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Biomedical subjects

C Buffet

Publications and source records attributed to C Buffet.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Portal hypertension in cirrhoses: mechanisms, symptomatology and complications].

Cirrhosis is the most common cause of portal hypertension. This disease creates an intrahepatic block, principally by reducing the volume of sinusoids. Clinically, portal hypertension in cirrhosis is characterized by spleen enlargement, collateral venous circulation and the presence of oesophageal or gastric varices; these signs are frequent but not constant. Ultrasonography is used in the evaluation of all patients with portal hypertension. Beside the presence of oesophageal varices at fibroscopy, it is the best morphological exploration method to visualize portal hypertension. Portal hypertension may be complicated by haemorrhages due to rupture of the oesophageal varices and by ascites or encephalopathy, the latter two complications occurring when liver cell degeneration is associated with portal hypertension.

Ascitic Fluid↗
PubMed1990

Nodular regenerative hyperplasia of the liver, peliosis hepatis, and perisinusoidal fibrosis. Association with angioimmunoblastic lymphadenopathy and severe hypoxemia.

Three different liver lesions were found in a 20-year-old woman with angioimmunoblastic lymphadenopathy. The lesions included nodular regenerative hyperplasia of the liver, perisinusoidal fibrosis, and peliosis hepatis. It is suggested that the association of angioimmunoblastic lymphadenopathy with this broad spectrum of liver lesions was not fortuitous.

Adult↗
PubMed1990

Culture-negative neutrocytic ascites: a less severe variant of spontaneous bacterial peritonitis.

The clinical signs and symptoms, the biological data and the prognosis of 38 cirrhotic patients with culture-positive spontaneous bacterial peritonitis and 15 cirrhotic patients with culture-negative neutrocytic ascites were compared. The diagnosis of culture-negative neutrocytic ascites was based on the following criteria: an ascitic fluid polymorphonuclear count greater than 250/mm3, a negative ascitic fluid culture and the absence of previous antibiotic therapy and intraabdominal source of infection. All patients were treated by antibiotic therapy. There were no differences in clinical signs and symptoms and Pugh grading between the two groups of patients. Serum creatinine and prevalence of positive-blood culture were higher in spontaneous bacterial peritonitis. Patients with culture-positive spontaneous bacterial peritonitis had a higher ascitic fluid polymorphonuclear count and a lower ascitic fluid pH. Mortality was higher in patients with culture-positive spontaneous bacterial peritonitis than in patients with culture-negative neutrocytic ascites (relative risk: 2.6, p less than 0.01): cumulative mortality was, respectively, 50% and 20% at 1 months, 61% and 33% at 6 months, 75% and 41% at 1 year. The higher mortality observed in patients with culture-positive spontaneous bacterial peritonitis persisted after hospitalization (relative risk: 3, p less than 0.03). Our results suggest that culture-negative neutrocytic ascites is a less severe variant of spontaneous bacterial peritonitis.

Adult↗
PubMed1990

[Unusual cause of ascites: the POEMS syndrome].

A 39-year-old woman presented with polyneuropathy, hepatomegaly, splenomegaly, endocrinopathy, monoclonal protein and skin changes, several of the many clinical features of the recently described POEMS syndrome. In addition, she had a Castleman's disease (angiofollicular lymph node hyperplasia). In this case ascites was a main presenting feature. Thus, the POEMS syndrome must be added to the list of rare causes of ascites. Electron microscopy of the liver showed perisinusoidal fibrosis.

Adult↗
PubMed1990

[Effect of alcohol and cirrhosis on the presence of Helicobacter pylori in the gastric mucosa].

