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Biomedical subjects

R Brenard

Publications and source records attributed to R Brenard.

41 records · Page 3Linked to original sources
PubMedDate not supplied

[Current contribution of molecular biology in the diagnosis of hepatitis B].

Recent advances in molecular biology had led to a better understanding of the pathology of hepatitis B virus. The polymerase chain reaction technique has shown that the genome of hepatitis B virus is highly variable. Mutations in the pre-core region are associated with HBe Ag negative chronic hepatitis and fulminant hepatitis B; moreover, rare cases of hepatitis due to HBV with mutations within the S gene have been reported in HBV-vaccinated patients. The aim of this paper is to assess the clinical, serological and therapeutic features of hepatitis B variants.

Genome↗
PubMedDate not supplied

Transjugular liver biopsy. An experience based on 500 procedures.

We report our experience based on 500 transjugular liver biopsies, a safe procedure even in high risk patients. Transjugular liver biopsies represents one third of all liver biopsies performed in our Hepato-Gastroenterology units. Liver specimen was adequate to evaluate liver architecture in 87.6% of patients in whom a minimal size of 7.6 mm of the liver core was found suitable for this purpose. The size of the liver specimen negatively correlated with the increase in hepatic venous pressure gradient (p < 0.0001). The liver biopsy was unsuccessful in 3.6% of patients. Hepatic capsular perforation occurred in 3.4% of patients but remained invariably asymptomatic.

Adolescent↗
PubMedDate not supplied

Practical management of patients treated with alpha interferon.

Interferon alpha is currently used in chronic hepatitis and side effects are well known. They always must be kept in mind to start and to follow a patient under this therapy. A large number of autoantibodies may appear during interferon therapy, usually without clinical manifestations. The detection of dysthyroidism, requires measurement of antithyroid antibodies and TSH before and during interferon therapy. Exacerbation of chronic liver disease under IFN may be found in case of seroconversion in a patient with hepatitis B cirrhosis or in patient with a misdiagnosis of autoimmune hepatitis. Neurolopsychological disturbances are frequently reported; most of them spontaneously disappear. However, depression must be detected because of the risk of attempted or successful suicide. Worsening or sudden onset of psoriasis or lichen planus have been reported in patients treated with interferon. Appearance or aggravation of some clinical symptoms and biochemical tests may threaten life's patient under IFN therapy. The decision to maintain or to interrupt therapy should take into account the response to interferon and the severity of side effect.

Antiviral Agents↗
PubMedDate not supplied

Is antiviral treatment (IFN alpha and/or ribavirin) justified in cirrhosis related to hepatitis C virus? Société Royale Belge de Gastro-entérologie.

AIM: To assess the benefit risk ratio of interferon and ribavirin in the treatment of patients with post hepatitis C cirrhosis we summarize the spontaneous over mortality of this disease, and made an overview of the randomized trials and of other controlled studies. RESULTS: In comparison to controls, patients with post hepatitis C cirrhosis have a 17 fold increase risk of dying from a liver disease that a control population, and a 6 fold increase from primary liver cancer. In France the hepatitis C epidemic which start in the sixties explains now the observed dramatic increase in mortality by primary liver cancer, both in men and women. Meta-analysis of randomized trials and controlled retrospective studies showed that interferon treatment is associated with a significant increase in ALT response at the end of the treatment, with a decrease in hepatocellular incidence as well as a decrease in mortality in comparison with controls. Very few data are published concerning ribavirin alone or in combination with interferon in patients with cirrhosis. Preliminary data suggest that this combination during 48 weeks permit to obtain in patients with compensated cirrhosis 20% of sustained virological response. The safety was acceptable but patients with low initial blood cells count must be carefully followed. In conclusion this overview clearly demonstrates a benefit-risk ratio in favor of treatment in patients with post hepatitis C cirrhosis by interferon.

Antiviral Agents↗