Aged↗
PubMed1989

[Upper gastrointestinal hemorrhage caused by anti-inflammatory agents].

The aim of this study was to describe the clinical and evolutive characteristics of gastroduodenal bleeding occurring in patients receiving nonsteroidal anti-inflammatory (NSAI) drugs, containing salicylates or not, and to determine the relative toxicity of the NSAI drugs without salicylates. Eight hundred and fourty-five consecutive patients with upper gastrointestinal bleeding related to endoscopically proven peptic ulcer or gastroduodenal erosions were admitted between 1983 and June 1987 to an intensive care unit for digestive tract hemorrhage. Of these, 267 were using anti-inflammatory drugs; 151 (56 p. 100) were taking NSAI drugs other than salicylates, 97 salicylates (36 p. 100) and 10, steroids (4 p. 100). Patients taking nonsteroidal drugs without or with salicylates were compared with patients bleeding from gastroduodenal ulcer or erosion not receiving anti-inflammatory therapy. Patients receiving nonsteroidal drugs not containing salicylates were older (70 p. 100 over 65 years of age vs 46 p. 100, p less than 0.001) and the proportion of female patients was greater (54 p. 100 vs 33 p. 100, p less than 0.001) than in the other group. No significant difference was observed with regard to the following parameters: percentage of gastric lesions, concomitant anticoagulant therapy, need for surgical hemostasis, or mortality. Patients taking aspirin had more gastric lesions (75 p. 100 vs 64 p. 100, p less than 0.05) and less need for surgical hemostasis (7 p. 100 vs 15 p. 100, p less than 0.05); the other parameters did not differ. NSAI drugs other than salicylates were taken more often for osteoarthritis than salicylates (33.6 p. 100 vs 17.4 p. 100, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1988

Change in energy and protein status during chemotherapy in patients with acute leukemia.

The energy and protein status of 12 adult patients with acute leukemia (AL) was investigated during induction chemotherapy. Parenteral nutrition (PN) (nonprotein [NP], 31.4 kcal/kg/d; nitrogen [N], 0.177 g/kg/d) was started on day 6 after the beginning of chemotherapy and continued through all of the cytopenic phase. A clinical and metabolic evaluation, including measurement of resting energy expenditure (REE) by indirect calorimetry, was performed on each patient within the 2 days before beginning chemotherapy (D0), on the third day of chemotherapy (D3), and then weekly from day 7 until the end of the cytopenic phase. Measured REE at day 0 (29.5 +/- 1.4 kcal/kg/d) was significantly higher (+34 +/- 6%) than theoretical REE. Chemotherapy induced a significant decrease in REE at day 3 (26.2 +/- 1.7 kcal/kg/d; P less than 0.05), but during the cytopenic phase REE was not different significantly from its initial values (D0). A positive energy balance was observed during the whole study after the beginning of PN. In contrast, mean nitrogen balance remained negative always, due to a sharp increase in urinary nitrogen loss during the cytopenic phase. The fact that nutritional support falls short of its goal may explain why no improvement in tumor response to therapy has been described in most studies.

Acute Disease↗
PubMed1988

[Reduction of postprandial gastroesophageal reflux with sodium alginate in suspension. Multicenter pH study in 21 patients].

The purpose of this study was to ascertain the pharmacological effectiveness of sodium alginate liquid in the treatment of gastroesophageal acid reflux. The pharmacological test selected was 3 hours postprandial oesophageal pH, because of the physico-chemical properties of this drug. Twenty-one patients of both sexes were included in this study. The initial pH measurement served both as inclusion criteria, by confirming the presence of gastric acid reflux, and as reference for the evaluation of the effect of sodium alginate liquid by a second pH determination after treatment. After treatment with sodium alginate liquid, the number and mean duration of episodes of reflux, as well as the time spent at each pH level, had significantly decreased as compared to the initial value. The gastroesophageal reflux score was significantly reduced during the second hour in recumbent posture, but none of the different parameters studied separately (number and mean duration of episodes of reflux and time spent at each pH level) was significantly decreased. This study demonstrates the pharmacological effectiveness of the drug during the post prandial period and indicates that it is more effective in upright than in supine position.

Adult↗
PubMed1988

Effects of intravenous and intraduodenal fat on jejunal motility and on plasma cholecystokinin in man.

