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Biomedical subjects

C Cornu

Publications and source records attributed to C Cornu.

At least 55 records · Page 3Linked to original sources
PubMed1994

Survey of the attitudes to management of acute pyelonephritis in children. GEP.

Although urinary tract infections are of particular concern in young children, as they may lead to permanent health problems, there is no consensus for their acute management. We carried out a mailed survey of 455 general practitioners, 143 paediatricians (randomly selected from a list of physicians in the Rhône-Alpes region of France) and 45 paediatric nephrologists (all the members of the "Société de Néphrologie Pédiatrique") to examine their attitudes to the management of a fictitious case of a young girl with symptoms indicative of acute pyelonephritis. The responses given by the general practitioners and paediatricians were similar, whereas those given by the paediatric were similar, whereas those given by the paediatric nephrologists were often different, for example 20% of the general practitioners and 17% of the paediatricians said they would hospitalize the child, compared with 69% of the paediatric nephrologists. The majority of the general practitioners and paediatricians favoured single oral antibiotic therapy, whereas the paediatric nephrologists were split between single and combined antibiotic therapy, but preferred intravenous administration. The most frequently prescribed drug was a penicillin. The heterogeneity of the results from this survey stresses the need for the assessment of various strategies in terms of their efficacy for preventing kidney scarring and their risk-to-benefit ratios in well-designed randomised controlled trials.

Acute Disease↗
PubMed1994

Outcome of HCV infection after renal transplantation.

The fate and significance of hepatitis C virus (HCV) infection after renal transplantation (TP) remain debated. We therefore evaluated the incidence and outcome of HCV infection in 120 kidney graft recipients both at the time of TP and 54 +/- 28 (13 to 123) months later using ELISA-II and RIBA-II immunoblot. Furthermore, the presence of anti-HCV antibodies at follow-up was correlated with HCV viremia, as detected by the nested polymerase chain reaction (PCR), and with chronically abnormal ALT levels. At the time of TP, 17 patients (14.2%) had anti-HCV antibodies. Compared to anti-HCV (-) patients, anti-HCV (+) patients had a longer duration of pre-TP dialysis (P < 0.001) and had received more pre-TP blood transfusions (P < 0.01). After an average follow-up of 48.5 +/- 24.7 (21 to 97) months, all these patients remained anti-HCV (+) but only 10 were still RIBA "reactive" due to the loss of reactivity against the 5-1-1, C100 and C33 (but not the C22) antigens. Five initially anti-HCV (-) patients had become (+) at follow-up. Among the 22 patients anti-HCV (+) at follow-up, 20 had HCV-RNA detectable by PCR but only 10 had elevated ALT. Ten out of 13 HBsAg (-) patients with elevated ALT were anti-HCV (+). Our study indicates that disappearance of ELISA-II anti-HCV antibodies is rare in kidney recipients and that HCV infection may also occur after TP. Anti-HCV antibodies are likely to reflect a persisting infection as suggested by the frequent detection of HCV-RNA.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine Transaminase↗
PubMed1994

Anti-HCV seroconversion in multitransfused and immunocompromised patients. A long-term longitudinal study.

In a series of 6 multitransfused, immunocompromised patients, the diagnosis of posttransfusion hepatitis C was based upon the analysis of long-term follow-up serum samples. The HCV RNA was detected by a nested PCR assay using primers located in the 5' noncoding region (5'NCR), and anti-HCV antibodies were assayed with third-generation tests. The interval between the first rise in alanine aminotransferase and seroconversion varied from less than 5 months to more than 38 months. Five out of 6 patients seroconverted after 14 months or later. In most cases, the anti-NS3 and anti-NS4 antibodies appeared first. In such patients, the etiology of chronic liver disease may thus be overlooked for 1 or more years, a definitive diagnosis requiring the detection of HCV RNA.

Adult↗
PubMed1993

Anti-neutrophil antibodies in chronic hepatitis and the effect of alpha-interferon therapy.

