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Christoph Sarrazin - One of the best experts on this subject based on the ideXlab platform.

  • 13c methacetin breath Test as Liver Function Test in patients with chronic hepatitis c virus infection
    Alimentary Pharmacology & Therapeutics, 2005
    Co-Authors: Barbara Braden, D Faust, C F Dietrich, U Sarrazin, Wolfgang F Caspary, Christoph Sarrazin
    Abstract:

    Summary Background : The 13C-methacetin breath Test enables the quantitative evaluation of the cytochrome P450-dependent Liver Function. Aim : To find out whether this breath Test is sensitive in noncirrhotic patients also with chronic hepatitis C in early stages of fibrosis. Methods : Sixty-one healthy controls and 81 patients with chronic hepatitis C underwent a 13C-methacetin breath Test. In all patients, a Liver biopsy was performed. The Liver histology was classified according to the histology activity index–Knodell score. Results : Delta over baseline values of the patients at 15 min significantly differed from controls (19.2 ± 9.2‰ vs. 24.1 ± 5.7‰; P < 0.003). The cumulative recovery after 30 min in patients was 11.4 ± 4.8% and in healthy controls 13.8 ± 2.8% (P < 0.002). However, patients with early fibrosis (histology activity index IVB) did not differ in delta over baseline values of the patients at 15 min (23.2 ± 7.9‰ vs. 22.6 ± 7.2‰; P = 0.61) or cumulative recovery (13.6 ± 3.7% vs. 13.2 ± 3.8%; P = 0.45) from patients with more advanced fibrosis (histology activity index IVC). Patients with clinically nonsymptomatic cirrhosis (histology activity index IVD; Child A) metabolized 13C-methacetin to a significantly lesser extent (delta over baseline values of the patients at 15 min: 8.3 ± 4.9‰; P < 0.005 and cumulative recovery after 30 min: 5.6 ± 3.2%; P < 0.003). The 13C-methacetin breath Test identified cirrhotic patients with 95.0% sensitivity and 96.7% specificity. Conclusion : The non-invasive 13C-methacetin breath Test reliably distinguishes between early cirrhotic (Child A) and noncirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C.

  • 13c methacetin breath Test as Liver Function Test in patients with chronic hepatitis c virus infection
    Alimentary Pharmacology & Therapeutics, 2005
    Co-Authors: Barbara Braden, D Faust, C F Dietrich, U Sarrazin, Wolfgang F Caspary, S Zeuzem, Christoph Sarrazin
    Abstract:

    BACKGROUND The 13C-methacetin breath Test enables the quantitative evaluation of the cytochrome P450-dependent Liver Function. AIM To find out whether this breath Test is sensitive in noncirrhotic patients also with chronic hepatitis C in early stages of fibrosis. METHODS Sixty-one healthy controls and 81 patients with chronic hepatitis C underwent a 13C-methacetin breath Test. In all patients, a Liver biopsy was performed. The Liver histology was classified according to the histology activity index-Knodell score. RESULTS Delta over baseline values of the patients at 15 min significantly differed from controls (19.2 +/- 9.2 per thousand vs. 24.1 +/- 5.7 per thousand; P < 0.003). The cumulative recovery after 30 min in patients was 11.4 +/- 4.8% and in healthy controls 13.8 +/- 2.8% (P < 0.002). However, patients with early fibrosis (histology activity index IVB) did not differ in delta over baseline values of the patients at 15 min (23.2 +/- 7.9 per thousand vs. 22.6 +/- 7.2 per thousand; P = 0.61) or cumulative recovery (13.6 +/- 3.7% vs. 13.2 +/- 3.8%; P = 0.45) from patients with more advanced fibrosis (histology activity index IVC). Patients with clinically nonsymptomatic cirrhosis (histology activity index IVD; Child A) metabolized 13C-methacetin to a significantly lesser extent (delta over baseline values of the patients at 15 min: 8.3 +/- 4.9 per thousand; P < 0.005 and cumulative recovery after 30 min: 5.6 +/- 3.2%; P < 0.003). The 13C-methacetin breath Test identified cirrhotic patients with 95.0% sensitivity and 96.7% specificity. CONCLUSION The non-invasive 13C-methacetin breath Test reliably distinguishes between early cirrhotic (Child A) and noncirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C.

Samuel Kinde - One of the best experts on this subject based on the ideXlab platform.

  • robust reference intervals for Liver Function Test lft analytes in newborns and infants
    BMC Research Notes, 2012
    Co-Authors: Mulugeta Melkie, Mahilet Yigeremu, Paulos Nigussie, Shawel Asrat, Tatek Gebreegziabher, Tilahun Teka, Samuel Kinde
    Abstract:

    Background Reference intervals (RIs) are ranges of upper and lower limits of a given analyte which are used for a laboratory Test to determine whether a disease is present or absent or to know if the patient is at risk for future disease states. In Ethiopia, a country with highly diversified population groups and geographical sites, there are no established RIs to metabolic analytes including the Liver Function Test (LFT) analytes for the pediatric population though it has been known that Liver Function assessment in this population is vital as a result of varied vulnerability to both endogenous and xenobiotic substances.

