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Biomedical subjects

D Vincent

Publications and source records attributed to D Vincent.

At least 19 recordsLinked to original sources
PubMed2004

[Resurgence of syphilis: a prospective study at an University Hospital, Nimes].

BACKGROUND: Since 2000, the incidence of syphilis has increased in France. The study objective was to estimate the frequency of syphilis in Languedoc Roussillon region in Southern France. METHOD: The prospective study was conducted between January 1, 2003 and June 30, 2003 in different medical wards in a French University Hospital, Nimes. The diseased patients in this study answered to a questionnaire, providing epidemiological and socio-economic data, symptomatology and treatment-seeking behaviour. Blood specimens were tested for syphilis by the serological methods (TPHA, VDRL, FTA). RESULTS: In 6 months, serologic evidence of syphilis infection was found in 30 patients. Men were more than twice as likely as women to be infected with syphilis. Most men (64.7%) acquired the infection homosexually. Four women acquired infection during pregnancy. The mean age of study population was 46.3 years. 40.7% were married. Out of 27 cases, 70.4% cases had an associated sexually transmitted infection (HIV, hepatitis, herpes, and gonorrhoea). CONCLUSIONS: These data confirm the increase of syphilis in south of France and underline the importance of a permanent monitoring of sexually transmitted infection in target populations to allow a timely diagnosis and an appropriate treatment, and to plan preventive strategies.

Adult↗
PubMed2004

[Bronchial presentation of stage IVB Hodgkins disease].

INTRODUCTION: Bronchial localisation of Hodgkins disease has been described only rarely and it is exceptional as the presenting feature. More frequently the clinical presentation is extrinsic bronchial compression. OBSERVATION: Mr B.C., 34 years old, had a past history of cured alcoholism and abuse of cannabis and buprenorphine. In February 2001 he presented with generalised pruritus, weight loss of 8 kg in one year, a 1 cm node above the right clavicle, hypereosinophilia, and CT evidence of non-obstructive mediastinal adenopathy and interstitial lesions in the right lower lobe. Five months later he was admitted to hospital with a febrile illness. The right supraclavicular node had disappeared but there was gross mediastinal adenopathy, associated with a right perihilar soft tIssue mass encircling the upper, middle and lower lobe bronchi and multiple peripheral parenchymal nodules. Bronchoscopy revealed complete stenosis of the right upper lobe bronchus and bronchial histology confirmed Hodgkins disease. CONCLUSIONS: Bronchoscopy is an effective investigation for the detection of endobronchial Hodgkins disease, often overlooked because parenchymal abnormalities are attributed to extrinsic compression. In order to determine the disease stage more precisely we advise immediate bronchoscopy when there is suspicion that Hodgkins disease may be the cause of clinical.

Adult↗
PubMed2004

Low plasma levels of dehydroepiandrosterone sulphate in HIV-positive patients coinfected with hepatitis C virus.

OBJECTIVES: To evaluate plasma levels of dehydroepiandrosterone sulphate (DHEAS) in a cohort of HIV-infected patients and to analyse factors associated with DHEAS levels. METHODS: We conducted a cross-sectional survey in the Nîmes University Hospital cohort of HIV-infected patients in south-eastern France. All HIV-infected patients with at least one outpatient visit between 1 January and 1 September 2002 were included in the study. Sociodemographic, clinical, therapeutic, immuno-virological and plasma DHEAS level data were collected during this period. Hepatitis C virus (HCV) coinfection was defined as the presence of HCV antibody with positive RNA. To identify factors associated with plasma DHEAS levels, Spearman's rank correlation and univariate and multivariate linear regression analyses were used. RESULTS: The DHEAS plasma level was measured in 137 patients (104 men and 33 women), 37 (27.0%) of whom were HCV coinfected. The median age of the patients was 39.1 years [interquartile range (IQR): 34.9-48.7] for women and 41.8 years (36.5-47.7) for men. The median DHEAS level was 5.5 micromol/L (IQR: 2.3-8.8) for the whole sample of 137 patients, and was lower in women (2.4 micromol/L; 1.5-6.6) than in men (6.1 micromol/L; 2.5-9.0) (P<0.01), and lower in patients coinfected with HCV (2.1 micromol/L; 0.6-6.7) than in those not coinfected (6.6 micromol/L; 3.0-9.1) (P<0.01). Of all prognostic factors studied in the variance covariance analysis, three factors were associated with DHEAS: age, gender and HCV coinfection. Subgroup analysis revealed that the age-adjusted mean of the DHEAS level was lower in HCV coinfected patients for both women (1.3+/-1.1 micromol/L) and men (4.0+/-0.7 micromol/L), compared with patients not HCV coinfected (women, 5.3+/-0.7 micromol/L; men, 7.2+/-0.4 micromol/L) (P<0.01). CONCLUSIONS: This is the first report of the determination of DHEAS plasma levels in HIV/HCV coinfected patients. When age and sex were taken into account, the DHEAS plasma level was found to be significantly lower in HCV coinfected patients. To date, the pathophysiology of such findings is unknown.

