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Biomedical subjects

D Allard

Publications and source records attributed to D Allard.

At least 19 recordsLinked to original sources
PubMed2002

[Varicella complicated with necrotizing fasciitis caused by group A hemolytic Streptococcus].

UNLABELLED: Chickenpox has a high risk of invasive group A streptococcal disease and necroziting fasciitis. CASE REPORT: A five-year-old girl, during chickenpox treated with ibuprofen, developed sepsis and edematous and necrotic lesions of the pelvis and the abdominal wall. The child improved with surgical treatment and adjunction of clindamycin to the antibiotic therapy. CONCLUSION: We review the optimal medical and surgical treatment of necrotizing fasciitis and discuss the role of chickenpox and non steroidal antiinflammatory agents in this disease.

Chickenpox↗
PubMed2001

[Chronic recurrent multifocal osteomyelitis in children: report of 17 cases].

UNLABELLED: Chronic recurrent multifocal osteitis (OCRM) is a rare condition in children, of unknown aetiology, which may be misdiagnosed as osteomyelitis, arthritis or tumour. PATIENTS AND METHODS: We present a retrospective multicentric study of 17 patients (five boys and 12 girls) with an average follow-up of 7.5 years (six months-25 years). RESULTS: A spectrum of presenting features is possible, ranging from bone lesions alone to lesions combined with arthritis, palmoplantar pustulosis or psoriasis. The diagnosis was delayed from two weeks to five years. Roentgenographic evaluation was often normal at the beginning of the disease or showed nonspecific bone reactions. Radioisotope bone scans assisted in establishing the diagnosis and in identifying lesions that were initially clinically silent. Bone biopsies were performed in seven cases. Histopathological examination showed only mild inflammatory nonspecific changes. Microbiological cultures were always negative. Treatments were different according to the evolution of the disease and the hospital. There was no response to antibiotics in seven patients. The response to nonsteroidal anti-inflammatory agents and steroids was moderate and often transient. Salazopyrine and pamidronate treatment used in two patients allowed a durable remission. We lost sight of four patients, pain persisted in three in spite of treatment, it disappeared in two with treatment, mild pain persisted in five without treatment and remission occurred in three without treatment. CONCLUSION: This study clarifies the clinical and radiologic features of chronic recurrent multifocal osteomyelitis. The recognition of this rare entity is often delayed and difficulties in patient management sometimes emerge from its usual protracted course.

Adolescent↗
PubMed2001

Testing local independence between two point processes.

Dependencies between two types of points in a spatial point process can be due either to a real dependence between the two types or to the dependence on common underlying variables. We propose a global test for dependence between two point processes that is valid for a wide range of models. In contrast with previously proposed methods, it is based on a number of local test statistics, which makes it possible to map the local association between the two processes. The behavior of the test is evaluated by a simulation study. It is then applied to a vegetation pattern data set from Burkina Faso.

Burkina Faso↗
PubMed2000

Testing local dependence of spatial structures on images

Associations between two spatial processes can be due to a real dependence between the two processes or to the dependence on common underlying variables. We propose to test the existence of a real dependence by use of local tests, leading to a global test of real dependence and a map of local interactions. We present first how classical interaction tests based on random rotations between completely observed processes such as those developed by Berman (Berman. Appl. Statist. (1986) 35, 54-62), can be integrated in local analyses. For this purpose, tests are first performed locally, and the distribution of their p-values is then compared to the corresponding value under the null hypothesis. A similar approach is proposed to test non-stationarity of a point pattern by using distance statistics popularized by Diggle (Diggle. Statistical Analysis of Spatial Point Patterns. (1983) Academic Press, New York). The problem of testing the interaction between a random field and a censoring area pattern process is discussed and an approach similar to the preceding ones is then proposed. The methods are mainly applied to agricultural examples but they can be applied to any microscopical images for which one wishes to analyse the spatial structure.

Journal Article↗
PubMed1998

The importance of 99Tcm-DMSA renal scintigraphy in the follow-up of acute pyelonephritis in children: comparison with urographic data.

