[Cardiovascular complications of alpha interferon]. / Complications cardiovasculaires de l'interféron-alpha.

Interferon-alpha is a biological response modifier with antiviral and tumoral effect that is used in the treatment of chronic viral hepatitis. Cardiovascular complications occurred in clinical trials of interferon. The most common presentations of cardio toxicity were cardiac arrhythmia, dilated cardiomyopathy, atrial extrasystole and symptoms of ischemic heart disease, including myocardial infarction and other effects less common and dangerous: low-level conduction impairment or reversible hypertension. The physiopathology of this cardiotoxicity remains unknown, but rigorous cardiological monitoring of all patients receiving this treatment seems necessary.

[Alpha-fetoprotein-producing poorly differentiated gastric adenocarcinoma: hepatoid carcinoma?]. / Adénocarcinome gastrique peu différencié produisant de l'alfafoetoprotéine: tumeur hépatoïde?

We report the case of a 42-Year-old man with a poorly differentiated gastric cancer revealed by a very high level of serum alpha-fetoprotein-protein, associated with liver metastasis, and treated by chemotherapy. We discuss the possible diagnosis of hepatoid carcinoma.

[Endoscopic drainage of cystic dystrophy of the duodenal wall: report of three cases]. / Traitement endoscopique de la dystrophie kystique de la paroi duodénale. A propos de trois cas.

Optimal management of cystic dystrophy of a heterotopic duodenal pancreas or cystic dystrophy of the duodenal wall has not yet been established. Surgical treatment by pancreaticoduodenectomy or by-pass procedure is indicated in patients with the most serious symptoms. Endoscopic cystic drainage is an alternative to surgery. We report three cases of cystic dystrophy of the duodenal wall successfully treated by endoscopic drainage. Symptoms disappeared immediately in all cases. No complications were observed. In one case, a second drainage was necessary 15 months after the first one. The 3 patients were free of symptoms after 6, 36, and 44 months of follow-up, respectively. No recurrence was found with CT-scan. The long-term efficiency of the endoscopic procedure must to be evaluated.

[Appropiateness of colonoscopy in a gastrointestinal unit in 2001: a prospective study using criteria established by a European panel of experts]. / Pertinence des indications de la coloscopie dans un service de gastroentérologie de l'AP-HP en 2001. Application de critères établis par un panel d'experts européens.

UNLABELLED: Criteria for appropriateness of colonoscopy have been elaborated by an European Panel (EPAGE). OBJECTIVES: 1) To assess the feasibility of EPAGE criteria in clinical practice, 2) to assess colonoscopy appropriateness using EPAGE criteria, 3) to compare colonoscopy appropriateness and findings. PATIENTS AND METHODS: Four hundred and six consecutive examinations were included. The referral indication was judged using a scoring system on the basis of the EPAGE criteria. RESULTS: Appropriateness could be assessed in 94% of the colonoscopies. Fifty-four percent were appropriate, 40% equivocal, and 6% inappropriate. Rate of abnormal colonoscopy was not different between the 3 groups, however endoscopic findings were more severe when the indication was appropriate. In the appropriate group, adenomatous polyps were more frequent (24%) than in the two other groups (13% and 12%; P<0.05) and tended to be larger in size. In the inappropriate group, patients were significantly younger, and no cancer was found. There were 5 colonic cancers in the inappropriate group and 12 in the appropriate group. CONCLUSION: Colonoscopy is generally not overused according to EPAGE guidelines. However, on an individual basis it could be rather difficult to determine colonoscopy appropriateness using a scoring system. Indeed, a third of the indications was judged equivocal and the endoscopic findings were no different whether indication was appropriate or equivocal.

[Intraductal papillary mucinous tumor with pancreatobiliary and pancreatodigestive fistulae: a case report]. / Tumeur intra-canalaire papillaire mucineuse pancréatique fistulisée dans la voie biliaire, le duodénum et l'estomac.

Pancreatobiliary or pancreatodigestive fistulae are rare during the course of intraductal papillary mucinous tumors. The mechanism of the fistula is either malignant involvement or mechanical. We report the case of an 81-year-old patient with intraductal papillary mucinous tumor complicated by fistulae between the main pancreatic duct and common bile duct, duodenum and stomach. These fistulae were treated endoscopically and radiologically by several metallic stents.