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Biomedical subjects

L Bedenne

Publications and source records attributed to L Bedenne.

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

[Is the Tru-Cut needle more efficient than the fine needle in the diagnosis of hepatic lesions? Comparative study of 45 echography-guided punctures].

A comparison of diagnostic efficiency of fine needle biopsy (22 G) versus coarse needle biopsy (Tru-Cut 14 G) was performed on ultrasound-guided liver biopsies in 45 patients. Diagnosis was established through clinical, paraclinical and pathologic features. For each patient pathologic examination of both fine needle biopsy (cytology and histology) and coarse needle biopsy (histology) were performed by a pathologist unaware of any clinical data. Of 36 malignant tumors, diagnosis of malignancy was made in 83 percent of the cases by fine needle biopsy and in 81 percent of the cases by Tru-Cut biopsy, and distinction between primary and secondary cancer, in 83 and 86 percent of cases respectively. Specificity was 100 percent with both techniques. Of 9 benign lesions, the 6 focalized fatty infiltrations were diagnosed by both fine and coarse needle biopsies. As fine needle biopsy is less invasive than coarse needle biopsy and gave equally satisfying results, we suggest that it should be used preferentially in the diagnosis of focalized liver lesions.

Biopsy, Needle↗
PubMed1990

[Treatment and prognosis of stomach cancers in the population of the Cote d'Or's District (1976-1985)].

The present study on treatment and prognosis of gastric cancers is based on the data of the digestive tract cancer registry set up for the French department of Côte-d'Or. During the 1976-1985 period, 784 cases of gastric cancer were diagnosed. Resection for cure was performed in 41.3% of gastric cancers and that proportion remained the same during the course of the study period. Operative mortality was 18.5% after resection for cure and 26.7% after palliative surgery. The overall survival rate was 31.7% at 1 year, 17.0% at 3 years, and 13.0% at 5 years. Ten different criteria (personal data, histologic and therapeutic parameters) were studied in relation to survival. With the univariate analysis, the survival rates were related to age, duration of the symptoms, history of previous gastric ulcer, tumour location, stage of diagnosis and treatment. Only 4 aspects were of good prognosis according to the multivariate analysis (Cox model): extension limited to the gastric wall, resection for cure, duration of the symptoms and location to the antrum or the angulus. These results underline the fact that the prognosis of gastric cancer in a well-defined population remains poor. Because of its severity, gastric cancer still represents a major cancer problem.

Aged↗
PubMed1990

[Descriptive epidemiology of cancer of the pancreas].

Cancer of the pancreas is a relatively common malignancy in France, where it represents 10% of all digestive tract cancers. Over the world, there is little variation in incidence rates; Europe, North America, South America, Oceania and parts of Asia represent high risk areas. The regions with the lowest incidence rates are India, mid-western countries and Africa. In most countries, pancreatic cancer incidence rates increased between 1950 and 1965; however little change in incidence has been observed over the past 20 years. Pancreatic cancer occurs more frequently in males than in females in all age groups. No consistent differences have been identified in urban/rural distribution or in socioeconomic status. Studies of migrant populations and some religious groups indicate that environmental factors are of overwhelming importance in determining the incidence of pancreatic cancer in a given population. In the same areas, difference in incidence has been reported among various ethnic groups: in the United States the rate is higher in Blacks than in Whites, in New Zealand in Maoris and Polynesians than in Whites, in Israel in Jews than in non-Jews. This data leads us to the conclusion that diet is of importance in pancreatic cancer etiology. No premalignant lesion has been clearly identified. Particular attention has been paid to diabetes mellitus and chronic pancreatitis, but a firm conclusion cannot be drawn. Some potentially valuable clues for clarifying the etiology of pancreatic cancer have been found by way of descriptive epidemiology. In view of the severe prognosis of the disease, there is an urgent need for further aetiological studies in order to develop effective methods of prevention.

Adult↗
PubMed1990

[Preliminary results of a mass screening program for colorectal cancer].

The Digestive Tumours Registry of Burgundy set up a study to assess acceptability and results of colorectal cancers screening using the Hemoccult test. A total of 95,000 people, aged 45 to 74, were included, 55,000 in 1988 and 40,000 in 1989. The aim of this paper is to report the results of the first screening process in the population tested from January to July 1988, i.e. 27,421 subjects. Information on colorectal cancer was mailed to all homes in the screening areas and a news campaign was organized. During the first 4 months, the general practitioners (GPs) either prescribed the test which was then reimbursed (Autun area), or gave it free to their patients (other areas). After that phase, the test was mailed to all subjects who had not consulted their GP, and a second letter was sent 1 month later when the test had not been sent back. A total of 14,603 subjects performed the Hemoccult test (53.3 percent). Acceptability was higher in those areas there the test was initially given free by the GPs (57.3 percent) than in those where it was prescribed (40.0 percent). Acceptability was higher in women (55.8 percent) than in men (50.6 percent). A total of 57.8 percent of the performed tests were done during the medical offer phase, 29.1 percent after mailing and 13.1 percent after the recall letter. There was a positive test in 340 subjects (2.3 percent) and 288 (84.7 percent) had colonic investigations, a colonoscopy in 99 percent of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1989

Rioprostil and ranitidine in the prevention of duodenal ulcer relapse.

