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Biomedical subjects

R Colin

Publications and source records attributed to R Colin.

At least 109 records · Page 6Linked 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

[Epidemiology of cancer of the pancreas. Current data].

In view of the poor prognosis of pancreatic cancer, improvements in our knowledge of its epidemiology are desirable. The present study describes its main geographical and chronological features and presents an up-to-date view of the principal risk factors associated with that disease. Mortality from pancreatic cancer is characterized by its increase with age, its predominance among males and its preferential ethnic and geographical distribution. The most striking point, however, is the increase of incidence noted since 1950, with an as yet unexplained tendency to stabilization. Among the various risk factors suspected of being associated with pancreatic cancer, only tobacco smoking seems to be well established. The methodological problems encountered in analytical studies explain that the role of nutritional, occupational and associated pathological factors remains hypothetical in the present state of our knowledge.

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↗
PubMed1986

Decreased brush border hydrolase activities without gross morphologic changes in human intestinal mucosa after prolonged total parenteral nutrition of adults.

Animal experimentation with total parenteral nutrition (TPN) has revealed the occurrence of atrophy of the intestinal mucosa and decreased enzyme activities of the brush border, notably the disaccharidases. These findings have heretofore not been confirmed in human investigation. We performed endoscopic biopsies in the third part of the duodenum in 7 adults before TPN, after 21 days of TPN, and after a progressive oral refeeding. We noted a clear-cut decrease of major enzyme activities during TPN (sucrase, maltase, lactase, glucoamylase, acid aminopeptidase, dipeptidyl peptidase) without any morphologic modifications as observed with standard histology. Electron microscopy showed a slight but significant decrease in the height of microvilli. The decreased enzyme activities were rapidly restored after oral refeeding. Thus, the functional consequences of the modifications observed during medium-term TPN in adults are probably limited.

Adult↗
PubMed1986

Controlled trial of bowel rest in the treatment of severe acute colitis.

In a prospective, randomised clinical trial, 47 patients with severe, acute, non-infective colitis treated with 60 mg intravenous prednisolone daily, received either bowel rest with parenteral nutrition or oral diet. Although those who received 'bowel rest' experienced a reduction in daily stool weight, there were no differences in the operation or mortality rates between the groups. Fourteen of the 27 patients with ulcerative colitis, but none of the 16 patients with Crohn's disease required urgent surgery. Bowel rest did not affect the outcome in severe ulcerative colitis treated with intravenous prednisolone. Ulcerative colitis and Crohn's colitis behaved differently in the acute attack.

Acute Disease↗
PubMed1986

[Myoclonic cerebellar dyssynergia (Ramsay-Hunt syndrome) and cerebellar telangiectasia].

A 8 year-old girl presented with generalized epileptic seizures followed by the progressive onset of myoclonic jerks, sometimes associated with willed movements, and a static and kinetic cerebellar syndrome without conspicuous intellectual impairment. Death occurred 10 years after the onset of the disorders. There was no family history. Neuropathological studies showed lesions confined to the cerebellum. Diffuse and bilateral telangiectases were present in the cerebellar white matter. They were associated with patchy cortical alterations of the distal parts of some folia involving mainly the granule-cells ans sparing the Purkinje cells. No Lafora bodies and no abnormal lipofuscin storage were observed. The dentate nuclei, superior cerebellar peduncles and red nuclei were normal as were the inferior olives and inferior cerebellar peduncles. The spino-cerebellar tracts were unaffected. This case confirms the hypothesis that dyssynergia cerebellaris myoclonica corresponds only to a clinical entity. It may be encountered in various degenerative or metabolic disorders involving the cerebellum and/or its pathways. To our knowledge the association of a Ramsay Hunt syndrome with a vascular malformation has not been previously reported.

Adolescent↗
PubMed1986

[Hereditary visceral myopathy: an entity in idiopathic intestinal pseudo-obstruction].

A 17 year-old girl with chronic idiopathic intestinal pseudo-obstruction is reported. Abnormalities of smooth intestinal muscle were shown on light and electron microscopic studies of the excised small intestine and led to the diagnosis of visceral myopathy based on the following features: vacuolar degeneration of intestinal smooth muscle cells with replacement by fibrous preferential involvement of the external longitudinal muscle layer normal myenteric plexus. For the first time similar ultrastructural changes were found on histological study of the colon. Manometric studies revealed a diffuse disease involving the esophagus, small bowel, and bladder. Anorectal abnormalities, never described before, were reported. Family involvement was shown by abnormal esophageal and anorectal manometries in the patient's brother and by paternal history of fatal small intestine occlusion without mechanical obstruction. The prognosis of severe forms of visceral myopathy is generally poor because of the inefficiency of drugs. In this case, after a long period of parenteral nutrition with maintenance of a good nutritional status, a terminal ileostomy (with a special procedure to avoid evagination) associated with a second stage total colectomy allowed to stop parenteral nutrition.

Adolescent↗
PubMed1985

Hepatic antipyrine metabolism in malnourished patients: influence of the type of malnutrition and course after nutritional rehabilitation.

The present study of hepatic mixed function oxidase activity was carried out by determining antipyrine clearance in 49 patients presenting with energy malnutrition (group E, n = 26) or global protein-calorie malnutrition (group P, n = 23). A control group (group C, n = 25) was composed of subjects with good nutritional status. The metabolic clearance rate and weight-corrected clearance in group P were significantly lower than those in groups E and C. The weight clearances in the latter two groups were not significantly different, suggesting that mixed function oxidase activity decreases only in protein-calorie malnutrition. Antipyrine clearance was studied again in 27 patients after nutritional rehabilitation with artificial nutrition for 31 +/- 4 days (means +/- SEM). Concomitant with an improvement in nutritional state, clearances tended towards normal values in group P (n = 17) and were not significantly modified in group E (n = 10). It is thus important to take the type of malnutrition into account in pharmacological studies of malnourished humans in order to correctly adapt therapeutic doses.

