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Biomedical subjects

E Camus

Publications and source records attributed to E Camus.

At least 19 recordsLinked to original sources
PubMed2004

[Medical treatment of ectopic pregnancy: a randomized clinical trial comparing metotrexate-mifepristone and methotrexate-placebo].

BACKGROUND: Medical treatment of ectopic pregnancy is widespread. To increase the efficacy of methotrexate, combination with mifepristone has been proposed. METHODS: We performed a large prospective multicentre double-blind sequential randomized trial in order to compare the efficacy of methotrexate and mifepristone (600 mg given orally) versus methotrexate and placebo. RESULTS: Two hundred twelve ectopic pregnancies were randomized. There was no significant difference in the initial characteristics between the 2 groups. There was no significant difference in the success rate of medical treatment between the methotrexate-mifepristone (n=113) and the methotrexate-placebo group (n=99): 79.6% (90/113) vs 74.2% (72/97) respectively, RR [95% CI]: 1.07 [0.92-1.25], p=0.41. However, there was a quantitative interaction between progesterone level and effect of treatment: when progesterone level was 10 ng/l, the efficacy of the combination of mifepristone and methotrexate was significantly higher than the combination of methotrexate and placebo, with a 83.3% success rate (15/18) vs 38.5% (5/13) respectively. CONCLUSION: Our study failed to demonstrate any benefit of the addition of mifepristone to methotrexate. By contrast, the quantitative interaction between treatment effect and base line serum progesterone suggested that this combination could be reserved to ectopic pregnancies associated with high serum progesterone concentrations.

Abortifacient Agents, Nonsteroidal↗
PubMed2003

Abdominal wall metastasis of a cervical adenocarcinoma at the laparoscopic trocar insertion site after ovarian transposition: case report and review of the literature.

BACKGROUND: Laparoscopic ovarian transposition is currently used in the preirradiation management of cervical cancer in young women. This surgical technique helps avoid the short- and long-term complications of early menopause. Because there remains a risk of metastasis at the site where the laparoscopic trocar is inserted, more precise indications for this surgery are required. CASE: We report the case of a patient with an abdominal wall metastasis that followed laparoscopic ovarian transposition performed before radiation therapy and surgical treatment for a stage IIb cervical adenocarcinoma. Observations during the laparotomy nonetheless led us to resect the transposed ovary during the laparotomy. The pathology examination of the ovary found a microscopic metastasis. Several months later, a left abdominal parietal nodule, corresponding to a metastasis of the adenocarcinoma, was found on the site through which the trocar had been inserted during the laparoscopy and was probably associated with the ovarian transposition. CONCLUSION: This is the only published case to describe an abdominal wall metastasis due to laparoscopic trocar insertion during ovarian transposition. The decision to perform a laparoscopic ovarian transposition in cervical cancer must take into account the frequency of trocar site metastases, which seems to be higher with advanced-stage cervical cancers, in cases of lymph node involvement and especially in adenocarcinomas.

Abdominal Neoplasms↗
PubMed2003

[Ovarian choriocarcinoma: about one case].

We report the case of a woman, 43 years old, presenting with an ovarian choriocarcinoma. This patient, addressed for a right-side suspicious pelvic mass, had an exploratory laparotomy. Frozen section found an ovarian cancer. The patient had total hysterectomy, left annexectomy and a complete staging surgery. Histology concluded to an ovarian gestational choriocarcinoma. It is a rare germinal tumour, the treatment of which was medical, with radical exeresis and complete staging surgery associated with polychemotherapy.

Adult↗
PubMed2003

[Expectative management: a valid option for ectopic pregnancy].

Advances in laboratory tests and transvaginal ultrasound have enabled very early diagnosis of ectopic pregnancy. Expectative management has progressively become a real medical option for ectopic pregnancies as an alternative to surgery or medical treatment. The decision to abstain from treatment must be based on very strict criteria: patients with no symptoms, hematosalpinx<3 cm, no hemoperitoneum, hCG level<1000 mUI/ml and decreasing 48 hours later, a progesterone level<10 ng/ml. Regular surveillance until normalization of clinical, ultrasound and biological results is essential. The rate of success, which reaches 90%, clearly justifies this medical option.

Chorionic Gonadotropin↗
PubMed2002

In vivo performance of a matrix-based quantitative ultrasound imaging device dedicated to calcaneus investigation.