One hundred and ninety duodenal ulcer patients who had relief of pain and endoscopically proven ulcer healing after a short treatment period are allocated at random to double-blind maintenance treatment with a synthetic dehydroprostaglandin-E1, rioprostil, 300 micrograms, or ranitidine, 150 mg, at bedtime for 6 months. Patients are monitored every two months and examined by endoscopy after six months of treatment, or more often if warranted. The cumulative relapse rate in the rioprostil group at six months is 32% (25/78) vs. 28% (20/72) in the ranitidine group. This difference is not significant. The percentage of side effects observed is 17% in the rioprostil group vs. 5% in the ranitidine group, but discontinuation of treatment is observed with the same frequency in the two groups.

Anti-Ulcer Agents↗
PubMed1989

[Trends in the incidence of colorectal cancer at the Department of Côte-d'Or between 1976 and 1985].

Colorectal cancer is the leading cause of cancer morbidity in France when both sexes are considered together. There are few available data on time trends, although such data would prove both necessary for planning screening programs and usefull to construct hypotheses on etiological factors. Data from the Registre des Tumeurs Digestives de Côte d'Or permitted to establish time trends for the different locations of colorectal cancer during the 1976-1985 period. Changes in incidence rates as based on the world reference population were studied using a log linear model as well as the Armitage test. Overall colon cancer rates have increased in both sexes. The mean annual increase of left colonic cancer was 3.1 p. 100 in men (p less than 0.05) and 4.0 p. 100 in women (NS), whereas rectal cancer decreased by 2.4 p. 100 in men and 3.3 p. 100 in women (NS). In men, left colonic cancer rates increased mainly in rural areas (+ 7.3 p. 100; p less than 0.05) whereas it increased mainly in urban areas in women (+ 6.0 p. 100; NS). In both sexes, the left colonic cancer increase was particularly noticeable in the 45-64 age group, which could indicate that the observed trend is likely to become more important in the next years. As for rectal cancer, the decrease was most important in the 65-74 age groups. That inversed trend for colon and rectum cancer has already been observed in other countries including the USA and Canada. As the trends we observed for right colon, left colon and rectal cancer differ, colorectal cancer etiology should be studied separately.

Aged↗
PubMed1988

Primary liver cancer in Côte d'Or (France).

The registry of digestive tract tumours established for the department of Cote d'Or (France) was used to study the incidence and some of the characteristics of primary liver cancer (PLC) in this area. The annual age-standardized incidence rate was 7.6/100,000 for males, and 1.8/100,000 for females. As compared to other areas the Cote d'Or is in the intermediate incidence areas. The risk of PLC was higher in urban than in rural areas in men (p less than 0.01). There was no significant variation in PLC incidence over the eight years of the study. Alfafoetoprotein levels over 200 ng/ml were observed in only 48.9% of the cases. Alfafoetoprotein measurement has to be complemented by other investigations in screening of high-risk patients. Liver cirrhosis was present in 70.9% of the cases in which the information was available. The male:female ratio in the non-cirrhotic group was 1.5:1, very different to the 8.8:1 in the cirrhotic group. Cirrhosis was associated with excessive alcohol consumption in 92% of cases. The prevalence of serological markers of hepatitis B virus infection was investigated in 91 patients. Hepatitis Bs-antigen was found in 8.8% and evidence of past or present infection in 28.2%. In view of the prevalence of chronic alcoholism in patients with cirrhosis it is suggested that alcohol leads to an increased risk of cirrhosis followed by an increased incidence of PLC. Further studies are needed to elucidate the eventual role of HBV infection and other suspected environmental factors in the aetiology of PLC.

Adolescent↗
PubMed1988

[Epidemiology of cancers of the small intestine. Evaluation of 10 years' registration at the Cote-d'Or department].

The registry of digestive tract tumours established for the department of Côte-d'Or was used to study the epidemiologic characteristics of cancer of the small intestine. Over a period of 10 years (1976-1985), 42 new cases were recorded. Age standardized incidence rates, based on world standard population, were 0.7/100,000 for males and 0.4/100,000 for females. As compared with the data from other cancer registries, the risk in Côte-d'Or is in the intermediate range. The mean age was 60.9 years for males and 73.3 years for females (P less than 0.05). Adenocarcinomas represented 40% of the cases, lymphomas 20%, carcinoid tumours 20%, sarcomas 17% and undifferentiated carcinomas 2%. The mean time between symptoms and diagnosis was 4.6 months. Lymph node involvement or metastatic disease were found in 3/4 of the cases at time of diagnosis (31/42). Patients were treated by surgery in 95% of the cases. Curative surgery was used in 23 cases (55%). The post-operative death rate was 13% after curative surgery and 37.5% after palliative surgery. The overall survival rates were 39.9% at 1 year, 19.5% at 3 years and 11.7% at 5 years. Prognosis depended on the stage of diagnosis and the finality of surgical treatment. These results indicate that cancers of the small intestine are rare and difficult to diagnose, explaining the delay in diagnosis and the poor prognosis.

