Laurent Siproudhis

Long-term outcome of non-fistulizing (ulcers, stricture) perianal Crohn's disease in patients treated with infliximab

Backgroundu2002 In Crohn’s disease, anal ulcers and stricture can be disabling.

INFLIXIMAB FOR REFRACTORY ULCERATIVE PROCTITIS

Aliment Pharmacol Theru200231, 1178–1185

Outcomes of intra-detrusor injections of botulinum toxin in patients with spina bifida: A systematic review

Bladder management in spina bifida patients relies on clean intermittent catheterization and oral antimuscarinics with a significant failure rate. The efficacy of intradetrusor injections of botulinum toxin has been confirmed in patients with spinal cord injury or multiple sclerosis but not in patients with myelomeningocele.

Constipation iatrogène@@@Iatrogenic constipation

RésuméAvec le bilan d’organicité, l’identification des causes iatrogènes médicamenteuses constitue la première étape du bilan étiologique d’une constipation. Son expression peut aller du simple inconfort passager à une occlusion sur iléus paralytique. L’éviction du médicament iatrogène n’est pas toujours possible, comme lors des traitements antiparkinsoniens, certains traitements antidépresseurs ou l’analgésie aux opiacés. Une analyse systématique des facteurs iatrogènes non médicamenteux est de ce fait d’autant plus indispensable, tout particulièrement chez la personne âgée ou les sujets institutionnalisés.AbstractWith evident symptoms of organicity, identifying medication causes may be the first step in the etiology of constipation. Its expression can range from transient discomfort to an occlusion on paralytic ileus. The eviction of iatrogenic medication is not always possible, as in some Parkinson’s treatments, antidepressants, or opiate analgesia. A systematic analysis of other iatrogenic factors is therefore all the more essential, especially in elderly or institutionalized subjects.

Comparison of neurogenic lower urinary tract dysfunctions in open versus closed spinal dysraphism: A prospective cross-sectional study of 318 patients

To compare the neurogenic lower urinary tract dysfunction (NLUTD) in patients with closed spinal dysraphism (CSD) versus patients with open spinal dysraphism (OSD) as well as their management patterns.

Reliability of urinary cytology and cystoscopy for the screening and diagnosis of bladder cancer in patients with neurogenic bladder: A systematic review

To assess the reliability of urinary cytology and cystoscopy to screen and diagnose bladder cancer in patients with NB.

Risk of prolapse and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor using clean intermittent catheterization versus Valsalva voiding

To assess the relative risks of pelvic organ prolapse (POP) and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor voiding with Valsalva versus those using clean‐intermittent catheterization (CIC).

Differential effects of two types of antidepressants, amitriptyline and fluoxetine, on anorectal motility and visceral perception

to assess the effects of 2 types of antidepressants (tricyclic, serotoninergic) on anorectal motility and visceral perception. Methods: placebo‐controlled, randomized, double‐blind, crossover study performed in 12 healthy male volunteers who received a single oral dose of amitriptyline (80 mg), fluoxetine (40 mg) or a placebo. Drug effects were assessed using phasic isobaric distension of the rectum with an electronic barostat (11 levels from 1 to 51 mm Hg) 3‐4 h after drug intake. Rectal volume and pressure, pressures at upper and lower parts of anal canal, rectal defecation (5–level scale) and pain (visual analogue scale) perceptions were recorded at each level of pressure. Results: Ten subjects completed the study. Compared to placebo, neither amitriptyline nor fluoxetine modified maximal rectal volume and pressure and rectal perceptions. Compared to placebo, antidepressants significantly reduced mean and residual pressures at upper part of anal canal (−18%, P=0.0019, and −27%, P=0.0002, respectively, for amitriptyline; −26%, P=0.0001, and −33%, P=0.0001, respectively, for fluoxetine) whereas only amitriptyline significantly reduced mean pressure at lower part of anal canal (−16%, P=0.0008). Conclusions: both antidepressants similarly relax internal anal sphincter, probably through a non‐specific mechanism, without modifying visceral perception. Only amitriptyline relaxes external anal sphincter suggesting specific noradrenergic alteration of motor‐somatic reflex.