We developed a prototype of an ultrasound (US) bone matrix densitometer, the BEAM scanner, in the context of a European Space Agency research program. This device, which is a contact imaging device, was designed to overcome the limitations of immersion devices in space. Broadband US attenuation (BUA) and speed of sound (SOS) parameters were calculated from the radiofrequency (RF) signal. The principle aim of this study was to evaluate in vivo performance in direct comparison with a currently available device (UBIS 3000, DMS, France). The short-term precision of the BEAM scanner for BUA was estimated at 2.8%, whereas it was 2.3% with UBIS 3000. The short-term precision for SOS was 0.3%, and this was the same as the coefficient of variation (CV) of the UBIS 3000. CVs of 3.4% and 0.6% for midterm precision were found for BUA and SOS, respectively, and UBIS 3000 scores were 3% and 0.4%, respectively. This preliminary study demonstrates the high performance of the BEAM scanner and its new concept offers a wide range of improvements and new applications.

Adult↗
PubMed2002

Measuring cervical length with ultrasound: evaluation of the procedures and duration of a learning method.

OBJECTIVE: To evaluate the learning curve and principal learning steps for a novice ultrasound operator to master the technique for measuring cervical length by transvaginal ultrasound. SUBJECTS AND METHODS: The study involved asymptomatic patients with a singleton pregnancy between 21 and 38 weeks attending for a routine ultrasound scan. Two operators new to cervical ultrasound including one with experience in transvaginal gynecological ultrasound were assessed during their training. After an initial lecture session on the technique of cervical measurement, the trainees had one or two supervised practice sessions, validated by two interobserver agreement studies with 30 patients at a time; these compared the level of agreement between trainer and trainee throughout. Five examinations were performed in the first practice session; a second session was planned if the trainee could not perform all five examinations alone satisfactorily, in agreement with four quality criteria predefined for good cervical measurements. The second session lasted until five consecutive examinations could be performed adequately without the trainer's aid. Agreement between the two operators was assessed by intraclass correlation coefficient (ICC). The ICCs were compared with Fisher's Z transformation. RESULTS: Of the 150 patients included, 2.7% gave birth before term. The trainee with no experience in transvaginal ultrasound required two practice sessions; none of the five ultrasound scans performed in the first session was correct. In the second session, 18 consecutive ultrasound examinations were necessary to obtain five consecutive adequate results. During interobserver studies with the trainer, the ICC progressed from 0.43 in the first study to 0.64 in the second and 0.77 in the third (P = 0.049 between the first and third studies). The trainee with experience in transvaginal ultrasound required only one practice session. The ICC increased from 0.73 to 0.85 in the two interobserver studies with the trainer. CONCLUSIONS: Measurement of cervical length by transvaginal ultrasound examination is a technique that can be learnt rapidly. While roughly 23 supervised ultrasound scans appear necessary for an operator with no experience in transvaginal ultrasound, substantially fewer are required for an operator already familiar with this approach for other indications.

Adult↗
PubMed2002

Induced apoptosis and expression of related proteins in granulosa cells from women undergoing IVF: a preliminary study.

BACKGROUND: Because apoptosis may be involved in the outcome of IVF, the expression of pro- and anti-apoptosis proteins in a model of induced granulosa cell (GC) apoptosis was evaluated in 25 women with normal FSH levels undergoing IVF. METHODS: After 1 day of culture, apoptosis was induced with interferon (IFN)-gamma (200 IU/ml), followed 24 h later by an agonistic anti-Fas antibody (0.5 microg/ml). On day 3, apoptotic GC, identified by chromatin condensation and/or nuclear fragmentation after DAPI staining, were counted among 1000 cells in randomly chosen fields under UV microscopy, and enabled allocation of women into two groups with either low (group 1) or high (group 2) percentages of apoptosis (11.6 +/- 4.8 and 59.5 +/- 14.8% respectively; P < 0.001). Immunoblotting was used to evaluate the following in proteins: poly (ADP-ribose) polymerase (PARP), caspases 8 and 3, Bcl-2, heat shock protein (HSP) 70, Bax, Bak and Stat-1 (a protein known to be inducible by IFN-gamma). RESULTS: Based on densitometric analysis of immunoblots, the PARP 116 kDa bands were respectively 4.3- and 33.3-fold lower for treated groups 1 and 2. Caspase 8, caspase 3 and HSP70 were expressed slightly less in treated group 2 than treated group 1. Densitometric analysis of bands corresponding to Bcl-2 showed respectively for treated groups 1 and 2, 3.2- and 2.5-fold decreases. Bak expression was similar in both control groups, and comparably lower in the two treated groups. With regard to Stat-1, densitometry showed 3.3- and 1.3-fold increases respectively in treated groups 1 and 2. CONCLUSIONS: These results suggested that Fas-mediated apoptosis of GC is accompanied by significant changes in proteins acting in apoptosis, and that this type of programmed cell death might play a potential prognostic role for women undergoing IVF.

