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Biomedical subjects

F Denis

Publications and source records attributed to F Denis.

At least 91 records · Page 5Linked to original sources

[New hepatitis viruses "E, GB, etc."].

Some cases of hepatitis were non A, non B, non C, non D. Hepatitis E virus (Calicivirus) transmission is fecal-oral similar to that of the hepatitis A virus. Viral hepatitis E is endemic and frequently epidemic in many developing countries, but exceptionally observed in France. A high mortality rate was observed in pregnant women. Recently, ELISA assays for IgM anti-HCV are available. Many hepatitis cases (acute and chronic) are not caused by known viruses (non A-non E). Four Flavivirus like have recently been cloned from infectious tamarin serum, derived from human viral hepatitis. Three viruses GB Virus A (GBV-A), GB Virus B (GBV-B) and GB Virus C (GBV-C) were identified. The GB viruses and HG Virus are not genotypes of hepatitis C Virus (HCV) and perhaps that GBV-A/GBV-C and HGV are closely related. GBV-A could be an indigenous tamarin virus. The new hepatitis (non A-non E) viruses were associated with blood transmission and with chronic diseases. The development of specific diagnostic reagents using polymerase chain reaction (PCR) and ELISA assays are essential to answer many questions on the epidemiology (and the incidence of post-transfusion hepatitis), and the pathogenesis of GBV and HGV viruses.

Enzyme-Linked Immunosorbent Assay↗

Seroepidemiological study of retroviruses (HTLV-I/II, HIV-1, HIV-2) in the Department of Atacora, northern Benin.

A seroepidemiological survey to determine the prevalence of retrovirus infection (HTLV-I/II, HIV-1, HIV-2) by representative sampling of the general population in the Department of Atacora in north-western Benin is reported. The seroprevalence rate of HTLV-I in this sample was at 1.86% (95% CI 1.20-2.52%). This is in agreement with prevalence rates reported from neighbouring countries of the sub-region. No sera were found positive for HTLV-II. Seropositivity to HIV-1 was 0.3%; HIV-2 seropositivity was not encountered.

Adolescent↗

The surgical and medical perioperative complications of anterior spinal fusion surgery in the thoracic and lumbar spine in adults. A review of 1223 procedures.

STUDY DESIGN: A retrospective review of 1223 thoracic and lumbar anterior spinal fusions was performed from 1969 through 1992. OBJECTIVES: To document the incidence and specific types of perspective complications related to anterior spinal fusions. SUMMARY OF BACKGROUND DATA: Despite the increased use of anterior spinal surgery, there has been little documentation of the specific types and frequencies of the complications associated with its use. METHODS: All Minnesota Spine Center patients age 18 years or older who had anterior spinal fusions between the levels of T1 and S1 from August 1969 to June 1992 were reviewed for the occurrence of perioperative complications. Surgical approach and technique and associated comorbidity was recorded. RESULTS: The risk of a complication was increased for patients over age 60 years, for women, and for patients with multiple preexisting health problems. Serious complications, such as death (0.3%), paraplegia (0.2%), and deep wound infection (0.6%) were rare. The complication rate for complications that were directly attributed to the anterior spinal surgery was 11.5%. CONCLUSIONS: Anterior spinal fusion surgery is a safe procedure and can be used with confidence when the nature of a patient's spinal disorder dictates its use. Complications are often approach specific.

Adolescent↗

Enteric prevalence of adenovirus in human immunodeficiency virus seropositive patients.

To evaluate the prevalence of adenovirus strains in human immunodeficiency virus (HIV)-positive patients and to investigate their possible role in the onset of diarrhea, a total of 103 stools from HIV-seropositive patients at various stages of infection and 200 stools from sex and age cross-matched control subjects were examined. Adenovirus prevalence was measured by ELISA as well as conventional and rapid cell culture techniques. Results were compared between patients suffering from diarrhea and those without diarrhea. Adenovirus prevalence was statistically greater in HIV-seropositive cases than controls (8.7%, 2.5%, respectively). No significant difference was found between HIV-positive patients with diarrhea and those without gastrointestinal complications (P > 0.05). However, a significant difference in adenovirus prevalence was found between HIV-positive patients with diarrhea and control subjects with diarrhea (P = 0.02). Although viral prevalence varied with the different stages of HIV infection, differences were not statistically significant. In conclusion, although current opinion considers adenoviruses to be no more than opportunistic pathogens, the results of this large-scale study do not exclude a potential reactivation of latent adenovirus in HIV infection and suggest that further effort should be directed to elucidating such a mechanism if it exists as well as investigating the specific role of certain adenovirus serotypes in provoking diarrhea during later stages of HIV infection.

