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Biomedical subjects

E Bercoff

Publications and source records attributed to E Bercoff.

At least 55 records · Page 3Linked to original sources

[A case of primary osteosarcoma of the liver].

The authors report a case of primary osteosarcoma of the liver in a 75 year-old man with post hepatitic B cirrhosis. The hepatic tumor was discovered on ultrasound and computed tomography. Angiography showed a hypervascularized tumor. The patient died rapidly. Diagnosis of primary osteosarcoma of the liver was established through histopathological examination of post mortem specimens and was confirmed by immunohistochemical study. From this and two other previously reported cases the authors describe the different primary hepatic tumors mimicking osteosarcoma.

Aged↗

Carbimazole-induced acute cholestatic hepatitis.

A case of carbimazole-induced cholestatic hepatitis is presented. A woman received carbimazole for hyperthyroidism for 3 months. Five months later, she had prompt recurrence of cholestasis parameters after rechallenge (2 days of treatment). Histologic examination showed predominantly centrilobular cholestasis. Only 5 other cases have been published in the literature. An idiosyncratic mechanism seems likely.

Acute Disease↗

A randomised controlled study of propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis.

74 cirrhotic patients with a history of variceal or gastric bleeding were randomly assigned to treatment with propranolol (40 to 360 mg/day) or placebo. The patients were all in good condition and doses of propranolol were titrated until a 25% reduction in heart rate was achieved. After 2 years, the cumulative percentage of patients free from rebleeding was significantly greater among the patients receiving propranolol (79%) than in the placebo group (32%; p less than 0.0001). Similarly, the percentage of surviving patients was significantly greater with propranolol (90%) than with placebo (57%; p less than 0.02) after 2 years. It was concluded that in cirrhotic patients in good condition, propranolol reduced both the risk of recurrent gastrointestinal haemorrhage and the mortality rate during a 2-year period of continuous administration of the drug.

Adult↗

The evaluation of CA 19-9 antigen level in the early detection of pancreatic cancer. A prospective study of 866 patients.

To establish if CA 19-9 could detect early pancreatic cancer, we measured its serum concentration in 866 patients admitted for benign diseases and observed for 2 years. All patients with an elevated CA 19-9 level (greater than 40 units (U)/ml) were submitted to a computed tomography (CT) scan of the pancreas. The CA 19-9 level was increased in 117 patients. One hundred fifteen of these 117 patients had false-positive elevations. The CA 19-9 concentration was elevated mostly in benign hepatobiliary diseases. In this group of patients, CA 19-9 was correlated to alkaline phosphatase values. Eleven patients showed an elevated CA 19-9 level for 10 months without any malignancy developing. One patient had a normal CA 19-9 concentration 8 months before clinical signs of pancreatic carcinoma developed. We conclude that CA 19-9 measurement is of no value for the early detection of this malignancy.

Aged↗

[Diagnostic value of a distinct rise in sedimentation rate].

Among the 931 patients who were admitted, over a 9-month period, to an internal medicine department, a group of 84 patients (9 p. 100) whose erythrocyte sedimentation rate (ESR) was 70 mm or more at 1 hour was selected and compared to the remaining 847 patients whose ESR was below 70 mm at 1 hour. In most cases, a pathology likely to account for the distinct rise observed in ESR was found (infection in 42 p. 100 of the cases, malignant disease in 27 p. 100, inflammation in 20 p. 100), and only 5 p. 100 of these rises remained unexplained. This makes an ESR of 70 mm or more a good index of morbidity generally, without pointing at any specific disease. An ESR of 70 mm or more has very low sensitivity (always below 30 p. 100), so that no disease whatsoever can be excluded when the ESR is only slightly elevated. Moreover, in all but infectious diseases a distinctly high ESR is not an index of severity.

Aged↗

[Changes in arterial pressure in the postprandial period in the elderly].