Adult↗
PubMed2000

Alternative splicing in the human interleukin enhancer binding factor 3 (ILF3) gene.

The Interleukin Enhancer Binding Factor 3 (ILF3) gene has been mapped to chromosome 19 in humans and to chromosome 9 in mice. Several reported double-stranded RNA binding proteins including NF90, ILF3, MPP4 and DRBP76 have been suggested to be isoforms of the ILF3 gene but this has not been clearly established. We isolated several ilf3 transcripts from a melanoma cDNA library and two corresponding genomic fragments, and report alternative splicing and polyadenylation site selection in the human ILF3 gene. We show the existence of an alternative splice site responsible for the sequence divergence in the 3' part of the transcripts. Another alternative splicing event at a site between the two double-stranded RNA binding motifs leads to the additional presence in some cases of a four amino acids NVKQ peptide. We also describe the utilization of three distinct polyadenylation signals and the generation of an ilf3 transcript with a long extended 3' UTR. The expression of the different transcripts was evaluated. We used a GenBank sequence for the part of chromosome 19 corresponding to the ILF3 gene to determine the exon-intron organization of the entire gene which spans 38 kb and is divided into 21 exons.

Alternative Splicing↗
PubMed2000

[Surgical treatment of carpometacarpal joint osteoarthritis of the thumb by trapeziectomy-interposition-ligamentoplasty].

INTRODUCTION: Osteoarthritis of the carpometacarpal joint of the thumb is a common pathology. Several surgical methods exist, including trapeziectomy, arthrodesis, cemented or cementless prosthesis. Therefore, one must question the legitimacy of non prosthetic surgery. The authors have tried to answer this question. METHOD: Surgery consisted in trapeziectomy and ligament reconstruction with tendon interposition arthroplasty (LRTI). Authors reviewed 47 cases with five years follow-up. Patients were evaluated using a functional score, including pain, professional and domestic activities, and leisure involving the hand. Objective data were also assessed: thumb opposition, radiographic scaphometacarpal mobility, key and tip pinch, grasp strength. RESULTS: Functional results ranged from good to excellent in 42 cases. Opposition was satisfactory in 46 cases. Scapho-metacarpal range of motion was 16 degrees. Pinch strength was 4.2 kg and grasp strength was 23 kg. There were no complications. Loss of pinch strength was 1 to 2 kg as compared to our reference group. Such a loss does not impair patients' daily life. Age and operated side do not influence results. Scores do not decrease with time. Radiographic staging seems to be linked with scoring. Reducing the trapezial space does not influence results. We had none of the complications described in other techniques: synovitis, ossifications, loosening and reflex sympathetic dystrophy. DISCUSSION: This study, as well as literature, confirms that trapeziectomy and ligament reconstruction with tendon interposition arthroplasty gives satisfactory functional results which are stable with time and without complication. For all these reasons, the authors prefer this technique in degenerative osteoarthritis.

Activities of Daily Living↗
PubMed2000

A perspective on animal protein production in sub-Saharan Africa.

A large survey of animal protein production in sub-Saharan Africa was performed. The objective was to identify specific production needed to ensure sustainable development. Starting from data collection and analysis to gain control of this information, the study proposes possible paths of evolution for supply and demand for animal production. Africa will be the continent where the demand will grow the most (together with Asia), because of demography and urbanization. Urbanization will represent an extraordinary opportunity for the development of animal production. In 2020, the global demand will be 20 million tons per year (7.3 in 1994) for meat, 45 million tons for milk (18.6 in 1994) and 2.9 million tons for eggs (1.1 in 1994). Red meat, which now provides 55.6% of present meat consumption will satisfy only 36.5% in 2020. This underlines the immense effort needed to intensify ruminant production and/or to develop monogastric production. Consequently, there is a need in tropical animal health and research for better knowledge and control of monogastric diseases and particularly those linked to intensification. The development of peri-urban milk production will require particular attention to hemoparasitic diseases. Globally, there is an urgent need to set up projects for the development of animal production.

