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Biomedical subjects

Y Bacq

Publications and source records attributed to Y Bacq.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Serologic diagnosis and epidemiology of acute delta hepatitis in Indre-et-Loire].

A 6 years retrospective study (1981-1986) of 153 consecutive cases of HBsAg positive acute hepatitis was carried out to assess the prevalence of delta virus infections in the Indre-et-Loire a district of the Loire Valley in France. Diagnostic value of the various serum markers of delta infection, i. e. HDAg, anti-HD and anti-HD IgM, were evaluated using immunoenzyme assays. During the survey, 22 cases of delta hepatitis were diagnosed (12 co-infections, 10 superinfections). They all involved young adults, 21 of them were drug-addicts, and one young woman was the consort of a drug-addict. In Indre-et-Loire, delta virus infection was responsible for half of acute HBsAg positive hepatitis among drug-users in the last 3 years of our study. Clinical and biological features of acute delta hepatitis were compared to those of the other HBsAg positive hepatitis: two cases of fulminant hepatitis occurred among the 12 co-infections; 4 of 6 superinfection that could be followed up to 6 months developed biopsy-proven chronic active hepatitis. Delta Ag was found constantly during the first week of the disease, its disappearance was always followed by a seroconversion to anti-HD after four weeks. Anti-delta IgM was an inconstant and late marker: it was detected within the first 4 weeks in only one case (a co-infection); it persisted only in superinfections. Our study shows that delta Ag is an efficient serum marker for the early diagnosis of acute delta hepatitis.

Acute Disease↗
PubMed1986

[Acute fatty liver of pregnancy].

The authors analyse 115 cases of acute fatty liver of pregnancy, proven histologically. Characteristics of the condition is the finding of central nuclei in the hepatocytes containing microvesicular droplets. The disease occurs more frequently in primiparous women (54 per cent) and usually occurs in the third trimester of the pregnancy. A pre-icteric phase usually precedes the jaundice and during that time there is usually vomiting and/or nausa with abdominal pain or anarexia. In 92 per cent of case there is transient loss of consciousness with hepatic encephalopathy. Further tests show that there is more defective liver function than would be expected from the extent of cell lysis; and there is defective renal function. The worst complications are intestinal haemorrhages (48 per cent of cases)--genital bleeding (43 per cent of cases)--shock--diffuse intravascular coagulation and complications associated with coma. Maternal mortality at present runs at 25 per cent and fetal mortality at 60 per cent. The condition does not recur. Early evacuation of the uterus is recommended by most authors and does probably improve the outlook. The various hypotheses concerning the aetiology are discussed.

Acute Disease↗
PubMedDate not supplied

[Interferon-alpha and ribavirin treatment in a patient with hepatitis C virus-associated cutaneous periarteritis nodosa].

BACKGROUND: Hepatitis C virus (HCV) frequently causes leucocytoclastic vasculitis as a result of type II or III cryoglobulinemia. HCV-associated vasculitis without cryoglobulinemia is less common. PATIENTS AND METHODS: A 33-year-old woman consulted for infiltrative necrotic purpura of the lower limbs, responsible for leg ulcers measuring less than 1 cm. Histopathological examination revealed vasculitis affecting the hypodermic arterioles and caused by periarteritis nodosa. No extracutaneous involvement was observed. The patient had presented asymptomatic untreated HVC infection (genotype 3) for two years. Antiviral treatment resulted in elimination of the patient's viremia and no relapse of skin lesions was observed two years after the end of treatment. COMMENTS: This patient presented vasculitis due to cutaneous nodular periarteritis associated with HVC without cryoglobulinemia. Hepatic impairment was mild and did not require any antiviral treatment. No further skin involvement was seen after treatment with colchicine and because the patient's viral genotype was favorable, we decided to initiate antiviral therapy. This therapeutic approach should be considered by dermatologists, but it is nevertheless important to assess the risk of interferon-induced aggravation of vasculitis.

Adult↗
PubMedDate not supplied

[Changes in nutritional status at the initial phase of treatment of cancers and malignant hemopathies].