Adult↗
PubMed2004

[Ragweed pollinosis in the Gard and the Vaucluse: myth or reality? For the Associated Group of Independent Allergologues and Hospital Staff of Nimes].

Thirteen allergists reviewed 18 patients living and working in Vaucluse and Gard who suffered from ragweed from August 15 to October 15 2004. This preliminary study showed how difficult it is to realise a clinical data collection about pollinosis. It is entirely necessary to work together to build the protocol, with a clear and valid definition of inclusion and exclusion criteria.

Adolescent↗
PubMed2004

[Evaluation of the health inpact of the floods in the Gard on respiratory health of disaster victims].

In 2002 the Gard was subjected to exceptional flooding, as much by their size as by the number of affected community victims, more than the Nimes floods in October 1988. No community was spared and more than 800 families had to be rapidly re-located. As the medical bibliography of the impact of the floods on respiratory heath was not conclusive we have proposed to the CHU of Nimes a hospital clinical research project undertaken by the members of RNSA, the Institute of Public Health of Brussels and the European Centre for Medical Bioclimate Research and Teaching, who have accepted to share their knowledge with the Gard. It seems to us to be indispensable, considering the certifications made by the professionals on the health on the department, to validate the study methods for the evaluation of the health impact of the floods, with regard to the development of moulds in the environment, so as to recognise the risk to health, in the very special circumstances, and so allow the mobilisabion of useful resources more rapidly than previously. The new floods to which the department was subjected in December 2003 made us regret that we had not developed this project more quickly.

Academies and Institutes↗
PubMed2003

[Usefulness of molecular genetic analysis of the PRNP gene in patients with cerebellar ataxia: a new case of fatal familial insomnia].

We report the fifth French case of fatal familial insomnia, characterized by a mutation at codon 178 of prion protein gene and by heterozygoty (Met/Val) at codon 129. The clinical picture included cerebellar ataxia, dysautonomia and frontal lobe syndrome. Prion protein gene analysis was performed in order to support a diagnosis of Creutzfeldt-Jakob disease and assert the diagnosis of fatal familial insomnia. Neuropathologic analysis showed unusual changes including severe neuronal loss in the inferior olive and the dentate nucleus, and absence of obvious lesions in the thalamus. Moreover, spongiform changes were moderate in the superior temporal cortex and the occipital cortex. There was no spongiform change in frontal cortex. Abnormal prion protein (PrP(res)) was mainly evidenced in the parietal cortex. Molecular genetic study of the PRNP gene should be performed in patients who present with a cerebellar ataxia of equivocal origin.

Amyloid↗
PubMed2002

[Primary orthostatic tremor].

INTRODUCTION: Tremor is frequent in neurologic practice but primary orthostatic tremor was first described in 1984. Its prevalence accounts for around 4% for tremors explored in neurophysiology; in contrast, essential and parkinsonian tremors represent respectively 28 and 22% of these cases. EXEGESIS: Orthostatic tremor is characterized by its appearance while standing. Walking, sitting, and lying down are unaffected. Clinical examination is normal except for unsteadiness disappearing when walking. Surface electromyography in the standing position is necessary for the diagnosis and shows a regular rapid tremor (frequency around 14 to 18 Hz). Its pathophysiology is unknown. CONCLUSION: Clonazepam is the first-line treatment for orthostatic tremor. In cases of resistance or side effects of this drug orthostatic tremor may be improved by primidone or, as in our case, gabapentin.

Female↗
PubMed2002

Using cost-analysis techniques to measure the value of nurse practitioner care.

