[Epidemiological studies of intestinal functional disorders: aims and methods].
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Biomedical subjects
Publications and source records attributed to S Naveau.
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The simultaneous detection of IgM antibodies to hepatitis A virus (anti-HAV IgM) and IgM antibodies to viral capsid antigen (anti-VCA IgM) of Epstein-Barr virus (EBV) in patients with acute viral hepatitis has led us to systematically study serological markers of EBV in patients with anti-HAV IgM positive acute hepatitis and to test for anti-HAV IgM in sera of patients with acute hepatitis associated with serological evidence of current primary EBV infection. All patients studied were HBsAg negative and were not drug-addicts, nor homosexuals. In 15 consecutive patients with anti-HAV IgM positive acute hepatitis, anti-HAV IgM and anti-VCA EBV IgM antibodies were simultaneously detected in 9 cases. Of these 9 patients, antibodies to nuclear antigen were positive in 8 cases, antibodies to early antigen were positive in 7 cases and rheumatoid factor was positive in 4 cases. In 5 consecutive patients with acute hepatitis associated with serological evidence of current primary EBV infection, anti-HAV IgM was not detected. Simultaneous presence of anti-VCA EBV IgM, early antigen IgG antibodies and nuclear antigen antibodies in 7 patients with acute hepatitis associated with anti-HAV IgM suggests reactivation of EBV or reactivation of clones secreting antibodies anti-EBV in HAV infections. Furthermore, these results show that anti-VCA IgM only cannot be considered to be a specific marker of early EBV infection in patients with acute hepatitis.
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Because hospital length of stay is the most important determinant of cost of hospitalization, this study was performed to analyse factors contributing to hospital length of stay in an hepato-gastroenterology unit. Prospectively collected computerized files of the first 750 patients admitted in 1982 were analyzed according to primary diagnosis, age and sex. Ten primary diagnosis categories were established. By multivariate analysis, alcoholic liver disease and the non-digestive diseases correlated best with the hospital length of stay. Variables most predictive of an hospital length of stay greater than 14 days were diagnosis of alcoholic liver disease, patient age and diagnosis of non-alcoholic cirrhosis. Analyses of this kind are essential in making policy decisions regarding hospital cost reduction.
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A sixty-four year-old woman was admitted for chronic diarrhea with severe weight loss. Investigations showed hepatomegaly, positive serologic tests for syphilis, and nephrotic syndrome with proteinuria. Anasarca occurred and the patient died shortly after admission. Necropsy showed sclero-gummatous hepatic syphilis, generalized amyloïdosis and ulcerative colitis. These last two manifestations and their association with tertiary stage syphilis are discussed.
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