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Biomedical subjects

F Lecomte

Publications and source records attributed to F Lecomte.

At least 37 records · Page 2Linked to original sources

[Red fingers syndrome in the course of HIV infection. A new case].

Human immunodeficiency virus can be associated with vascular manifestations such as arteritis mainly with cerebrovascular localization, arterial aneurysms or accelerated formation of atherosclerosis lesions. Red fingers syndrome has been recently described in i.v.-drug patients with HIV and hepatitis C infection. We report a new case in a 36-year old woman, and suggest that this syndrome must be considered as a new microcirculatory manifestation of HIV infection. Red fingers syndrome in patients with HIV is likely secondary to co-infection with hepatitis C or immunological disturbances-associated such as cryoglobulinemia.

AIDS-Related Opportunistic Infections↗

[Thrombophlebitis and cancer: evaluation of the diagnostic value of abdominal ultrasonography in the acute phase of a deep venous thrombosis. Report of 148 consecutive examinations].

If an association between venous thromboembolism and malignancy is now well established, there is no consensus about the investigations which should be performed to detect occult malignancy after deep vein thrombosis episode. We investigated the usefulness of systematic abdomino-pelvic ultrasonography in 148 consecutive patients older than 40 with deep vein thrombosis and or pulmonary embolism. Ultrasonography was abnormal in 8 patients (5.4%) and detected only 6 cancers. In 5 cases, clinical examination and laboratory tests were sufficient to suggest malignancy. Our results suggest that ultrasonography should not be systematically performed in patients with deep vein thrombosis. Decisions to performed additional diagnostic tests can be based on the finding of the initial clinical examination, that includes medical history, physical examination, routine laboratory tests and chest-x-ray.

Abdomen↗

The mammalian RPS6 gene, homolog of the Drosophila air8 tumor suppressor gene: is it an oncosuppressor gene?

The mammalian gene encoding the S6 ribosomal protein is the homolog of the Drosophila air8 tumor suppressor gene. We assigned the rat Rps6 gene to chromosome 5q22-33. The rat 5q22-33 chromosome region, previously shown to bear a malignant transformation suppressor gene, is homologous to the human 9p2l region, frequently deleted in various kinds of cancers and also containing at least one tumor suppressor (oncosuppressor) gene. To test the possibility that the Rps6 gene could be an oncosuppressor gene in mammals, we analysed its sequence and expression in normal and malignantly transformed cells. In mouse hepatoma cells (BWTG3), the Rps6 gene is hemizygously deleted but the remaining copy shows no sequence anomaly in the coding region, indicating that Rps6 is not oncosuppressor and that another gene acting as an oncosuppressor is located in its vicinity. In human tumor cells, the RPS6 gene is retained in cells showing deletion of the near-by gene, IFNB. Our results do not support the possibility that the RPS6 gene acts as an oncosuppressor gene in mammalian cells.

Animals↗

[Endonasal ethmoidectomy in naso-sinusal polyposis. Results in 110 surgically treated patients].

We assessed retrospectively functional and endoscopic results obtained in 110 patients who underwent endonasal ethmoidectomy (n = 218). The patients were divided into 3 groups according to associated pathology (polyposis alone, asthma without intolerance to aspirin, Widal's disease) and outcome was evaluated after a mean 19.5 month follow-up. Function was improved in 88% of the patients. Endoscopic recurrence was seen in 40% of the patients including 10% with major polyposis. Oedema of the mucose remained in 20% of the patients and the mucosa was normal in 40%. Improvement in patients with Widal's disease was the least favourable among the three groups and was best in those with asthma and no intolerance to aspirin. Post-operative complications occurred in 12.6% of the patients and were severe in 0.9%. These satisfactory results, both in terms of function and the low rate of complications, suggest that the current medicosurgical management should be continued with particular attention to the rate of endoscopic recurrence.

Adult↗

Study of the efficacy and safety of ciprofloxacin in the treatment of chronic sinusitis.

