Education by a nurse increases response of patients with chronic hepatitis C to therapy with peginterferon-α2a and ribavirin.

Background & Aims: Education of patients with chronic hepatitis C has been proposed to increase response to therapy with peginterferon and ribavirin. We performed a prospective study to determine the effects of systematic consultation by a nurse on patient adherence and the efficacy of therapy.

Methods: We analyzed data from 244 patients who received either systematic consultation after each medical visit from a nurse who used a standard evaluation grid and provided information about the disease and treatment (group A [GrA], n = 123) or the conventional clinical follow-up procedure (group B [GrB], n = 121).

Access to electronic hepatitis C medical files by general practitioners.

Objectives: Hepatitis C virus (HCV) infection is a recognized public health issue in France. Institutional networks were created to improve healthcare practices and facilitate multi-disciplinary care for chronic diseases. The electronic medical file is one of the tools used by the networks to optimize patient care.

[Patients with alcoholic liver disease hospitalized in gastroenterology. A national multicenter study].

Objectives: To describe the characteristics of in-patients with alcoholic liver disease in Hepatogastroenterology and to evaluate whether geographic location was a risk factor for cirrhosis.

Methods: A French, national, multicenter, prospective investigation was performed in the last quarter of 1997. To be included in the study, patients had to have drunk at least 50 g of alcohol per day for the past year or to have cirrhosis.

[Highly elevated alphafetoprotein and hepatic cirrhosis. It is not always hepatocarcinoma].

Background: Alphafetoprotein assay contributes considerably to the diagnosis of hepatocarcinoma in patients with hepatic cirrhosis. We report the case of a cirrhotic patient whose elevated alphafetoprotein level was not associated with liver disease.

Case Report: Alphafetoprotein level was followed in a 64-year-old man with hepatic cirrhosis.

Early administration of vapreotide for variceal bleeding in patients with cirrhosis.

Background: In patients with cirrhosis, pharmacologic or endoscopic treatment may control variceal bleeding. However, the effects of early administration of a somatostatin analogue followed by endoscopic treatment are unknown.

Methods: We studied the effects of treatment with vapreotide, a somatostatin analogue, begun before endoscopic treatment in 227 patients with cirrhosis who were hospitalized for acute upper gastrointestinal bleeding.

[Apheresis for Byler syndrome in pregnancy: tolerance and effectiveness].

We report the first known case of a successful pregnancy in a 22-year-old white woman suffering from hepatic Byler's syndrome, a familial fibrogenic cholestasis observed in children and usually leading to death during adolescence or to liver transplantation. A first pregnancy was unsuccessful with intrauterine death. Medical surveillance of the second pregnancy was reinforced due to major cholestasis and itching sensation.

Anti-inflammatory drugs and variceal bleeding: a case-control study.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) can have severe gastrointestinal effects and cause peptic ulcers to bleed. Acute bleeding from oesophageal varices is a major complication of cirrhosis of the liver.

Aims: To investigate the role, using a case-control study, of NSAIDs in first bleeding episodes associated with oesophageal or cardial varices in cirrhotic patients.

A prospective randomized study comparing high- and low-dose leucovorin combined with same-dose 5-fluorouracil in advanced colorectal cancer.

Although the efficacy of 5-fluorouracil (5-FU) modulated by leucovorin is well established for advanced colorectal cancer, the question of the most effective regimen and optimal dose of leucovorin remains unanswered. This prospective randomized trial compares low-dose (group 1) and high-dose (group 2) leucovorin, combined with the same dose of 5-FU to determine whether high-dose leucovorin was more beneficial than low-dose on overall survival. Inclusion criteria were: unresectable metastatic colorectal carcinoma, with or without evaluable tumor response; a performance status of less than grade 3 (World Health Organization classification); and no previous chemotherapy for metastases.

[Percutaneous hepatic puncture biopsy in ambulatory care. 231 patients].

Objectives: The aim of this study was to verify that percutaneous liver biopsy does not require prolonged hospitalization over 24 hours and can be performed in a day care clinic without increased morbidity.

Patients And Methods: Two hundred thirty-one outpatients underwent percutaneous liver biopsies in a day care clinic from November 1, 1994 to June 30, 1996. There were 136 men and 95 women, mean age 39.

A phase II study of 5-fluorouracil, leucovorin and cisplatin (FLP) for metastatic gastric cancer.

The modulation of 5-fluorouracil (5-FU) with folinic acid (leucovorin, LV) is more efficacious than 5-FU alone in the treatment of metastatic colorectal cancer, and the combination of 5-FU with cisplatin is currently one of the most active regimens in advanced gastric cancer. A phase II study was therefore conducted to test the efficacy and toxicity of the combination of 5-FU, LV and cisplatin (FLP) in metastatic gastric cancer. 28 patients entered the study.

Sclerotherapy with or without octreotide for acute variceal bleeding.

Background: Sclerotherapy is considered the most effective way to stop bleeding from esophageal varices, but acute variceal bleeding is still associated with a high risk of rebleeding and death. We compared sclerotherapy alone with sclerotherapy and octreotide to control acute variceal bleeding and prevent early rebleeding in patients with cirrhosis.

Methods: In a double-blind, prospective trial, 199 patients with cirrhosis and acute variceal bleeding who underwent emergency sclerotherapy were randomly assigned to receive a continuous infusion of octreotide (25 micrograms per hour) or placebo for five days.

[Cystic dystrophy in an aberrant pancreas. Contribution of computerized tomography and MRI].

Case report of a cystic dystrophia appearing in an ectopic pancreas. The clinical diagnosis was preoperatively suspected by the findings of CT scan revealing a tumor located in the wall of the duodenum and by the data of MRI indicating its cystic and fibrotic structure. A focus of reacting pancreatitis was found in the vicinity of the cystic dystrophia while the remaining pancreas was normal.

[Impaired fibrinolytic response to the venous occlusion test in patients with cryptogenic colitis].

The fibrinolytic response to venous occlusion was studied in 17 patients with inflammatory bowel disease: 7 with Crohn's disease, 10 with ulcerative colitis and compared with those obtained in 20 controls. Patients with inflammatory bowel disease showed decreased tissue-type plasminogen activator antigen release (t-PA Ag), no significant Von Willebrand antigen release (vWF Ag), and a residual plasminogen activator inhibitor activity (PAI activity) after venous occlusion. These modifications were more important in the evolutive colitis group compared with the remission group.

Inhibitory effect of the C-terminal octapeptide of oxyntomodulin on pentagastrin-stimulated gastric acid secretion in man.

The effect of the C-terminal octapeptide of human oxyntomodulin (KA-8) on pentagastrin-stimulated gastric acid secretion was studied versus placebo in eight human volunteers after an overnight fast, using a double-blind randomized protocol. KA-8 (7.5 nmol/kg body weight) was bolus-injected at a plateau stimulation obtained with pentagastrin (3 micrograms/kg/h).

[Electromyographic analysis of the motility of the right and transverse colon in 9 colostomized patients].

The aim of this work was to study the electric pattern of proximal colonic motility in patients with permanent colostomy but without past history of an irritable bowel syndrome. Nine patients (55 to 70 years-old) were investigated using a colonoscope with 5 annular electrodes. An electromyogram was recorded during 4 h.