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Biomedical subjects

C Buffet

Publications and source records attributed to C Buffet.

At least 91 records · Page 5Linked to original sources
PubMed1994

Prevention of relapse in patients with chronic non-A, non-B/C hepatitis who respond to alpha-interferon. A controlled multicenter trial of low-dose maintenance therapy. Groupe d'Etude Multicentrique de l'Interféron dans les Hépatites.

We tested the efficacy of maintenance treatment with alpha-2a interferon, 1 megaunit thrice weekly for 6 months, in preventing relapse of non-A, non-B/C hepatitis in remission after treatment with alpha interferon given thrice weekly according to the following dose schedule: 3 megaunits for 3 months, 2 megaunits for 2 months and 1 megaunit for 1 month. Fifty-three patients with hepatitis C in remission were randomly allocated to a treatment group (n = 26) or a control group (n = 27). A relapse (aminotransferase activity > 1.5 times the upper limit of normal) occurred in 46% of the controls and 35% of the treated patients (NS). Maintenance treatment had no significant influence on histopathologic changes evaluated by three independent observers: in both groups the overall score for histologic lesions improved between the initiation of interferon therapy and the end of the study. We conclude that relapses in patients with non-A, non-B/C hepatitis in remission after treatment with alpha interferon at tapering doses are not prevented by maintenance therapy with low-dose alpha interferon. Journal of Hepatology.

Alanine Transaminase↗
PubMed1994

Analysis of sera indeterminate by Ortho-HCV RIBA-2 by using three confirmatory assays for anti-hepatitis C virus antibody.

The diagnostic performances of three commercially available recombinant immunoblot assays (RIBAs) for anti-hepatitis C virus antibody were evaluated on 50 ORTHO-HCV RIBA-2 (RIBA-2)-indeterminate serum samples. Concordant interpretations were obtained with the three tests in 60% of the samples, with 56% positive, 2% indeterminate, and 2% negative results. Considering test performance in regard to the number of remaining indeterminate results, analyzing sera by RIBA-3, INNO-LIA HCV Ab III, and DECISCAN HCV reduced the number of samples reacting indeterminately to 40, 6, and 8%, respectively. The three serum samples classified as indeterminate in the INNO-LIA HCV Ab III as well as three of four serum samples interpreted as indeterminate in the DECISCAN HCV and 16 of 20 samples classified as indeterminate in the RIBA-3 were hepatitis C virus RNA positive by PCR. This study clearly shows the good performance of the three tests as confirmatory assays compared with that of the RIBA-2. However, according to the manufacturers' criteria of positivity, the INNO-LIA HCV Ab III and DECISCAN HCV appeared to be more suitable than the RIBA-3 for interpreting serum samples found indeterminate in the RIBA-2.

Antigens, Viral↗
PubMed1994

[Exudative gastropathy associated with cytomegalovirus infection after allogenic bone marrow transplantation].

The authors report a case of protein losing gastropathy associated with cytomegalovirus. This form which is extremely rare in adults occurred alone after allogenic bone marrow transplantation and become apparent by a hypoalbuminaemia causing oedema of the lower limbs. Gastrocopy showed large red folds of approximately a centimetre covered in a whitish hypersecretion coating. Biopsy demonstrated active gastritis which appeared on a hypertrophic and hypersecretive gastritis. Outcome was favourable within 3 months without treatment.

Adult↗
PubMed1993

[Non-parasitic cysts of the liver].

Solitary biliary cysts and polycystic liver disease are among the most frequent cystic lesions of the liver. Solitary biliary cysts have a prevalence of 1 to 2 percent; they are almost always asymptomatic and do not require treatment. Ultrasonography shows a regular, round or oval, entirely liquid and trans-sonic image sufficient to make the diagnosis. Complications are exceptional. Polycystic liver disease is associated with polycystic kidney disease in 50 percent of the cases, and the prognosis depends on the degree of renal failure. In polycystic disease of the liver and kidney the hepatic cysts develop before the renal cysts. Complications (e.g. cyst infection) are rare and principally observed in patients with terminal renal failure. In patients with complicated polycystic liver disease various treatments, such as needle aspiration, alcohol sclerotherapy or surgery, must be considered.