In 34 patients with non-A non-B, 28 with type B and 11 with autoimmune chronic hepatitis, anti-neutrophil antibodies were investigated using indirect immunofluorescence and anti-myeloperoxidase antibodies by enzyme-linked immunosorbent assay. Granulocyte-specific antinuclear antibodies, were detected in 14 patients with advanced stages of non-A, non-B hepatitis (41%). Their presence correlated with histological features of disease activity but not with response to interferon therapy. Within 24 h after the first dose of interferon, 9 of these became negative and 3 more became negative after 1, 3 and 5 months. Myeloperoxidase-positive perinuclear neutrophil cytoplasmic antibodies were detected in a single patient and increased reaching a peak level after 8 weeks of interferon, decreasing thereafter. In type B, all were negative before and during the 6 months of therapy. In 6 patients with autoimmune hepatitis (55%), myeloperoxidase-negative perinuclear neutrophil cytoplasmic antibodies were detected in high titers. The association of granulocyte-specific anti-nuclear antibodies with non-A, non-B hepatitis support the hypothesis that hepatitis C virus infection might trigger humoral autoimmune response. In chronic autoimmune hepatitis, perinuclear neutrophil cytoplasmic antibodies appear as another marker of autoimmunity.

Adult↗
PubMed1993

Incidence and risk factors for hepatitis C seroconversion in hemodialysis: a prospective study. The UCL Collaborative Group.

To delineate the incidence and risk factors for seroconversion (SC) for HCV, from May 1991 to November 1992 we followed all 401 patients (no i.v. drug abusers) dialyzed in 15 Belgian hemodialysis (HD) units, none of which isolates anti-HCV (+) patients. The sensitive ELISA II test was performed in the same laboratory for all patients. ELISA II (+) sera were considered truly positive if specific antibodies were detected by RIBA II against at least one HCV antigen. Blood transfusions given from 12 months prior to inclusion in the study, dialyzer reuse and frequency of dialysis monitor sterilization were recorded. In May 1991, prevalence of truly positive ELISA II tests averaged 13.5% (54/399). During the three consecutive six-month periods, ELISA II became truly positive in 3 of 305 (1%), 4 of 314 (1.3%) and 1 of 313 (0.3%) patients, respectively, which was an average yearly incidence of 1.7%. SC was preceded (1 to 6 months) in all cases by an unexplained, unprecedented increase in the alanine aminotransferase level. The mean monthly rate of transfusions was significantly higher (P < 0.001) in eight patients with SC (0.7 +/- 0.6 U) than in 393 patients without SC (0.1 +/- 0.01 U). However, three of eight patients with SC had not been transfused at all. SC was observed in only 3 of 13 units (1, 3 and 4 cases, respectively) dialyzing ELISA (+) patients. In the unit with three SC, patients were always assigned a fixed station: SC was observed only in patients dialyzed next to an ELISA II (+) patient (3 of 8 vs. 0 of 30, P < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Decreased glucose-induced thermogenesis at the onset of obesity.

To investigate the possible existence of a defect of thermogenesis at the onset of obesity, we studied glucose-induced thermogenesis (GIT) during an oral glucose-tolerance test (OGTT) (1 g/kg body wt) in 12 women who were at the onset of obesity (group A) compared with 12 long-standing obese women (group B) and 8 lean control subjects. During OGTT hyperinsulinemia and glucose intolerance were measured in group B, suggesting an insulin-resistant state, but not in group A. A similar defect in GIT occurred in both obese groups (8.9 +/- 1.5% in control subjects vs 4.2 +/- 1.1% in group A and 4.3 +/- 1.0% in group B, P < 0.05) despite the absence of alteration in nonoxidative glucose metabolism. We conclude that a decrease in GIT already exists at the onset of obesity, which supports the hypothesis of a possible involvement of this defect in the genesis of obesity.

Absorption↗
PubMed1993

Interferon alfa-2b therapy in children with chronic hepatitis B.

