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Biomedical subjects

C Billy

Publications and source records attributed to C Billy.

15 recordsLinked to original sources

[BCG vaccine and place of tuberculin skin test in 2006].

COMMENT: Today in France, except some contra-indications BCG remains a compulsory vaccination. However a modification of BCG vaccine policy is in progress. Primo-vaccination remains but revaccination was recently abandoned, then totally abandon of BCG is the challenge. This article states the art of the BCG and of the tuberculin skin test. KEY POINTS: This approach is incorporated in a globally thought of necessary adaptations for organising fight against tuberculosis and more treatment of latent tuberculosis infections is urged on. These measures set back again tuberculin skin test in the tuberculosis infection screening process. PERSPECTIVES: New diagnosis blood tests would bring more reliability. Their place and their spread should be confirmed.

Antigens, Bacterial↗

Tuberculosis treatment duration in France: From guidelines to daily practice.

BACKGROUND: Guidelines for tuberculosis (TB) recommend 6 months of treatment except for meningeal TB, where a 9- to 12-month course may be preferred. METHODS: In order to assess whether practices in France are in agreement with those guidelines, we performed an anonymous audit of the policy of French physicians, focusing on TB treatment duration and corticosteroid use according to the TB presentation. RESULTS: Sixty-six completed forms were analyzed. Reported treatment duration was usually 6 months for pulmonary TB (91% of physicians) and miliary TB (45%), 9 months for pulmonary TB in HIV-infected patients (42%) and for TB lymphadenitis (57%), and 12 months for TB meningitis (79%) and osteo-articular TB (65%). Corticosteroid use was systematic for meningitis (80%) and pericarditis (65%). CONCLUSION: This study reveals discrepancies between guidelines and daily practice for TB treatment duration in France: We observed a very high reported rate of unnecessary, prolonged treatment for most extrapulmonary TB.

Journal Article↗

Rituximab alone or in association with corticosteroids in the treatment of acquired factor VIII inhibitors: report of two cases.

Acquired haemophilia is a factor VIII (FVIII) deficiency due to autoantibodies directed against FVIII that can be responsible for severe haemorrhage. The therapeutic approach, in addition to the treatment of bleeding episodes with clotting factor infusion, relies on corticosteroids (CS), cyclophosphamide (CYC), and/or high-dose intravenous immunoglobulins (IVIg). However, the efficacy of IVIg is limited, and CS and CYC may cause a number of adverse effects. Recently, rituximab has been proposed, alone or in combination with CS and immunosuppressants in a small number of patients with acquired anti-FVIII antibodies with a good efficacy. We report here on two patients, aged 74 and 81, respectively, who developed acquired haemophilia, with high titre FVIII inhibitors and severe haemorrhage, in the absence of a detectable cause. Both of them received rituximab as a first line therapy with a marked and prolonged efficacy.

Adrenal Cortex Hormones↗

Cranial nerve palsy revealing an occipitovertebral metastasis from carcinoma of the uterine cervix.

A 37-year-old woman had a histologically documented occipitovertebral metastasis from an invasive epidermoid carcinoma of the uterine cervix. The metastasis was found 3 months after the primary and was treated by local radiation therapy followed by systemic chemotherapy. Radiation therapy was highly effective in relieving the pain but was not associated with changes in magnetic resonance imaging findings. Lymph node involvement and local extension occurred. The patient died 1 year after the diagnosis of the metastasis. Involvement of the occipitovertebral junction by uterine cervix carcinoma metastasis is exceedingly rare. The relevant literature is reviewed.

Adult↗

[Atypical paraneoplastic myasthenic syndrome: Lambert-Eaton syndrome or myasthenia?].

We report a case of paraneoplastic myasthenic syndrome with clinical features suggesting Lambert Eaton syndrome but without the electromyographic elements required for diagnosis. Anti-calcium channel antibodies were also lacking. The electromyogram evidenced a block and the Tensilon test was positive. The efficacy of anticholinesterases argued in favor of myasthenia but anti-acetylcholine receptor antibodies were negative. The block was more of a mixed nature, involving both presynaptic transmission as in Lambert Eaton syndrome and post-synaptic transmission as in paraneoplastic myasthenia. The primary tumor was identified as a small-cell neuroendocrine lung carcinoma on mediastinal biopsies obtained directly on CT-scan guided puncture of a mediastinal node. Thoracotomy was thus avoided. The Lambert Eaton syndrome is a paraneoplastic manifestation of small-cell lung cancer in 50% of the cases unlike generalized myasthenia which apparently is never associated with small-cell lung cancer. A mixed paraneoplastic neuro-muscle junction disorder with aspects of each can be exceptionally observed.

Antineoplastic Agents↗

[Epilepsy, cerebral calcifications and celiac disease].

Epilepsy, frequently with complex partial seizures, is observed in 5.5 p. 100 of all cases of celiac sprue. Bilateral parieto-occipital calcifications in the cortical or subcortical areas are found in about one-half of these patients. This triple association is apparently not fortuitous. Prognosis of epilepsy would depend on how early the gluten-free diet was started. The diagnosis of celiac sprue should be entertained in patients with brain calcifications and epilepsy. Search for anti-endomysium antibodies could provide useful information although villosity atrophy in the proximal portion of the small bowel and its regression with gluten-free diet remain the essential elements for the diagnosis of celiac sprue.

Brain Diseases↗

[Calcifying bacteria and carbonic anhydrase].

Carbonic anhydrase activity was measured on bacteria known for their calcifying power. The results obtained allow us to conclude that carbonic anhydrase is not present in their enzymatic equipment. Nevertheless, the addition of carbonic anhydrase in culture media increases the growth of the cultures and their calcifying power. This result is due to the direct action of the enzyme on the pH of the culture medium. The results obtained could be applied to the mechanism of dental plaque calcification.

Alcaligenes↗