Bacterial Infections↗
PubMed1993

Gastrointestinal complications in renal transplantation.

One wonders whether the use of cyclosporin, histamine receptor antagonists, low doses of steroids, and early diagnosis and treatment actually modify the incidence, morbidity, and mortality of gastrointestinal (GI) and pancreatic complications in renal transplantation. To find out, we reviewed 614 kidney transplant recipients between January 1984 and December 1988. One hundred patients (16.2%) were found to have GI and/or pancreatic complications in the following distribution: 9.6% gastroduodenal, 1.3% pancreatic, 4% colonic, and 0.4% small bowel. None of the patients presenting a gastroduodenal ulcer had perforation or bleeding. Fifty-five percent of the patients with this complication had a past history of eso-gastroduodenal disease, compared to 19.6% in recipients without gastroduodenal complications. Some 4.4% of the patients had a small bowel or a colonic complication and four died of peritonitis due to bowel perforation. Mortality was 35% in those having intestinal resection and/or perforation with peritonitis. Sixteen percent of patients with colonic complications had a known history of diverticula, compared to 3% for those without colonic complications. The incidence of GI and/or pancreatic complications in renal transplant recipients remains high and has caused 1.1% of the deaths in our series. Mortality is essentially due to upper GI bleeding, peritonitis following perforation, and infectious colitis. Better detection of gastroduodenal and colonic disease before transplantation seems to be mandatory. Prevention with histamine H2 receptor antagonists and early surgical treatment of complicated colonic diverticula help to reduce the morbidity and mortality in kidney graft recipients.

Adult↗
PubMed1993

Grand mal seizures as a complication of treatment with pefloxacin in patients with cirrhosis. A report of three cases.

In this paper, three cases of grand mal seizures are reported as a complication of pefloxacin at usual doses (400 mg twice a day) in patients with cirrhosis. Grand mal seizures occurred from 12 h to 8 days after the onset of pefloxacin treatment. In 1 case, seizures recurred after inadvertent rechallenge with the drug. Elevated pefloxacin serum levels were demonstrated in 2 cases. Brain computed tomography in all 3 cases and cerebrospinal fluid examination showed normal results. No etiology other than pefloxacin overdose was found. After pefloxacin withdrawal, no recurrence of seizures were observed. Therefore, when pefloxacin treatment is indicated for cirrhotic patients, a reduced dosage and/or careful monitoring of pefloxacin serum levels should be recommended.

Child↗
PubMed1993

[Palliative treatment by endoprosthesis of icterus caused by distal biliary tumoral obstruction].

Between March 1982 and December 1987, 466 patients (256 women, 210 men, mean age 73 years) with tumor obstruction of the common bile duct were referred to our department. The causes of obstruction were carcinoma of the pancreas (298 patients), carcinoma of the ampulla of Vater (32 patients) and carcinoma of the common bile duct (136 patients). Endoscopical insertion of a biliary prosthesis was initially possible in 377 patients (81%). In case of failure, patients were referred to the radiologist for percutaneous drainage. Successful drainage was obtained in 58 patients with an overall success rate of 93% (435 patients). Endoscopic replacement was necessary in 170 cases for 114 patients and was successful in 155 (91%). Pruritus was relieved in 89% of the patients. Serum bilirubin levels decreased more than 75% after initial endoscopic endoprosthesis, repeated endoscopic endoprosthesis and percutaneous prosthesis insertion in 80%, 79%, and 62% of the patients, respectively. Short term complications of endoscopic endoprosthesis occurred in 28% of patients with a mortality rate of 8%. Percutaneous prosthesis complications occurred in 33% of patients with a mortality rate of 11%. In the long term, cholangitis was the main complication and occurred in 27% of patients with a delay of 103 +/- 105 days. Intestinal obstruction was observed in 7% of patients. The average life expectancy of endoscopic endoprosthesis and percutaneous prosthesis was 109 +/- 157 and 92 +/- 101 days, respectively. The average life expectancy of patients was 163 +/- 224 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Septicemias after endoscopic retrograde cholangiopancreatography. Risk factors and antibiotic prophylaxis].