Actuarial Analysis↗
PubMed1988

[Colorectal cancers disclosed by an obstruction. Frequency and prognosis in a population].

The registry of digestive tumors of the department of Cote-d'Or recorded between 1976 and 1982, among 1543 colorectal cancers, 142 cases (9.2%) diagnosed with acute obstruction. Distribution of the tumors along the large bowel was as follows: rectal cancers were rarely obstructive (3.8%) whereas it was a more common feature in the sigmoid (14.2%), the caecum (12.2%) and the transverse colon (15.8%). Symptoms preceded the acute obstruction in 39.7% of the cases. Limited tumors were rare in obstructive cancers, 2.8% were Dukes A, 30.3% Dukes B; the corresponding data for non obstructive cancers were 15.6 and 27.7% respectively (P less than 0.01). Treatment was surgical in 97.9% of obstructive cancers. Surgery was more often palliative in obstructive tumors (45.8%) than in the other types of tumors (21.3%; P less than 0.01). The postoperative mortality rate was 30.9%, ie 21.6% after curative surgery, 30% after palliative surgery, 43.6% after derivative surgery. The overall survival rates for obstructive cancers were 42.7% after one year and 17.6% after 5 years; they were respectively 59.1 and 31.1% for non obstructive cancers (P less than 0.001). After curative surgery and excluding postoperative mortality prognosis was the same for obstructive and obstructive cancers within the same Dukes' stage. This study permitted to highlight the rather high frequency of obstructive colorectal cancers, and their bad prognosis linked to the extension of the tumors and to high postoperative mortality rates.

Adult↗
PubMed1987

Biliary tract cancers in Cote-d'Or (France): incidence and natural history.

The registry of digestive tract tumours established for the department of Cote-d'Or (France) was used to study the epidemiological characteristics and the natural history of biliary tract cancers. Age standardised incidence rates for gallbladder cancers were 2.7/100,000 for women and 0.9/100,000 for men. The corresponding rates for extrahepatic bile duct cancers were 0.5/100,000 and 1.7/100,000, and for ampulla of Vater cancer 0.3/100,000 and 0.3/100,000. The three cancers differ in their descriptive epidemiology and should be considered separately in epidemiological analytical investigations. The incidence of each of the three diseases increased with age, and cancers of known histological type were mainly adenocarcinomas. Some gallbladder cancers were undifferentiated or squamous cell carcinomas. There was no significant variation in incidence for gallbladder cancer and extrahepatic bile duct cancer over the eight years of the study. The association with gallstones was frequent in gallbladder cancer: 70.5% compared to 13.0% in other biliary tract cancers (less than 0.001). Although the association of gallbladder cancer with gallstones is frequent, few patients with cholelithiasis experience development of a gallbladder cancer. It is necessary to identify among patients with gallstones a subgroup at high risk of gallbladder cancer in whom prophylactic surgery might be justified. Biliary tract cancers are seldom diagnosed early: lymph nodes or visceral metastases were present in 77% of gallbladder cancers, in 83% of extrahepatic bile duct cancers, and in 55% of ampulla of Vater cancers at the time of diagnosis. The corresponding resectability rates were 46.1%, 11.9%, and 38.9%. The five-year overall survival rates were 2.9% for gallbladder cancer, 0% for extrahepatic bile duct cancer, and 18.3% for ampulla of Vater cancer. The corresponding five-year survival rates after surgery for cure were 10.3%, 0%, and 35.7%. Biliary tract cancer still represent a great therapeutic challenge.

Adenocarcinoma↗
PubMed1987

[Cancer of the gallbladder in the Côte d'Or].

The registry of digestive tract tumours established for the department of Côte d'Or was used to study the epidemiologic characteristics and treatment of gallbladder cancer. During 8 years (1976-1983), 139 new cases were recorded. Age standardized incidence rates based on world standard population were 3.1/100,000 for females, 0.9/100,000 for males. As in all population-based studies, there was a female predominance. As compared with the data of other cancer registries the risk in the Côte d'Or is in the intermediate range. The incidence of gallbladder cancer was similar in urban and rural areas, but high risk lieus were identified by the study. The most frequent histologic type was adenocarcinoma (79.5 p. 100). Only 20.9 p. 100 of the patients underwent curative surgery. The overall 1-year survival rate was 14.4 p. 100 and the 5-year survival rate was 2.9 p. 100. The 5-year survival rate was 11.5 p. 100 after curative surgery. These results underline the fact that the prognosis of gallbladder cancer in a well defined population remains poor. The frequency of gallstones was 73.3 p. 100 in females and 56.5 p. 100 in males. Although this association is frequent few people with cholelithiasis develop gallbladder cancer. Among patients with gallstones, a subgroup at high risk of gallbladder cancer, in whom prophylactic surgery might be justified, remains to be identified.

Aged↗