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Biomedical subjects

C Buffet

Publications and source records attributed to C Buffet.

At least 181 records · Page 10Linked to original sources
PubMed1985

[Viral hepatitis in pregnancy and materno-fetal transmission of the B virus].

Acute viral hepatitis is the most common cause of jaundice in pregnant women. In Western Europe and North America acute hepatitis is equally frequent and severe during and outside pregnancy, whereas its frequency and severity are higher during pregnancy in developing countries. The foetal prognosis is dependent upon the severity of the disease in the mother; there is no increase in the incidence of congenital malformations or mongolism. The mode of transmission of hepatitis B virus from mother to foetus is well known. The risk is particularly high in HBe Ag-positive women. In the majority of cases the disease is transmitted during labour or by maternal nursing after birth. Transmission through milk is of minor importance and transmission before birth is rare. It is now possible to prevent maternal foetal transmission by giving infants of HBs Ag-positive mothers an injection of anti-HBs gammaglobulins at birth and by vaccinating them against hepatitis B virus in the same way as adults. Neonates respond well to vaccination. These prophylactic measures offer hopes of eradicating chronic hepatitis, virus-induced cirrhosis of the liver and hepatocellular carcinoma.

Female↗
PubMed1985

[Hepatocellular carcinoma in France. Clinical, biological and virological aspects in 197 patients].

The authors report the clinical and biological features in 197 patients with hepatocellular carcinoma seen in two French hospitals. Mean age was 63 +/- 12 years. Eighty-nine per cent were men. Cirrhosis was present in 88 p. 100. Alcoholic liver disease was associated with hepatocellular carcinoma in 71.5 p. 100. At the time of diagnosis, ascites was present in 62 p. 100 of the patients, jaundice in 49 p. 100, encephalopathy in 20 p. 100 and gastrointestinal bleeding in 12.5 p. 100. Twenty patients (10 p. 100) did not have any of these complications. An increase in serum gammaglutamyl transpeptidase and ASAT was the most frequent biological abnormality observed in 96 and 94 p. 100 of patients respectively. Hypercalcemia and a high hematocrit were present in 5 and 6 p. 100 of patients respectively. Serum HBs Ag (RIA) was present in 17.5 p. 100 of patients, anti-HBc in 50 p. 100 and anti-HBs in 33.5 p. 100; 38.5 p. 100 of patients had no serum HBV marker. Serum alphafetoprotein levels were higher than 20 ng/ml, 250 ng/ml and 1,000 ng/ml in 76.5 p. 100, 43.5 p. 100 and 33 p. 100 of patients respectively. There were no relationships between the presence of serum markers of HBV or high alphafetoprotein levels and clinical and biological data. These results confirm that the clinical, biological and virological aspects of hepatocellular carcinoma in France are similar to those reported in other western countries.

Adult↗
PubMed1985

[Secondary cancer of the liver: value and efficacy of laparoscopy].

The indications for laparoscopy have been greatly reduced by the development of ultrasonography. However, laparoscopy is still indicated in secondary cancer of the liver, as it can provide histological proof of the diagnosis by means of biopsies taken under direct vision. It is therefore more effective than the non-invasive morphological examinations, but, in the future, it may be replaced by ultrasound guided biopsies. In general, laparoscopy only confirms a diagnosis which is very probable on the basis of clinical and laboratory data. Furthermore, it is very unlikely that laparoscopy will reveal small metastases; this is due to the multicentric nature of hepatic metastases, rather than to a deficiency in the investigation itself.

Humans↗
PubMed1985

[Propranolol prevention of hemorrhagic recurrence caused by rupture of esophageal varices: worsened prognosis in ascites and jaundice].

Between October 1981 and December 1983, 46 consecutive unselected cirrhotic patients who had been admitted for variceal hemorrhage were assigned to propranolol for the prevention of variceal rebleeding and followed for a mean period of 13.3 months (ranges: 1 day, 45 months). At the time of inclusion, 87 p. 100 of patients had alcoholic cirrhosis: ascites was present in 43 p. 100, jaundice in 43 p. 100 and encephalopathy in 33 p. 100 of cases. The goal of this retrospective study was to assess the effectiveness of propranolol in these unselected patients and to determine variables associated with a high rebleeding rate. Twenty-four patients (52 p. 100) rebled from esophageal varices within a mean time of 8.2 months (range: 6 days, 39 months) and 12 of these patients died. The percentage of patients who rebled from varices was 27 p. 100 at 6 months, 43 p. 100 at 1 year, 52 p. 100 at 18 months. Patients with ascites at the time of inclusion were 3.5 times more likely to rebleed than patients without ascites (p = 0.007). Patients with jaundice (total bilirubin greater than or equal to 50 mumol/l) were 3.1 times more likely to rebleed than patients without jaundice (p = 0.01). One year after the beginning of this treatment, the probability of rebleeding was 19 p. 100 in the 17 Pugh-Child class A cirrhotic patients, 60 p. 100 in the 15 class B patients, 55 p. 100 in the 14 class C patients. Neither proper acceptance in taking propranolol nor alcohol withdrawal were associated with significantly modified risks of rebleeding in these unselected alcoholic patients.

Ascites↗
PubMed1985

[Results of endoscopic sphincterotomy in common bile duct lithiasis].