  • robust reference intervals for Liver Function Test lft analytes in newborns and infants
    BMC Research Notes, 2012
    Co-Authors: Mulugeta Melkie, Mahilet Yigeremu, Paulos Nigussie, Shawel Asrat, Tatek Gebreegziabher, Tilahun Teka, Samuel Kinde
    Abstract:

    Reference intervals (RIs) are ranges of upper and lower limits of a given analyte which are used for a laboratory Test to determine whether a disease is present or absent or to know if the patient is at risk for future disease states. In Ethiopia, a country with highly diversified population groups and geographical sites, there are no established RIs to metabolic analytes including the Liver Function Test (LFT) analytes for the pediatric population though it has been known that Liver Function assessment in this population is vital as a result of varied vulnerability to both endogenous and xenobiotic substances. A cross sectional study was conducted in Tikur Anbessa Specialized Hospital (TASH) and Teklehaymanot Health Center (THC) from November 2010 to April 2011. 117 cord blood (from newborns) and venous blood samples (from infants) were collected and analyzed using HumaStar 300. All pre-analytical, analytical and post-analytical aspects were thoroughly controlled. A robust, CLSI/ IFCC recommended, method was used for the determination of upper and lower end points covering 95% of the reference values of each analyte with respective 90% CIs using MedCalc® software. Combined RIs for newborns and infants were established for albumin, AST, ALP, direct bilirubin and total bilirubin to be 3.88-5.82 g/dl, 16.1-55.4U/l, 130-831U/l, <0.41 mg/dl and <1.37 mg/dl respectively. But, separated RIs were indicated for ALT and GGT as 1.2-23.1U/l and 6.94-24.8U/l ALT; and 30.6-160.7U/L and 10–28.2U/l GGT for newborns and infants respectively. Some maternal and infantile factors were identified to affect the values of analytes. Almost all analytes were different from previously reported values for other target population of similar age group, kit insert values and adult values. So, interpretation of values of these analytes in newborns and infants of Ethiopian population sounds better to be performed by using such RIs taking the effect of some maternal and infantile factors in to account.

Barbara Braden - One of the best experts on this subject based on the ideXlab platform.

  • 13c methacetin breath Test as Liver Function Test in patients with chronic hepatitis c virus infection
    Alimentary Pharmacology & Therapeutics, 2005
    Co-Authors: Barbara Braden, D Faust, C F Dietrich, U Sarrazin, Wolfgang F Caspary, Christoph Sarrazin
    Abstract:

    Summary Background : The 13C-methacetin breath Test enables the quantitative evaluation of the cytochrome P450-dependent Liver Function. Aim : To find out whether this breath Test is sensitive in noncirrhotic patients also with chronic hepatitis C in early stages of fibrosis. Methods : Sixty-one healthy controls and 81 patients with chronic hepatitis C underwent a 13C-methacetin breath Test. In all patients, a Liver biopsy was performed. The Liver histology was classified according to the histology activity index–Knodell score. Results : Delta over baseline values of the patients at 15 min significantly differed from controls (19.2 ± 9.2‰ vs. 24.1 ± 5.7‰; P < 0.003). The cumulative recovery after 30 min in patients was 11.4 ± 4.8% and in healthy controls 13.8 ± 2.8% (P < 0.002). However, patients with early fibrosis (histology activity index IVB) did not differ in delta over baseline values of the patients at 15 min (23.2 ± 7.9‰ vs. 22.6 ± 7.2‰; P = 0.61) or cumulative recovery (13.6 ± 3.7% vs. 13.2 ± 3.8%; P = 0.45) from patients with more advanced fibrosis (histology activity index IVC). Patients with clinically nonsymptomatic cirrhosis (histology activity index IVD; Child A) metabolized 13C-methacetin to a significantly lesser extent (delta over baseline values of the patients at 15 min: 8.3 ± 4.9‰; P < 0.005 and cumulative recovery after 30 min: 5.6 ± 3.2%; P < 0.003). The 13C-methacetin breath Test identified cirrhotic patients with 95.0% sensitivity and 96.7% specificity. Conclusion : The non-invasive 13C-methacetin breath Test reliably distinguishes between early cirrhotic (Child A) and noncirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C.

  • 13c methacetin breath Test as Liver Function Test in patients with chronic hepatitis c virus infection
    Alimentary Pharmacology & Therapeutics, 2005
    Co-Authors: Barbara Braden, D Faust, C F Dietrich, U Sarrazin, Wolfgang F Caspary, S Zeuzem, Christoph Sarrazin
    Abstract:

