[Imported dengue: study of 44 cases observed from 1994 to 1997 in 9 university hospital centers. Infectio-Sud-France group]. / Dengue importée: étude de 44 cas observés de 1994 à 1997 dans 9 centres hospitaliers universitaires. Groupe Infectio-Sud-France.

Imported dengue is increasingly observed in non endemic countries. We report a retrospective study of 44 cases of dengue fever diagnosed in nine french university hospitals between 1994 and 1997. The patients were aged between 13 and 67 years. Most of them were tourists and had been traveling for a few weeks, in French West Indies and French Guyana (18), South-East Asia (10), India (7) or Polynesia (4). Only, two contracted the disease in Africa. The onset of symptoms preceded the return or followed it within 7 days. The most frequent clinical presentation was a febrile and painful syndrome. Cutaneous manifestations (rash or macular exanthem) were observed in 59% of cases, digestive symptoms in 50%, pharyngitis and/or cough in 25%, microadenopathy in 20%, moderate mucous haemorrhagic manifestations in 16% and neuropsychiatric manifestations in 14%. The common biological abnormalities were thrombocytopenia (84%), leukopenia (59%), and elevated transminases (57%). The diagnosis, orientated by negativity of malaria smears, the knowledge of an epidemic in the visited country, or occurrence of similar cases in the entourage, were argued by serological results: presence of anti-DEN IgM in 25 cases, serological conversion (anti- DEN IgG) in 7 cases or very high seropositivity (anti-DEN IgG > 1/1280) in 12 cases. No virus isolation was obtained.

[Study of lymphocyte subpopulations with monoclonal antibodies in acute hepatitis A and B]. / Estudio de sub-poblaciones linfocitarias mediante anticuerpos monoclonales en hepatitis aguda A y B.

Using monoclonal antibodies, it was determined the T3, T4 and T8 1ym phocyte populations in the blood samples of 40 patients with acute viral hepatitis (20 type A and 20 type B). al patients showed complete remission from it. The results of this study were compared with those of a control group of 20 healthy subjects. There was a non significant decreased of the total number of lymphocytes measured with the T3 monoclonal antibody in both types of hepatitis. The number of T8 lymphocytes was significantly increased (p less than 0.05) when the results were compared with those of the control group. The quotient T4/T8 was diminished in the initial phase of the disease (p less than 0.05). There were no other differences between hepatitis A and hepatitis B. In the follow up of the disease, the results tend to normal values in the whole group of patients.

[Acute hepatic lesion caused by Giardia lamblia]. / Lesión hepática aguda por Giardia lamblia.

A study was made of 20 rats infested by Giardia muris in which a histologic study was made of the liver, as well as of 25 patients with giardiasis and elevated alanine-aminotransferase levels. Patients with positive A or B hepatitis markers, cholelithiasis or history of drug or alcohol use were excluded. Tests of liver function and liver biopsy were performed and antiparasite therapy was given during three months of follow-up, after which the liver biopsy was repeated. Humoral alterations were compared to those of 30 patients with acute viral hepatitis (15 type A and 15 type B) over the same periods of time. In 20% of the rats, nonspecific liver lesions were found. In the patients liver enzymes and the thymol test normalized a month after treatment and serum bile acids became normal in the third month. The liver biopsy demonstrated hepatic damage in 94% of the patients (in 20 cases cell lesions and in 12 cases inflammatory lesions) which regressed in the third month, the follow-up biopsy being normal after eradication of the parasite was confirmed. The comparative study with viral hepatitis showed highly significant differences in all the variables studied during the follow-up stage. Emphasis is placed on the importance of this lesion and its differential diagnosis to prevent its progression to chronic liver disease.

[Study of lymphocyte subpopulations by means of monoclonal antibodies in acute hepatitis A and B]. / Estudio de sub-poblaciones linfocitarias mediante anticuerpos monoclonales en hepatitis aguda A y B.

