Search PubMed⌕ Search

Biomedical subjects

S Chaussade

Publications and source records attributed to S Chaussade.

176 records · Page 10Linked to original sources
PubMed1986

[HBe antigen and B virus DNA in patients with chronic active hepatitis].

The detection of HBe antigen (HBeAg) in the sera of chronic HBV carriers is classically used as a marker of viral replication and therefore of development and infectivity of the disease. On this basis, it was used for the selection of patients for antiviral treatment. However, discrepancies between the presence of HBeAg and signs attesting to viral replication, namely HBV DNA and DNA polymerase, have been reported. We attempted to determine the prevalence of markers of viral replication in a group of patients with chronic active hepatitis associated or not with cirrhosis. All 41 patients were HBs Ag carriers; HBe Ag was present in 36 (88 p. 100), and HBV DNA in 28 (68 p. 100). A statistically positive correlation was found between the presence of cirrhosis and the absence of viral replication. In spite of the detection of HBe Ag, no direct signs of viral replication were observed in 30 p. 100 of patients, mainly those with cirrhosis. Therefore it is clear that the detection of HBe Ag alone cannot be considered as a sign of viral replication. Direct signs of viral replication should help to select patients for antiviral therapy, which should be started before the occurrence of cirrhosis.

Adult↗
PubMed1984

[Digestive hemorrhage under anticoagulant treatment. Retrospective analysis of a series of 178 consecutive cases].

The aim of this study was to describe the clinical characteristics, prognosis and epidemiological pattern of gastrointestinal bleeding occurring in patients receiving anticoagulant therapy. From 1971 to 1981, among 3,194 consecutive patients admitted to a gastrointestinal unit because of acute gastrointestinal bleeding, 178 were under anticoagulant therapy (i.e. antivitamin K and heparin or heparin derivative in respectively 85 and 13 p. 100 of the cases). Fourteen percent of these 178 patients had also taken gastrotoxic drugs before the bleeding occurred. Indications for anticoagulant therapy were as follows: ischemic heart disease (21 p. 100), arrhythmias (20.3 p. 100), venous thrombosis and pulmonary embolism (15.8 p. 100), arteritis (10.8 p. 100), aortic, coronary or peripheral arterial grafts (8.4 p. 100), prophylaxis of venous thrombosis (8.4 p. 100), valve prosthesis (7.3 p. 100). The lesion responsible for bleeding was found in 80 p. 100 of the cases. Surgical hemostasis was required in only 4 patients. Ten patients died (2 postoperatively). During the study period, the incidence of bleeding associated with anticoagulant therapy in the group of patients admitted to the unit with gastrointestinal hemorrhage increased from 1.5 p. 100 to 8.0 p. 100. This fact appeared to be closely related to new indications (valve prosthesis, arterial grafts, prophylaxis of venous thrombosis) and to an increased incidence of gastrointestinal bleeding especially in association with acenocoumarol treatment. These results show that, although occurring in a high risk population, gastrointestinal bleeding related to anticoagulant therapy generally has a favorable outcome. They also suggest that a prospective epidemiological study may be of interest to determine the reasons for the increasing incidence and to propose preventive measures.

Adult↗
PubMedDate not supplied

Hepatofugal portal flow in advanced liver cirrhosis with spontaneous portosystemic shunts: effects on parenchymal hepatic enhancement at dual-phase helical CT.

BACKGROUND: We investigated whether spontaneous hepatofugal portal flow in advanced cirrhosis affects hepatic enhancement on dual-phase helical computed tomography. METHODS: Fifteen patients with hepatofugal portal flow on Doppler sonography and angiography (group 1) and 15 age- and sex-matched patients with hepatopetal portal flow (control; group 2) underwent dual-phase helical computed tomography. Vascular and liver attenuation values were measured on unenhanced scans and scans obtained during hepatic arterial (HAP; 25 s) and portal venous (PVP; 70 s) phases. RESULTS: Portal vein enhancement was lower during PVP in group 1 than in group 2 ( p < 0.0001). Liver enhancement was higher during HAP and lower and delayed during PVP in group 1 versus group 2 ( p < 0.0001). CONCLUSION: In hepatofugal portal flow, liver enhancement is increased during HAP and compensating for decreased and delayed liver enhancement during PVP, resulting in potential decreased hypervascular tumor conspicuity.

Collateral Circulation↗
PubMedDate not supplied

Endoscopic ultrasonography in the staging and follow-up of epidermoid carcinoma of the anal canal.

Epidermoid (squamous cell) carcinomas of the anal canal are relatively rare, accounting for less than 3% of all malignant tumors affecting the large intestine. Radiation therapy alone or combined with chemotherapy is the treatment of choice. To be effective, this requires initially correct staging and accurate follow-up. Endoscopic ultrasonography plays an essential role, which, during a period of 20 months, we applied to 20 patients. This made possible initial staging according to the TNM classification system. Follow-up examinations showed reduction in size of lesions in all cases. Three patients required early post-radiation surgical intervention because of rectal or vaginal invasion or lymph node metastases. Recurrence in 3 patients, evident by mural expansion on consecutive ultrasound examinations, was diagnosed at 6, 10, and 12 months. In all 6 patients requiring surgical intervention, good correlation was observed between ultrasonic images and operative findings.

Aged↗
PubMedDate not supplied

[Functional studies in idiopathic constipation and irritable colon].

The pathophysiology of idiopathic constipation and of the irritable bowel syndrome is complex and not easily approached through clinical data alone, none of which appearing to be highly specific of these diagnoses. Abnormal visceral sensation as well as colonic and ano-rectal motor dysfunction have been demonstrated. Functional evaluation may then focus on establishing the presence of such abnormalities or on trying to understand their underlying mechanisms. Thus, for example, measuring colonic transit time may distinguish those patients with constipation and a prolonged transit time from those with a normal one. Ano-rectal manometry may be used to evaluate the recto-anal inhibitory reflex which is absent in Hirschsprung's disease, although its use in patients with idiopathic constipation requires further study. Electromyography (EMG) of the anal sphincter can be used to demonstrate a paradoxical contraction during defecation, which is thought to be an important mechanism in some types of constipation. Manometry an EMG are useful tools in evaluating the patient with severe constipation, particularly if surgery is contemplated.

Anal Canal↗
PubMedDate not supplied

[Constipation--a new approach].

Chronic idiopathic constipation is defined as the emission of less than 3 stools per week. Beside signs evoking a severe form (Hirschsprung's disease, idiopathic megacolon), a treatment with bran, at a dose of 20 grams per day, is instituted right away, which cures almost 60% of the patients (constipation secondary to dietetic errors). If this is not the case, the study of the colonic transit time of markers, anorectal manometry, defecation radiographs, enables to recognize various etiological forms (colonic inertia, irritable colon, anism, descending perineum, etc...) which require a specific treatment.

Anal Canal↗