Over a 12-month period, 56 patients with acute exacerbations of chronic sinusitis were included in this study. The mean age of the patients was 48.6 +/- 10.1 years. The period between the onset of sinus symptoms and inclusion in the study was 10.1 +/- 12.1 years and the exacerbation had lasted 2.4 +/- 4.4 months. Patients were given 500 mg ciprofloxacin twice daily for 9 days. Bacteriological specimens taken at inclusion were positive in 53.6% of cases, 25 Gram-positive and 16 Gram-negative pathogens being isolated. At the end of the treatment, rhinorrhoea, which was the main criterion for evaluation of the efficacy of treatment, had disappeared in 46/54 (85%) patients who were examined. Of the 30 patients whose sinusitis was confirmed by bacteriological test, the bacteria were eradicated in 90% of cases. At the end of a 4-week follow-up period after the end of treatment, the clinical success rate was 74.5%, the partial success rate 21.2% and the failure rate 4.3%. There were no bacteriological recurrences. Ten adverse events were observed in seven patients and in four (7%) of these treatment had to be withdrawn. This study showed ciprofloxacin to be an effective and well tolerated treatment for exacerbations of chronic sinusitis treated in non-hospital practice.

Adult↗

Study of the efficacy and safety of ciprofloxacin in the treatment of chronic otitis.

Over a period of 18 months 76 patients presenting with acute exacerbations of chronic otitis were enrolled in this study. The mean age of the patients was 46.4 +/- 16.8 years, the interval between the onset of symptoms of otitis and enrollment in the study was 22.1 +/- 19.4 years and the infective episode had been developing for 36.4 +/- 72.4 days. The patients received either 500 or 750 mg ciprofloxacin twice daily for a period of 9 days with no topical antibiotic treatment. The bacteriological specimen taken at enrollment was positive in 93% of the patients and led to the isolation of 85 microorganisms, 65% of which were Pseudomonas aeruginosa, Staphylococcus aureus or Proteus mirabilis. At the end of the treatment period, discharge from the ears (the primary clinical evaluation criterion) had ceased in 44/69 (64%) patients examined. The clinical cure rate was 23/39 (59%) for patients treated with 500 mg ciprofloxacin twice daily and 21/30 (70%) for those treated with 750 mg twice daily (difference was not statistically significant). At the end of a 4-week post-treatment follow-up, the clinical relapse rate was 7%. There was no relapse in the patients with chronic otitis which had been bacteriologically documented. Eight adverse effects were observed in five patients and treatment had to be discontinued in one case. This study shows ciprofloxacin to be an effective and safe agent for use in the treatment of acute exacerbations of chronic otitis treated in general practice. In certain cases, however, additional treatment with a topical antibiotic may be desirable.

Adult↗

[Initial results of 132 ethmoidectomies by endonasal approach].

47 cases of nasal polyposis and 19 cases of suppurated ethmoiditis were treated by intranasal ethmoidectomy. Results were evaluated by functional signs and nasosinusal endoscopy. 15 patients, among nasal polyposis, suffered from corticodependent asthma and 5 from Widal's disease. 64 patients were regularly followed-up for 1 to 4 years. Results in polyposis, after two years, in 47% of cases no recurrence was noted, a minor recurrence in 40% of cases, and 13% of failures with predominant Widal's disease. These results with low percentage of complications have lead us to choose intranasal ethmoidectomy. In suppurated ethmoiditis, results are good in 90% of cases if follow up is regular.

Adult↗

[Evaluation and utilization patterns of antibiotic therapy. A study in 4 hospital departments].

The use of antibiotics in 480 cases in 4 hospital wards during 1988 was assessed by examination of medical records. Only the first antibiotic therapy administered during the first stay in the ward for each patient was included. Antibiotics were administered to 163 in-patients (37% of hospitalizations) for infections in 113 (26%) cases. Amoxycillin and macrolides were the drugs most frequently used. Sixty-eight percent of the treatments were administered in the absence of microbiological data. Single drug therapy was used in 60% of treatments. Fifty in-patients (11% overall; 41% of patients undergoing surgery) received antibiotics for prophylaxis. The exact indication(s) for the choice of therapy was not given in the medical records of 39% of cases. Treatment started within 48 hours of infection in 15% of the cases. Overall, 93% of the treatments given were indicated, but 53% were inappropriate because they were too expensive, unlikely to be effective or were multiple drug therapy without justification. There are a variety of factors that cause such inappropriate administration of antibiotics.

