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Biomedical subjects

T Vallot

Publications and source records attributed to T Vallot.

At least 37 records · Page 2Linked to original sources
PubMed1995

Gastric distension, hunger and energy intake after balloon implantation in severe obesity.

OBJECTIVE: To investigate the interrelationships between satiety feelings, abdominal perception, energy intake and weight loss, related to the presence of an intragastric balloon. DESIGN: Randomized double blind study. SUBJECTS: 20 severely obese subjects, BMI > 40 kg/m2, randomly assigned either to receive an air filled balloon (n = 11) or to have a sham procedure (n = 9). All subjects had dietary counselling to help them follow a relatively low energy diet (60% of individual spontaneous intake). MEASUREMENTS: During biweekly visits, body weight was recorded, visual analogic scales for stomach distension, hunger and feeling of balloon presence were completed. Blood chemistry profiles were monitored once every 4 weeks. RESULTS: In the balloon group, the sensations related to the presence of the balloon and to abdominal distension dramatically increased after insertion, and plateaued during the next 4 weeks. Both feelings of presence and distension decreased thereafter, and after 10 weeks they were not significantly different from those of the sham balloon group. Hunger dramatically decreased to about 30% of initial rating in the first week, but slowly returned to the initial value by the 12th week. Hunger feelings were highly and negatively correlated with feelings of distension. During the same period, the sham balloon group continued to maintain the low energy intake, and did not register any feelings of distension or presence; hunger level did not differ from initial levels throughout the whole study. The energy intake and the rate of weight loss (8-9 kg) was similar in the two groups during the study, and were not correlated with the feelings of distension. CONCLUSION: This study showed that in severely obese subjects submitted to a restrictive diet, an intragastric balloon has a measurable but transient effect on the sensation of epigastric distension and is able to decrease feelings of hunger. Unfortunately, these effects were not associated with a lower energy intake or a higher rate of weight loss than the sham situation. Thus, the present study does not support the interest of such a balloon (500 ml, air filled) in the treatment of severe obesity.

Adult↗
PubMed1994

[Helicobacter pylori and gastroduodenal disease].

Gastroduodenal infection by Helicobacter pylori is a known cause of many gastric and duodenal disorders. Infection by H. pylori is very frequent ant its prevalence increases with age by about 1% per year. Human-to-human transmission appears probable. H. pylori lives under the mucous layer of gastric-type epithelium. It is the main causal agent of chronic diffuse superficial gastritis (type B). After several decades lesions of superficial gastritis can evolve to atrophic gastritis. Spontaneous short- or long-term disappearance of H. pylori from the antral mucosa is rare. H. pylori infection appears to be necessary for the recurrence of duodenal as well as gastric ulcer. Eradication decreases the frequency of relapses, but its long-term effect remains to be evaluated. The presence of H. pylori, however, is not itself sufficient for ulcer development. Why only some patients infected with H. pylori develop ulcer has not been elucidated. The role of H. pylori infection in the gastrotoxicity of non-steroid anti-inflammatory agents is still debated. It has not yet been determined whether eradication leads to reduction of the high digestive morbidity linked to intake of such agents, but it is known that eradication of H. pylori does not obviate the risk of ulcer and of complication. There is a significant association between H. pylori infection, atrophic gastritis and intestinal type gastric cancer. H. pylori infection appears to be one of the factors in gastric cancerogenesis. Cellular proliferation of gastric lymphomas to low-grade B cells would in most cases be secondary to chronic H. pylori infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Duodenal Diseases↗
PubMed1994

[Stenosing esophagitis in Zollinger-Ellison syndrome].

Three patients with the Zollinger-Ellison syndrome and severe oesophagitis are reported. Intractable oesophageal stricture developed, leading to oesophago-gastrectomy in two patients and iterative oesophageal dilatations in the third. The retrospective analysis of these 3 cases led us to recommend, in case of oesophagitis in patients who have or might have the Zollinger-Ellison syndrome, to quickly institute a major antisecretory treatment, by parenteral route if necessary, to precociously and repeatedly control the efficacy of the antisecretory treatment mainly by measuring basal acid output and to avoid unjustified treatment discontinuance and gastric intubations.

Esophageal Stenosis↗
PubMed1994

[Comparative efficacy of lansoprazole and omeprazole on the intragastric pH measured over a period of 24 hours and on the basal].

