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Biomedical subjects

C Buffet

Publications and source records attributed to C Buffet.

At least 127 records · Page 7Linked to original sources
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↗
PubMed1989

[Idiopathic granulomatous hepatitis and lymphoma of serous membranes].

We described the case of a woman with idiopathic granulomatous hepatitis who developed a type B lymphoma with serous effusion six years later. This association raised the hypothesis that sarcoidosis or lymphoma could present as idiopathic liver granuloma. We suggest that lymphoma developed in our patient as a consequence of the granulomatous hepatitis. This lymphoma was particular because only sera were involved.

Ascitic Fluid↗
PubMed1989

[Prognosis of spontaneous ascitic infection in cirrhotic patients].

The aim of this retrospective study was to define prognostic factors for cure and survival after spontaneous bacterial peritonitis. In a 4-year period from 1982 to 1986, spontaneous bacterial peritonitis was diagnosed in 38 consecutive hospitalized cirrhotic patients (positive ascites culture and polymorphonuclear cell concentration greater than 250 cells per mm3). Twenty-five patients recovered from their infection (69 p. 100) in a mean time of 9 +/- 7 days. The cumulative survival was 68 p. 100 at one week, 50 p. 100 at one month, and 25 p. 100 at one year. The best independent prognostic factors for lack of cure from peritonitis were a low ascitic pH value (p less than 0.001), an elevated serum creatinine level (p = 0.01) and the presence of hepatocellular carcinoma (p less than 0.05). The best prognostic factors for death were low ascitic pH value (p = 0.001) and gastrointestinal hemorrhage (p = 0.005). A low ascitic pH value was correlated with other signs of severe infection (signs of generalized infection, ongoing infection during the first week after diagnosis), with signs of severe liver disease (encephalopathy, hepatocellular carcinoma) or severe renal dysfunction (high serum creatinine level, low arterial pH value). Because of the late high-death rate associated with spontaneous bacterial peritonitis, liver transplantation should be considered in these patients.

Bacterial Infections↗
PubMed1989

[Serum activity of mitochondrial aspartate aminotransferase and extrahepatic cholestasis].

Serum mitochondrial aspartate aminotransferase (mAST) level and the mitochondrial aspartate aminotransferase/total aspartate aminotransferase ratio (mAST/AST) have been proposed as sensitive markers of chronic alcoholism. Their specificity, however, remains poorly defined. The purpose of this study was to compare these markers in three groups of hospitalized patients: group I, 80 patients with chronic alcoholic liver disease; group II, 51 patients with chronic liver disease without alcoholism; group III, 44 patients with extrahepatic cholestasis (due to choledocholithiasis in 21 and malignant in 23). mAST was measured after immuno-precipitation of cytoplasmic aspartate aminotransferase. The normal values of mAST (less than or equal to 2 mu/l) and mAST/AST (less than or equal to 6 p. 100) were defined in a group of 59 non alcoholic subjects without liver disease (controls). mAST was increased as compared with controls in 91 p. 100 of the patients of group I, 20 p. 100 of group II, 61 p. 100 of group III. mAST was comparable in groups I (mean +/- SD: 10 +/- 10.8) and III (10.3 +/- 12.9), and higher than in group II (1.8 +/- 2.4). m/AST was increased in 59 p. 100 of the patients of group I, 6 p. 100 of group II and 36 p. 100 of group III. It was higher in group I (8 +/- 4 p. 100) than in group III (6 +/- 4 p. 100, p less than 0.02), and particularly higher in both these groups than in group II (2 +/- 1 p. 100, p less than 0.00001). mAST was correlated to AST in each of these three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗
PubMed1988

[Is the focal echographic lesion of the liver in patients with cirrhosis always correlated with hepatocellular carcinoma? 217 cases].

The value of ultrasonography and serum alpha foetoprotein assay in the detection of hepatocellular carcinoma was evaluated in a retrospective study of 217 patients, (135 men and 82 women; mean age 58 years) who had been hospitalized for 18 months. Cirrhosis was of alcoholic origin in 76 per cent of the cases and complicated by ascites in 54 per cent. Twenty-four patients (11 per cent) had hepatocellular carcinoma diagnosed at ultrasonography in 20 cases. The carcinoma was diffuse in 7 cases, focal in 13 cases and less than 3 cm in diameter in 3 cases. A second ultrasonography diagnosed hepatocellular carcinoma in 4 cases. In 25/217 patients (11.5 per cent) the focal lesion seen at sonography was obviously not a carcinoma. Among the 207 patients who had a serum alpha foetoprotein assay, the result was normal in 167 (81 per cent) and 4 of these had a carcinoma. Among the 40 patients with an abnormal level of alpha foetoprotein, 19 had a carcinoma. This study confirms the good sensitivity of ultrasonography in the detection of hepatocellular carcinoma, but it also shows its low specificity, especially in cases with focal lesions. Ultrasonography and serum alpha foetoprotein assay should be used to detect hepatocellular carcinomas in cirrhotic patients who may benefit from surgical treatment. In the other patients, ultrasonically-guided biopsy should provide a firm diagnosis of carcinoma before undertaking other treatments, such as chemoembolization.

Adolescent↗