Twenty nine children (mean age 8.3 years, 18 boys, 11 girls) who had biopsy proved chronic hepatitis B virus infection (HBV) with active viral replication were given a 16 week course of interferon alfa-2b treatment (9 million units (MU)/m2, thrice weekly). Fourteen children (48%) showed persistent loss of HBV-DNA 8 months after the end of treatment; 11 (38%) lost hepatitis B e antigen (HBeAg), and two (7%) hepatitis B surface antigen (HBsAg). Alanine aminotransferase activities returned to normal in 12 children. Those who responded had significantly higher initial transaminase activities than those who did not (p < 0.01) but similar serum HBV-DNA. Results were compared with the natural evolution of the disease in a group of 25 children (mean age 8.3 years) with identical initial mean serum HBV-DNA values, followed up during the same period. Two of these (8%) lost HBeAg and one (4%) HBsAg. The 23 remaining control subjects had no decrease in serum HBV-DNA or in transaminase activities compared with values 1 year earlier. It is concluded that treatment with interferon alfa-2b in children may lead to inhibition of HBV replication similar to that described in adults, and may thus shorten disease evolution. Further studies are necessary to establish the best protocols and to identify those patients who are the most likely to respond to treatment.

Alanine Transaminase↗
PubMed1993

Rationale for testing thrombolysis in acute ischaemic stroke. MAST Group.

Stroke is an important health problem in developed countries, being a common cause of death and disability. Prognosis is poor for hospitalised stroke patients, with a 30-day mortality rate of 20-30%, and 30% of the survivors remaining severely disabled. Based on results from experimental animal studies it is thought that early intervention will improve the patients' prognosis. Thrombolytic therapy has been shown to reduce mortality in patients with acute myocardial infarction, and several trials aim to assess its efficacy in patients with acute cerebral infarction. Although many clinical trials have been performed to address this problem, none have provided a clear answer, either because the sample size was insufficient, or by modern standards, the methodology used was not adequate. The Multicenter Acute Stroke Trials (MAST) has been designed to assess the safety and efficacy of thrombolytic therapy with streptokinase for this indication.

Animals↗
PubMed1993

Detection of hepatitis B virus DNA in HBsAg chronic carriers using a liquid phase molecular hybridization (Abbott HBV DNA) and the DNA polymerase assay: comparison of results.

These data clearly show the sensitivity differences and the correlations between the HBV DNA and the DNA polymerase assay. The Abbott HBV DNA is a molecular hybridization test in a liquid phase using a 125I-labelled probe and allowing the detection and the quantitation of HBV DNA in serum samples. This test was found to be 20-200 times more sensitive than the DNA polymerase assay and its sensitivity was evaluated to be about 0.3 pg HBV DNA. It is very easy to use and the results are obtained within 24 hours. In the patients with persistent HBV infection a close correlation between the positivity of the DNA polymerase activity and of the HBV DNA (R = 0.94) was observed. These two markers evolve quite parallel whatever the results obtained in the HBe system or whatever the sample time in a group of patients treated with recombinant interferon.

Carrier State↗
PubMed1992

[Primary leiomyosarcoma of the pulmonary artery. Apropos of a case. Review of the literature].

A 59-year-old woman hospitalised because of dyspnea and a heart murmur in a context of pyrexia was found to have evidence of obstruction of the pulmonary arterial system, clearly defined by ultrasonography, catheterisation and angiography and Imatron scan. The particular feature of this fifth reported case of pulmonary artery leiomyosarcoma is its documentation by transesophageal ultrasonography and tumor biopsy during catheterisation. Surgery with partial excision of the tumor was followed by survival for 6 months, bearing in mind the absence of chemo- or radiosensitivity of this type of tumor. Cases from the literature are reviewed.

Angiography↗
PubMed1991

Patterns of hepatitis delta virus reinfection and disease in liver transplantation.

