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La Revue de Médecine Interne 04/2001; 22(3):310-3. · 0.61 Impact Factor
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ABSTRACT: INTRODUCTION: Small intestinal bacterial overgrowth syndrome (SIBOS) has various clinical and biological presentations. Six observations are described in this review which is aimed at reporting recent data on SIBOS and proposing diagnosis and therapeutic attitudes. CURRENT KNOWLEDGE AND KEY POINTS: Chronic diarrhea, malabsorption syndrome and exsudative enteropathy are the main criteria of diagnosis. Breath hydrogen testing is commonly performed to confirm diagnosis, with a 78% sensitivity and a 89% specificity. The aim of therapy is reparation of malabsorption consequences, reduction of intestinal bacterial overgrowth, and surgical correction of intestinal stasis. In the absence of consensus, norfloxacin or amoxicillin-clavulinic acid (administered for a mean of 7 to 15 days) seem the more appropriate antibiotics. When possible, surgery represents the primary treatment of SIBOS recurrences. FUTURE PROSPECTS AND PROJECTS: Diagnosis of small intestinal bacterial overgrowth syndrome must be evoked on the basis of either surgical or medical context, i.e., the existence of chronic diarrhea, malabsorption syndrome (complete or not), and exsudative enteropathy. This review reports essential factors for diagnosis and treatment.
La Revue de Médecine Interne 02/2001; 22(1):20-9. · 0.61 Impact Factor
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Gastroentérologie Clinique et Biologique 01/2001; 24(12):1237-40. · 0.80 Impact Factor
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La Presse Médicale 04/2000; 29(10):542. · 0.67 Impact Factor
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Gastroentérologie Clinique et Biologique 12/1999; 23(11):1258-60. · 0.80 Impact Factor
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La Presse Médicale 10/1999; 28(27):1466-7. · 0.67 Impact Factor
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ABSTRACT: Dissecting aneurysms of the internal carotid artery are due to arterial wall dissection caused by hematoma. We report a case of spontaneous dissection.
A 65-year-old man presented with painful Horner's syndrome and hypoglossal palsy, without a history of arterial traumatism. Magnetic resonance imaging showed carotid artery dissection.
Distal and subadventicial dissection can induce compression of adjacent nerves without modifications of the arterial lumen. This type of wall hematoma may not be detected by ultrasonography and angiography. Magnetic resonance imaging proves to be the best method of investigation and should be primarily advocated. Anticoagulation treatment is necessary.
La Revue de Médecine Interne 06/1999; 20(5):427-30. · 0.61 Impact Factor
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La Revue de Médecine Interne 05/1999; 20(4):374-5. · 0.61 Impact Factor
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ABSTRACT: Due to ifosfamide urotoxicity, encephalopathy is a frequent complication accompanying treatment with this drug. The various clinical, physiological and therapeutical aspects of ifosfamide-related encephalopathy are reviewed. We report two cases and review current literature.
Ifosfamide-related encephalopathy has polymorphous and non-specific clinical picture. The disease severity is variable, as related deaths have been reported. Clinical signs disappear with treatment discontinuation. Routes of administration, doses, tumoral site and gender have been implicated in the disease physiopathology. Admittedly, metabolite mitochondrial toxicity would be the underlying mechanism. Treatment would be based on intravenous methylene blue. A clinical trial aimed at studying prophylaxis is in progress. A few number of patients have been cured until now.
Further studies are required to confirm the involved physiopathological mechanisms and methylene blue effects.
La Revue de Médecine Interne 04/1999; 20(3):264-6. · 0.61 Impact Factor
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La Revue de Médecine Interne 03/1999; 20(2):184-5. · 0.61 Impact Factor
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La Presse Médicale 03/1999; 28(7):339. · 0.67 Impact Factor
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La Presse Médicale 03/1999; 28(5):232. · 0.67 Impact Factor
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La Revue de Médecine Interne 02/1999; 20 Suppl 2:308s-310s. · 0.61 Impact Factor
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Gastroentérologie Clinique et Biologique 01/1999; 22(12):1113-4. · 0.80 Impact Factor
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La Revue de Médecine Interne 01/1999; 19(12):937-8. · 0.61 Impact Factor
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ABSTRACT: Empty sella syndrome is sometimes associated with anterior pituitary insufficiency, the latter being mostly partial or dissociated.
We report a case of a profound panhypopituitarism revealing an empty sella syndrome. This case shows that empty sella syndrome, although a generally benign and asymptomatic condition, can be associated with hypopituitarism.
In case of empty sella syndrome, especially if an endocrine dysfunction is clinically suspected, minimal hormonal analysis must be requested.
La Revue de Médecine Interne 09/1998; 19(8):565-7. · 0.61 Impact Factor
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Gastroentérologie Clinique et Biologique 06/1998; 22(5):558-9. · 0.80 Impact Factor
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La Presse Médicale 04/1998; 27(12):571. · 0.67 Impact Factor
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ABSTRACT: Autoimmune cholangitis is a rare cause of chronic liver disease which has recently been described and associates the clinical, biological, and histological patterns of primary biliary cirrhosis without serum anti-mitochondrial antibodies. We report a case of this disease in a 67-year-old female. The patient presented with jaundice and marked biological cholestasis associated with pulmonary fibrosis and salivary and lacrymal sicca syndrome. Serum anti-smooth muscle antibodies were found without anti-mitochondrial antibodies. Corticotherapy resulted in rapid improvement of clinical and hepatic abnormalities, as well as of pulmonary lesions. The patient was still healthy 18 months later, with low dose corticotherapy. This report emphasizes the possible effectiveness of corticotherapy in autoimmune cholangitis.
Gastroentérologie Clinique et Biologique 02/1998; 22(1):94-7. · 0.80 Impact Factor
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La Revue de Médecine Interne 08/1997; 18(7):582-3. · 0.61 Impact Factor