Africa South of the Sahara↗
PubMed2000

Analysis of the axial transmission technique for the assessment of skeletal status.

Ultrasonic wave propagation in human cortical bone has been investigated in vitro using the so-called axial transmission technique. This technique, which relies on velocity measurement of the first arriving signal, has been used in earlier investigations to study bone status during fracture healing or osteoporosis. Two quasi-point-source elements, one transmitter and one receiver (central frequency 0.5 MHz), were used to generate a wide ultrasonic beam, part of which strikes the sample surface at the longitudinal critical angle, and to receive the signals reflected from the sample surface. The analysis of the field reflected from a fluid-solid interface for an incident spherical wave predicts the existence of a lateral wave propagating along the sample surface at a velocity close to the longitudinal velocity, in addition to the ordinary reflected wave and vibration modes. The transducer-sample and the transmitter-receiver distances were chosen such that the lateral wave is the first arriving signal. Validation of the measuring technique was performed on test materials and was followed by experiments on human cortical bones. Experimental results (arrival time and velocity) strongly suggest that the first detected signal corresponds to the lateral wave predicted by theory.

Bone Density↗
PubMed2000

Evaluation of error bounds on calcaneal speed of sound caused by surrounding soft tissue.

For absorptiometry measurements, soft tissue may have an impact on quantitative ultrasound (QUS) measurements. In the present study, we focused primarily on the quantification of measurement error on speed of sound (SOS) caused by surrounding soft tissue. The relevant soft tissue parameters affecting the inherent SOS inaccuracies are thickness and sound velocity. To meet our goal, SOS measurements were taken at the right heel using a QUS imaging device in 21 healthy subjects. Site-matched measurements of soft tissue thickness (STT) and bone width were performed using magnetic resonance imaging of the heel. Several bone velocities were calculated either by accounting for bone width (SOSBW) only or by taking into account the exact path lengths of all major components traversed by ultrasound &lapr;V(b)). Given that soft tissue composition is difficult to determine in vivo, we chose to estimate lower and upper error bounds on bone velocity (V(b lower) and V(b upper)) by spanning the full range of available values in the literature. The mean BW was 30.7 +/- 2.7 mm and the mean medial and external STTs were 8.8 +/- 1.7 and 8.5 +/- 1.5 mm, respectively. Accounting for true BW only resulted in no significant difference between SOS (1533 +/- 37) and SOSBW (1531 +/- 33). By contrast, accounting for both true BW and surrounding soft tissue resulted in an increase in the calculated bone velocity and statistically significant differences between SOS and V(b upper) (1568 +/- 36) and V(b lower) (1542 +/- 34). Root mean square errors between SOS and the calculated velocities were 0.34, 2. 32, and 0.70% for SOSBW, V(b upper), and V(b lower), respectively. We report here measurement errors caused by soft tissue to be 3 to 20 times higher than the SOS short-term precision (SOS coefficient of variation of 0.1%). Our results suggest that inaccuracies in SOS measurement caused by overlying soft tissue cannot be neglected. Overlying soft tissues may influence outcomes of longitudinal studies, especially if variations in tissue thickness and composition occur during the longitudinal follow-up. A practical way of minimizing the measurement error could be to perform an adequate correction for the overlying soft tissue. However, ideally, this should require knowing both the thickness and sound velocity in soft tissue. One might preferably conduct experimental investigations that directly control soft tissue thickness and composition to resolve this problem.

Adult↗
PubMed2000

Comparison of efficacy of American and African Amblyomma ticks as vectors of heartwater (Cowdria ruminantium) infection by molecular analyses and transmission trials.

