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Biomedical subjects

B Christoforov

Publications and source records attributed to B Christoforov.

At least 37 records · Page 2Linked to original sources

Patterns of sexual and injecting risk behaviours in French intravenous drug users not reporting HIV and hepatitis C virus seropositivities.

AIMS: To characterize and identify determinants of risk behaviour patterns of intravenous drug users (IDUs) independently of changes due to knowledge of HIV or hepatitis C Virus (HCV) seropositivity. DESIGN: A cross-sectional survey using a structured questionnaire concerning sexual, injecting and HIV and HCV antibody testing practices. SETTING: IDUs were interviewed in the Paris region at 10 treatment or psychosocial centres. PARTICIPANTS: Six hundred and twelve consecutive sexually active IDUs over 18 years able to answer the questionnaire. MEASUREMENTS: Five hundred and ninety-five IDUs completed the questionnaire. The risk-behaviour patterns of the 328 IDUs not reporting HIV or HCV seropositivity were analysed by phi correlation. Risk factors for each risk behaviour were determined by regression logistic models yielding odds ratios (OR) and their 95% confidence intervals (95% CI). FINDINGS: Several risk behaviour patterns were suggested: (1) lending, borrowing; (2) not or inconsistently testing HIV and HCV serology and not or inconsistently using condoms; (3) having multiple partners and prostitution; and (4) not using clean equipment. Alcohol abuse was independently and specifically associated with lending (OR = 3.8; 95% CI: 2.1-7.0) and borrowing (OR = 3.3; 95% CI: 1.8-6.1); homelessness with injecting risk behaviours and with prostitution (OR = 2.7; 95% CI: 1.2-6.1); low educational level and having children with not or inconsistently using condom and serology testing; and cocaine use with not or inconsistently using condoms (OR = 0.4; 95% CI: 0.3-0.7) and serology testing and not using clean equipment (OR = 0.4; 95% CI: 0.2-0.8). Having multiple partners and prostitution had no common risk factors. CONCLUSIONS: Identifying specific risk factors could help to target drug harm reduction programmes for each risk behaviour pattern among IDUs not reporting HIV and HCV seropositivity.

Adult↗

High incidence of brain metastases in patients treated with an M-VAC regimen for advanced bladder cancer.

OBJECTIVE: We report on central nervous system metastases from urothelial bladder carcinoma in patients treated with M-VAC chemotherapy. METHODS: 50 patients with advanced transitional cell carcinoma of the bladder were treated with the M-VAC regimen at the Hôpital Cochin (Paris, France) between December 1989 and February 1995. Brain relapses were diagnosed by CT scanning. RESULTS: We observed a surprising increase in the number of central nervous system relapses (8/50) in patients treated consecutively at the same institution. The mean time to metastatic recurrence in the brain from the initiation of first chemotherapy was 21 months (range 7-38). Six patients had single and 2 patients had multiple central nervous system metastases. Treatment consisted of radiotherapy alone (n = 5) or both surgery and radiotherapy (n = 3). Median survival time from the appearance of cerebral metastases was 3 months (range 1-10). CONCLUSION: The prolonged duration of remissions which are achieved following M-VAC chemotherapy may explain the greater likelihood of the detection of cerebral involvement.

Aged↗

[Turner syndrome and nodular regenerative hyperplasia of the liver].

Turner's syndrome is an ovarian dysgenesis (karyotype 45 X0) characterized by sexual infantilism and multiple malformations. Liver enzyme anomalies are often observed, but the underlying pathogenic mechanism remains unknown. Nodular regenerative hyperplasia of the liver is associated with another disease in about 80% of cases. However, these two diseases have only been reported together in one woman. We describe here a second case of this association "Turner's syndrome and nodular regenerative hyperplasia". We think that women with Turner's syndrome should benefit from screening for nodular regenerative hyperplasia by searching for elevated liver enzymes. This easily applicable screening protocol would provide early diagnostic of nodular regenerative hyperplasia and allow early and effective treatment of portal hypertension. Moreover, this approach would improve our knowledge of this association.

Adult↗

Acquired hemophilia secondary to factor VIII inhibitors after pregnancy.

We report the case of a 26 year-old woman who developed acquired hemophilia secondary to factor VIII inhibitors, two months after a normal pregnancy. The initial hemorrhagic event was a spontaneous deep muscular hematoma mimicking a deep venous thrombosis. This observation was marqued by the apparition of antibodies against porcin factor VIII under treatment by porcin factor VIII. Intravenous immunoglobulin was ineffective, then cyclophosphamide was necessary to control the disease.

Acenocoumarol↗

Treatment of good-prognosis polyarteritis nodosa and Churg-Strauss syndrome: comparison of steroids and oral or pulse cyclophosphamide in 25 patients. French Cooperative Study Group for Vasculitides.