The effects of intravenous and intraduodenal fat on jejunal motility were studied in nine normal volunteers. Using a nitrogen hydraulic infusion system, recording was performed continuously during 4 hr of fasting and 5 hr of 100 ml/hr infusion of fat (Intralipid 10%) given either intraduodenally (group ID) or intravenously (group IV) and 9 hr after the end of fat administration successively. The two experiments were performed at seven-day intervals in random order. In six of the nine subjects, a third experiment, in which 20 g of cholestyramine was given by mouth during intraduodenal fat infusion (group ID + C), was carried out. Venous blood samples were drawn for measurement of serum triglyceride levels and radioimmunoassay of plasma cholecystokinin. Intraduodenal fat, alone or plus cholestyramine, induced a significant reduction in incidence of phase III of the migrating motor complex. Intravenous fat reduced the incidence of phase III. However, this reduction was significant only during the last 3 hr of fat infusion, corresponding to the highest serum triglyceride concentration. In the three groups, fat infusion induced a significant increase in duration of phase II, leading to a postprandial-like pattern. Plasma cholecystokinin increased significantly in the three groups during fat administration, with a significant positive correlation between serum triglyceride concentration and plasma cholecystokinin in the group IV. The data suggest that, in addition to its known inhibitory effects on activity fronts when acting luminally, fat given intravenously may inhibit phase III activity. The effects in both instances may be mediated in part by cholecystokinin.

Adult↗
PubMed1988

A comparison of enprostil and ranitidine in treatment of duodenal ulcer.

Enprostil is a new synthetic prostaglandin E2 with antisecretory and mucosal-protective effects. We compared it with ranitidine in the healing of duodenal ulcer and also examined the subsequent relapse rate. Three hundred thirteen patients were recruited in 15 centers in Europe, of whom 158 were treated with enprostil (E) 35 micrograms twice daily and 155 with ranitidine (R) 150 mg twice daily for up to 6 weeks, using a double-blind method. Patients in both groups were of comparable demography. Healing was significantly quicker with ranitidine. Of patients randomized to treatment, healing (intention-to-treat analysis) at 4 weeks was E 47% and R 69%, and at 6 weeks it was E 66% and R 88%. In patients who met all protocol criteria and completed treatment, healing at 4 weeks was E 58% and R 80%, and at 6 weeks it was E 81% and R 92%. Early relief of pain, both during the day and at night, was significantly quicker with ranitidine. Nausea, diarrhea, vomiting, and abdominal pain occurred more often with enprostil. There were no clinically important abnormalities in hematology or biochemistry. Relapse rates were similar. In conclusion, enprostil is not as effective as ranitidine in healing duodenal ulcers.

Adolescent↗
PubMed1988

[Colonic pseudo-obstruction associated with diffuse digestive and vesical motor anomalies. Apropos of 2 cases].

Two patients with acute colectasia, and acute urinary retention following pregnancy (case n. 1) and Klebsiellae septicemia (case n. 2) requiring endoscopic exsufflation in both cases, were seen. At onset, both patients had esophageal and anorectal manometric abnormalities with right colonic transit delay, and in case n. 2 urodynamic perturbation. Several months later, abnormalities disappeared in case 1, but remained unchanged in case 2. Jejunal manometry performed in case 2 showed decreased interdigestive complex frequency. These data suggest that: 1) acute colectasia may be major expression of digestive and urinary motility disorders, 2) acute colectasia can be the first symptom of a chronic disease, suggesting the usefulness of manometric studies in these patients, once the acute episode is over.

Adult↗
PubMed1987

Gastro-oesophageal reflux and alcoholic cirrhosis. A reappraisal.

The oesophageal pH was recorded for 3 h after a test-meal in 27 healthy control subjects (group I), 40 patients with alcoholic cirrhosis (group II), and 22 patients with a normal liver and symptoms of gastro-oesophageal reflux (control refluxers). Gastro-oesophageal reflux was observed in 10 of the cirrhotic patients. Marked reflux episodes lasted longer in cirrhotic refluxers than in control refluxers (P less than 0.05). The frequency of ascites, bleeding from ruptured oesophageal varices, peripheral neuropathy and hepatic encephalopathy were not significantly different according to presence or absence of reflux. Plasma concentrations of gastrin, somatostatin, motilin and vasoactive intestinal peptide (VIP) were measured in groups I and II. Fasting plasma motilin levels, and the release of motilin and of VIP after the meal were higher in group II than in group I. Basal levels and post-prandial profiles of the four peptides tested did not differ between cirrhotics with or without gastro-oesophageal reflux. We conclude that in patients with alcoholic cirrhosis: gastro-oesophageal reflux is frequent (25%) and characterized by prolonged reflux episodes; reflux is not correlated with the degree of liver failure and plays no significant role in the rupture of oesophageal varices; and raised plasma motilin and VIP levels cannot account for the high incidence of reflux in cirrhotics.

Adult↗
PubMed1987

Somatostatin effect on rectal muscle in human healthy volunteers.

The effect of somatostatin on the rectal muscle has been studied in 15 healthy volunteers who received on 2 separate days and in a random order a continuous 1-hour infusion somatostatin (250 micrograms initially as an intravenous bolus and then 250 micrograms/h via infusion) or placebo (saline 0.15 M). Our results show that somatostatin significantly reduces the rectal basal tone after 30 and 50 min of infusion without modifying the rectal distensibility. Although they were obtained through a pharmacological increase of plasma somatostatin levels, these data suggest that somatostatin could play a part in the reservoir function of the rectum.

Adult↗