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Biomedical subjects

D Lambert

Publications and source records attributed to D Lambert.

At least 73 records · Page 4Linked to original sources
PubMed1995

Access of rural AFDC Medicaid beneficiaries to mental health services.

This article examines geographic differences in the use of mental health services among Aid to Families with Dependent Children (AFDC)-eligible Medicaid beneficiaries in Maine. Findings indicate that rural AFDC beneficiaries have significantly lower utilization of mental health services than urban beneficiaries. Specialty mental health providers account for the majority of ambulatory visits for both rural and urban beneficiaries. However, rural beneficiaries rely more on primary-care providers than do urban beneficiaries. Differences in use are largely explained by variations in the supply of specialty mental health providers. This finding supports the long-held assumption that lower supply is a barrier to access to mental health services in rural areas.

Aid to Families with Dependent Children↗
PubMed1995

[Purulent pericarditis in dermatopolymyositis].

The authors report the case of a 33-year-old patient with dermatopolymyositis, admitted to hospital for acute cystic pericarditis with fever and deterioration of the general state. The aetiological diagnosis was obtained by analysis of the pericardial fluid after surgical drainage, revealing purulent Staphylococcus aureus pericarditis. This case emphasises that, despite the marked rarity of pericardial effusion in the course of dermatopolymyositis, due to the steroid sensitivity of this disease, the possibility of septic contamination should be considered in the presence of persistent pericarditis in the context of this disease.

Adult↗
PubMed1995

[Verrucous carcinoma. Nosologic aspects, apropos of 4 cases].

INTRODUCTION: The nosology of verrucous carcinomas is a complicated problem. The name given to each manifestation may vary with localization. We report our findings in four cases with this skin disease. CASE REPORTS: Four patients, 76, 52, 76 and 55 years of age, presented with verrucous carcinoma. In the first case, the disease began with a chronic varicose ulceration localized on the anterolateral aspect of the right leg. In the second, the lesion was localized on the lateral aspect of the right leg facing a zone showing signs of repeated microtraumatisms. HPV-18 was isolated in this patient. The third case had a vegetating lesion on the dorsal aspect of the right hand, simulating a wart. The fourth case is a historic case in which a voluminous tumour developed over several years on an ulceration of the medial aspect of the left malleole, associated with trauma and venous insufficiency. COMMENTS: The three recent cases did not raise any particular problem with diagnosis. The diagnosis in the historical case, published in 1969 as a vegetating pyoderma, was corrected later. This illustrates the nosology problems raised in this particular form of epidermoid carcinoma which often has an impressive clinical presentation and a reassuring histology. The group of verrucous carcinomas include different skin or mucosal lesions formerly designated as oral florid papillomatosis, Buschke-Löwenstein acuminate condyloma or pseudo-epitheliomatous vegetating pyoderma. Cuniculatum epithelioma was added to this group for simplification although this rarely observed lesion is a separate entity. CONCLUSION: The pathology diagnosis of verrucous carcinoma requires large and deep biopsy. Treatment is surgical and regular follow-up is needed as for all malignant tumours.

Aged↗
PubMed1995

[Chronic urticaria and autoimmune thyroid diseases].

INTRODUCTION: Chronic urticaria results from multiple interactive causes. For certain authors dythyroidism is significantly more frequent in patients with chronic urticaria, often associated with other autoimmune disorders. PATIENTS AND METHODS: This study included 45 patients with chronic urticaria (29 men and 16 women, mean age 45.6 years). All underwent clinical examination for thyroid disease with assay of free T3 and T4, ultrasensitive TSH and antimicrosome and antithyroperoxidase antithyroid antibodies. RESULTS: Among the 45 patients, 8, all women, had an autoimmune thyroid disease: Graves' disease (n = 1), juvenile chronic thyroiditis (n = 1), autoimmune disease n = 6). All had goiter but most had no clinical sign suggestive of hypothyroidism or hyperthyroidism. Other clinical features or laboratory findings suggested autoimmune disorders in 3. DISCUSSION: These results suggest that a complete thyroid examination with hormone assay, especially in women, should be performed in patients with chronic urticaria. TSH and antiperoxidase antibodies appear to be the most sensitive and specific assays in patients with autoimmune thyroid disease.