Twenty-seven carriers of the hepatitis B surface antigen who underwent liver transplantation in Italy and Belgium for terminal Hepatitis delta virus (HDV) cirrhosis were investigated. In 22 of the patients, HDV infection recurred. Two patients died of coexisting HDV and hepatitis B virus (HBV) reactivation. Four patients who died of unrelated causes were found to have HDV without signs of HBV reactivation. Five patients (18%) cleared both HBV and HDV after transplantation with no evidence of hepatitis (mean follow-up, 29 months). In many surviving patients. HDV infection recurred early without signs of HBV reactivation. Disease returned in the 11 HDV-infected patients in whom HBV also recurred. Histological hepatitis did not recur during an interim of 12-33 months in the 5 HDV-infected patients in whom HBV did not return. The overall medium-term survival in patients with HDV who underwent transplantation was 77.7%. Liver transplantation offers patients with HDV a hope of cure from disease despite a high risk of reinfection. In the transplantation setting. HDV can cause subclinical infections without any apparent assistance from HBV; these infections become symptomatic only if and when HBV reactivates. Thus, HDV may not be in itself pathogenic but requires cooperation from HBV to cause the appearance of the disease.

Adolescent↗
PubMed1991

Assay of anti-HBs antibodies using a recombinant antigen and latex particle counting: comparison with five commercial tests.

An assay of anti-HBs antibodies based on agglutination of latex particles coated with recombinant HBs-antigen was compared with Abbott radioimmunoassay (Abbott-RIA), which uses a human plasma-derived antigen. The population examined consisted of 76 Abbott-RIA anti-HBs-negative prevaccinated subjects and 1044 serum samples anti-HBs found positive by Abbott-RIA, including 283 samples of subjects vaccinated either with a human plasma-derived vaccine (group A; n = 180) or with a recombinant vaccine (group B; n = 103). Correlation coefficients between the two techniques were respectively r = 0.89 for the whole population (n = 1044), r = 0.98 in group A and r = 0.74 in group B. Anti-HBs titres were higher with latex than with RIA in group B as shown by the regression slopes: latex = 508 + 1.11 RIA in group A and latex = -1138 + 3.97 RIA in group B, suggesting that some vaccinated subjects from group B produced antibodies against epitopes proper to the recombinant antigen. In the prevaccinated population and in group A, the latex results were compared with those of radioimmunoassays (Abbott, Sorin) and enzyme immunoassays (Behring, Roche, Pasteur). Only the Roche-EIA detected anti-HBs in the prevaccinated subjects. The correlation between the various immunoassays was r greater than 0.96 only for values higher than 100 IU/l.

Agglutination Tests↗
PubMed1990

Epstein-Barr virus infection in 59 orthotopic liver transplant patients.

Fifty-nine orthotopic liver transplant (OLT) patients were studied after transplantation to detect Epstein-Barr virus (EBV) primoinfection and reactivation. Nineteen, all children under 10 years, were EBV seronegative. Seroconversion occurred in 12 (63.3%) of the seronegative patients. Most of these patients (10/12) seroconverted 2 or 3 months after transplantation; 11 out of the 12 demonstrated clinical signs at the time of seroconversion. From 9 primoinfected patients tested for EBV excretion, 8 were found to be positive. Serological evidence of reactivation was found in 9 out 40 (22.5%) seropositive patients and EBV was isolated from 5 (56%). Eleven pediatric OLT patients with primoinfection showed high and persistent titers of anti-EA antibodies (from 1:32 to greater than or equal to 1:256), when tested at least 3 months after seroconversion; however, anti-EBNA antibodies failed to develop in 5 patients and remained persistently low in 4. These patients with high EA and with negative or low EBNA titers constitute an "at risk" group for EBV-related lymphoproliferative syndrome (LpS). At presently, after a period of follow-up ranging from 3 months to 3 years, none of our 12 primoinfected patients have developed any lymphoproliferative evolution. However, in 1, during the acute phase, lymphoblasts and lymphoproliferation were observed in a tonsil biopsy.

Acute-Phase Proteins↗