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Biomedical subjects

R Modigliani

Publications and source records attributed to R Modigliani.

At least 109 records · Page 6Linked to original sources
PubMed1984

[Treatment of duodenal ulcer outbreak with omeprazole. Results of a multicenter non-controlled study].

Sixty-one patients with symptomatic endoscopically confirmed duodenal ulcer, 5 mm or more in diameter, were treated with omeprazole 30 mg once daily in the morning for 4 weeks. Complete ulcer healing was assessed by endoscopy performed after 15 and, if necessary, 29 days of treatment. The healing rate as 83 p. 100 (49/59 patients) after 2 weeks, and 98 p. 100 (58/59 patients) after 4 weeks. Only 5 patients remained symptomatic on day 15. Fifty-six patients did not take any antacid during the course of treatment. There were few adverse effects. No clinically significant changes in laboratory parameters were observed. These results confirm: the remarkable efficiency of omeprazole in short-term treatment of duodenal ulcer, the good tolerance to this drug, at least in short duration treatment.

Adult↗
PubMed1984

[Digestive localizations of scleroderma].

Systemic scleroderma involves the gastro-intestinal tract in over 50 p. 100 of cases, the commonest target organs being the oesophagus, the small intestine, the colon and the stomach in that order. The G-I symptoms of this collagenosis are all related to disorder of motility secondary to disturbances of innervation and then to atrophy of the smooth muscle and fibrous infiltration. Oesophageal involvement results in gastro-oesophageal reflux and/or dysphagia due to the lack of tonicity of the lower oesophageal sphincter and a reduction of peristalsis. Disease of the small intestine may cause pseudo-intestinal obstruction or a secondary malabsorption syndrome due to abnormal intraluminal bacterial flora. Colonic involvement causes severe constipation with formation of faecoliths. Finally, scleroderma may be complicated by an acute abdominal syndrome: occlusion due to diffuse reduction in small intestinal motility, peritonitis due to perforation of the small intestine, ileo-colonic infarction, gastro-intestinal haemorrhage complicating telangiectasia. Treatment is purely symptomatic: classical remedies for gastro-oesophageal reflux and its complications, and antibiotics for malabsorption syndromes.

Anus Diseases↗
PubMed1983

Acquired immunodeficiency with intestinal cryptosporidiosis: possible transmission by Haitian whole blood.

A 31-year-old Frenchman had an acquired immunodeficiency syndrome (AIDS) with profound depression of cellular immunity and relative sparing of humoral immunity. The clinical picture included intractable secretory diarrhoea, vomiting, abdominal pain, and weight loss. Gastrointestinal cryptosporidiosis was present and a perfusion technique showed profuse secretion of fluid in the proximal small bowel. The patient also had recurrent Salmonella typhimurium septicaemia, cytomegalovirus infection, and cerebral toxoplasmosis and he died within 13 months. This patient did not belong to any of the groups known to be affected by this type of acquired immunodeficiency (homosexuals, drug addicts, haemophiliacs, Haitians) but had been transfused with Haitian blood 4 years before onset of symptoms. This case supports the notion that some forms of AIDS may be transmitted by blood, with a long incubation period.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Gut hormones in inflammatory bowel disease.

We have studied fasting levels and the response to a standard test breakfast of blood glucose and several gut hormones in 24 patients with ulcerative colitis, in 14 patients with Crohn's disease, and in 14 healthy control subjects. Patients with ulcerative colitis had significantly elevated fasting human pancreatic polypeptide (HPP) concentrations, and both basal and postprandial levels of gastrin, gastric inhibitory polypeptide (GIP), and motilin were greater than normal. In contrast, patients with Crohn's disease had normal gastrin levels but had increased fasting and postprandial levels of GIP and motilin and, in addition, of enteroglucagon, compared with controls. These patients also had greater than normal HPP concentrations 30 min after the breakfast. Normal levels of insulin, pancreatic glucagon, neurotensin, and vasoactive intestinal polypeptide were found in both groups of patients. Much remains to be known about the pathophysiology of these two debilitating diseases, and the abnormal release of gut hormones may be of importance.

Adolescent↗
PubMed1983

[Total villous atrophy, mesenteric lymph-node cavitation, splenic atrophy. An unusual form of celiac disease in adults, apropos of a new case].