The infection following endoscopic retrograde cholangiopancreatography (ERCP) is one of the most severe complications. The aim of the present study was to assess the prevalence and the prognosis of this complication, to look for the risk factors and to define bacterial ecology in order to put forward the most appropriate antibiotherapy. Two thousand and ten patients were included in this study. Among these, 51 (2.5%) had a septic complication following ERCP. Endoscopy biliary drainage was complete in 24 cases, incomplete in 19 and lacking in 8. Transhepatic biliary drainage was carried out in 17 cases. Sixteen patients (31%) with tumor obstructions died within 30 days after ERCP. Four risk factors were isolated when comparing infected patients with other patients: the completeness of biliary obstruction (90 vs 48%, P < 0.001); multiple cannulation attempts (1.76 +/- 1.12 vs 1.25 +/- 0.70, P < 0.001); the malignant nature of the obstruction (80 vs 23%, P < 0.002) and the lack of satisfactory drainage following endoscopy (53 vs 23%, P = 0.009). Pseudomonas aeruginosa was the most frequently isolated species, both from blood cultures (30%) and bile samples (23%). The preventive therapy of septic complications following ERCP must include strict rules concerning the disinfection of endoscopic material.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Current results of endoscopic sphincterotomy for lithiasis of the common bile duct].

Between January 1989 and June 1990, endoscopic sphincterotomy was performed in 308 consecutive patients with common bile duct stones (mean age: 74 years). Complete clearance of common bile duct was achieved at the first attempt in 65% of cases. This rate was significantly related to the size and the number of biliary stones. The success rate reached 97 percent after repeated endoscopic sessions (127 patients), mechanical lithotripsy (20 patients), extracorporeal or intracorporeal lithotripsy (18 and 11 patients, respectively). During the month following the endoscopic sphincterotomy, 39 patients (13%) developed one or more complications and 11 patients (3.7%) died. The complication rate was related to the time elapsed between biliary opacification and endoscopic sphincterotomy (P = 0.04) and between endoscopic sphincterotomy and total common bile duct clearance (P = 0.0007). No patient younger than 75 years died, but death occurred in 4.5% of the patients older than 75 years. Thirty patients (10%) developed endoscopic sphincterotomy-related complications. Cholangitis and bleeding were the most frequent complications (4 and 2%, respectively). Cholangitis occurred more frequently among the patients older than 75 (P < 0.05) or when transhepatic guided endoscopic sphincterotomy or intracorporeal lithotripsy was used (P < 0.005). Cholangitis led to death in 2 patients, 86 and 87 years old (0.7%). Endoscopic sphincterotomy related complications developed within 48 hours in all but 4 patients (2 patients with pancreatitis and 2 patients with cholecystitis).

Acute Disease↗
PubMed1993

[Portal cavernoma compressing the bile duct. Apropos of three cases].

Three cases of biliary tract compression caused by a cavernous transformation of the portal vein are reported. Revealing symptoms of biliary disease were anicteric and asymptomatic cholestasis in one patient, and cholangitis and obstructive jaundice in one case each. Endoscopic retrograde cholangiograms showed that the compression was located in the common bile duct in two cases and in the main bile duct in one. The responsibility of the portal cavernoma was established by the disappearance of jaundice after splenorenal shunt in one case. Biliary consequences of a portal cavernoma are very uncommon. Compression by the turgescent venous network combined with a sclero-inflammatory reaction of the biliary tract are the most likely causes.

Aged↗