AIDS-Related Opportunistic Infections↗

Large-scale study suggests no direct link between human herpesvirus-6 and primary Sjögren's syndrome.

The aim of this study was to evaluate the role of human herpesvirus-6 (HHV-6) in the development of primary Sjögren's syndrome (PSS). Serum HHV-6 antibody levels, as measured by immunofluorescence assay (IFA) and the prevalence of HHV-6 DNA in peripheral blood mononuclear cells (PBMCs) determined by polymerase chain reaction (PCR), were studied in 49 PSS patients and 50 control subjects, all in-patients in the University Hospital Internal Medicine ward, Limoges, France. In addition, portions of labial salivary gland were obtained from 34 patients and 15 controls, the presence of viral DNA being detected by the same PCR technique. The results were then compared with clinical observations of systemic disease manifestations in patients and a histological study of salivary gland involvement. No significant difference in HHV-6 seroprevalence was found between control subjects (50.0%) and patients (63.3%) nor was there any statistically significant difference between patient and control groups for total viral DNA in PBMCs (22.4%, 12.0%) and salivary glands (8.8%, 6.6%). Analysis of clinical and histological data revealed no detectable correlation between disease severity and viral involvement. Tests for HHV-6A and HHV-6B proved positive in patient and control groups, HHV-6B being the most frequently encountered type in both groups. In conclusion, the results of this large-scale trial does not confirm the suspected direct role of HHV-6 in the etiology of PSS.

Antibodies, Viral↗

No direct relationship between HIV1/2 infection and HHV-6 antibody response in a large-scale European and African trial.

BACKGROUND: Tropism of both human herpesvirus-6 (HHV-6) and human immunodeficiency virus (HIV) for CD4+ lymphocytes, and several studies on HIV enhancer transactivation by HHV-6 have suggested that HHV-6 could be implicated as a cofactor in the progression of HIV infection to AIDS. OBJECTIVES: To determine if there is any relationship between HHV-6 infection and the course of HIV infection. STUDY DESIGN: 527 French and 558 African sera (210 from Senegal, 348 from Ivory Coast) were tested for HHV-6 titers by immunofluorescence assay (IFA). For each country, patients studied were divided into several groups; those with AIDS, those who were HIV-seropositive but symptomless, and HIV-seronegative patients. RESULTS: No statistical difference could be found between HHV-6 prevalences or HHV-6 geometric mean titers obtained for each geographical area in the different HIV-1- and/or HIV-2-positive and HIV-negative groups. HIV patients with clinical manifestations of AIDS did not differ in percent seropositivity or distribution of titers from the HIV-asymptomatic patients or HIV-seronegative patients. CONCLUSION: These findings suggest that there is no correlation between HHV-6 antibodies and HIV seropositivity or with the stage of HIV infection.

Journal Article↗

Excision of hemivertebrae and wedge resection in the treatment of congenital scoliosis.

The results of anterior and posterior excision or wedge resection of a hemivertebra and arthrodesis of the spine were reviewed retrospectively for thirty-seven patients. The degree of correction that was obtained and maintained, the balance and alignment of the trunk, changes in pelvic obliquity, and associated complications were evaluated. The average age at the time of the operation was twelve years (range, six months to forty-two years). The average duration of follow-up was six years (range, two to nineteen years). The resection was at the mid-thoracic level in six patients, at the thoracolumbar level in nine, at the mid-lumbar level in seven, and at the lumbosacral level in seventeen. (Two patients had an excision of a hemivertebra at two levels.) Instrumentation was used in twenty-eight patients. Postoperatively, all patients were managed with a body cast, with a unilateral or bilateral pantaloon extension, for four to six months. The instrumentation allowed early walking and the use of a unilateral rather than a bilateral pantaloon extension. The index curve (the curve containing the hemivertebra) averaged 54 degrees (range, 18 to 132 degrees) preoperatively, 33 degrees (range, 0 to 105 degrees) postoperatively, and 35 degrees (range, 0 to 110 degrees) at the most recent follow-up evaluation. A measurable improvement in balance was achieved and maintained in nineteen patients. Pelvic obliquity did not change appreciably, as it was related primarily to limb-length inequality in this series. Complications included a temporary nerve-root lesion in seven patients, a permanent neurological deficit involving the first sacral nerve root in one patient, a pseudarthrosis in three patients, and a wound infection in three patients. Six patients had extension of the arthrodesis to include additional vertebrae.

Adolescent↗

[Prevalence of hepatitis B viral markers in a population of pregnant women in Brazzaville (Congo)].

