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Biomedical subjects

A Poitrine

Publications and source records attributed to A Poitrine.

25 records · Page 2Linked to original sources
PubMedDate not supplied

Prognostic value of serum fibronectin concentration in alcoholic cirrhotic patients.

The aim of this study was to assess prospectively the prognostic value of serum fibronectin in 114 alcoholic cirrhotic patients and to compare serum fibronectin with other prognostic variables. The Cox model and log-rank test were used to compare survival rates at 1 year. Considered alone, serum fibronectin, age, serum albumin, total serum bilirubin, gamma-glutamyl transpeptidase, prothrombin time, presence of encephalopathy and ascites were associated with survival to 1 year. The estimated survival rate at the end of 1 year was, for patients with serum fibronectin greater than 165 mg per liter: 84 +/- 5%, and for patients with serum fibronectin less than or equal to 165 mg per liter: 53 +/- 7% (p less than 0.001). With the step-wise multidimensional analysis using the Cox model to assess the combined effect of several prognostic variables, serum fibronectin was the first variable selected followed by age, encephalopathy and serum albumin which entered the model by virtue of their independent prognostic value. Multivariate regression and partial correlation analysis showed that fibronectin was independently correlated with serum albumin, gamma-glutamyl transpeptidase and total serum bilirubin explaining that the prognostic value of albumin diminished and that the prognostic value of total serum bilirubin and gamma-glutamyl transpeptidase disappeared when combined with serum fibronectin.

Bilirubin↗
PubMedDate not supplied

A randomized clinical trial of supplementary parenteral nutrition in jaundiced alcoholic cirrhotic patients.

Between March 1982 and September 1983, 40 inpatients (25 men and 15 women, mean age 53 years) with alcoholic cirrhosis and total serum bilirubin greater than or equal to 5 mg per dl were studied. Those with hepatocellular carcinoma, renal failure, hyponatremia, septicemia, spontaneous bacterial peritonitis, gastrointestinal bleeding, and hepatic coma were excluded. Patients were studied for 28 days. The two groups were offered an oral diet containing 40 kcal per kg per day. Patients in the supplementary parenteral nutrition group received 40 kcal per kg per day and 200 mg nitrogen per kg per day using a central catheter. The major endpoint was total serum bilirubin on Day 28. On admission, serum bilirubin was not significantly different in the two groups: oral group, 12.5 +/- 6.6 mg per dl; supplementary parenteral nutrition group, 12.3 +/- 8.5 mg per dl. On Day 28, serum bilirubin was lower in the supplementary parenteral nutrition group (2.5 +/- 1.4 mg per dl) than in the oral group (4.1 +/- 2.2 mg per dl) (p less than 0.02). Serum bilirubin was also lower in the supplementary parenteral nutrition group than in the oral group on Days 7, 14 and 21 (p less than 0.05). Analysis of covariance, considering serum bilirubin on admission and at randomization and time between admission and randomization, confirmed these results. On Day 28, anthropometric parameters, serum transferrin, prealbumin and retinol-binding protein were higher in the supplementary parenteral nutrition group, but the differences were not significant. Serum albumin was significantly lower in the supplementary parenteral nutrition group. The incidence of encephalopathy and sepsis was not significantly different between the two groups.

Adult↗
PubMedDate not supplied

A randomized study of a coaxial fiber versus a naked fiber for endoscopic Nd:YAG laser therapy of esophageal and rectal tumors.

The aim of the study was to determine whether the number of Nd:YAG laser sessions necessary to produce the maximal endoscopic effect was different with the noncontact method using the coaxial fiber than with the contact method using the naked fiber inserted into the tumor. Over a 6-month period, 40 consecutive patients were treated for esophageal and rectal cancers or for benign tumors too large to be removed with a diathermy snare. All of the patients who were offered this treatment had been assessed as unsuitable for surgery and radiotherapy. Twenty patients were randomly assigned to the coaxial fiber group and 20 patients to the naked fiber group. Before treatment, patients in the two groups were not different with respect to age, sex, kind of tumor, contraindication for surgery and radiotherapy, luminal patency, and tumor circumferential extent. At the end of the treatment, the endoscopic score, the transit score, and the evolution of rectal hemorrhage and mucous secretions were not different between the two groups. The number of treatments required to achieve the maximal endoscopic benefit was 6.7 +/- 4.9 (range, 2 to 20) (median = 5) in the coaxial fiber group and 3.4 +/- 1 (range, 2 to 5) (median = 3) in the naked fiber group (p = 0.01). Treatment tolerance and complications were not different between the two groups, but the financial cost related to the fiber was lower in the naked fiber group than in the coaxial fiber group. Therefore, we recommend the contact method using the naked fiber inserted into the tumor in endoscopic Nd:YAG laser therapy for gastrointestinal tumors.

