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Biomedical subjects

B Roge

Publications and source records attributed to B Roge.

10 recordsLinked to original sources
PubMed2001

The use of and response to second-line protease inhibitor regimens: results from the EuroSIDA study.

OBJECTIVE: To describe the use of second line protease-inhibitor (PI) regimens across Europe and to determine factors associated with virological and immunological response. DESIGN: Analysis of data from 984 patients with a median follow-up of 21 months enrolled in EuroSIDA. Patients started their second PI-containing regimen at least 16 weeks after starting the first PI-containing regimen and with viral load > 1000 copies/ml. METHODS: Virological response was defined as a viral load < 500 copies/ml and immunological response as an increase of 50 x 10(6)/l or more in CD4 lymphocyte count. RESULTS: The median CD4 cell count at starting the second PI was 171 x 10(6) cells/l; viral load was 4.45 log copies/ml. As a second PI regimen, 45% were using a dual PI, while of those on one PI, indinavir (42%) and nelfinavir (34%) were most common. In multivariate Cox models, a higher viral load at starting the second PI [relative hazard (RH), 0.67 per 1 log higher; 95% confidence interval (CI), 0.58-0.77; P < 0.0001) and a lower CD4 cell count (RH, 1.15 per 50% higher; 95% CI, 1.06-1.26; P = 0.0014) were associated with a reduced probability of virological response. Those who had achieved viral suppression on the first PI-regimen were more likely to respond to the second (RH, 1.65; 95% CI, 1.30-2.10; P < 0.0001) as were those who added one or two new nucleosides to their second PI. CONCLUSIONS: Patients who initiate a second PI regimen at lower viral load, higher CD4 cell count or who added new nucleosides tended to be more likely to achieve a viral load < 500 copies/ml. The roles of cross-resistance and adherence in response to second-line regimens needs further investigation.

Adolescent↗
PubMed1984

[The surface of epiphyses of the knee: index of the duration of neonatal hypothyroidism].

The surfaces of the epiphyses of the knees were calculated in 34 neonates with hypothyroidism detected with a systematic screening and in 32 normal neonates. In the group of neonates with hypothyroidism, the surface of the lower femoral point was 12.7 +/- 0.9 mm2 and that of the upper tibial point 1.8 +/- 0.9 mm2. There was a significant difference (P less than 0.01) for both epiphyses between children of the 2 groups. The use of mathematical formula excluding non specific factors showed significant correlation between the corrected values for lower femoral points, and T4 and T3 plasma levels. These corrected values were higher in neonates with thyroid ectopia than in neonates with thyroid aplasia. There was also a significant correlation between the corrected values for lower femoral points and the IQ at 6 months and 2 years. Thus, the calculation of the surface of the epiphyses of the knee may be considered as a criterion of duration and severity o hypothyroidism and may be an index for the determination of the ante- or post-natal onset of the disease.

Bone Development↗
PubMed1980

[Screening for neonatal hypothyroidism by measurement of both T4 and TSH in dried blood eluates (author's transl)].

Systematic screening for neonatal hypothyroidism has been undertaken since January 1977 in Southern France by the measurement of both T4 and TSH in dried blood eluates. 76,432 measurements were performed in 3 years and 22 cases of hypothyroidism were detected. There were several advantages of this method; detection of all forms of thyroid disease, immediate diagnosis of primary hypothyroidism with T4 < -2 S.D. and TSH > 80 microU/ml, decrease in the number of false positive results, detection of some false negative values with normal T4 but high TSH values. In Southern France the frequency of thyroid abnormalities is 1/34,000 births. The causes of these abnormalities in 22 cases was as follows: Absent thyroid (10), ectopic thyroid (11) and one thyroid in the normal position. In all cases TSH levels were above 80 microU/ml but in six cases with ectopic thyroids the T4 levels were between -1 and -2 S.D. These cases would not have been detected with T4 measurements alone.

Congenital Hypothyroidism↗
PubMedDate not supplied

[Detection, prevention and treatment of postpartum depression: a controlled study of 859 patients].