Nurse practitioners are in a unique position to deliver high-quality care to a variety of populations and are being utilized in many countries worldwide. Although certain aspects of the nurse practitioner role may differ from country to country, limited financial support and competition for access to patients make it incumbent on nurse practitioners to document the cost-effectiveness of their care. Cost analysis, a business tool that can be used by any practitioner in any health care system, was used to examine business practices of an academic-based nurse-managed centre. In order for this tool to be effective, nurse practitioners must become comfortable with using cost-analysis techniques in their practices. Linking outcome data with cost data was found to be one method for explicating the value of nurse practitioner practice. Nurse practitioners must also recognize that they are competing with primary-care physician practices and other primary health-care practices. It is vital for nurse practitioners to document both the quality and the costs of their care in order to compete with physicians and other health care providers, in order to influence policy and other health-care decision makers.

Costs and Cost Analysis↗
PubMed2002

Peripheral neuropathy associated with mitochondrial disorders: 8 cases and review of the literature.

Forty-three cases of peripheral neuropathy (PN) have been reported in the literature with a proven mitochondria (mt) DNA mutation, and 21 had a peripheral nerve biopsy (PNB). We studied 8 patients, 1 of whom had severe sensory PN, 3 mild PN, and 4 subclinical PN. Nerve biopsy was performed in every case; all patients showed axonal degeneration and 4 showed features of primary myelin damage. In addition, there were 2 crystalline-like inclusions in the Schwann cell cytoplasm of a patient with MERRF, and 1 in a patient with multiple deletions on the mtDNA. There are 11 cases of PNB in the literature with axonal lesions, 5 with demyelination, and 4 with mixed lesions. One PNB was not modified. A few crystalline-like inclusions were seen in 1 case of MERRF. Such inclusions were first reported in the Schwann cell cytoplasm of unmyelinated fibers in a patient with Refsum disease and were considered to be modified mitochondria. However, their mitochondrial origin remains debatable.

Adolescent↗
PubMed2002

Systemic anaphylaxis induced by intradermal testing.

We report the case of a patient who was referred for suspected anaphylaxis with anesthetic drugs. Gallamine was diagnosed the responsible drug and our patient developed anaphylaxis during intradermal testing (IDT) with this compound. IDT should be monitored carefully.

Anaphylaxis↗
PubMed2002

[Post-traumatic medial nerve injury due to a foreign body].

A case of delayed injury to the median nerve by glass fragment is described. A median nerve palsy developed 3 years after a minor injury, totally forgotten by patient. A 34-year-old patient presented with a painful progressive median nerve lesion, with a Tinel sign just below elbow. Surgical exploration revealed a glass fragment in close proximity to median nerve. The foreign body was removed. Improvement was noted immediately, but the patient continues to have slight paresthesiae in the fingers 1 year later.

Adult↗
PubMed2002

[Inhaled corticoids and systemic secondary effects: controversies].

Studies that compare the systemic impact of inhaled corticosteroids (CI) abound in the literature often with contradictory results. Most of the studies report secondary biological effects in the suprarenal function without clinical effect due to taking high doses of inhaled corticosteroids. Surveillance of the secondary effects on bone is difficult to demonstrate. Finally, speed for recognition in asthmatic children during the first year of treatment is slowed down but the level at adult age is not affected. The variability of these results is associated with the former taking of corticosteroids by the general route. Administration of corticosteroids by the systemic route, therefore makes difficult the evaluation of secondary effects due only taking inhaled corticosteroids.

Administration, Inhalation↗
PubMed2002

Chronic cough induced by abacavir apart from a context of hypersensitivity.

We report the case of an HIV-infected woman, who presented with chronic and productive cough without sign of hypersensitivity (fever, cutaneous eruption, gastrointestinal disorders), while taking abacavir. All complementary exams being negative, the involvement of abacavir has been suspected. So the drug was stopped leading to a rapid disappearance of cough. It is the first report of chronic cough with abacavir apart of a context of hypersensitivity reaction.

Alkynes↗
PubMed2001

Identification of the platelet ADP receptor targeted by antithrombotic drugs.