We studied T3, T4 and T8 lymphocyte populations in peripheral blood by monoclonal antibodies in 40 patients with acute viral hepatitis (Type A 20; Type B 20) who underwent outcome to complete recovery. We compared the results with 20 healthy subjects (control group). We found a decrease in total lymphocytes measured by T3 monoclonal antibodies and a significant increase in T8 lymphocyte populations compared with control groups. In the early stage the T4/T8 ratio was decreased. Lymphocyte populations and T4/T8 ratio was normal in 3-6 month follow-up for the acute A hepatitis group and 3.6 month to a year follow-up for the B hepatitis group. Results were related to the humoral and clinical outcome.

Propanol en la prevención de sangramiento digestivo en pacientes cirróticos

Se administró Propranolol a 15 pacientes cirróticos a dosis requerida para reducir el gasto cardíaco en un 25%. Fueron seguidos por un período de 1 a 2 años comparándose las tasas de sangramiento y el tamaño de las várices esofágicas con otros 15 pacientes tratados com placebo tomados como grupo control y seguidos por el mismo período de tiempo. En el grupo tratado sólo un paciente presentó sangramiento detectado por hemocult mientras que en el grupo control el 46,6% de los pacientes presentó sangramiento el cual fue la causa de muerte en dos de ellos. El tamaño de las várices por endoscopia disminuyó en el 73,3% de los pacientes del grupo tratado lo cual no se apreció en el grupo control. El Propranolol es un medicamento útil para la reducción del tamaño de las váricaces esofágicas y para la prevención del sangramiento digestivo en pacientes cirróticos

Propanol en la prevención de sangramiento digestivo en pacientes cirróticos

Se administró Propranolol a 15 pacientes cirróticos a dosis requerida para reducir el gasto cardíaco en un 25%. Fueron seguidos por un período de 1 a 2 años comparándose las tasas de sangramiento y el tamaño de las várices esofágicas con otros 15 pacientes tratados com placebo tomados como grupo control y seguidos por el mismo período de tiempo. En el grupo tratado sólo un paciente presentó sangramiento detectado por hemocult mientras que en el grupo control el 46,6% de los pacientes presentó sangramiento el cual fue la causa de muerte en dos de ellos. El tamaño de las várices por endoscopia disminuyó en el 73,3% de los pacientes del grupo tratado lo cual no se apreció en el grupo control. El Propranolol es un medicamento útil para la reducción del tamaño de las váricaces esofágicas y para la prevención del sangramiento digestivo en pacientes cirróticos (AU)

[Propranolol in the prevention of digestive bleeding in cirrhotic patients]. / Propranolol en la prevención de sangramiento digestivo en pacientes cirróticos.

Propranolol was administered to fifteen cirrhotic patients at requires doses, to reduce cardiac output by 25%. Patients were followed up for a period of 1 to 2 years. Bleeding rates and esophagic varices size were compared against fifteen patients treated with placebo, serwing as control group. On the treated group only one patient showed bleeding, detected by hemoccult while controls showed a 46.6% of bleedings which cause two deaths. The endoscopic size of varices decreased in 73.3% on the treated group, this was not observed on the controls. Propranolol is a useful medicament for the reduction of esophagic varices size and prevention of digestive bleeding in cirrhotic patients.

Propranolol en la prevención de sangramiento digestivo en pacientes cirróticos. / [Propranolol in the prevention of digestive bleeding in cirrhotic patients]

Propranolol was administered to fifteen cirrhotic patients at requires doses, to reduce cardiac output by 25

. Patients were followed up for a period of 1 to 2 years. Bleeding rates and esophagic varices size were compared against fifteen patients treated with placebo, serwing as control group. On the treated group only one patient showed bleeding, detected by hemoccult while controls showed a 46.6

of bleedings which cause two deaths. The endoscopic size of varices decreased in 73.3

on the treated group, this was not observed on the controls. Propranolol is a useful medicament for the reduction of esophagic varices size and prevention of digestive bleeding in cirrhotic patients.

