[Intrahepatic portosystemic venous shunt].
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Biomedical subjects
Publications and source records attributed to G Soubiran.
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OBJECTIVE: To describe the variations in cancer incidence in the population born in French Polynesia (FP) according to the archipelago of birth and to compare this incidence with that of Hawaiians and Maoris. METHODS: Study of data from the Cancer Registry of FP, evacuation files, insurance records, hospital and pathology laboratory files. RESULTS: The overall world standardized cancer incidence in FP during the 1985-95 period in the populations born and living in FP was 246 per 105 person-years (PY) among women and 244 per 105 PY among men. The overall cancer incidence was similar to that in Hawaiians, but 25% lower than in Maoris. Digestive tract cancer incidence was a third that of these two reference populations, whereas that of pharynx, larynx and thyroid cancers was approximately twice as high. The overall cancer incidence rate increased between the period 1985-89 and the period 1990-95 in women, but was stable in men. Colorectal cancer incidence was highest in inhabitants born on the Windward Islands. Women born on the Austral Islands had a higher thyroid and liver cancer incidence and a lower breast cancer incidence. CONCLUSIONS: Further studies are needed to elucidate the variations observed between FP archipelagos, Maoris and Hawaiians.
Authors searched by mean of radio-immuno-essay A and C anti-meningococcal antibodies in two villages from Niger (181 and 92 patients) in a meningitidis endemic area, which one profited 10 months ago of a mass vaccination campaign (A and C polysaccharides). A and C antibodies quantities and percentages of protected patients are not significantly different between the two villages. In one hand anti-C levels increase with patients age. In the other hand, there is a correlation between C meningococcal antibodies and anti-Hbc antibodies.
Seven volunteers (3 females and 4 males; 3 Caucasians and 4 Africans) participated in two 24 h sessions during the cool dry (CD) and the hot dry (HD) seasons of the sahelian tropical climate. Body temperatures were taken on portable cassette recorders for 24 h. Rectal (Tre) and mean skin (Tsk) temperatures decreased in the HD compared to the CD conditions, meeting one of the criteria for adaptation to heat. No ethnic differences in thermal responses were found. Males and females differed in their body temperature rhythms and in their reactions to heat. Body temperatures were higher in females than in males. Males reacted to heat with a decrease in Tre, without change in the Tre-Tsk gradient. Females showed a decrease in both Tre and Tsk, more marked for Tsk, with an increase in the Tre-Tsk gradient. It was concluded that males showed seasonal acclimatization to heat via a decrease in metabolism confirmed by a decrease in plasma levels of thyroid stimulating hormone (TSH) in the HD condition. Females showed a mixed metabolic and thermolytic type of acclimatization, with an absence of variation in plasma TSH levels. In conclusion, the steady rise in temperature between the CD and HD conditions was sufficient to trigger an acclimatization to heat similar in Caucasian and African subjects, although exposure to the external climate differed widely.
From October 1982 to June 1985 158 hospitalized patients in the National Hospital of Niamey, Republic of Niger, were selected whenever one of the following signs was found: hepatomegaly, jaundice, ascites, oesophageal varices, abdominal venous pattern, or splenomegaly. Investigations included hepatic echography (158/158), needle liver biopsy (68/158), radioimmunoassays for serum hepatitis B surface antigen (HBsAg; 158/158), anti-HBs (152/158), anti-HBc (129/158) and anti-delta antibody (anti-HD; 158/158). 112 patients with liver diseases comprised 28 with chronic hepatitis, 55 with non-alcoholic hepatic cirrhosis, and 29 with hepatocellular carcinoma (HCC). 46 patients with other diagnoses were used as controls. 71/112 liver disease patients were positive for HBsAg in serum compared with 1/46 controls (P less than 10(-9)). Prevalences of delta superinfection in patients with serum HBsAg (+) and anti-HD (+) were 45/112 (40.2%) in liver disease patients versus 1/46 (2.2%) in controls (P less than 10(-9)). Delta superinfection was very frequent in chronic hepatitis (8/28), non-alcoholic cirrhosis (24/55) and HCC (14/29). In chronic hepatitis, delta superinfection was more frequent in the chronic active form than in the chronic persistent type (not significant). Cirrhosis patients with delta superinfection were younger (10 years in males, 11 years in females) than those without (P less than 0.05).