Adult↗
PubMed1985

[Anorectal motility in idiopathic constipation. Study of 200 consecutive patients].

The aim of our work was to study anorectal motility and tension of the rectal wall in 200 constipated adult patients. Anorectal manometry was normal in 88 patients (group A), showed abnormal amplitude of the anorectal inhibitory reflex in 33 patients (group B) and hypertonia and ultraslow waves in 70 patients (group C). These anomalies were: a) reproducible in the 20 patients studied twice; b) observed in patients with enterocolitis, thus not specific of constipation; c) associated with an increased frequency of fecal evacuation difficulties. Despite normal values of tension of the rectal wall: a) the threshold of conscious perception of distension was increased in 14 p. 100 of patients; b) a paradoxical relationship between the anorectal inhibitory reflex and rectal tension was observed in group B patients. Our results support the concept of outlet obstruction due to anorectal dysfunction and suggest the possibility of neurologic and or ischemic mechanisms in group B patients.

Adolescent↗
PubMed1985

[Temporo-spatial epidemiology of cancer of the pancreas. Study of international and French mortality].

The aim of this study was to describe the main geographical and chronological epidemiologic characteristics of the mortality rates for pancreatic cancer (PC) in France and in other countries. The international geographical study shows PC standardized rates ranging from 3.1 to 9.9/100,000 for men and from 2.1 to 7.2/100,000 for women. Higher rates are observed in Northern and Eastern Europe, as well as in North America. In France, mortality rates decrease from the North-East to the South-West of the country. During the period 1950-1980, the median annual increase in PC mortality rates was 3 p. 100 for men, and 2.5 p. 100 for women in the countries studied. The increase was greater where initial PC mortality rates were low. This trend has slowed down during the last ten years (1971-1980). In France, annual PC mortality rates have increased more for men (+ 3.46 p. 100) than for women (+ 1.94 p. 100). There is evidence of an increased PC mortality rate from one generation to another. Cohort analysis points to a significant stabilization of PC mortality rates for women in France.

Female↗
PubMed1984

Ranitidine, cimetidine, antacids, and gastro-oesophageal reflux: results of a 20-hour oesophageal pH study.

This study compared the effects of cimetidine, ranitidine, and antacids on oesophageal pH levels. Forty-five patients were confirmed as having a gastro-oesophageal acid reflux by 3-hour postprandial metered pH measurements. The 45 patients were randomly placed into three treatment groups; one group received cimetidine 1 g/day, the second received ranitidine 300 mg/day, and the third received 60 ml/day of an antacid. The patients were retested under treatment (3-hour postprandial metered pH and prolonged 20-hour metered pH). The 3-hour postprandial metered pH was then compared to the pretreatment tests. The 20-hour postprandial metered pH test was compared with the results from 43 control (untreated) subjects with gastro-oesophageal acid refluxes. The 3-hour postprandial comparison showed a significant decrease in acid reflux with all three treatment drugs. The 20-hour measurement demonstrated a significant decrease with all three drugs in the number of acid reflux incidences compared to the untreated control patients; the ranitidine group had a significant decrease in the percentage of time with acid pH. No significant differences appeared in the comparison of the records of the 45 treated patients except for the percentage of time below pH 2 for 20 hours which was significantly lower for ranitidine. All three treatments were effective with a clear advantage in favour of ranitidine.

Adult↗
PubMed1984

[Digestive hemorrhage under anticoagulant treatment. Retrospective analysis of a series of 178 consecutive cases].

The aim of this study was to describe the clinical characteristics, prognosis and epidemiological pattern of gastrointestinal bleeding occurring in patients receiving anticoagulant therapy. From 1971 to 1981, among 3,194 consecutive patients admitted to a gastrointestinal unit because of acute gastrointestinal bleeding, 178 were under anticoagulant therapy (i.e. antivitamin K and heparin or heparin derivative in respectively 85 and 13 p. 100 of the cases). Fourteen percent of these 178 patients had also taken gastrotoxic drugs before the bleeding occurred. Indications for anticoagulant therapy were as follows: ischemic heart disease (21 p. 100), arrhythmias (20.3 p. 100), venous thrombosis and pulmonary embolism (15.8 p. 100), arteritis (10.8 p. 100), aortic, coronary or peripheral arterial grafts (8.4 p. 100), prophylaxis of venous thrombosis (8.4 p. 100), valve prosthesis (7.3 p. 100). The lesion responsible for bleeding was found in 80 p. 100 of the cases. Surgical hemostasis was required in only 4 patients. Ten patients died (2 postoperatively). During the study period, the incidence of bleeding associated with anticoagulant therapy in the group of patients admitted to the unit with gastrointestinal hemorrhage increased from 1.5 p. 100 to 8.0 p. 100. This fact appeared to be closely related to new indications (valve prosthesis, arterial grafts, prophylaxis of venous thrombosis) and to an increased incidence of gastrointestinal bleeding especially in association with acenocoumarol treatment. These results show that, although occurring in a high risk population, gastrointestinal bleeding related to anticoagulant therapy generally has a favorable outcome. They also suggest that a prospective epidemiological study may be of interest to determine the reasons for the increasing incidence and to propose preventive measures.

Adult↗