Tratamiento de la hepatitis crónica activa tipo B con interferón leucocitario humano

Se administró interferon leucocitario humano a 62 pacientes con hepatitis crónica activa tipo B, durante un período de seis meses a una dosis total de 400 millones U.I. Se siguieron mensualmente durante un periodo de un año, repitiéndose la biopsia hepática. Las cifras de alanino-amino-transferasa se normalizaron en el 67.7 por ciento de los pacientes y se logró la seroconversión antígeno-anticuerpo o en el 59 por ciento. El antígeno no fue detectable al final del tratamiento en solo cuatro pacientes. La histología hepática mostro una normalización en 17 pacientes y una mejoría en casi la mitad de los mismos. Solo 3 pacientes evolucionaron hacia una cirrosis hepática. Los mejores resultados se apreciaron en sujetos jóvenes y en aquellos que no habían recibido previamente terapia inmunosupresora

[Long-term study of patients with active chronic hepatitis treated with leukocyte interferon]. / Estudio a largo plazo de pacientes con hepatitis crónica activa tratados con interferón leucocitario.

Seven patients with active chronic hepatitis who received Interferon Alfa showed a marked humoral and histological improvement one year after the treatment was concluded, in 3 patients the hepatic histology was almost normal, 2 evolved to a persistent chronic hepatitis and only one showed deterioration. These results differed from those obtained immediately after the treatment (p 0.05). Interferon Alfa proves to be of the most usefulness in this disease, studies should be continued up to one year after the treatment has ended.

Estudio a largo plazo de pacientes con hepatitis crónica activa tratados con interferón leucocitario. / [Long-term study of patients with active chronic hepatitis treated with leukocyte interferon]

Seven patients with active chronic hepatitis who received Interferon Alfa showed a marked humoral and histological improvement one year after the treatment was concluded, in 3 patients the hepatic histology was almost normal, 2 evolved to a persistent chronic hepatitis and only one showed deterioration. These results differed from those obtained immediately after the treatment (p 0.05). Interferon Alfa proves to be of the most usefulness in this disease, studies should be continued up to one year after the treatment has ended.

Manifestaciones hepáticas en la Giardiasis / Hepatic manifestations in Giardiasis

En 25 pacientes portadores de Giardiasis comprobada por sondaje duodenal se realizaron pruebas de funcionalismo hepático y biopsia hepática con trócar de Menghini. El 60% de los pacientes presentaron alteraciones en la histología hepática: el 36% esteatosis y el 24% lesiones inflamatorias, de ellos 3 Hepatitis Crónica Persistente y 2 Hepatitis Crónica Activa. Estas lesiones regresaron sólo con el tratamiento antiparasitario y la reaparición de las mismas estuvo en dependencia con reinfectaciones del parásito en algunos casos. Se concluye que la Giardia Lamblia puede ocasionar lesiones hepáticas importantes y conducir a una enfermedad crónica activa del hígado. Se recomienda en todo paciente con diagnóstico de Hepatitis Crónica no viral descartar una Giardiasis, y tratarla, antes de decidir otro tipo de conducta terapéutica

Manifestaciones hepáticas en la Giardiasis / Hepatic manifestations in Giardiasis

En 25 pacientes portadores de Giardiasis comprobada por sondaje duodenal se realizaron pruebas de funcionalismo hepático y biopsia hepática con trócar de Menghini. El 60% de los pacientes presentaron alteraciones en la histología hepática: el 36% esteatosis y el 24% lesiones inflamatorias, de ellos 3 Hepatitis Crónica Persistente y 2 Hepatitis Crónica Activa. Estas lesiones regresaron sólo con el tratamiento antiparasitario y la reaparición de las mismas estuvo en dependencia con reinfectaciones del parásito en algunos casos. Se concluye que la Giardia Lamblia puede ocasionar lesiones hepáticas importantes y conducir a una enfermedad crónica activa del hígado. Se recomienda en todo paciente con diagnóstico de Hepatitis Crónica no viral descartar una Giardiasis, y tratarla, antes de decidir otro tipo de conducta terapéutica (AU)

[Hepatic manifestations in giardiasis]. / Manifestaciones hepáticas en la giardiasis.