Adult↗
PubMed1995

[Congenital pachyonychia, neurofibromatosis and sensory-motor polyneuropathy].

INTRODUCTION: A 71-year-old man consulted because he could not walk due to spots of hyperalgic, invalidating plantar keratodermia. A nearly identical symptomatology was observed in several members of the family suggesting an autosomal dominant hereditary disease due to painful callosities as described by Roth in 1978. CASE REPORT: The patient had pachyonychia on all fingers and toes, only the ring fingers and the fifth toes were not involved. Multiple epidermoid follicular cysts were also found on the trunk suggesting the diagnosis of type II hereditary pachyonychia or Jackson-Lawler disease. Axonal polyneuropathy was also found with cutaneous signs of neurofibromatosis. Cytology studies were performed in order to elucidate the relationship between these different findings. It was not possible to retain the diagnosis of complex axonal polyneuropathy as described by Tolmie where autosomal dominant inheritance of early onset ungueal dystrophy is associated with punctuated palmoplantar keratodermia and hereditary sensoromotor axonal neuropathy. CONCLUSION: This patient presented several types of complex neurocutaneous manifestations which could not be successfully related to each other.

Aged↗
PubMed1995

[Sheep wool granuloma].

INTRODUCTION: We report the unusual case of cutaneous foreign body granulomas provoked by sheep wool. CASE REPORT: A 45-years old woman presented within one year two episodes of a papular eruption on her neck and limbs. She was working as a farmer's wife and each episode occurred after preparing the ewes for coupling. She had to keep a tight hold on the ewes while the farmer introduced warm and moist compresses in the genitals of the animals. Each diseased skin area was closely related to the tight contact with the sheep's wool and on histological slides each granuloma was centered by a tiny ply of wool. DISCUSSION: This foreign body reaction may be compared to the trichogranulomas of hairdressers. In sheep breeders this occupational practice is very usual and one may wonder why this type of reaction seems so rare.

Animals↗
PubMed1994

Juvenile dermatomyositis: treatment with intravenous gammaglobulin.

High-dose intravenous gammaglobulin (IVGG) has proved to be effective in the treatment of a number of immune disorders. We report two patients with juvenile dermatomyositis (DM) who improved with IVGG therapy. These patients had become refractory to corticosteroids and had developed unacceptable steroid toxicity. We suggest that IVGG can be useful in the treatment of juvenile DM, by reducing steroid requirements, and replacing immunosuppressive drugs.

Child↗
PubMed1994

Magnetic resonance imaging of the paranasal sinuses and nasal cavities.

Magnetic resonance imaging has proven to be a useful tool for imaging the paranasal sinuses and nasal cavities. Of particular interest in this region is the ability to distinguish between lesions that are highly cellular with little free water (neoplasms) and lesions that have significant amounts of serous and mucinous secretions and thus contain predominantly free water (infections).

Humans↗
PubMed1994

[Contact allergy to gold and its alloys. Pertinence of gold salt patch tests].

Allergic contact dermatitis to gold and its alloys is a rare affection and it is difficult to interpret gold salts patch tests. We report two cases of patients with positive patch tests to 0.5% sodium aurothiosulfate discovered during a dermatology exploration of an occupational contact eczema (for the first patient) and an intolerance to gold jewelry (for the second). There is much confusion in the literature concerning the allergologic exploration of contact dermatitis to gold: no standardized test, possible cross reactions between different gold salts, the tests often irritate. The mechanism of sensitization to gold salts is unknown since pure gold is inalterable and does not contain any salts. The pertinence of a positive test to one or more gold salts must therefore be examined carefully and the diagnosis of gold allergy must not be made without sufficient evidence.

Adult↗
PubMed1993

CoA esters of valproic acid and related metabolites are oxidized in peroxisomes through a pathway distinct from peroxisomal fatty and bile acyl-CoA beta-oxidation.

