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Biomedical subjects

T Poynard

Publications and source records attributed to T Poynard.

At least 235 records · Page 13Linked to original sources
PubMed1987

Reduction of the observed prevalence of so-called non-A non-B hepatitis using sensitive markers of HBV and herpes viruses infections.

In the absence of a specific marker, the observed prevalence of so called non-A non-B hepatitis depends on the sensitivity of the markers of the other viral infections known to induce hepatitis. We have reevaluated this prevalence after using sensitive markers of HBV (HBs monoclonal radioimmunoassay M-RIA and IgM anti-HBc), EBV (IgM anti-VCA), CMV (IgM anti-CMV) and HSV (IgM anti-HSV) in a group of 53 subjects usually considered as having acute or chronic hepatitis. Detection of IgM against HBc, CMV and HSV used immunocapture tests. Among the 37 patients with acute hepatitis, 11 (30 p. 100) were positive for at least one sensitive marker, including 10 markers of HBV (7 M-RIA and 3 IgM anti-HBc) and one IgM anti-CMV. Among the 16 patients with chronic hepatitis, one was positive for HBV by M-RIA; five patients had a false positive reaction to EBV (IgM anti-VCA) disappearing when rheumatoid factor was eliminated. This study shows that many cases of the so-called non-A non-B hepatitis are in fact due to HBV or to a variant of HBV. Definition of non-A non-B hepatitis must include subjects negative for HBV by M-RIA and IgM anti-HBc and negative for CMV by IgM anti-CMV.

Acute Disease↗
PubMed1986

Risk of hepatic vein thrombosis in relation to recent use of oral contraceptives. A case-control study.

In a case-control study, we evaluated the relative risk of hepatic vein thrombosis among recent oral contraceptive users as compared with nonusers. Thirty-three cases of hepatic vein thrombosis affecting women aged 15-45 yr were collected between 1970 and 1983, and individually matched to 3 or 4 controls interviewed in 1982-1984. There were 18 recent oral contraceptive users among the 33 cases, and 44 recent oral contraceptive users among the 128 case-matched controls. The relative risk of hepatic vein thrombosis was 2.37 (95% confidence interval: 1.05-5.34, p less than 0.02). The relative risk of hepatic vein thrombosis is close to that of stroke, myocardial infarction, and venous thromboembolism among oral contraceptive users as compared with nonusers.

Adolescent↗
PubMed1986

[Palliative treatment of adenocarcinoma of the rectum by Nd-YAG laser. Immediate and long-term results. Study of factors related to the initial destruction of the tumor].

Fourty-five patients, 28 men, 17 women (mean age 73 +/- 18 yrs) with rectal carcinoma underwent palliative endoscopic neodymium YAG laser therapy. Rectal hemorrhage ceased in 89 p. 100 of affected patients after 3 +/- 2 sessions and a normal rectal transit was restored in 80 p. 100 of affected patients after 3 +/- 1 sessions. Total destruction of intraluminal tumor was achieved in 40 p. 100 of patients after 4 +/- 1 sessions. Symptomatic improvement was more frequent in patients in whom total destruction of intraluminal tumor was achieved (p less than 0.01). Stepwise logistic regression selected 2 independent variables capable of predicting tumoral destruction: the kind of surgical contraindication, more often related to cancer extension (p less than 0.001) and a greater tumor length (p less than 0.03) in patients in whom destruction of intraluminal tumor was incomplete. Twenty-eight patients were subsequently treated after palliation was achieved. Cumulative probability of remaining improved at 6 months when treatment was not stopped was 40 p. 100 (confidence limits to 95 p. 100: 23 p. 100-59 p. 100). Five complications occurred, 3 rectovaginal fistulas and 2 stenosis.

Adenocarcinoma↗
PubMed1986

[Ulcerative colitis caused by Histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome].

The authors report a case of ulcerative colitis due to Histoplasma capsulatum in a previously healthy 35 year-old french geologist with acquired immune deficiency syndrome (AIDS). Gomori-Grocott and PAS stains and indirect immunofluorescence revealed Histoplasma capsulatum in colonic biopsies. The search for LAV antibody was positive. T-lymphocyte analysis revealed 10/mm3 OKT4 with OKT4/OKT8 ratio of 0.16. Histoplasmosis should be considered in subjects with ulcerative colitis according to the epidemiological context. In patients with AIDS relapses after discontinuation of treatment are to be expected and suppressive therapy with an imidazole derivative should probably be continued indefinitely.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The retrieval of randomized clinical trials in liver disease from the medical literature. A comparison of MEDLARS and manual methods.