Twenty-five patients with good-prognosis polyarteritis nodosa or Churg-Strauss syndrome entered a prospective, randomized, multicentre study comparing two treatments: either oral corticosteroids and oral cyclophosphamide (CY; 2 mg/kg/day) for 1 yr (group A), or oral corticosteroids and monthly i.v. CY pulses (0.6 g/m2) (group B) for 1 yr. The objective was to determine the optimal CY regimen. Judgement criteria were the efficacy of the treatment in controlling the disease and the development of side-effects. Among the 25 patients who could be analysed, complete recovery was achieved with the experimental treatment in 9/12 patients in group A and 10/13 patients in group B. Two patients in each group relapsed after the end of therapy and were well controlled by corticosteroids or other drugs. One failure occurred in each group. The mean follow-up was 60.8 +/- 14.5 months after the beginning of the treatment. Side-effects associated with the administration of CY and steroids were noted 27 times in group A vs 14 times in group B (not significant). The oldest patient in these series (group B) died of pneumonia. No superiority in terms of efficacy could be established between the two regimens; however, the number of patients included was too small to conclude definitively. Toxic side-effects were significantly more frequent in women (P < 0.02). The high number of adverse effects leads us to recommend pulse over oral CY and an overall lowering of the doses of immunosuppression.

Adult↗

[Primary bilateral adrenal lymphoma as viewed by MRI. Apropos of a case].

Clinically silent adrenal involvement in lymphoma is a relatively common occurrence, involvement of bilateral adrenal glands by lymphoma as the sole manifestation of lymphoma is very rare, with only 30 cases reported in the literature. We report a patient with this unusual conditions, with CT scan and MRI aspects.

Adrenal Gland Neoplasms↗

[Week-long hospitalization in a Department of Internal Medicine: patients and care patterns. Description and comparison with standard hospitalization].

OBJECTIVES: The objective of this study was to determine the inpatient and care pathway predictive factors of week hospitalization (week-end excluded = HDS) compared to classical short term hospitalization (HC). METHODS: We compared 340 HDS stays to 65 HC stays. We analyzed the major in-patient sociodemographic and medical characteristics, and their care pathways. RESULTS: HDS inpatients were younger, more living in couples, had a higher educational level, better social insurance, more cancer, less associated diagnosis, less general health impairment than HC in-patients. More chemotherapies and endoscopies were performed in HDS. Hospital physicians were more often involved in HDS admissions than in HC admissions and general practitioners were more often involved in outpatient hospital visits for advice before HDS hospitalization than before HC hospitalization. HDS hospitalizations per in-patient were more numerous than HC hospitalizations. HDS inpatients were discharged directly to their home more often. After logistic regression modeling, most of these factors remained independently associated with HDS hospitalization, except for sociodemographic characteristics, age excluded, admission rates and home discharge. CONCLUSIONS: Type of hospitalization (HDS vs. HC) was mainly determined by medical characteristics of patients and by care pathways. Limiting factors were mainly due to organization of care.

Day Care, Medical↗

Cyclic sciatica. A manifestation of compression of the sciatic nerve by endometriosis. A case report.

STUDY DESIGN: A case of cyclic sciatica secondary to ovarian cyst endometriosis is presented. OBJECTIVES: To report the clinical description and magnetic resonance imaging aspects of cyclic sciatica. SUMMARY OF BACKGROUND DATA: Endometriosis of the sciatic nerve is rare, but must be included in the differential diagnosis of sciatic mononeuropathies. METHODS: The authors report a new case of a woman whose cyclic sciatica was caused by an ovarian cystic endometriosis lesion. RESULTS: Magnetic resonance imaging was described as hyper- and hypointense on T1-weighted sequences, and hyperintense on T2-weighted sequences at the sciatic notch. CONCLUSION: Magnetic resonance imaging may permit a specific diagnosis of this unusual cause of sciatica by showing a hemorrhagic mass in the region of the sciatic nerve. Early recognition is necessary to prevent permanent damage to the sciatic nerve.

Adult↗

Recurring episodes of meningitis (Mollaret's meningitis) with one showing an association with herpes simplex virus type 2.

Benign recurrent aseptic (Mollaret's) meningitis is a rare disease of unknown aetiology. We report the case of a 27-year-old woman who experienced three episodes of lymphocytic meningitis. Human Simplex Virus (HSV) type 2 DNA was detected in the CSF by PCR amplification indicating the diagnosis of recurrent HSV type 2 meningitis. Our observation suggests that search of herpes virus DNA by PCR amplification on CSF may be useful in unexplained recurrent meningitis.

Adult↗

Central retinal vein thrombosis associated with resistance to activated protein C.

PURPOSE/METHODS: Activated protein C resistance was recently described as a major cause of venous thrombosis. We observed a central retinal vein thrombosis in a woman with activated protein C resistance. RESULTS/CONCLUSION: DNA analysis showed the patient to be heterozygous for the factor V gene mutation, which is related to activated protein C resistance. Patients with retinal vein thrombosis should be examined for activated protein C resistance.

DNA Mutational Analysis↗