Search PubMed⌕ Search

Biomedical subjects

J C Chaput

Publications and source records attributed to J C Chaput.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Prognostic value of total serum bilirubin/gamma-glutamyl transpeptidase ratio in cirrhotic patients.

The aim of this study was to assess the prognostic value of total serum bilirubin (TSB), gamma-glutamyl transpeptidase (GGT) and the TSB/GGT ratio in 129 consecutive cirrhotic patients, and to determine how seven other clinical and biochemical variables affect the prognostic value of these measurements. The Cox model and log rank test were used to compare survival rates at 1 year. Considered alone, encephalopathy, ascites, TSB, prothrombin time, serum albumin, GGT and the TSB/GGT ratio (TSB expressed in mumoles per liter and GGT in IU per liter were associated to the 1-year survival (p less than 0.10). The estimated per cent surviving at the end of 1 year was 20% for those with encephalopathy and 59% for those without, 46% and 62% for those with and without ascites, 28% for those with TSB greater than 3.0 mg per dl, 68% for those with TSB less than or equal to 3.0 mg per dl, 44% for those with GGT less than or equal to 100 IU per liter, 60% for those with GGT greater than 100 IU per liter, and 12% for those with TSB/GGT greater than 1, 66% for those with TSB/GGT less than or equal to 1. With the Cox model, which was used to assess the combined effect of several prognostic variables, GGT was the only biochemical variable which added significant prognostic value to TSB. The combination of TSB and GGT added significant prognostic value to encephalopathy and ascites.

Aspartate Aminotransferases↗
PubMedDate not supplied

Lack of in vivo activation of the interferon system in HBsAg-positive chronic active hepatitis.

The in vivo activation state of the interferon system was biochemically evaluated in patients with HBsAg-positive liver disease by assaying the interferon-induced enzyme, 2'5'-oligoadenylate synthetase, in peripheral blood mononuclear cells. All patients with chronic active hepatitis had normal levels of enzyme activity. Increased values were found in 77% of patients with acute hepatitis, 50% of those with chronic persistent hepatitis and 54% chronic healthy carriers. These results provide evidence for lack of activation of the interferon system in HBsAg-positive chronic active hepatitis and support the hypothesis that an in vivo defective interferon response may aid in development of chronic active hepatitis.

2',5'-Oligoadenylate Synthetase↗
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

Apolipoprotein AI and alcoholic liver disease.

A prospective study of apolipoprotein AI has been undertaken in 581 alcoholic patients and in 100 controls in order to describe the changes of apolipoprotein AI according to the different stages of the alcoholic liver disease, to correlate the changes to serum liver tests and to estimate its diagnosis and prognostic value. Results showed that apolipoprotein AI concentration is highly related to the degree of liver injury, reaching a maximum in patients with steatosis (229 +/- 90 mg per dl), beginning to decrease in patients with fibrosis (188 +/- 88 mg per dl) and reaching a minimum in patients with severe cirrhosis (91 +/- 46 mg per dl). Apolipoprotein AI had an independent and discriminative value for the diagnosis of fibrosis (p less than 0.001) vs. steatosis and for the diagnosis of cirrhotic vs. noncirrhotic fibrosis (p less than 0.001) or vs. acute alcoholic hepatitis without cirrhosis (p less than 0.001). Cirrhotic patients with apolipoprotein AI less than 100 mg per dl had a lower survival rate at 1 year (62 +/- 7%) than patients with greater value (80 +/- 6%; p less than 0.05), but this prognostic value disappeared in multivariate analysis when other known prognostic factors were taken into account.

Adult↗
PubMedDate not supplied

Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a prospective study of factors associated with rebleeding.

In a previous randomized trial, we demonstrated that propranolol prevented recurrent gastrointestinal bleeding in patients with cirrhosis. We have undertaken the present study in a new group of patients to ascertain the factors associated with rebleeding. Among 232 patients with cirrhosis admitted for gastrointestinal bleeding, 127 were included. They received propranolol orally at a dose reducing the heart rate by 25%. The median follow-up period was 682 days. The following factors were studied: cause of cirrhosis; severity of cirrhosis; hepatocellular carcinoma recognized after inclusion; compliance; persistent decrease in heart rate; dose of propranolol; alcohol abstinence; previous history of hemorrhage; time interval from hemorrhage to onset of propranolol administration, and source of bleeding. The percentage of patients free of rebleeding was 71% at 1 year and 57% at 2 years. Only five factors were significantly and independently associated with rebleeding: occurrence of hepatocellular carcinoma; lack of compliance; lack of persistent decrease in heart rate; lack of abstinence, and previous history of bleeding. In conclusion, this study confirms the results of our previous trial and suggests that certain factors play a role in the mechanism of rebleeding in patients receiving propranolol.

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↗