The risk of perinatal transmission of hepatitis B virus is well-known; but, in Congo, where hepatitis B virus is endemic and the prevalence of hepatocellular carcinoma is high, there is no study on this mode of transmission. For three months, we screened systematically for HBsAg in 292 pregnant women who came as outpatients or to deliver in 3 health centres in Brazzaville. Positive sera for HBsAg were also tested for the other markers of HBV, except for specific DNA. The seroprevalence of HBV among these women was 6.5%. It was significantly higher among inpatients than among outpatients. The overall prevalence of HBs was 57.8%; the prevalence of the profile HBsAg + HBeAg was 2.05%. The risk of maternofoetal transmission of HBV was 2.7%. This study shows that the antenatal screening for HBV and the integration of the immunization against HBV in the expanded programme of immunization against HBV are good means to prevent the infection.

Adolescent↗

[Evolution of the susceptibility to penicillin G of Streptococcus pneumoniae at the Limoge University Hospital Center].

A systematic detection of Streptococcus pneumoniae strains with reduced susceptibility to penicillin has been realized at Limoges Hospital during two years half. Of 302 strains isolated, 27 had reduced susceptibility to penicillin (8,9%), and, for 15 strains (5%), the MIC of penicillin G reached at least 2 mg/l. The frequency of strains with reduced susceptibility to penicillin increased from 1992 to 1994: 8,2% in 1992, 8,7% in 1993 and 12,2% in 1994. The resistance level exhibited by pneumococcus strains increased since 1992: the percentage of resistant strains (MIC mg/l > 1) was 2,7% in 1992, 6,9% in 1993 and 7,3% in 1994. Most of the strains with reduced susceptibility to penicillin belonged to serotype 23 (52%) and were isolated from blood cultures, cerebral-spinal or pleural fluids (41%).

France↗

[Dynamics of the nasal colonization by methicillin resistant Staphylococcus aureus in patients hospitalized in an intensive care unit].

Prospective study on MRSA nasal cariage was done during two months in an intensive care unit in Limoges University Hospital. Nasal swab specimens were taken daily and cultured on selective and non selective media. Sixty eight patients were included in this study (878 swab collected, 575 MRSA isolated). Patients mean âge was 62 years and stay period mean was 12.3 days (median: 7 days). Among these patients, 16 were already carrying MRSA when entering in the unit and 26 became positive for MRSA during their stay. The mean colonisation delay was 5.5 days (median 4 days). All patients, except one, have shown a nasal carriage during all their stay. During the study period, 17 patients became infected and only two patients neither carried nasal MRSA before and during infection. In all cases, glycopeptide treatment did not affect nasal carriage. Colonisation and infection risk factors were discussed.

Adolescent↗

[Intra-family transmission of human T-cell lymphotropic virus-1 (HTLV-1) in a cohort of HTLV-1-positive patients (Bénin)].

We are reporting the results of a familial study carried out in Benin in March 1994 within a cohort of HTLV-1 positive subjects. This study aims at appraising the different modes of intra-familial transmission of this retrovirus. The study has included 212 persons: 33 seropositive subjects (identified during two previous seroprevalence surveys and followed up since 1991), and 179 members of their families. Blood specimens have been taken from each of these subjects. Sera have been screened for HTLV-1 antibodies by ELISA test and positive results confirmed by Western blot test. Out of 18 children born during the follow up period, 2 cases of seroconversion have been observed. One case of seroconversion has also been noted among the 17 couples in which either of the spouses is seropositive. Among the 136 children of the cohort: 17.8% of them are HTLV-1 positive when both parents are seropositive 26.1% if the mother only is seropositive and 0% if the father only is seropositive. The incidence rate in this cohort is estimated to be 0.43%. These data relative to the intra-familial transmission of HTLV-1 in Benin appear to be consistent with those previously reported in Japan.

Benin↗

[Adenoviruses from stool samples in hospital units. Comparison with main pathogens in gastroenteritis (rotavirus, Campylobacter, Salmonella)].

During a six-years period (1988-1993), a total of 14,644 stool samples from in-patients of Limoges University Hospital were examined for the presence of principal enteric pathogens, such as adenovirus, rotavirus, Campylobacter, Salmonella, Shigella and others. Stools were processed for identification of bacteria by standard methods and viruses were detected in fecal specimens using antigen detection methods: ELISA (Enzyme Linked Immunosorbent Assay) and latex agglutination test. The decreasing rates of presence of enteric agents were respectively 6% for rotavirus, 3.2% for Salmonella, 2% for adenovirus, 1.6% for Campylobacter and 0.2% for Shigella, but according to the lack of sensibility of latex agglutination test, adenovirus prevalence was probably underestimated. Concerning the distribution of enteric pathogens throughout the year, our data demonstrate that rotavirus were rather shed during the months from January to April, adenovirus between April and August, Campylobacter during summer and Salmonella from July to October. The two thirds of Campylobacter and rotavirus infections and the half of adenovirus and Salmonella infections were identified during the ten first years of life. The highest prevalence occurs before 5 years old, during the 2nd year of life for adenovirus (4.4%) and rotavirus (22.3%) and during the 3rd year of life for Campylobacter (6.84%) and Salmonella (8.6%).

