[Prévalence de l'infection à Helicobacter pylori et des lésions endoscopiques hautes chez les diabétiques: Etude cas/témoins]. / Prevalence of helicobacter pylori infection and gastroscopic finding in diabetic patients: a case-control study.

BACKGROUND: Current data on the prevalence of Helicobacter pylori infection in dyspeptic diabetic patients are contradictory in the literature. AIM: the aim was to assess the prevalence of Helicobacter pylori infection, gastroscopic lesions, and gastric histopathological lesions, in dyspeptic diabetic patients. METHODS: It was a case-control study collecting 394 dyspeptic patients (194 diabetic and 200 nondiabetic patients). RESULTS: The average age of patients was 47 years. 144 patients (47%) were male and 150 patients (53%) were female. The two patient groups were matched for age and sex. The prevalence of Helicobacter pylori infection was comparable between the two groups of patients (85% in diabetics versus 90% in the controls). The frequency of gastroscopic lesions was 50% in diabetics and 55% in controls with no significant difference between the two groups. At histology, the prevalence of chronic gastritis, intestinal metaplasia, and gastric atrophy was 85%, 13% and 39% respectively in the group of diabetic patients. These results were comparable to those found in patients without diabetes. CONCLUSION: Our work shows no difference between diabetics and non-diabetics on the prevalence of Helicobacter pylori infection, gastroscopic, and gastric histopathological lesions.

Sclerosing Cholangitis in Behçet's Disease.

Introduction. Sclerosing cholangitis is characterized by an inflammatory and fibrotic lesion of intra- and/or extrahepatic bile ducts. When a causal mechanism of a bile duct lesion is identified, the sclerosing cholangitis is considered secondary. The vasculitis, including the Behçet disease, is cited as a probable cause of the ischemia and the sclerosing cholangitis. No cases of extrahepatic secondary sclerosing cholangitis have been reported to date. Case Report. We report the first case of secondary sclerosing cholangitis of the extrahepatic bile ducts associated with Behçet disease in a male who is aged 43, with a previous history of the angio-Behçet followed by complications of thrombophlebitis and a cerebral thrombophlebitis, and who has a cholestatic jaundice. The diagnosis has been carried out by the MR cholangiopancreatography which has objectified a moderate distension of the intrahepatic bile ducts upstream of regular stacked parietal thickening of the main bile duct. The patient has been treated successfully with the ursodeoxycholic acid and the placement of a plastic stent. Conclusion. This diagnosis should be mentioned to any patient with vasculitis and who has a cholestatic jaundice.

[Hepatic steatosis in chronic hepatitis B: prevalence, risk factors, and impact on fibrosis and therapeutic response]. / La stéatose hépatique au cours de l'hépatite chronique B: prévalence, facteurs de risque, et effet sur la fibrose et la réponse thérapeutique.

BACKGROUND: steatosis is a common injury in chronic hepatitis C, but this association has not been sufficiently studied in chronic hepatitis B. aim: To evaluate the prevalence of hepatic steatosis in chronic hepatitis B and determine its association with various histologic, biochemical, virological, and metabolic diseases, and its effect on fibrosis and therapeutic response. METHODS: Our study was compiled 133 patients with chronic hepatitis B who received no antiviral therapy and who had a liver biopsy. Our patients were divided into 2 groups: 51 patients (38.3%) had steatosis (Group I), while 82 (61.7%) had no steatosis (Group II). RESULTS: In groupeI, the average age, BMI, cholesterol, triglycerides, and glucose were significantly higher than the group without steatosis in univariate study (P <0.05). In multivariate analysis, only high BMI and hypertriglyceridemia were included.No significant difference between the two groups was observed in the rate of transaminases, HBeAg status, viral load (P> 0.05). Steatosis doesn't influence fibrosis stage and therapeutic response. CONCLUSION: During chronic hepatitis B, steatosis appears to be the result of metabolic factors of the host rather than the effect of the virus. Hepatic steatosis does not seem to influence the progression of liver fibrosis, or therapeutic response, however, the role of steatosis should be better studied by prospective longitudinal clinical studies on large populations of patients.