Randomized clinical trials (RCTs) provide the most reliable therapeutic information available. Unfortunately, there are no systemic listing of RCTs. We compared a MEDLARS search of 3686 biomedical journals for RCTs with a manual search of the medical literature for the period 1966-1982. For the former search we used subject headings (1) liver disease or (2) biliary tract disease and subheadings (1) drug therapy, (2) surgery, (3) radiotherapy, or (4) therapy, and check tags (1) comparative study or (2) clinical research. For the manual search, the contents of 34 arbitrarily selected, gastroenterologic, hepatologic, surgical, or general journals were perused. The MEDLARS search identified 160 RCTs and 29 others were found in the references of the 160. One hundred fifty-four RCTs were identified by both methods. The manual search identified 208 RCTs and an additional 34 were found in the references of the 208. The MEDLARS search identified only 107 of 208 RCTs found in the references of the 208. The MEDLARS search identified only 107 of 208 RCTs found manually in the 36 journals, an efficiency rate of 51%. We estimate that 330 hepatobiliary RCTs had been published during this 17-year period. Sixty percent of the RCTs found by MEDLARS used the key word "randomized," "double blind," or "controlled" in the title, compared to 36% in those found by the manual search. In order to retrieve RCTs, it is essential that editors require that RCTs be identified in their titles or key words by specific terms such as "controlled," "randomized," and "double blind," that papers be so catalogued and indexed, and that searchers be instructed in appropriate search strategies.

Clinical Trials as Topic↗
PubMed1985

[Simultaneous detection of IgM antibodies against the hepatitis A virus and the viral capsid antigen of Epstein-Barr virus in acute hepatitis].

The simultaneous detection of IgM antibodies to hepatitis A virus (anti-HAV IgM) and IgM antibodies to viral capsid antigen (anti-VCA IgM) of Epstein-Barr virus (EBV) in patients with acute viral hepatitis has led us to systematically study serological markers of EBV in patients with anti-HAV IgM positive acute hepatitis and to test for anti-HAV IgM in sera of patients with acute hepatitis associated with serological evidence of current primary EBV infection. All patients studied were HBsAg negative and were not drug-addicts, nor homosexuals. In 15 consecutive patients with anti-HAV IgM positive acute hepatitis, anti-HAV IgM and anti-VCA EBV IgM antibodies were simultaneously detected in 9 cases. Of these 9 patients, antibodies to nuclear antigen were positive in 8 cases, antibodies to early antigen were positive in 7 cases and rheumatoid factor was positive in 4 cases. In 5 consecutive patients with acute hepatitis associated with serological evidence of current primary EBV infection, anti-HAV IgM was not detected. Simultaneous presence of anti-VCA EBV IgM, early antigen IgG antibodies and nuclear antigen antibodies in 7 patients with acute hepatitis associated with anti-HAV IgM suggests reactivation of EBV or reactivation of clones secreting antibodies anti-EBV in HAV infections. Furthermore, these results show that anti-VCA IgM only cannot be considered to be a specific marker of early EBV infection in patients with acute hepatitis.

Acute Disease↗
PubMed1984

[Peri-anal ulceration. Tuberculosis should not be overlooked].

Two cases of peri-anal ulceration of tuberculous origin are reported: one revealed an active pulmonary and ileo-caecal tuberculosis, the other complicated a chronic pulmonary tuberculosis of several years' duration. Cutaneous manifestations of tuberculosis are exceptional. In patients with protracted peri-anal ulceration, a biopsy should be performed that will show a typical tuberculoid granuloma. The most frequently encountered anorectal tuberculous lesions are suppurations and fistulae. The main differential diagnosis is Crohn's disease with anorectal manifestations.

Adult↗
PubMed1984

[Systemic circulatory hyperkinetic syndrome in patients with cirrhosis. Relation with hepatocellular failure and portal hypertension].

Hyperkinetic circulatory state is common in patients with cirrhosis but the cause of this syndrome has not been clearly elucidated. Systemic hemodynamic changes and their relationship to liver failure and splanchnic hemodynamics were studied in 100 patients with cirrhosis and were compared to a group of 15 patients without portal hypertension. Cardiac output was significantly higher and systemic vascular resistance was significantly lower in cirrhotic patients than in control patients. Multivariate analysis revealed that among different clinical, biochemical and splanchnic hemodynamic data, serum albumin, serum bilirubin, plasma prothrombin, and gastrointestinal bleeding significantly and independently explained the variation of cardiac output and systemic vascular resistance. No relationship was found between hepatic venous pressures or the presence of ascites and the hyperkinetic syndrome. From these results, it is concluded that in patients with cirrhosis liver failure is partly responsible for the hyperkinetic state.

Adult↗