The ability of Amblyomma americanum, Amblyomma cajennense, Amblyomma maculatum, and Amblyomma variegatum to acquire and transmit Cowdria ruminantium infection was investigated. Uninfected nymphs were fed on clinically reacting C. ruminantium-infected sheep and then analyzed for infection by specific DNA detection assays and by tick transmission trials. By polymerase chain reaction (PCR), the mean infection prevalence of A. maculatum ticks (50.7%) was similar to that of A. variegatum, Elevage strain (43.5%; P = 0.83) and Petit Bourg strain (45.9%; P = 0.26) ticks. Though Amblyomma hebraeum were not tested by PCR, by DNA probe their infection prevalence was 94%. In contrast, A. americanum and A. cajennense ticks demonstrated very low susceptibility to C. ruminantium, and the prevalence of infection by PCR was approximately 1%. The higher susceptibility of A. maculatum and A. variegatum to C. ruminantium correlated with superior vector efficiency, depicted by similar prepatent periods and severity of disease transmissions to sheep. Amblyomma americanum and A. cajennense failed to transmit infection, confirming that low susceptibility to C. ruminantium correlates with the poor vector status of these species. These results highlight the importance of A. maculatum as a potential vector that is likely to play a major role in the establishment and maintenance of heartwater, if the disease were to be introduced to the U.S.A., Central, and South America.

Animals↗
PubMed2000

[Contributions of endosonography in ovarian neoplasms: Report of 3 cases].

Ovarian investigations are necessary to answer to two questions Intraoperative explorations play a main part for that decision. Endoscopic sonography could contribute to distinguish benign from malignant lesions. We present three cases of endoscopic sonography of ovarian disease. In each case, endoscopic explorations induced to change usual surgical procedure. The authors suggest that endoscopic sonographic becomes an intraoperative step of ovarian surgery.

Adult↗
PubMed1999

Pregnancy rates after in-vitro fertilization in cases of tubal infertility with and without hydrosalpinx: a meta-analysis of published comparative studies.

This meta-analysis was intended to evaluate differences in pregnancy rates after in-vitro fertilization (IVF) in tubal fertility with and without hydrosalpinx. It examined nine published retrospective comparative series and five series published as abstracts for which additional information was obtained. In all, these studies involved 5592 patients (1004 with hydrosalpinx and 4588 with tubal infertility without hydrosalpinx). The main outcome measures were rates of pregnancy, implantation, live delivery, and early pregnancy loss. Pregnancy rates were significantly lower in the presence of hydrosalpinx: 31.2% for the tubal sterility group without hydrosalpinx and 19.7% for the group with hydrosalpinx (odds ratio: 0.64; 95% confidence interval: 0.56, 0.74). Similarly, the implantation rate and the delivery rate per transfer in the hydrosalpinx group were only slightly more than half those of the non-hydrosalpinx group (implantation: 8.5 and 13.7%, respectively; delivery: 13.4 and 23.4%). The incidence of early pregnancy loss was also higher in the hydrosalpinx group (43.7%) than in the control group (31.1%). This meta-analysis makes it clear that hydrosalpinx present during IVF-embryo transfer has negative consequences on the rates of pregnancy, implantation, live delivery, and early pregnancy loss. It would be premature, nonetheless, to conclude that routine salpingectomy should be performed on all patients with hydrosalpinx.

Body Fluids↗
PubMed1998

Validation and comparison of three enzyme-linked immunosorbent assays for the detection of antibodies to Cowdria ruminantium infection.

Serological tests for Cowdria ruminantium infection have been hampered by low specificity. Here, an indirect ELISA based on purified antigen, a competitive ELISA using a recombinant major antigenic protein (MAP-1) and an indirect ELISA based on the MAP-1B region of the recombinant MAP-1 were compared. The tests were validated using 3000 sera of ruminants from 14 islands of the Lesser Antilles as well as sequential serum samples from 10 cattle, 17 goats and 10 sheep vaccinated with inactivated C. ruminantium in ISA 50 adjuvant and from 14 goats infected with a virulent culture supernatant. All tests detected significantly higher percentages of positives on Antigua, Guadeloupe and Marie-Galante, where C. ruminantium had been isolated before. Overall specificity calculated with sera from the other 11 heartwater-free islands was 98.1%, 98.5%, and 99.4% for the ELISA based on crude antigen, recombinant MAP-1 and MAP-1B, respectively. Sensitivities observed with sequential serum samples were similar for all tests. Tests based on recombinant antigens, especially the MAP-1B, showed improved specificity, suggesting their use for epidemiological studies in regions where the distribution of cowdriosis is unknown. In addition, the competitive ELISA is useful for studies in wildlife for which species-specific conjugates do not exist.

Animals↗