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Biomedical subjects

C Rapp

Publications and source records attributed to C Rapp.

At least 19 recordsLinked to original sources
PubMed2006

[Performances of the "Amplified Mycobacterium tuberculosis Direct Test" in respiratory and non-respiratory specimens].

From March 1998 to December 2004, 3641 specimens (2427 respiratory samples and 1214 non-respiratory samples) collected from 2079 patients, were tested using the "Gen-Probe Amplified Mycobacterium tuberculosis Direct Test" (AMTD). After decontamination procedure every sample was testing by AMTD and by culture on solid and liquid media. The "Gold-standard" was considered by the combination of culture results and clinical diagnosis. Respiratory tuberculosis was present in 9.7% (127 patients), and non-respiratory tuberculosis was present in 18.9% (170 patients, mostly originated from Africa). Among the 2427 respiratory samples (197 culture positive samples, 211 AMTD positive) 225 corresponded to tuberculosis; for the 1214 non-respiratory samples (184 culture positive samples, 213 AMTD positive) 231 corresponded to tuberculosis. After resolving the discordant results, the sensitivity, specificity, positive and negative predictive values were 93.8, 100, 100, 99.4% respectively for respiratory samples and 92.2, 99.9, 99.5, 98% for non respiratory samples.

Gene Amplification↗
PubMed2006

[Outbreak of cutaneous leishmaniasis in military population coming back from French Guiana].

BACKGROUND: An outbreak of cutaneous leishmaniasis occurred among 71 soldiers who had participated in various missions during a 4-month's period in French Guiana. The aims of this study were (i) to describe outbreak and (ii) to determine risk factors of cutaneous leishmaniasis. METHODS: All patients were hospitalised. Cutaneous lesions were biopsied and cultured for species identification. Individual information was collected by a physician or a nurse, using on a standardised, anonymous chart. Data were processed with EpiInfo 6.04 and SAS. RESULTS: Mean age of the 71 soldiers was about 25.9 years (19-37 years). Twelve soldiers presented 56 lesions due to Leishmania (Viannia) guyanensis (attack rate = 16.9 for 100). Among 56 lesions, 13 lesions were localized on the trunk, usually an unexposed body area. Logistic regression highlighted military exercises in the forest during a high risk period of leishmaniasis transmission (OR = 11.2; p < 0.01), and the young age (OR = 1.33; p = 0.04). Vector control measures were not statistically significant. CONCLUSION: Military authorities should restrict deep forest activities during periods of high risk transmission. Vector control measures are essential. Officers should motivate their soldiers and supervise vector control measures. As ecotourism is developing, tourists as well as workers staying in deep forest must be informed of the risk and about vector control measures.

Adult↗
PubMed2005

[Inflammatory pseudotumor of lymph node].

INTRODUCTION: Inflammatory pseudotumor of lymph node is a rare case in the etiology of fever of unknown origin. OBSERVATION: We report the observation of a woman, aged 40, hospitalized with intermittent fever revealing under-diaphragm adenopathy related to inflammatory pseudotumor of lymph node. CONCLUSION: Inflammatory pseudotumor of lymph node is a rare pathology whose nosological definition is unclear. It should probably be considered as belonging to a category different from the inflammatory pseudotumor of other organs. The diagnosis presents itself in case of isolated adenopathy or prolonged fever and is based on an anatomopathology that essentially calls to mind a lymphoma. The evolution of the condition is shown to be favorable : it can lead to a spontaneous remission, or call for a non-steroid anti-inflammatory treatment, or a steroid therapy.

Adult↗
PubMed2005

[Utility and limitations of laboratory diagnosis of amebiasis].