At present, 99Tcm-dimercaptosuccinic acid (DMSA) renal scintigraphy is the most sensitive examination for the detection of parenchymal damage during acute pyelonephritis (APN) in children. This prospective study had three aims: (1) to evaluate the medium-term evolution of the scintigraphic abnormalities, to find a prognostic criterion of scintigraphic evolution; (2) to assess the correlation between the severity of early or late scintigraphic damage and selected clinical factors; and (3) to compare the permanent scintigraphic renal scars with intravenous urography (IVU) 2 years after the acute infection. Seventy-four children (mean age 32 months), presenting with a first clinical episode of pyelonephritis and an initial scintigraphic abnormality, were included in the study. Patients with a history of urinary tract infection (UTI), uropathy other than vesico-ureteral reflux (VUR) and a relapse of acute pyelonephritis were excluded. All children underwent control scintigraphy (mean 9 months after APN) and 43 had an IVU (mean 26 months after APN). Fifty-seven children (77%) still have scintigraphic abnormalities of varying severity (7 atrophic kidneys). Initial relative DMSA uptake of less than 45% results in a worse scintigraphic prognosis. The age of the child has no bearing on the severity of the initial renal involvement or on the evolution of the scintigraphic abnormalities. The rapid introduction of antibiotics (< 12 h) significantly improves the scintigraphic prognosis (P < 0.01). The presence of reflux (n = 39) leads to more serious initial damage, but we did not find any effect on later evolution in this study, in which all reflux was low grade in nature. Among the 43 children who had an IVU, 5 showed typical urographic and scintigraphic renal scars in the corresponding region and 38 showed a normal IVU with 28 cases of scintigraphic abnormalities. A DMSA scan is more sensitive than IVU for the detection of renal scarring after a first episode of APN.

Acute Disease↗
PubMed1998

[Surgical management of malignant bone tumors in the child. Saint-Etienne Hospital experience, apropos of 17 cases].

From 1980 to 1997, seventeen children were treated for malignant bone tumors in the Department of Paediatric Surgery of the Saint-Etienne Hospital, with an average follow-up of 6 years and 3 months (2M-17Y). The histologic diagnoses were osteosarcomas (12 cases) and Ewing's sarcomas (5 cases). All children were treated surgically. For the 12 lower limb tumors, the techniques used were prosthetic replacement in 7 cases (associated with bone allograft in 3 cases), amputation in 3 cases and isolated bone allograft in 2 cases. The two ilium tumors were treated by resection and reconstruction with autologous bone graft. A single resection was performed for the shoulder-blade Ewing's tumors and a prosthesis for the 2 proximal humerus tumors. Six children died during follow-up. The authors stress that carcinologic resection is a priority before functional results. They insist on the mechanical failures of implants and on the difficulties of reoperations.

Adolescent↗
PubMed1997

Imaging of pyelonephritis.

OBJECTIVE: Accurate diagnosis of pyelonephritis using clinical and laboratory parameters is often difficult, especially in children. The main aims of this prospective study were to compare the value of different imaging techniques [renal sonography, cortical scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc DMSA) and computed tomography (CT)] in detecting renal involvement in acute urinary tract infections and to determine the sensitivity of DMSA scans for permanent renal scars 6 months later. MATERIALS AND METHODS: Between February 1992 and January 1993, 55 children admitted to our pediatric unit with febrile symptomatic urinary tract infections were eligible for analysis. Ultrasonography (US), DMSA scanning and micturating cystourethrography were performed in every case. Only 18 children underwent CT. A second DMSA scan was performed in 48 children a mean of 7.5 months after the first. RESULTS: US abnormalities were found in 25 children (45 %). The first DMSA scan showed a parenchymal aspect suggestive of pyelonephritis in 51 patients (93 %). Among the 18 patients studied by CT, 14 had abnormalities. Normal US findings did not rule out renal parenchymal involvement. Scintigraphy appeared to be more sensitive than CT for renal involvement. The frequency and degree of initial renal parenchymal damage seemed to correlate with vesicoureteral reflux, but the most severe initial parenchymal defects were not associated with marked clinical or laboratory manifestations. Repeat DMSA scans, performed on 45 kidneys with abnormalities at the first examination, showed resolution in 19, improvement in 16, persistence in 8 and deterioration in 2. The prevalence of vesicoureteral reflux was not higher in patients with renal scarring on the second DMSA scan than in patients whose scans showed an improvement. CONCLUSION: DMSA scans should be considered as a reference in the detection and follow-up of renal scarring associated with acute urinary tract infection as this technique is more sensitive than US and CT, the latter being unsuitable because it entails radiation exposure and sedation of patients.

Acute Disease↗
PubMed1997

Salmonella spondylitis.