OBJECTIVES: This paper aimed at evaluating the comparative efficacy of lansoprazole and omeprazole in reducing gastric acid secretion in patients suffering from Zollinger-Ellison syndrome. METHODS: Nine patients with non-resected gastrinoma(s) an previously well controlled by omeprazole (mean dosage 75 +/- 12.4 (SEM) mg/day; extremes: 20-160 mg/day) underwent 24-hour intragastric pH-metry, baseline acid output before next dosing and serum gastrin dosages, receiving their usual therapy and thereafter lansoprazole at a weight equivalent posology (mean dosage 81.6 +/- 12.5 (SEM) mg/day; extremes: 30-165 mg/day). RESULTS: Lansoprazole maintained intragastric pH and basal acid output at therapeutic levels, but a discrete reacidification, that deserves confirmation on a larger group of patients, was observed between the meals. CONCLUSIONS: The possible long-term benefit of this phenomenon, especially on gastrinemia and the fundic ECL-cells density and gastric bacterial content, remains to be evaluated.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1994

[Role of Helicobacter pylori in digestive disease in AIDS].

The frequent combination of chronic antral gastritis with the presence of Helicobacter pylori has been known for ten years. On the basis of studies carried out so far, Helicobacter gastritis is very infrequent in patients suffering from AIDS with digestive pathology. Our study of 317 patients with AIDS confirms the low incidence of this disorder which leads to the conclusion that the treatments intended to combat HIV are apt to modify the physico-chemical conditions of the stomach thus impeding Helicobacter colonization.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Molecular fractionation of gastric mucus component by high-performance liquid chromatography: application to pig gastric mucus in vitro and to human gastric mucus collected by aspiration during gastric endoscopy.

The glycoprotein molecular composition of antral and fundic adherent mucus has been studied by high-performance liquid chromatography on a silica gel column. Preliminary assays with pig gastric mucus allowed us to demonstrate the reproducibility of the method. The mucolytic activity of pepsin on this mucus demonstrates its ability to detect degradation of its glycoprotein components. This method was applied to control the state of pig antral mucosa that has previously been used in an in vitro antacid evaluation procedure, and also study human fundic and antral mucus collected by aspiration from normal and diseased stomachs during upper gastrointestinal endoscopy. Different elution profiles were obtained with these samples, depending on the presence of non-degraded or degraded mucus or due to the lack of mucus on the mucosa.

Adult↗
PubMed1993

Acute treatment of duodenal ulcer: experience with lansoprazole.

Clinical experience with lansoprazole in the acute treatment of duodenal ulcer patients has been compared with treatment using placebo, H2-antagonists or omeprazole. Among the various lansoprazole dosage regimens that have been tested, 30 mg daily for 4 weeks appears to be the optimal regimen to relieve pain rapidly and to heal ulceration in up to 90-95% of patients. Lansoprazole tolerability in the short term appears excellent, most adverse effects are trivial and not dose related. Duodenal ulcer relapse after ulcer healing with lansoprazole appears to occur at a rate similar to that observed after treatment with omeprazole or histamine H2-antagonists.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1993

Treatment of patients with Zollinger-Ellison syndrome.

In the treatment of Zollinger-Ellison syndrome patients with severe disease and acid hypersecretion, proton pump inhibitors are the drugs of choice. Data have now been accumulated on lansoprazole treatment of 41 patients (21 treated at the National Institutes of Health [NIH], Bethesda, Maryland, USA, and 20 treated at the Bichat-Claude Bernard Hospital, Paris, France). Short-term studies of the inhibitory action of lansoprazole on acid secretion have been carried out in both institutions. Our group first performed a dose-response analysis of the efficacy of lansoprazole in reducing basal acid output (BAO) in four patients with severe Zollinger-Ellison syndrome (mean BAO 52 +/- 9 [SD] mmol H+/h) who had previously been treated with a mean omeprazole dosage of 75 mg/day. The maximum acid inhibitory effect was obtained with lansoprazole 60-90 mg/day. The 40-hour duration of action of lansoprazole appears equivalent to that of omeprazole. In a second study at the Bichat-Claude Bernard Hospital, nine Zollinger-Ellison syndrome patients underwent 24-hour intragastric pH monitoring while receiving lansoprazole (mean dosage 80 mg/day, range 30-165 mg/day) or omeprazole (mean dosage 75 mg/day, range 20-180 mg/day). The acid inhibitory activity of the two drugs was comparable. Those patients are currently receiving long-term maintenance treatment with lansoprazole, and satisfactory clinical and biological secretory control has been achieved. The long-term safety and efficacy of lansoprazole administration were studied in the 21 patients followed at the NIH. In those patients the initial maintenance dose was determined using acid inhibition studies; in all patients lansoprazole controlled gastric acid hypersecretion and peptic symptoms in both the short and long term. The mean initial maintenance dose was 60 mg QID, except for two patients who required 60 mg BID. During long-term treatment (mean duration 31 months, range 1-43 months), six patients required a dosage increase within the first year, while the lansoprazole dose could be reduced in six others. The safety profile of lansoprazole has been excellent. Comparable results have been noted in nine Zollinger-Ellison syndrome patients during an ongoing evaluation in our institution. These studies indicate that lansoprazole is an efficacious, well-tolerated antisecretory agent in patients with Zollinger-Ellison syndrome.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1993

[The importance of follow-up of colorectal polyps].