In 1984 and 1985, a non-random survey was conducted among healthy Africans living on the campus of the University of Niamey, Niger. Of 238 asymptomatic subjects, 17.6% carried hepatitis B surface antigen (HBsAg) in their serum, while 50.8% demonstrated protective anti-HBs antibodies. Antibodies to delta virus were detected in 29.3% of HBsAg-positive sera. This suggests that hepatitis B virus (HBV) and hepatitis delta virus (HDV) are common in Niger, and the factors that increase the likelihood of HBV transmission may also enhance the risk of HDV transmission.
Five imported falciparum malaria cases with severe evolution are reported. Treatment associated a blood exchange transfusion and an antimalaria chemotherapy (mefloquine in three patients and quinine in two patients). All patients were successfully cured despite of serious visceral complications occurring in two patients (pulmonary and cerebral oedema). Technical management of treatment is detailed. Exchange transfusion should be considered in falciparum malaria when parasitaemia overcomes 20% and when serious visceral impairment, hemolysis or consumption coagulopathy are occurring.
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78 hospitalized patients were selected when presenting with at least one of these signs: hepatomegaly, jaundice, ascites, oesophageal varices, abdominal venous pattern, splenomegaly. All had radioimmunoassays for hepatitis B surface antigen (HBsAg) and antidelta antibody (78/78). Acute or chronic hepatic disease was diagnosed in 56 patients: 7 acute viral hepatitis, 13 chronic hepatitis, 23 non alcoholic hepatic cirrhosis, and 13 hepatocellular carcinoma. Twenty-two patients with other diagnoses served as controls. Serum antidelta was present in each group: acute viral hepatitis (2/7), chronic hepatitis (2/13), non alcoholic hepatic cirrhosis (9/23), hepatocellular carcinoma (3/13), controls (2/22). Every patient with acute or chronic hepatic disease and positive serum anti-delta was positive for serum HBsAg. Amony controls, 2 patients with positive serum antidelta were negative for serum HBsAg but positive for antiHBs. Delta superinfection is present in the sahelian region; Patients with acute viral hepatitis, chronic hepatitis, non alcoholic hepatic cirrhosis, and hepatocellular carcinoma are electively infected. Patients with acute or chronic hepatitis and positive serum antidelta have hepatitis B virus evolutive infection (positive serum HBsAg).
In Niger, two communities, a urban one (Maradi) and a rural one (Tarna), living in a same malarious Soudano-Sahelian climatic area, were compared during wet and dry seasons by different methods (spleen rate, parasite rate, parasite count, level of immunity). During wet and dry season, spleen rates (0.7% and 2.6%) and parasite rates (1% and 1.6%) are considerably lower at Maradi than those observed at Tarna (spleen rates: 38% and 42%; parasites rates: 10% and 22.5%). It is shown that seroconversion occurs later in urban sector (100% between 20 and 29 year age) than in rural sector (100% between 10 and 15 year age). All malarious indicators were negative in a high percentage of Maradi-born children under 9 (79% during wet season and 81% during dry season) against respectively 28% and 31% at Tarna. Better paludometric index in urban community is a favourable sanitary indication. But epidemiological control must be prosecuted since the number of non-immune subjects is increased.
From December 1982 to June 1985, 185 patients with signs of chronic liver disease are investigated in National Hospital (Niamey, Republic of Niger). A first group ("Hepatopathy") of 131 patients (75 males, 56 females) is made of 3 chronic liver diseases: 35 chronic hepatitis (CH), 58 hepatic cirrhosis (HC), 38 hepatocellular carcinoma (HCC). A second group ("Controls") of 54 patients (29 males, 25 females) is made of miscellaneous diseases other than CH, HC, HCC. In the first group ("Hepatopathy") serum hepatitis B virus (HBV) surface antigen (HBsAg-radioimmunoassay) is present in 64.9% (85/131). In the second group ("Controls") serum HBsAg is present in 3.7% (2/54) (Chi-2 test P less than 10(-9)). Serum HBsAg prevalence is more than 50% in each group of CH, HC and HCC. A maximum value is observed in males with HCC (75.7%). These results demonstrate the importance of evolutive HBV infection in the course of CH, HC and HCC in the sahelian region.
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Hepatobiliary scintigraphy using Tc-99m diethyl IDA was performed on 14 jaundiced neonates. It aided greatly the differential diagnosis between neonatal hepatitis and biliary atresia. Limitations in the interpretation of the results are described, as neonatal hepatitis may be accompanied by biliary excretion ranging from zero to normal. Also both biliary atresia (intra- and extrahepatic) and neonatal hepatitis may show no biliary excretion within 24 hours.
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