The aim of this study was to determine whether there was any relationship between alcohol consumption, cirrhosis and Helicobacter pylori associated antral gastritis. One hundred and forty-four patients undergoing upper gastrointestinal endoscopy were prospectively included and classified in four groups. The first group of 23 patients had cirrhosis and an alcohol consumption below 80 g per day. The second group of 31 patients had cirrhosis and an alcohol consumption over 80 g per day. The third group of 34 patients had an alcohol consumption over 80 g per day without cirrhosis. The fourth group of 56 patients had an alcohol consumption below 80 g per day without any preexisting liver disease and underwent upper gastrointestinal endoscopy for non specific digestive symptoms. The diagnosis of Helicobacter pylori was made at histological examination using the hematoxylin and eosin stain and the Whartin-Starry stain in each case. Histopathological results were confirmed by a bacteriological study in 15 cases. One hundred and twelve of 144 patients (78 percent) had gastritis. Gastritis was more frequent (p less than 0.01) when Helicobacter pylori was present than when it was not (90 percent vs 68 percent). Gastritis was more frequent when alcohol consumption was high (86 percent vs 72 percent). Helicobacter pylori was found in 26 percent of the first group, 48 percent of the second group, 65 percent of the third group and 45 percent of the fourth group. These differences were significantly different (p less than 0.05). A statistically significant relationship between high alcohol consumption and the presence of Helicobacter pylori was noted, even in the presence of cirrhosis (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Role of the serum level of mitochondrial aspartate aminotransferase as marker of alcoholic intoxication in cirrhotic patients].

The purpose of this study was to assess the diagnostic value of serum mitochondrial aspartate aminotransferase activity (mAST) and of the mitochondrial aspartate aminotransferase/total aspartate aminotransferase ratio (mAST/t AST) as markers of chronic alcoholism in cirrhotic patients. Sixty-three hospitalized cirrhotic patients (35 drinkers, 28 abstainers) were investigated. Ninety-six per cent of abstainers had normal values of mAST activity, while 89 per cent of drinkers had high levels of mAST activity. Cirrhotic patients were better divided into drinkers and abstainers by mAST activity (92 per cent) than by mean globular corpuscular volume (MCV) (81 per cent, NS) or by gamma-glutamyltransferase activity (GGT) (75 per cent, P less than 0.01). When the hospital costs of these markers were taken into account, MCV had a better "quality/price" ratio (Q/P) defined as diagnostic value/mean hospital cost (Q/P = 2.5) than MCV plus GGT (diagnostic value 61 per cent, Q/P = 1.2). The measurement of mAST activity in patients with high MCV value or with discrepancy between MCV and GGT values increased the diagnostic value of the other laboratory measurement to 89 per cent, but at a higher cost (Q/P = 0.8). Mitochondrial AST activity is a sensitive and specific marker of chronic alcoholism in cirrhotic patients. However, owing to its high cost, it should be proposed as a second marker after MCV and GGT.

Alcoholism↗
PubMed1989

Hypercalcaemia associated with chronic viral hepatitis.

A patient with long lasting non-parathyroid hormone mediated hypercalcaemia occurring within the context of hepatitis B virus chronic hepatitis is reported. Hepatocellular carcinoma and bone malignancy were carefully excluded. The biological pattern associated hypercalcaemia with normal phosphataemia, low nephrogenic cAMP level and high level of tubular reabsorption of phosphate. The usual causes of hypercalcaemia were ruled out. Hypercalcaemia may represent a rare biological feature of some advanced liver disease. The underlying mechanisms remain to be elucidated.

Calcium↗
PubMed1989

[Colonic endoscopic screening and familial antecedent of sporadic rectocolonic cancer. Controlled prospective study].

We searched for colorectal tumors in asymptomatic patients older than 40 years with family history of sporadic colorectal cancer (only first degree relatives). One hundred and four patients at risk had a left-sided (n = 60) or a total colonoscopy (n = 44) and were compared to 104 control patients, matched for age, sex and type of colonic investigation. Three cancers were detected in the group at risk, 1 in the control group (NS). One or more adenomas without carcinoma were found in 10 percent of the patients at risk and in 9 percent of the controls (NS). There was no difference between groups in the number, size, histologic type, degree of dysplasia, or location of adenoma in the colon. These results do not exclude a family predisposition to sporadic colorectal cancer or adenoma. Because of the low rate of adenoma detection, relatives of patients with sporadic colorectal carcinoma but without personal risk factors cannot be considered as a high risk group for colorectal endoscopic screening.

Adult↗