Adult↗

Treatment of experimental Escherichia coli pyelonephritis in rat by ciprofloxacin in comparison with tobramycin.

The ciprofloxacin efficacy was compared to that of tobramycin in an Escherichia coli pyelonephritis model in rat. Treatments started 48 h after ligation of the left ureter and inoculation of the bladder and continued for 5 days. Ciprofloxacin (2.5 mg/kg/d and 10 mg/kg/d) was administered intravenously either in a single daily dose or in 2 divided doses at 12 h intervals. Tobramycin (2.5 mg/kg/d and 10 mg/kg/d) was administered by the intramuscular route, in a single daily dose. Ciprofloxacin 10 mg/kg/d was as efficacious as tobramycin irrespective of dosage schedule. Ciprofloxacin 2.5 mg/kg/d was more effective when given twice a day than once.

Animals↗

[Preventive treatment of infection caused by gram-negative bacteria using anti-lipopolysaccharide antibodies. Evaluation in patients with aplasia].

The prophylaxis of severe Gram-negative infections with human antiserum to lipopolysaccharide (LPS) was evaluated in a randomised study of 60 patients with therapeutic aplasia for leukaemia. The antiserum was found to be ineffective in preventing Gram-negative infections. The levels of anti-LPS antibodies showed that passive immunization was obtained in only one half of the patients. These disappointing results warrant further investigations to evaluate the effectiveness of this prophylactic treatment.

Adult↗

Neurological manifestations of Lyme disease and treatments.

Lyme disease is a multi-systemic infection due to B. burgdorferi, with neurological manifestations observed in its second and third stages. Except for the suggestive triad meningitis--radiculoneuritis--facial palsies, the diagnosis is often difficult because of the pleiomorphism of neurological manifestations. These can be localized or diffuse, with central involvement, meningitis or peripheral manifestations. Past history, cerebrospinal fluid (CSF) examination, immuno-assays for specific antibodies in serum and especially CSF are helpful in diagnosis. Betalactam antibiotics (penicillin G, amoxicillin, and third generation cephalosporins) are the most effective treatment with good results in the early and acute stages of neurological disease.

Anti-Bacterial Agents↗

[Therapeutic approach in chronic maxillary sinusitis. Apropos of 469 patients and 640 sinuses].

Between 1982 and 1987 we treated 469 patients who accounted for a total of 640 involved sinuses. These patients suffered from various stages of chronic sinusitis. Endoscopy of the maxillary sinuses enabled us to collect important information regarding the state of the mucosa and secretions, to collect bacteriological samples and to inspect the ostium and take pressure measurements. There was an 80% success rate in cases of sinusitis treated by drainage. In our opinion the indication for inferior meatotomy is as an extraction procedure and is not of value for aeration drainages. Nevertheless, out of a total of 141 inferior meatotomies performed, 80% remained patent after a mean follow up period of 3 years.

Chronic Disease↗

[Indications, technics and results of middle meatotomy. Apropos of 94 cases].

Middle meatotomies were essentially performed during the second period of our study from 1985 to 1987. The typical indication was for closed sinusitis, in order to allow aeration and satisfactory drainage. This was performed with an optical system at 30 degrees. The technique used was an anterior approach via total unciformectomy or a posterior approach using an Ostrum forceps. Good results, i.e. meatotomies which remained patent, were obtained in 80% of cases. The mean period of follow up was 3 years (6 months to 4 years). There were few complications overall for this form of endonasal surgery, though the possibility of damage to the lacrymal duct does exist. Synechiae were the most important functional complication and need to be prevented by meticulous post-operative care.

Drainage↗

[Diffusion of 5-fluorocytosine in bronchial secretions in patients with respiratory insufficiency].

The 5-Fluorocytosine bronchial secretion levels of 14 patients with a chronic respiratory disease were determined using a microbiological method. The mean maximal concentrations (7.76 +/- 7 micrograms/ml) were obtained at the end of a single 25 mg/kg i v perfusion over 30 minutes. The level increased when five i v perfusions were performed every 6 hours and bronchial diffusion was higher and faster by concomitant administration of (bromhexin hydrochloride). Therefore, 5-Fluorocytosine was not found in bronchial secretions of four patients in spite of a normal serum levels (21.5 +/- 5 micrograms/ml).

Bronchi↗