In 25 patients with diagnostic of Giardiasis by duodenal intubation we studied the hepatic functional tests and hepatic biopsy. 60% of patients presented alterations of hepatic histology; 36% steatosis and 24% inflammatory lesions, chronic persistent hepatitis 3 cases and chronic active hepatitis two of them. Hepatic lesions regression was reached only with antiparasitic treatment and in some cases reappearance of lesions depended on parasitic's reinfections. For every patient with histologic diagnosis of chronic hepatitis without viral markers we suggested to dismiss Giardiasis and to treat it before to undergo other therapeutical behavior.

[T and B lymphocytes in hepatic diseases]. / Linfocitos T y B en afecciones hepáticas.

T and B. lymphocytes in peripheral blood were determined in 102 patients with several hepatic diseases: acute hepatitis, persistent and chronic active hepatitis and hepatic cirrhosis. Significant differences (p less than 0.05) were found between all groups of patients and controls. T lymphocytes were decreased (p less than 0.05) in patients with acute hepatitis that developed chronic disease in relation with those with good evolution. A remarkable decrease was found in cirrhotic patients with hepatic insufficiency. The prognostic value of these lymphocytes populations in hepatic diseases is enhanced.

Linfocitos T y B en afecciones hepaticas / T and B lymphocytes in hepatic diseases

Se estudiaron en 102 pacientes con diversas afecciones hepáticas; 36 hepatitis agudas, 9 hepatitis crónicas persistentes, 36 hepatitis crónicas activas y 21 cirrosis hepáticas, realizándoles conteo de linfocitos T y B en sangre periférica. Ambas poblaciones linfoides fueron significativamente menores en todos los grupos estudiados en relación con los controles (p < 0,05). En los pacientes con hepatitis aguda que evolucionaron a la cronicidad la población de linfocitos T fue significativamente menor (p < 0,05> que la de aquéllos que fueron a la curación. Ambas poblaciones linfoides no diferieron entre los casos en que el antígeno de superficie de la hepatitis B fue negativo o positivo. En dos pacientes con cirrosis se apreció un descenso notable de los linfocitos T en el estadío de insuficiencia hepática severa. Se destaca el interés pronóstico de estas poblaciones linfoides en pacientes con afecciones hepáticas

Linfocitos T y B en afecciones hepáticas. / [T and B lymphocytes in hepatic diseases]

T and B. lymphocytes in peripheral blood were determined in 102 patients with several hepatic diseases: acute hepatitis, persistent and chronic active hepatitis and hepatic cirrhosis. Significant differences (p less than 0.05) were found between all groups of patients and controls. T lymphocytes were decreased (p less than 0.05) in patients with acute hepatitis that developed chronic disease in relation with those with good evolution. A remarkable decrease was found in cirrhotic patients with hepatic insufficiency. The prognostic value of these lymphocytes populations in hepatic diseases is enhanced.

Manifestaciones hepáticas en la giardiasis. / [Hepatic manifestations in giardiasis]

In 25 patients with diagnostic of Giardiasis by duodenal intubation we studied the hepatic functional tests and hepatic biopsy. 60

of patients presented alterations of hepatic histology; 36

steatosis and 24

inflammatory lesions, chronic persistent hepatitis 3 cases and chronic active hepatitis two of them. Hepatic lesions regression was reached only with antiparasitic treatment and in some cases reappearance of lesions depended on parasitics reinfections. For every patient with histologic diagnosis of chronic hepatitis without viral markers we suggested to dismiss Giardiasis and to treat it before to undergo other therapeutical behavior.