Adenovirus Infections, Human↗

[Bacterial dermo-hypodermatitis in adults. Incidence and role of streptococcal etiology].

INTRODUCTION: The frequency of bacterial dermohypodermal infections would appear to be increasing in western countries, particularly severe necrotizing forms. PATIENTS AND METHODS: We attempted to determine: (1) the incidence of the two most well-defined forms of bacterial dermohypodermal infections (erysipelas and necrotizing fasciitis) in a retrospective study of hospitalized cases seen over a period of 13 years in the Limoges University Hospital and (2) the role of streptococci as causative agents in bacterial dermohypodermal infections in the adult by collecting bacteriological data in 174 cases of erysipelas and 31 cases of necrotizing fasciitis. RESULTS: This retrospective analysis confirmed that the annual incidence of erysipelas was constantly increasing over the study period (1978-1991) while the annual incidence of necrotizing fasciitis was much lower and more constant. The two incidence curves were not parallel. Bacteriology, detection of streptococci (groups A, B, C or G) in skin specimen was better with direct immunofluorescence (64 p. 100) than with latex agglutination (47 p. 100) or classic culture techniques (28 p. 100) for erysipelas. Streptococci were determined to be the causative agent in 79 p. 100 (137/174) of the cases of erysipelas using at least one of the 3 bacteriological tests and/or serology. Group A streptococci predominated (67 p. 100 of the cases). For necrotizing fasciitis, streptococci was identified with classical culture technique, latex agglutination and/or serology in 12/131 cases (39 p. 100), again with a group A predominance (7 cases). In the other cases, multiple microbial flora (12 cases) were found including Staphylococcus aureus (3 cases) and Serratia liquefaciens (1 case). CONCLUSION: These results show that streptococci (group A predominantly and group G to a lesser extent) were the major, though not exclusive, causative agents in bacterial dermohypodermal infections in the adult, including necrotizing forms.

Adult↗

[Serologic and genomic research by PCR of hepatitis C virus in different populations in Lomé (Togo)].

An epidemiological survey carried out on several groups at University Hospital of Lome showed that the prevalence of anti-HCV antibodies is 3.3 % among blood donors, 1.3 % in STD positive subjects and 6.1 % in hospitalized patients. The disparity of the HCV seropositivity rate was not statistically significant among HIV-infected and non-infected subjects (6.9 % vs 3.3 % respectively). The HCV RNA was most frequently recovered from patients, whose serological pattern was confirmed but also from 30 % of subjects, for whom the HCV serology was proved. This shows the limits of serological tests in Africa.

Adolescent↗

[Prevalence of serum markers of hepatitis B and C in blood donors and pregnant women in Algeria].

Serologic markers of hepatitis B (AgHBs, anti-HBc) and hepatitis C (anti-HCV) are investigated in 1,112 apparently healthy blood donors and 715 pregnant women in Algeria. Data of this study have shown a low prevalence of HCV and confirm that this country belongs to the middle endemic area for HBV. Indeed the anti-HCV were detected in 0.18 % of blood donors and 0.19 % of pregnant women. The AgHBs were observed in 3.6 % of blood donors and 1.6 % of pregnant women, anti-HBc antibodies were found in 13 % of blood donors and 11.1 % of pregnant women.

Adolescent↗

[Value of media containing chromogenic substrates for the identification and the listing of urinary bacteria].

Performance in terms of enumeration, growth and identification with a new culture medium (CPS ID2, bioMérieux) was evaluated using 405 urine samples and 244 collection strains. The CPS ID2 medium contains chromogenic substrates enabling the detection of 4 bacterial enzymes which leads to the identification of colonies: Escherichia coli, Proteus mirabilis, Proteus-Morganella-Providencia and enterococci. No discrepancies in the enumeration were observed with the collected strains and urine samples. Sensibility and specificity of the identification of Proteae taxa (TDA +) and enterococcal taxa (Gram positive cocci and beta-glucosidase +) was 100% using urine samples and 95.1% of E. coli strains (beta-glucuronidase +, indole +) are detected. Routine use of this new medium for the bacterial examination of urine is satisfactory and an ultra-violet lamp is no longer required for reading as was the case previously with media containing fluorogenic substrates.

Anti-Bacterial Agents↗