Jean-Paul Martinet

Treatment of acute hepatitis C with interferon alpha-2b: early initiation of treatment is the most effective predictive factor of sustained viral response

Aim : To evaluate the efficacy of early interferon α‐2b in non‐post‐transfusion acute hepatitis C virus: a prospective study with historical comparison.

Circulating nucleosomes as new blood-based biomarkers for detection of colorectal cancer.

BackgroundColonoscopy is currently widely accepted as the gold standard for detection of colorectal cancer (CRC) providing detection of up to 95% of pre-cancerous lesions during the procedure. However, certain limitations exist in most countries including cost and access to the procedure. Moreover, colonoscopy is an invasive technique with risk inherent to the endoscopic procedure. For this reason, alternative screening tests, in particular, fecal occult blood-based tests, have been widely adopted for frontline screening. Limited compliance to colonoscopy and fecal screening approaches has prompted research on blood-based tests as an alternative approach to identifying individuals at risk who could then be referred for colonoscopy. Increased total levels of nucleosomes in the blood have been associated with tumor burden and malignancy progression. Here, we report for the first time, CRC-associated epigenetic profiles of circulating cell-free nucleosomes (cf-nucleosomes).MethodsLevels of 12 epigenetic cf-nucleosome epitopes were measured in the sera of 58 individuals referred for endoscopic screening for CRC.ResultsMultivariate analysis defined an age-adjusted panel of four cf-nucleosomes that provided an AUC of 0.97 for the discrimination of CRC from healthy controls with high sensitivity at early stages (sensitivity of 75 and 86 at 90% specificity for stages I and II, respectively). A second combination of four cf-nucleosome biomarkers provided an AUC of 0.72 for the discrimination of polyps from the healthy group.ConclusionsThis study suggests that a combination of different cf-nucleosome structures analyzed in serum samples by a simple ELISA is a promising approach to identify patients at risk of CRC.

Origine inattendue d'une ascite récidivante: á propos de 2 cas.

The authors report the cases of two patients suffering from ascites attributed for several years to a non pericarditic aetiology. The first patient presented with a diagnosis of right cardiac failure secondary to a right myocardial infarction. Cardiac catheterisation, magnetic resonance imaging and transoesophageal echocardiogram allowed to establish the diagnosis. In the second case, ascites was attributed to cirrhosis. Presence of pericardial calcifications, visible on a chest X-Ray led to suspect constrictive pericarditis. In both cases, ascites contained a high protein level. A pericardectomy allowed a favourable outcome in both cases. Thus, a diagnosis of constrictive pericarditis must be evoked in face of ascites of unclear origin and a normal cardiac size.

A well-differentiated hepatocellular carcinoma detected only by F-18 FDG positron emission tomography.

&NA; Because of its poor sensitivity, the role of F‐18 fluorodeoxyglucose (FDG)‐positron emission tomographic (PET) imaging in the management of hepatocellular carcinoma is still controversial. Some authors have suggested that its primary role is to assess tumor differentiation. The poorly differentiated tumors have higher FDG uptake, and therefore can predict the outcome of patients with hepatocellular carcinoma. Only rarely can FDG‐PET imaging reveal more lesions in the liver plus distant metastases than conventional radiologic studies. The authors present the case of a well‐differentiated hepatocellular carcinoma visualized only by FDG‐PET imaging, even though the tumor was suggested by its high serum &agr;‐fetoprotein level and portal thrombosis observed on conventional radiologic images.