We report a case of salmonella spondylitis in an adolescent without sickle cell disease or any history of salmonella gastroenteritis. The infecting organism (cultured from material aspirated from the bone lesion) was Salmonella enterica serovar Newport. With nonoperative treatment, evolution was favorable.

Adolescent↗
PubMed1996

Fracture of the occipital condyle.

We report the case of a patient with occipital condyle fracture who was neurologically intact. The patient was treated conservatively with a neck collar, and the symptoms resolved in 3 months. This diagnosis can be suspected in high-velocity road traffic accidents, in a patient with neck pain, disproportionate torticollis, or lower cranial nerve symptoms. Skull radiography and cervical spine films can be normal. The diagnosis is best made by high-resolution computed tomographic (CT) scanning with sagittal and coronal reconstruction.

Adolescent↗
PubMed1996

The alpha1-fetoprotein locus is activated by a nuclear receptor of the Drosophila FTZ-F1 family.

The alpha1-fetoprotein (AFP) gene is located between the albumin and alpha-albumin genes and is activated by transcription factor FTF (fetoprotein transcription factor), presumed to transduce early developmental signals to the albumin gene cluster. We have identified FTF as an orphan nuclear receptor of the Drosophila FTZ-F1 family. FTF recognizes the DNA sequence 5'-TCAAGGTCA-3', the canonical recognition motif for FTZ-F1 receptors. cDNA sequence homologies indicate that rat FTF is the ortholog of mouse LRH-1 and Xenopus xFF1rA. Rodent FTF is encoded by a single-copy gene, related to the gene encoding steroidogenic factor 1 (SF-1). The 5.2-kb FTF transcript is translated from several in-frame initiator codons into FTF isoforms (54 to 64 kDa) which appear to bind DNA as monomers, with no need for a specific ligand, similar KdS (approximately equal 3 x 10(-10) M), and similar transcriptional effects. FTF activates the AFP promoter without the use of an amino-terminal activation domain; carboxy-terminus-truncated FTF exerts strong dominant negative effects. In the AFP promoter, FTF recruits an accessory trans-activator which imparts glucocorticoid reactivity upon the AFP gene. FTF binding sites are found in the promoters of other liver-expressed genes, some encoding liver transcription factors; FTF, liver alpha1-antitrypsin promoter factor LFB2, and HNF-3beta promoter factor UF2-H3beta are probably the same factor. FTF is also abundantly expressed in the pancreas and may exert differentiation functions in endodermal sublineages, similar to SF-1 in steroidogenic tissues. HepG2 hepatoma cells seem to express a mutated form of FTF.

Amino Acid Sequence↗
PubMed1994

New albumin gene 3' adjacent to the alpha 1-fetoprotein locus.

The albumin multigene family encodes proteins synthesized in the liver and secreted in the serum to fulfill ligand-carrier functions. The albumin (ALB), alpha 1-fetoprotein (AFP), and vitamin D-binding protein genes are syntenic, the ALB and AFP genes are organized in tandem, and the AFP gene is selectively expressed in the fetal liver. We now report the existence of a fourth member of the albumin gene family, located 10 kilobases downstream from the AFP locus. The new gene, named alpha-albumin (alpha ALB), is selectively expressed in the liver at late stages of development. The alpha ALB mRNA sequence encodes a predicted secreted protein with the typical triple domain disulfide cross-linked structure. Comparisons of coding and promoter sequences suggest that alpha ALB could be a phylogenetic intermediate between the ALB and AFP genes. The developmental switch between alpha ALB gene activation and AFP gene repression suggests new regulatory interplays at the albumin locus and adult stage-specific ligand binding functions carried out by the alpha ALB gene product.

Albumins↗
PubMed1994

[Violence and consumption of illicit drugs in Quebec adolescents. An analysis of their perceptions].

OBJECTIVE: To study adolescents' perception of the connection between violence and the consumption of illegal drugs. DESIGN: A self-administered questionnaire. SETTING: A town with 30,000 inhabitants north of Montreal. PARTICIPANTS: Almost 3300 students between the ages of 12 and 19. RESULTS: About 25% reported that they had been victims of violence by other adolescents who were, in their estimation, under the influence of an illicit drug. This rate increased significantly among adolescents who used drugs themselves, and was highest among female adolescents between the ages of 12 and 15. CONCLUSION: Students, especially young women, who consume illegal drugs are more likely to be victims of violence than those who do not. Family physicians should advise young patients of this risk.

Adolescent↗