Platelets have a crucial role in the maintenance of normal haemostasis, and perturbations of this system can lead to pathological thrombus formation and vascular occlusion, resulting in stroke, myocardial infarction and unstable angina. ADP released from damaged vessels and red blood cells induces platelet aggregation through activation of the integrin GPIIb-IIIa and subsequent binding of fibrinogen. ADP is also secreted from platelets on activation, providing positive feedback that potentiates the actions of many platelet activators. ADP mediates platelet aggregation through its action on two G-protein-coupled receptor subtypes. The P2Y1 receptor couples to Gq and mobilizes intracellular calcium ions to mediate platelet shape change and aggregation. The second ADP receptor required for aggregation (variously called P2Y(ADP), P2Y(AC), P2Ycyc or P2T(AC)) is coupled to the inhibition of adenylyl cyclase through Gi. The molecular identity of the Gi-linked receptor is still elusive, even though it is the target of efficacious antithrombotic agents, such as ticlopidine and clopidogrel and AR-C66096 (ref. 9). Here we describe the cloning of this receptor, designated P2Y12, and provide evidence that a patient with a bleeding disorder has a defect in this gene. Cloning of the P2Y12 receptor should facilitate the development of better antiplatelet agents to treat cardiovascular diseases.

Adenosine Diphosphate↗
PubMed2001

Molecular discrimination of lactobacilli used as starter and probiotic cultures by amplified ribosomal DNA restriction analysis.

Lactic acid bacteria such as Lactobacillus helveticus, L. delbrueckii subsp. delbrueckii, L. delbrueckii subsp. lactis, L. delbrueckii subsp. bulgaricus, L. acidophilus, and L. casei related taxa which are widely used as starter or probiotic cultures can be identified by amplified ribosomal DNA restriction analysis (ARDRA). The genetic discrimination of the related species belonging to these groups was first obtained by PCR amplifications by using group-specific or species-specific 16S rDNA primers. The numerical analysis of the ARDRA patterns obtained by using CfoI, HinfI, Tru9I, and ScrFI was an efficient typing tool for identification of species of the L. acidophilus and L. casei complex. ARDRA by using CfoI was a reliable method for differentiation of L. delbrueckii subsp. bulgaricus and L. delbrueckii subsp. lactis. Finally, strains ATCC 393 and ATCC 15820 exhibited unique ARDRA patterns with CfoI and Tru9I restriction enzymes as compared with the other strains of L. casei, L. paracasei, and L. rhamnosus.

Base Sequence↗
PubMed2001

[Treatment of cluster headache].

INTRODUCTION: The cluster headache (CH) is one of the most severe types of head pain. It is a typical example of a periodic disease and the International Headache Society classification recognizes two forms of this disease: episodic and chronic CH. Its prevalence is about 0.1 to 0.4% in the general population. CURRENT KNOWLEDGE AND KEY POINTS PATHOPHYSIOLOGY: A global hypothesis is still lacking to explain the pain, the vasodilation, the autonomic features (ipsilateral lacrimation, conjunctiva injection, rhinorrhea, partial Horner syndrome, etc.) and the periodicity of the CH. Pain and vasodilation seem secondary to an activation of the trigeminal vascular system and the periodicity of the attacks is thought to be due to a dysfunction of hypothalamic biologic clock mechanisms. Treatment of acute CH attacks. The most effective agents are oxygen inhalation and subcutaneous sumatriptan, a 5HT1B and D receptor agonist which has vasoconstrictor and anti-neurogenic inflammation properties by blocking the release from the trigeminal-sensitive fibers of neuropeptides such as CGRP and substance P. With subcutaneous sumatriptan, headache relief is very rapid, within 5 to 10 min. Prophylactic treatment of CH: The number of attacks per day varies from one to three, but some patients can have four to eight per day and acute treatments fail to provide sufficient relief or give rise to side-effects. Several different regimens have been proven effective. FUTURE PROSPECTS AND PROJECTS: Contraindications and side-effects of the drugs limit the choice of the prophylactic treatment: corticosteroids in a tapering course, verapamil and methysergide are the most useful treatments of the episodic form. Lithium carbonate is more effective for the chronic stage of CH, but side-effects are often troublesome. Numerous other medications have been used for prophylaxis: valproate, capsaicin, beta-blockers. Unfortunately, double-blind studies are often lacking and are difficult to realize due to spontaneous variable remission of episodic CH. When adequate trials of drug therapies show a total resistance to the treatments, surgery may be considered. Radiofrequency trigeminal rhizotomy is the treatment of choice with 70% of beneficial effects. Risks and complications have to be discussed in balance with the benefit of the different surgical procedures.

Anti-Inflammatory Agents↗