Changes in nutritional status at the initial phase of treatment of cancers and malignant blood diseases were evaluated in 32 male patients (mean age 58 +/- 18 years) examined during three 4-day stays in hospital (T0, T1, T2) at 2 months' interval. On the first day of each stay the following parameters were measured: food intake (kcal/day), weight (kg), squared height (m), fat mass (kg) obtained by measuring 4 skin folds and using Durnin's tables, brachial muscle area (cm2) and total skeletal muscle mass (kg) calculated from Heymsfield's equations. On the third and fourth days, after 48 hours of meat-free and fish-free diet, 3-methylhistidine (mmol/g creatininuria) and creatinine (mg) were measured in urine, and the urinary creatinine/height ratio (mg/cm/day) was calculated. Full anthropomorphic measurements were performed on 19/32 patients and complete measurements of 3-methylhistidine and the urinary creatinine/height ratio in 9/32 patients. Subsequent examinations revealed a decrease in brachial muscle area, total skeletal muscle mass and urinary creatinine/height ratio which, together with an increase in baseline 3-methylhistidine, confirmed the loss of muscle mass. Mean losses of muscle and fat were 6 p. 100 between T1 and T0 and 7 p. 100 between T2 and T0 for the muscle mass, and 9 p. 100 between T2 and T0 for the fat mass. These losses of body mass occurred very early, with significant differences between T1 and T0 and between T2 and T0. They suggest that protein-calorie malnutrition develops at a very early stage in patients treated for cancer or malignant blood disease.

Adult↗
PubMedDate not supplied

[Toxoplasmic pleuro-pericarditis associated with Hodgkin's disease].

Pericarditis caused by toxoplasma infection is exceptional: 16 cases only have been published since 1943. The authors report a case of Hodgkin's disease associated with, and revealed by, toxoplasmic pleuro-pericarditis, and they review the literature on this complication of toxoplasmosis. Since the infection can be cured and since pericarditis may become chronic and constrictive if untreated, toxoplasmosis should be envisaged and confirmed or infirmed by serological tests in all patients presenting with pericarditis of uncertain origin. Provided it has not reached the chronic stage, toxoplasmic pericarditis responds well to the conventional treatment with pyrimethamine and sulfonamides.

Adolescent↗
PubMedDate not supplied

[Hepatic amebiasis in a metropolis. Apropos of 9 cases].

From 1981 to 1990 nine patients suffering from amebic liver abscess were under observation at the Tours hospital. Hepatic amebiasis is scarce in France. Most of the subjects have stayed in endemic areas. Most of the time patients are male adults suffering from fever and abdominal pains. In most cases the liver ultrasonography shows a single cut of the right lobe with variable and non specific aspects. Once the diagnosis has been given a metronidazole treatment must be prescribed. The diagnosis will be confirmed by serology reactions. Clinical supervision is essential. The clinical effectiveness of the treatment is spectacular. Comparatively it will take about six months until serology reactions and liver ultrasonography get back to normal. Management of hepatic amebiasis need exceptionally echo-guided percutaneous puncture or surgery.

Adult↗
PubMedDate not supplied

[An anicteric cholectasis and nephrotic syndrome: AL amyloïdosis in a 51 years-old man].

Amyloidosis is a multiple-organ disease for which the diagnosis is often confusing and thereby delayed. Here, we present an archetypal case illustrating such difficulties. A 51 years-old man presented a mixed dyslipemia in November 2002, in June 2004 he has finally been diagnosed with a primary AL-amyloidosis. Within these two years, the arising of a non-icteric cholestasis and a nephrotic syndrome have triggered the search for a disease related to a multiple-organ protein deposition. Confirmation of the AL-amyloidosis was obtained through an histological examination, including direct immuno-fluorescence. Amyloidosis is a life threatening disease that need to be diagnosed at an early stage, in order to maximise the therapeutic expectations. The average survival after the diagnosis of AL-amyloidosis is 5% at 10 years. Often, treatments are initiated late in the course of the disease, at a time when organ lesion are constituted, severely affecting the prognosis.

Amyloidosis↗