This study evaluated the clinical effectiveness of a programme aimed at detecting, preventing and treating postpartum depression. The French version of the EPDS was used to measure the intensity of postpartum blues on a sample of 859 women, during their stay at the obstetrical clinic. Subjects under treatment for psychological problems were excluded from the study. Mothers scoring 9 or above on the EPDS, which is predictive of pospartum depression, were randomly assigned to a prevention and a control group. Written informed consent was obtained from the subjects after the study procedure had been explained. The prevention group received a counselling session integrating supportive, educational and cognitive-behavioral components. Therapists included five female Master's Degree level students in psychology. All therapists participated in didactic and clinical training as wells as weekly supervision from the first author. All subjects were given a second EPDS with written instructions to complete the questionnaire during the period 4 to 6 weeks postpartum and return it for analysis. At four to 6 weeks, women in the prevention group had significant reductions in the frequency of probable depression, as defined by a score of 11 or above on the EPDS (30.2% vs 48.2%, chi 2 = 7.36, dl = 1, p = 0.0067) and in the intensity of depressive symptoms measured by the mean score on the EPDS (8.5, SD = 4 vs 10.3, SD = 4.4, t = 3.06, dl = 209, p = 0.0024). Mothers with a probable depression were interviewed at home and assessed using the MINI (Mini Neuropsychiatric Interview, Lecrubier et al., 1997) to diagnose major depressive episode, the SIGH-D (Structured Interview Guide for the Hamilton Depression Rating Scale, Williams, 1988) and the BDI (Beck Depression Inventory, Beck et al., 1988). The baseline depression rating scores, EPDS (mean = 13.6, SD = 4), BDI (mean = 15.7, SD = 5.9), HDRS (mean = 14.8, SD = 6), were consistent with moderate depression. No significant differences in baseline scores were observed between the two groups on all the rating scales (p < 0.001). Mothers with probable depression in the prevention group were offered a program of 5 to 8 home visits. Most of the mothers in the prevention group (72%) agreed to participate in the program. On the contrary, most of the mothers (83.3%) who scored below 9 on the first EPDS and 11 or above on the second, who so did not received the preventive counselling session, declined to participate. This suggests the importance of the preventive session in establishing therapeutic alliance. The home visits program integrated four components, supportive, educational, cognitive-behavioral and psychodynamic centred on the mother-infant relationship in terms of the mother's personal history. Therapist participated in clinical training and weekly supervision. Fifteen women (71.4%) in the study group demonstrated complete symptom remission, as defined by HDRS score below 7 after the intervention, compared with 4 women (10.5%) in the control group (chi 2 = 23, p < 0.0001). A clearly therapeutic response to treatment was observed in the treated group with a mean reduction in HDRS score of 9.5 (DS = 6.7) from baseline. The improvement in the women in the treated group, as measured by the mean HDRS scores was statistically greater than that in the control group (m = 5.35, SD = 3.5 vs m = 15.8, SD = 4.6, t = 8.24, dl = 52, p < 0.0001). Our results indicate that a program based on an intervention at obstetrical clinics and on home visits is efficacious and well accepted for prevention, detection and treatment of postpartum depression.

Adult↗
PubMedDate not supplied

[Results of psychomotor development in hypothyroidism detected at birth].

Thirty-five children in whom hypothyroidism was detected at birth were studied with respect to psychomotor development. A 5 year-follow-up was obtained in a few cases. The I.Q. was established using Brunet-Lezine's test or Griffith's test after age 30 months. Global quotients where normal: 98 + 10 at 6 months, 96 + 7 at 1 year, 99 + 7 at 3 years, 97 + 7 at 4 years and 97 + 4 at 5 years. Partial development quotients were normal concerning coordination and sociability. A transitory decrease was found at 1 year concerning posture and at 2 and 3 years concerning language, both returning to normal by age 4. These results were correlated with several factors: there was no significant difference between athyroidism and ectopia at the different ages but a difference appeared for partial development quotients at 2 and 3 years. There was no correlation between development quotients, clinical scores and dates of diagnosis. On the contrary, a significant correlation was found global development quotients at 6 months and the surfaces of epiphyses. Finally, a precise neurological evaluation showed an impairment of posture, coordination and fine movements of the extremities.

Congenital Hypothyroidism↗
PubMedDate not supplied

[Psychopharmacology of autism].

Results of recent studies in pharmacotherapy in autism are presented. Haloperidol, fenfluramine and naltrexone have been the most extensively studied drugs in systematic research. Haloperidol appeared to decrease levels of hyperactivity, stereotypies, emotional lability but also abnormal object relations and social withdrawal. However, the therapeutic effect was generally modest and long term administration was associated with dyskinesias in autistic children. The frequent hyperserotonemia in autism has suggested the use of fenfluramine, an antiserotoninergic agent. Although the initial reports were optimistic, more recent carefully designed studies often failed to show that fenfluramine was superior to placebo. Naltrexone, a potent opiate antagonist, was explored following the opioid hypothesis based on the similarity between autistic symptomatology and abnormal behaviors observed in opiate addicts and in laboratory animals administered opiates and on the abnormalities of endogenous opioids that exit in a subgroup of autistic children. However, the current studies do not concur and no definite conclusions can be made of the efficacy of naltrexone at present time. Low doses of amisulpride which have been shown to improve negative symptoms in schizophrenia and serotoninergic antidepressants, which have proven effective in repetitive and ritualized behaviors, have recently began to be evaluated in controlled studies. At present time, no medication has shown to alter the course or the symptoms of autism, but some seem to be effective in reducing severe aberrant behaviors.

Adolescent↗