In rat liver homogenates fortified with the appropriate cofactors (ATP and CoA), valproic acid induced H2O2 production rates by far lower than those recorded on the straight medium-chain fatty acid n-octanoic acid. Using directly the CoA esters of these carboxylic acids as substrates for the rat liver H2O2-generating enzyme activities, valproyl-CoA, and n-octanoyl-CoA were found to induce similar oxidation rates. In the rat liver homogenates, cyanide-insensitive valproyl-CoA and octanoyl-CoA oxidations occurred at rates similar to those of valproyl-CoA and octanoyl-CoA oxidase(s), respectively. Studies on fractions obtained from rat liver postnuclear supernatants by isopycnic centrifugation on a linear sucrose density gradient disclose that the density distribution of valproyl-CoA oxidase superimposes to those of catalase, fatty acyl-CoA oxidase and cyanide-insensitive fatty acyl-CoA oxidation, three peroxisomal marker activities. By contrast, the cyanide-insensitive valproyl-CoA oxidation does not adopt the typical peroxisomal distribution of these activities but rather exhibits a mitochondrial localization with, however, a minor peroxisomal component. Interestingly enough, the comparative study of rat tissue distribution, inducibility by clofibrate and sensitivity to deoxycholate indicated that valproyl-CoA oxidase is an enzyme distinct from fatty acyl-CoA oxidase and bile acyl-CoA oxidase. Taken as a whole, the results presented here support the occurrence of a peroxisomal oxidation of the CoA ester of valproic acid and its delta 4-enoic derivate which might be characterized by two major features: initiation by an acyl-CoA oxidase distinct from fatty and bile acyl-CoA oxidases, and inability to complete the beta-oxidation cycle which would not proceed, at significant rates, further than the beta-hydroxyacyl-CoA dehydrogenation step in peroxisomes.

Acyl Coenzyme A↗
PubMed1993

Patterns of venous reflux in limbs with skin changes associated with chronic venous insufficiency.

The distribution of venous reflux in patients with skin changes associated with chronic venous insufficiency presenting to a specialist clinic was assessed. A total of 300 limbs in 153 patients were examined by Doppler ultrasonography with colour-flow imaging for the presence of venous reflux in superficial veins, deep veins and medial perforating veins, both above and below the knee. Ninety-eight limbs had skin changes, which included hyperpigmentation, lipodermatosclerosis, atrophie blanche and ulceration. Of this group, 2 per cent had no evidence of venous reflux on duplex scanning, 39 per cent had deep vein incompetence, 57 per cent had superficial vein incompetence and 2 per cent had isolated medial perforating vein reflux. Of 25 limbs with ulceration, 13 had superficial and 12 deep vein reflux. A total of 202 legs, which included 20 normal control limbs, had no skin changes; 22.3 per cent of these had no venous reflux, 8.4 per cent had deep vein incompetence, 65.3 per cent had superficial incompetence and 4.0 per cent had isolated medial calf perforating vein incompetence.

Adolescent↗
PubMed1993

Preliminary studies about novel strategies to reverse chemoresistance to adriamycin regarding glutathione metabolism, peroxisomal and extraperoxisomal hydroperoxide and valproic acid metabolic pathways.

The present work was aimed at defining novel strategies to reverse chemoresistance to anticancer drugs, especially by interfering with cellular glutathione metabolism, peroxisomal and/or extraperoxisomal hydroperoxide metabolic pathways. Preliminary results are presented about molecules we demonstrated to be capable of interfering with hydrogen peroxide metabolism in cells. Prior to describing these molecules, a short overview of glutathione and free radical metabolic pathways is presented as well as a rapid presentation of the characteristics of chemo-sensitivity and -resistance towards the anticancer drug adriamycin, with special emphasis on hydrogen peroxide metabolism. The strategies currently developed to reverse chemoresistance are further presented in subsequent sections, our own strategy to achieve inhibition of hydrogen peroxide breakdown and stimulation of peroxisomal hydrogen peroxide production is illustrated on the basis of molecular modelling studies and biochemical investigations on extraperoxisomal and peroxisomal metabolic pathways. Preliminary studies on cultured cells have been initiated. The perspective for future studies is presented as well as other possible models of chemoresistance as target for the design of hydrogen peroxide metabolism-interfering pharmacomolecules.

ATP Binding Cassette Transporter, Subfamily B, Mem↗