Endoscopic sphincterotomy (ES) was attempted in 409 patients with common bile duct stone(s) (CBDS). The mean age of patients was 72.0 +/- 0.8 years (m +/- SEM); 47 p. 100 presented risk factors; 57 p.100 had previously been cholecystectomized while 43 p. 100 had not. On an average, patients in the former group were older (80 +/- 0.7 years) than in the latter 65.4 +/- 1.0 years, p less than 0.001). The procedure was successful in 98 p. 100 of the patients, after a standard ES in 78.5 p. 100 or after different technical artifices in 21.5 p. 100. The vacuity of the CBD was obtained in 96.5 p. 100 of the cases. During the first month after the ES, 13 p. 100 of the patients had complications and 4 p. 100 died; 37 complications (9 p. 100) were related to the ES and were responsible for death in 4 patients: 18 episodes of bleeding at the site of ES, 7 acute pancreatitis, 6 cholangitis, 4 retroperitoneal perforations and 2 other complications. The occurrence of these complications was closely related to the technique of ES being more frequent after technical artifices than after a standard ES (p less than 0.001). On the other hand, these complications occurred independently of the age of patients or of previous cholecystectomy. Seventeen complications (4 p. 100) did not depend directly on ES and were responsible for death in 14 patients (3 p. 100): pneumopathy, pulmonary embolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Endoscopy in tumors of the Oddi region. Diagnostic and therapeutic possibilities].

Between 1976 and 1983, 92 patients (mean age: 70 years) with ampullary or periampullary tumors, were evaluated by endoscopic procedures. The ampulla appeared malignant in 66 p. 100 of cases, enlarged but not obviously malignant in 15 p. 100 and normal in 18 p. 100. In one case, a tight duodenal stenosis prevented the endoscopist from seeing the ampulla. ERCP was performed in 70 patients and the common bile duct was opacified in 63 cases; it was dilated in 60 patients. Two types of tumors could be distinguished: 67 p. 100 grew within the duodenum and were seen by duodenoscopy and 33 p. 100 grew outside the duodenum and ERCP opacified a dilated common bile duct above a stenotic region; in these cases, diagnosis was established by biopsies performed through the ampulla, after endoscopic sphincterotomy (EST). Biopsy specimens were obtained in 67 p. 100 of cases and yielded a diagnosis of adenocarcinoma in 59 p. 100, questionable carcinoma in 15 p. 100, benign tumor in 16 p. 100 and normal mucosa in 10 p. 100. In 8 patients with the preoperative diagnosis of non-malignant tumor, operative biopsies finally revealed carcinoma in 7. EST or infundibulotomy was performed in 42 patients with 2 deaths from hemorrhage and cholangitis. Twenty-three patients received only EST as final treatment with complete disappearance of jaundice and/or cholangitis in 70 p. 100. Our results confirm the efficacy of duodenoscopy, ERCP and EST in the diagnosis and sometimes in the treatment of ampullary and periampullary tumors.

Adult↗
PubMed1984

Hepatic arterial embolization for malignant hypercalcemia in hepatocellular carcinoma.

A patient who presented with hypercalcemia was found to have an hepatocellular carcinoma. Medical treatment failed to normalize blood calcium levels. Liver resection was not feasible due to major extrahepatic involvement. Selective arterial embolization of the tumor was performed, resulting in correction of the hypercalcemia. This observation suggests that some life-threatening complications of unresectable hepatocellular carcinoma can be treated by arterial embolization of the tumor.

Carcinoma, Hepatocellular↗
PubMed1984

[Aneurysm of the trunk of the superior mesenteric artery and polyaneurysmal disease of the right paracolic arcade of fibromuscular hyperplasia type. A case].

The authors report a case of an aneurysm of the mid part of the superior mesenteric artery associated with polyaneurysmal disease of the right paracolic arterial arcade. Features of special interest in this case were the rarity of the location of the aneurysm and its aetiology: a hyperplastic fibromuscular angiodysplasia.

Aneurysm↗
PubMed1984

[Chronic alcoholic pancreatitis: relation of pain to withdrawal and pancreatic surgery].

A group of 73 patients suffering from painful alcoholic, chronic pancreatitis, hospitalized from 1971 to 1981, has been analyzed retrospectively. The aim was to assess the effects of alcohol withdrawal and pancreatic surgery on the course of pancreatic pain. The mean number of years during which the patients complained of pain was 3.5 +/- 0.5 (m +/- SEM). At the end of follow-up, 70 p. 100 of the patients did no longer suffer, alcohol withdrawal was obtained in 45 p. 100 and surgery had been performed in 41 p. 100. Continued alcohol abuse did not prevent pain relief: 60 p. 100 of patients continuing to drink at the end of follow-up, did not suffer any longer. One year after pancreatic surgery, pain relief was more frequent, if alcohol abstinence had been obtained before surgery (p less than 0.01). Among the 53 patients followed up to 5 years after the start of pain: a) the cumulative actuarial probability of disappearance of pain was 17 p. 100 at 2 years, 52 p. 100 at 5 years, 62 p. 100 at 8 years after the start of pain. Alcohol abstinence and surgery were observed during the first five years of pain; b) the mean number of years of pain was lower among the patients who became abstinent early (less than 4 years after the beginning of pain) than among those who did not (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