Entamoeba histolytica is an invasive and pathogenic protozoan parasite that causes amebiasis. It must be distinguished from Entamoeba dispar, a nonpathogenic commensal parasite of the human gut lumen that is morphologically identical to Entamoeba histolytica. Diagnosis of amoebic colitis currently requires combination of microscopic examination of stool specimens with another technique allowing positive identification of the two species. Stool culture followed by zymodem analysis is considered as gold standard but is not applicable in routine practice. Detection of specific Entamoeba histolytica antigens in stools is a fast, sensitive technique that should be considered as the method of choice. Stool PCR is a highly sensitive and specific technique but high cost make it unsuitable for use in endemic areas where economic conditions are difficult. The utility of serologic tests in distinguishing Entamoeba dispar from Entamoeba histolytica is controversial. However serology is still considered as the method of choice for diagnosis of extraintestinal amebiasis. Circulating Gal/GalNac lectin antigens can be detected in the serum of 96% of patients with untreated amoebic liver abscess. In the future this method should allow early diagnosis and treatment of extraintestinal amoebiasis in patients who have not yet developed detectable serum antibodies.

Amebiasis↗
PubMed2003

Supplementation of a corn-soybean meal diet with manganese, copper, and zinc from organic or inorganic sources improves eggshell quality in aged laying hens.

An experiment was conducted to evaluate the effects on eggshell quality of supplementing the diet of laying hens with a combination of Zn, Mn, and Cu from organic or inorganic sources. Three groups of hens, aged 32, 60, and 69 wk were fed a corn-soybean basal diet containing 32.6 mg/kg Zn, 24.7 mg/kg Mn, and 4.95 mg/kg Cu or a basal diet supplemented with 30-30-5 and 60-60-10 mg/kg of Zn, Mn, and Cu, respectively. Addition of Zn, Mn, and Cu in combination increased their concentrations in egg yolk and slightly decreased egg weight during some sampling from aged hens. The Zn, Cu, and Mn dietary supplementation did not affect the following measures of eggshell quality: percentage eggshell, eggshell index (shell weight per unit surface area), and eggshell stiffness. However, there was a small increase in elastic modulus of the eggs from one group of the older hens due to supplementation with Zn, Mn, and Cu. More consistently we observed improved breaking strength and fracture toughness (resistance to fracture) in the two oldest groups of hens at 1, 5, and 9 wk after introduction of the experimental diets. The effect was observed regardless of the source of trace elements.

Aging↗
PubMed2003

[Liposomal amphotericin B treatment of cutaneous leishmaniasis contracted in Djibouti and resistant to meglumine antimoniate].

Pentavalent antimony (PA) compounds remain the main therapeutic agents of cutaneous leishmaniasis (CL). CL infection resistant to PA is difficult to cure, limited by severe side effects and requiring a long course treatment of parenteral administration of recommended second line drugs. We report a case of CL unresponsive to meglumine antimoniate contracted in Djibouti, successfully treated with a short course treatment of AmBisome. In this case the subject had a recurrent thick crusted erythematous lesion on his left elbow associated with spreading micropapula on arms and thorax. The diagnosis of CL was confirmed by direct examination and genomic amplification by PCR of skin samples, cultures were negative. A short course treatment of parenteral AmBisome (18 mg/kg) has lead to clinical cure with no side effects and no relapse. In our hospital, the high cost of medication was counterbalanced by easiest administration, reduction of hospitalization duration, absence of adverse events and a gain of comfort. For this patient, a short course treatment of AmBisome proved to be a suitable alternative to traditional drugs used in CL resistant to PA.

Adult↗
PubMed2002

[Splenic rupture in infectious disease: splenectomy or conservative treatment? Report of three cases].