The repercussions of food intake on blood pressure may account for certain malaises which occur after meals in elderly people. In this study, blood pressure and heart rate were measured during and after a meal in 39 elderly hospital patients divided into two groups depending on whether or not they were taking drugs likely to act on arterial blood pressure. The patients were compared with two groups of controls: 29 young adults examined after a meal and 16 elderly subjects examined at a distance from meals. A significant fall in blood pressure starting 18 minutes after the meal and without concomitant increase in heart rate, was observed in the 2 groups of elderly patients. No significant changes in blood pressure and heart rate were observed in the 2 control groups. In elderly people, food intake might act on blood pressure through entrapment of blood in splanchnic territories and/or through alteration of baroreceptors.

Aged↗

[Can the protein concentration of the ascitic fluid in ascites predict the occurrence of an infection?].

In cirrhotic patients, spontaneous bacterial peritonitis is frequent and severe. This study was performed to determine if low protein concentration in ascitic fluid on admission could predict the occurrence of spontaneous bacterial peritonitis during hospitalization. Ninety-two cirrhotic patients with ascites, without spontaneous bacterial peritonitis were studied. Bacteriologic study and cultures of ascitic fluid were performed on admission and repeated every 5 days, and if any suspicion of infection occurred; 11 patients developed spontaneous bacterial peritonitis during hospitalization. Among the 92 patients in the study, protein concentration in ascitic fluid was initially less than 10 g/l in 45 and 10 of these 45 patients (22 p. 100) developed spontaneous bacterial peritonitis during hospitalization; protein concentration in ascitic fluid was initially greater than 10 g/l in 47 patients; only one of these 47 patients (2.1 p. 100) developed spontaneous bacterial peritonitis during hospitalization. This difference (22 p. 100 vs 2.1 p. 100) was significant (p less than 0.01). Ascitic fluid protein concentration (6.9 +/- 2.3 g/l) was significantly lower (p less than 0.01) in the spontaneous bacterial peritonitis group than in patients without peritonitis (13.8 +/- 10.5 g/l). These results suggest that: 1) ascitic fluid protein concentration on admission is lower in patients who will develop spontaneous bacterial peritonitis during hospitalization than in patients without infection and 2) patients with ascitic fluid protein concentration under 10 g/l on admission represent an high risk group for spontaneous bacterial peritonitis.

Ascitic Fluid↗

Buflomedil kinetics in patients with liver disease.

The pharmacokinetics of single intravenous (100 mg) and oral (450 mg) doses of buflomedil was studied in 3 and 6 patients respectively, suffering from chronic liver disease. Comparisons of buflomedil kinetic parameters between the patients and healthy subjects indicate a significant increase in AUC0 infinity, T beta, u' and a significant decrease in Cle', Clnr when the patients received the oral dose, but no significant differences when the patients received the intravenous dose probably due to the small number of patients explored. The elimination of buflomedil is impaired in chronic hepatic disease. It seems advisable to reduce the usual dose to half its value when the prothrombin index is around 50% associated with a low albumin concentration and a low factor V.

Administration, Oral↗

Acute effects of captopril on systemic and renal hemodynamics and on renal function in cirrhotic patients with ascites.

The reduction of angiotensin II production by captopril--an angiotensin-converting enzyme inhibitor--could suppress hyperaldosteronism without impairment of renal function and could thereby be useful in the treatment of ascites in patients with cirrhosis. Systemic and renal hemodynamics and renal function were studied in 6 nonazotemic patients with cirrhosis and ascites with a low-sodium diet before and after oral administration of 25 mg of captopril. Cardiac output and renal blood flow did not change significantly after administration of captopril, whereas mean arterial pressure significantly decreased. Systemic and renal vascular resistances were significantly reduced. There was a statistically significant reduction of glomerular filtration rate, filtration fraction, and urinary output. Plasma renin activity significantly increased in all patients after administration of captopril. A statistically significant correlation was found between the decrease in mean arterial pressure and the reduction of glomerular filtration, but no relationship was found between basal values of plasma renin activity and the other observed variations. We concluded that captopril mainly induces hypotension due to an increase in renal vasodilatation in ascitic patients with cirrhosis.

Ascites↗