The authors report a new case concerning the syndrome "total villous atrophy, mesenteric lymph-node cavity formation and splenic atrophy" in a 41 year old woman. This pathologic association is characterized by: a) a clinical and biological malabsorption syndrome; b) proximal small bowel alterations as observed in coeliac disease, with, especially subtotal or total villous atrophy, abnormal enterocytic epithelium, hyperplastic crypts and lymph-plasmacytic infiltrate in the lamina propria; c) lymph node mesenteric cavity formation with an heterogeneous necrotic, sometimes liquefied, substance, without germ or parasite. Rare cortical lymphoid follicles are still persistent; 3) a splenic atrophy. A temporary improvement with gluten-diet (G.F.D.) was followed by a one-year period of total resistance. A treatment including corticotherapy was then successful and since the 14 past months her health remained satisfactory. Clinical, pathological data and the evolution about this patient are compared with those of the six published cases. The aetiology of this syndrome only observed in adults at the present time is unknown; the fact that patient's child presents with a coeliac disease, allows to authenticate, for the first time, this syndrome as a special form of adult coeliac disease.

Adult↗
PubMed1982

Gut hormone release after intestinal resection.

To investigate the possible role of gut and pancreatic hormones in the adaptive responses to gut resection, plasma concentrations of the circulating hormones were measured, in response to a test breakfast, in patients with either small or large intestinal resection and in healthy control subjects. In 18 patients with partial ileal resection a significant threefold rise was found in basal and postprandial levels of pancreatic polypeptide, a fourfold increase in motilin, and more than a twofold increase in gastrin and enteroglucagon levels compared with healthy controls. In contrast, nine patients with colonic resection had a threefold rise in levels of pancreatic polypeptide only. One or more of these peptides may have a role in stimulating the adaptive changes found after gut resection.

Adult↗
PubMed1982

Pancreatic and gastrointestinal hormones in chronic pancreatitis.

Pancreatic and gut hormones have been measured in 39 patients with chronic pancreatitis, 16 of whom had severe pancreatic insufficiency. Patients with pancreatic insufficiency had significantly diminished fasting levels and postprandial rises of pancreatic polypeptide which were less than 20% of normal. Patients with chronic pancreatitis, with or without exocrine insufficiency, had two- to threefold higher plasma levels of motilin and enteroglucagon than controls. Plasma levels of insulin, pancreatic glucagon, gastric inhibitory polypeptide and gastrin were similar to normal in these patients. The pattern of response of these hormones to a test breakfast differs markedly from those seen in other gut disease states and may reflect pathophysiological mechanisms.

Adult↗
PubMed1980

Effect of a combination of gastrin, secretin, cholecystokinin, glucagon, and gastric inhibitory polypeptide on jejunal absorption in man.

In 11 conscious volunteers, the jejunal absorption was measured during basal state and during the simultaneous intravenous infusion of small doses of gastrin, secretin, cholecystokinin, glucagon and gastric inhibitory polypeptide. The blood levels of gastrin, secretin, glucagon, and GIP were measured by RIA and were close to those achieved after a meal. The basal net absorption of water and electrolytes was reversed to a net secretion during the hormonal infusion. These results suggest that the jejunal secretion observed after a meal in man may be mediated by hormones released by the meal.

Adolescent↗
PubMed1979

Depressed jejunal secretion of water and ions in response to prostaglandin E1 in adult celiac disease.

In order to test in man the concept that intestinal fluid secretion originates from the crypts of Lieberkühn, we assessed the jejunal secretory effect of intraluminal prostaglandin E1 (PGE1) (0.9 microgram/kg/min) in untreated adult celiac disease (ACD, N = 7), treated ACD (N = 4) and normal subjects using the intestinal perfusion technique. In untreated ACD (1) water and solutes were malabsorbed (or secreted) in the basal period; (2) fluid and ion secretion seen during PGE1 infusion and net secretory effect of PGE1 (difference in transport between basal and PGE1 periods) were reduced (P less than 0.01); (3) the effects of PGE1 inhibition of sodium insorption, and stimulation of sodium exsorption, were decreased and abolished, respectively. In treated patients PGE1-induced secretion returned towards normal values. Our finding of a depressed secretory response to PGE1 in the face of marked crypt hypertrophy do not support the concept that crypt cells are the major site of intestinal fluid secretion.

Adult↗