INTRODUCTION: Spontaneous splenic ruptures are rare but life-threatening complications of infectious diseases. Splenectomy is still the treatment of choice but numerous recent reports have documented favorable outcome with conservative treatment. EXEGESIS: We report three cases of splenic rupture occurring respectively with infectious mononucleosis, P. vivax infection and dengue fever. Diagnosis, treatment and indications are reviewed, an approach to management is suggested. The study included three military men respectively aged 23, 24 and 35 years, admitted for acute abdominal pain in the left upper quadrant. The abdominal computed tomography confirmed partial rupture (splenic hematoma) in the first two cases, and an hemoperitoneum in the dengue case. Splenic ruptures can reveal or complicate an evolving infection. Rupture can happen spontaneously or as a result of trauma, which may be minor and unnoticed. The typical presentation is acute, but progressive forms are described. The diagnosis is made by ultrasound and CT scan. Splenectomy dogma tends to be supplanted by conservative treatment. Non-operative management can be successful if appropriate criteria and a long period of follow-up are applied in carefully selected cases. When an operative approach is selected, conservative surgical treatment is attractive. Splenectomy should be reserved for patients with uncontrollable rupture or with recurrent splenic bleeding. CONCLUSION: Spontaneous splenic rupture are uncommon in infectious diseases. A multidisciplinary management is necessary. A conservative treatment should be considered in selected, closely monitored patients.

Abdominal Pain↗
PubMed2001

Comparative investigation of human stratum corneum ceramides.

The stratum corneum (SC) requires ceramides, cholesterol, and fatty acids to provide the cutaneous permeability barrier. SC lipids can be analyzed by normal-phase high-performance thin-layer chromatography (HPTLC). However, without further analysis, some uncertainty remains about the molecular composition of lipids represented by every TLC band of an unknown sample. We therefore analyzed each ceramide band further by subjecting the isolated lipids to a direct coupling of reversed-phase high-performance liquid chromatography and electrospray ionization-mass spectrometry (HPLC/ESI-MS, or LC/MS). LC/MS analysis and ESI-MS/MS negative ion and collision-induced dissociation experiments revealed that ceramide band 4 contained not only N-(omega-OH-acyl)acyl-6-OH-sphingosine, Cer(EOH), but also N-(alpha-OH-acyl)-sphingosine. Band 5 exclusively contained N-acyl-6-OH-sphingosine. Our results demonstrate the benefit of LC/MS analysis for selective identification of human SC ceramides. Moreover, the combination of HPTLC for pre-separation and LC/MS for identification of lipids is an even more powerful tool for detailed ceramide analysis.

Ceramides↗
PubMed2001

Rapid quantification of iodopropynyl butylcarbamate as the preservative in cosmetic formulations using high-performance liquid chromatography-electrospray mass spectrometry.

A simple, rapid and reproducible method for identification and quantification of iodopropynyl butylcarbamate (IPBC) in different cosmetic formulations is presented. The determination was carried out using a high-performance liquid chromatography (HPLC) procedure on a reversed phase column coupled to a single quadrupole mass spectrometer (MS) via an electrospray ionization (ESI) interface. Detection was performed in the positive selected ion-monitoring mode. In methanol/water extracts from different cosmetic formulations a detection limit between 50 and 100 ng/g could be achieved. A routine analytical procedure could be set up with good quantification reliability (relative standard deviation between 0.9 and 2.9%).

Anti-Infective Agents↗
PubMed2001

System effects of the Kansas Mental Health Reform Act of 1991.

This paper analyzes the impact of the Kansas Mental Health Reform Act on client outcomes. The Act is of general interest because it reflects a trial of greater accountability without major changes in financial incentives. It made Community Mental Health Centers [CMHCs] gatekeepers that were accountable for services for adults with severe and persistent mental illnesses. The Act sought reductions in hospitalizations rates, expanded use of community support services, and increased independent living. The structure of the Act and Client Status Reports allow rigorous examination of these outcomes. The number of clients served increased significantly. Even though hospital days fell by 23%, there is no clear evidence that the Act itself reduced hospital days per client. The proportion of community support program clients residing independently rose significantly; the proportion participating meaningfully in the labor market fell. The goals of the Act were realized overall, but the performance of CMHCs varied considerably.

Activities of Daily Living↗