Aged↗
PubMedDate not supplied

[Nd:YAG laser treatment of colorectal villous tumors].

Fifty-eight patients, 23 men, 35 women (mean age 76 +/- 10 yrs), with colorectal villous adenomas underwent endoscopic neodymium Yag laser therapy. In 50 patients with interpretable results, tumor ablation was complete in 45 p. 100 of extensive adenomas involving at least two thirds of the circumference and extending longitudinally for at least 4 cm, in 92 p. 100 of intermediate adenomas between 1 and 4 cm in diameter and in 100 p. 100 of small adenomas with diameter less than or equal to 1 cm. These patients had a mean follow up of 72 weeks (range 13-182 wks). Twelve adenomatous tissue recurrences occurred in 9 patients. In 10 of these recurrences, laser ablation was effective. Age, sex, dysplasia grade, macroscopic appearance, or tumor location did not influence the results which were related to the size of the villous adenomas. Four complications occurred: a symptomatic stenosis, an asymptomatic stenosis, an ileocaecal fistula and a rectal fistula near a colorectal anastomosis.

Adenoma↗
PubMedDate not supplied

[Glomerular nephropathies and B virus: apropos of 4 cases in adults, with an immunofluorescence study and review of the literature].

The association of glomerulonephritis and persistent HBs antigenemia is reported in 4 adults with nephrotic syndrome: 2 cases of membranous glomerulonephritis associated with chronic persistent hepatitis and 2 cases of membrano-proliferative glomerulonephritis associated with active cirrhosis. In 3 patients, all positive for HBsAg, anti-HBc and HBeAg by radioimmunoassay, indirect immunofluorescent study was performed on kidney and liver biopsies. Glomerular deposit of HBcAg was detected in two cases. HBsAg and HBcAg were not found in the liver. The pathogenesis of such glomerulonephritis remains uncertain and the role of HBs antigen-antibody circulating immune complexes is not clearly proved. Two patients were treated with vidarabine intravenously. Vidarabine produced a transitory decrease of HBsAg concentration in 2 cases and a transitory loss of DNA-polymerase activity associated with a decrease of HBeAg concentration in one case. Neither seroconversion nor improvement of the glomerular disease were ascertained.

Adult↗
PubMedDate not supplied

[Palliative treatment of cancers of the esophagus and cardia with YAG neodymium laser. (Preliminary noncontrolled trial)].

The aim of this study was to report results of endoscopic YAG laser therapy in palliative treatment of esophageal and cardial carcinoma. Twenty-eight patients were treated: 9 with adenocarcinoma and 19 with squamous cell carcinoma. Among these patients, 9 had complete aphagia; radiotherapy was contraindicated in 17; in the remaining 2 patients the aim of laser therapy was to achieve sufficient luminal enlargement to allow the endoscopic insertion of a prothesis. Dysphagia improved in 24 cases; destruction of a major portion of the intraluminal tumor was achieved in 17 patients, and incomplete destruction was possible in 9 patients. In one case, the treatment had no effect. Among 22 subjects in maintenance treatment, 13 good results were obtained. Several complications of laser therapy were observed: 2 cases of minor bleeding, 2 cases of esophagitis and 1 perforation of the upper esophagus. The patient died after surgical operation. It is concluded that endoscopic YAG laser therapy for palliative treatment of esophageal and cardial carcinoma is effective, providing rapid improvement of dysphagia. Maintenance treatment is necessary to sustain the improvement. Randomized studies are now needed to compare endoscopic laser therapy with other palliative treatment of malignant tumors of the upper gastrointestinal tract.

Adenocarcinoma↗