    BACKGROUND The 13C-methacetin breath Test enables the quantitative evaluation of the cytochrome P450-dependent Liver Function. AIM To find out whether this breath Test is sensitive in noncirrhotic patients also with chronic hepatitis C in early stages of fibrosis. METHODS Sixty-one healthy controls and 81 patients with chronic hepatitis C underwent a 13C-methacetin breath Test. In all patients, a Liver biopsy was performed. The Liver histology was classified according to the histology activity index-Knodell score. RESULTS Delta over baseline values of the patients at 15 min significantly differed from controls (19.2 +/- 9.2 per thousand vs. 24.1 +/- 5.7 per thousand; P < 0.003). The cumulative recovery after 30 min in patients was 11.4 +/- 4.8% and in healthy controls 13.8 +/- 2.8% (P < 0.002). However, patients with early fibrosis (histology activity index IVB) did not differ in delta over baseline values of the patients at 15 min (23.2 +/- 7.9 per thousand vs. 22.6 +/- 7.2 per thousand; P = 0.61) or cumulative recovery (13.6 +/- 3.7% vs. 13.2 +/- 3.8%; P = 0.45) from patients with more advanced fibrosis (histology activity index IVC). Patients with clinically nonsymptomatic cirrhosis (histology activity index IVD; Child A) metabolized 13C-methacetin to a significantly lesser extent (delta over baseline values of the patients at 15 min: 8.3 +/- 4.9 per thousand; P < 0.005 and cumulative recovery after 30 min: 5.6 +/- 3.2%; P < 0.003). The 13C-methacetin breath Test identified cirrhotic patients with 95.0% sensitivity and 96.7% specificity. CONCLUSION The non-invasive 13C-methacetin breath Test reliably distinguishes between early cirrhotic (Child A) and noncirrhotic patients, but fails to detect early stages of fibrosis in patients with chronic hepatitis C.

Francois Cauchy - One of the best experts on this subject based on the ideXlab platform.

  • reconstruction of bile duct injury and defect with the round ligament
    Journal of Gastrointestinal Surgery, 2017
    Co-Authors: Safi Dokmak, Beatrice Aussilhou, Emilia Ragot, Camille Tantardini, Francois Cauchy
    Abstract:

    Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. The vascularized round ligament is completely mobilized until its origin and used for lateral reconstruction of the bile duct to cover the defect. T tube was inserted and removed after few months. Patency of the bile duct was assessed by cholangiography, the Liver Function Test and magnetic resonance imaging (MRI). Two patients aged 33 and 59 years old underwent lateral reconstruction of the bile duct for defects secondary to choledocotomy for stone extraction or during dissection for Mirizzi syndrome. The defects measured 2 and 3 cm and occupied half of the bile duct circumference. The postoperative course was marked by low output biliary fistula resolved spontaneously. In one patient, the T tube was removed at 3 months after surgery and MRI at 9 months showed strictly normal aspect of the bile duct with normal Liver Function Test. The second patient is going very well 2 months after surgery and the T tube is closed. Lateral reconstruction of the bile duct can be safely achieved with the vascularized round ligament. We will extend our indications to tubular reconstruction.

Jeanne M Clark - One of the best experts on this subject based on the ideXlab platform.

  • brief communication clinical implications of short term variability in Liver Function Test results
    Annals of Internal Medicine, 2008
    Co-Authors: Mariana Lazo, Elizabeth Selvin, Jeanne M Clark
    Abstract:

    Background: Clinicians sometimes order Liver Tests as part of a screening examination or general work-up. Current guidelines do not recommend routine reTesting of abnormal results in asymptomatic patients. Objective: To characterize the magnitude of intraindividual variability of Liver Test results and determine the proportion of adults with persistently elevated levels after 1 positive Test. Design: Reliability study. Setting: The NHANES (National Health and Nutrition Examination Survey) III First and Second Examinations (1988 to 1994). Participants: 1864 men and women age 18 years or older living in the United States. Measurements: Repeated measurements (mean, 17.5 days apart) of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, γ-glutamyltransferase, and bilirubin. Results: Using NHANES III cutoffs for normal levels, 38% of adults with initially elevated bilirubin levels had normal levels at the second examination. These proportions were 36%, 31%, 17%, and 12% for AST, ALT, alkaline phosphatase, and γ-glutamyltranferase, respectively. More than 95% of initially normal results remained normal. The results did not differ by alcohol consumption; hepatitis A, B, or C serologic status; recent infection; body mass index; or sociodemographic characteristics. Intraindividual variability was significantly higher for bilirubin (coefficient of variation, 23.4%) and ALT (coefficient of variation, 20.4%) than for AST (coefficient of variation, 13.9%), γ-glutamyltransferase (coefficient of variation, 13.8%), and alkaline phosphatase (coefficient of variation, 6.7%). Limitations: Only 2 measurements were available. Complete Liver disease history was lacking. Conclusion: If reTested, more than 30% of adults with elevated AST, ALT, or bilirubin levels would be reclassified as normal. Clinicians should be aware of the high intraindividual variability in common Liver Tests, and practice guidelines should explicitly recommend reTesting of asymptomatic individuals with abnormal Liver Test results.

  • brief communication clinical implications of short term variability in Liver Function Test results
    Annals of Internal Medicine, 2008
    Co-Authors: Mariana Lazo, Elizabeth Selvin, Jeanne M Clark
    Abstract:

    The authors analyzed the results of performing repeated Liver Function Tests about 17 days apart. The population was 1864 men and women in the Third National Health and Nutrition Examination Survey...