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J Lafon

Publications and source records attributed to J Lafon.

At least 19 recordsLinked to original sources
PubMed2006

Low compliance with colonoscopic screening in first-degree relatives of patients with large adenomas.

BACKGROUND: Little is known about compliance with colonoscopy as a screening method in first-degree relatives of patients with large adenomas. Aims To evaluate the compliance with screening colonoscopy among this population, and its determinants. METHODS: Data were obtained from the family part of the GEADE study, a study on genetic factors of colorectal adenomas. Index cases were 306 patients with adenomas > or = 10 mm. All living first-degree relatives aged 40-75 who could be contacted by the index case were asked to undergo a colonoscopy, unless they had had one in the previous 5 years. RESULTS: Among 674 eligible relatives, 56 had had a colonoscopy within the preceding 5 years and 114 underwent a screening colonoscopy resulting in a compliance with screening colonoscopy of 18%. This was not related to most characteristics of index cases. Compliance was significantly lower when the index case lived in the Greater Paris area than when he/she lived in other areas (12% vs. 21%). It was higher in siblings (18%) and offspring (23%) than in parents (9%) and in relatives under 55 years old (22%) than in relatives aged 55 and over (15%). CONCLUSIONS: Compliance with colonoscopy was low in first-degree relatives of patients with large adenomas. The reasons for this should be determined and appropriate strategies developed to increase compliance.

Adenoma↗
PubMed2001

Successful combination therapy of polyarteritis nodosa associated with a pre-core promoter mutant hepatitis B virus infection.

BACKGROUND/AIMS: To describe the clinical and virological evolution of a polyarteritis nodosa (PAN) case associated with a hepatitis B virus (HBV) pre-core promoter mutant infection that was successfully treated with plasma exchanges, corticosteroids, and interferon alpha (IFN-alpha). METHODS: Viral markers were used, including HBV DNA quantified by the branched DNA assay and detected by PCR, the HBV genome sequence, pre-S1Ag and anti-HBC IgM which were studied throughout the treatment period and the entire follow-up in the serum, while the presence of virus in extrahepatic sites was detected by immuno-staining. RESULTS: The patient was infected with a typical pre-core promoter mutant harboring four point mutations. Pre-S1Ag was cleared rapidly from serum, most likely via the formation of immune complexes since HBV DNA declined more progressively. Viral infection was then cleared after a second episode of hepatocyte lysis. This was accompanied by a recovery from all clinical manifestations. CONCLUSIONS: The favorable treatment outcome observed in this first case of pre-core promoter HBV mutant associated PAN underlines that combination therapy based on IFN-alpha can clear pre-core promoter HBV infection and cure PAN. It also provides new insight in the pathogenesis of HBV associated PAN.

Adrenal Cortex Hormones↗
PubMed1999

[Infection of submucosal tumor after endosonography-guided needle biopsy].

Endosonography fine needle guided aspiration (EUS-FNA) biopsy is an interesting technique for the diagnosis of suspected gastrointestinal lesions, and is rarely complicated by infection. We report one case of severe infection after EUS-FNA of benign oesophageal leiomyoma, leading to an oesophagectomy. Recent studies about this technique described only infectious complications after biopsy of cystic lesions. They also show that EUS-FNA may misdiagnose leiomyosarcoma. Our report confirms these data, and relates a hitherto non-reported complication, i.e. the infection of a non-cystic lesion.

Abscess↗
PubMed1998

Colonoscopic screening in first-degree relatives of patients with 'sporadic' colorectal cancer: a case-control study. The Association Nationale des Gastroentérologues des Hôpitaux and Registre Bourguignon des Cancers Digestifs (INSERM CRI 9505)

BACKGROUND & AIMS: A screening policy has not been well defined in first-degree relatives of patients with sporadic colorectal cancer. This study estimated the risk of colorectal adenoma in a cohort of individuals with only 1 affected first-degree relative. METHODS: A total of 476 first-degree relatives (age, 40-74 years) of 195 patients with sporadic colorectal cancer were offered a colonoscopy. Each examined relative was matched with 2 controls for age, sex, symptoms, and center. The prevalence of colorectal adenomas was compared using a multiple logistic regression analysis. RESULTS: In 185 relatives, odds ratios were 1.5 (95% confidence interval [CI], 1.0-2.4) for adenomas, 2.5 for large adenomas (95% CI, 1.1-5.4), 1.2 for small adenomas (95% CI, 0.7-1.9), and 2.6 (95% CI, 1.3-5.1) for high-risk adenomas (> or = 1 cm in size and/or with a villous component). The prevalence of high-risk adenomas in relatives was higher when the index patient was younger than 65 years, was male, and had distal rather than proximal cancer. CONCLUSIONS: Subjects with only 1 affected first-degree relative are at increased risk for developing large adenomas.

Adenoma↗
PubMed1998

Cutaneous and gastrointestinal mastocytosis associated with cerebral toxoplasmosis.

A patient with systemic cutaneous and gastrointestinal mastocytosis and associated meningoencephalitic toxoplasmosis is reported. The simultaneous occurrence of the two conditions and their regression after treatment of the toxoplasmosis suggest a possible relationship between the mast cell proliferation and the parasitic infection. Mast cell activation and stimulation may be transitory in response to a stimulus, causing reactional mastocytosis.

Adult↗
PubMed1994

[Hemobilia caused by biliary cyst].

Recurrent angiocholitis attacks occurred in an 80-year-old woman, and repeated investigations could not provide any diagnosis. Subsequently, the patient developed haematemesis. Angiography revealed haemobilia from an intrahepatic cause. Surgical constatations and pathological examination of the resected specimen revealed that haemobilia was due to a non-parasitic cyst of the liver. In this case, haemobilia resulted from two unusual complications of this hepatic lesion: intra-cystic bleeding and communication with an intrahepatic duct. Haemobilia has never been reported as a complication of non-parasitic cyst of the liver.

Aged↗
PubMed1992

[Benign papillomatosis of Wirsung's duct associated with adenomyoma of the distal common bile duct].

We report the case of a 42 year-old man, with a history of alcohol and tobacco abuse, who was referred for suspicion of carcinoma of the head of pancreas. Pancreatoduodenectomy was performed. Histological study demonstrated obstructive benign adenomyoma of the distal common bile duct associated with villous papillomatosis of the pancreatic ducts and patchy lesions of chronic pancreatitis. Two years later, the patient was completely asymptomatic, but the risk of malignant transformation of villous papillomatosis requires periodic examination of the remaining pancreas and biliary tract.

Adult↗
PubMed1986

The treatment of refractory ascites by the LeVeen shunt. A multi-centre controlled trial (57 patients).

A multi-centre random trial of 57 cases of alcoholic cirrhosis with refractory ascites was carried out; 29 patients received a LeVeen shunt and 28 were treated by conventional medical therapy. The effectiveness of the LeVeen shunt in reducing ascites was good in the first month, but was not different from conventional medical therapy by the end of one year. Complications were significantly more frequent in the surgical group. Of the 29 patients fitted with a LeVeen shunt, 25 developed one or more complications. Of the 28 patients in the medical control group, only 8 developed complications. The mortality rate of the two groups also differed significantly. Twelve patients in the surgical group (41%) died in the course of the first month against only 5 (18%) in the medical control group. By the end of one year, the mortality rate of the two groups was almost identical: 23 (79%) and 21 (75%) respectively. These observations confirm the poor prognosis for refractory ascites in cases of alcoholic cirrhosis and the inadvisability of attempting to treat it by implanting a LeVeen shunt.

Ascites↗