In this paper, we have considered the indications for coloscopy for the screening of colon polyposis. On the basis of its sensitivity in detection and follow-up of colo-rectal cancer, we tried to determine the exact procedure to be followed subsequent to the discovery and ablation of a polyp. We have outlined the following parameters to be observed during the period of follow-up: dimension, number, histologic features of the polyp, age, general conditions and familiarity of the patient for colorectal cancer.

Adenocarcinoma↗
PubMed1992

[Gastric secretion of pepsin in gastroesophageal reflux complicated or not with peptic esophagitis].

Few data have concerned gastric peptic activity in reflux esophagitis. Gastric basal and pentagastrin-stimulated acid, pepsin, sialic acid (marker of gastric mucus erosion) and choline (marker of duodenal refluxate) outputs were measured in 75 patients with gastroesophageal reflux. Fifty-one patients had erosive esophagitis (grade greater than or equal to II) and 24 had no esophagitis or esophagitis grade I. In 12 patients of each group, gastric secretory parameters were correlated with results of 24-hour esophageal pH-metry. Stimulated pepsin output was significantly higher in patients with esophagitis than in the others (P less than 0.001). Basal pepsin output was significantly higher in women with esophagitis than in women without esophagitis (P less than 0.05). Acid, sialic acid, and choline outputs did not differ between the two groups. Thirty-seven and 49 percent of patients with esophagitis had elevated basal and stimulated pepsin outputs, respectively, as compared with 33 and 29 percent of patients without esophagitis. Thirty-one percent of patients with esophagitis had gastric acid hypersecretion, as compared with 25 percent of patients without esophagitis. There was no correlation between gastric secretory parameters and data obtained from esophageal pH-metry. Nevertheless, esophageal acid exposure was higher in patients with esophagitis than in patients without esophagitis. These results suggest that gastric proteolytic content is a pathophysiological factor for erosive esophagitis.

Adult↗
PubMed1991

[Role of lower digestive tract endoscopy and biopsy in inflammatory bowel diseases in adults].

The term inflammatory bowel diseases applies to two intestinal diseases (ulcerative colitis and Crohn's disease) localized to the colon. Clinical, morphological and histological data often point to one or the other of these diseases, but they are not always distinguishable, and intermediate forms classified under one name or the other are numerous. Lower digestive tract endoscopy and biopsies are determinant (1) for the diagnosis, as they provide a precise description of the lesions for each segment and evaluate their severity; (2) to monitor the course of the disease under treatment and detect precancerous lesions.

Biopsy↗
PubMed1991

Assessment of mucus glycoprotein erosion by measurement of sialic acid in gastric secretions: pathophysiologic and therapeutic aspects.

The quantification of mucus glycoproteins (GPs) faces paramount difficulties in terms of methods and interpretation. Mucus glycoprotein erosion, however, might be quantified in gastric juice by measurement of GP-bound sialic acid. Basal sialic acid content was low in normal healthy subjects (N) and in nonulcer dyspepsia (NUD) patients. They were five to six times higher in duodenal ulcer (DU), or more in Zollinger-Ellison patients. Pentagastrin stimulation induced a five- to sixfold rise in N and NUD patients although it did not affect DU patient sialic acid contents. Relationships between sialic acid content and pepsin output in DU indicate that pepsin exerts a variable mucolytic activity depending on disease evolution. In addition to pepsin, duodenogastric reflux exerts a potent mucolytic effect. Therapeutically, highly selective vagotomy without recurrent ulcer markedly reduced mucus erosion. The reduction of mucus erosion by protective drugs has been observed in some cases but in other cases sialic acid measurement did not allow to verify a protective effect. Adherent mucus analysis by high-performance liquid chromatography (HPLC) should allow one to appreciate GP fractions qualitatively. Combination of both methods should allow further determination of the mucus protective role, simultaneously investigating the adherent mucus quality and eroded GPs.

Aluminum↗