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Biomedical subjects

F Piette

Publications and source records attributed to F Piette.

At least 127 records · Page 7Linked to original sources

[Duxil and cognitive deficiency in the elderly. Results of a 6-month controlled multicenter study].

Two hundred and four patients, 70-85 years old, were included in a double-blind (Duxil/placebo), controlled, multicentric study. The inclusion criteria were a subjective complaint of a cognitive deficiency and a cognitive deficit objectively determined using the Folstein mini-mental state test and the Sandoz geriatric clinical evaluation score. The patients, treated for 6 months, were examined at the onset of the study (T0), then 3 (T3) and 6 months (T6) later. The assessment criteria included: a visual self-evaluation test measuring cognitive function and the following psychometric tests: trail making A (TMA), memorization of a shopping list, verbal fluidity, letter identification, repetition of a story, immediate recall of numbers and immediate visual memory. Anxiety and depression evaluations were also used to assess the effects of Duxil on the affective state. Statistical analysis of the observations made on the entire population did not reveal a significant difference between the treated group and the control placebo group, in terms of assessment criteria, between T0 and T6. However, this lack of a difference could be explained, in part, by the very wide variation in the initial psychometric performance scores of the subjects. In an attempt to control this possible bias, another statistical analysis was made for each psychometric test, after the patients had been divided into 3 classes based on their initial performance scores. The results of this second analysis showed that Duxil was able to improve memory performances in TMA and number retention better than the placebo. However, this effect was limited to the group of patients whose initial scores were in the intermediate class for TMA. These findings suggest that Duxil improves the concentrating ability of patients with light to moderate deficits in this function.

Aged↗

[Solid facial edema associated with acne. Therapeutic efficacy of isotretinoin].

Persistent solid facial edema is considered a complication of acne vulgaris and has never been reported in the French literature. The authors report the cases of 2 patients, a 15-year old girl and a 20-year old man, who suffered from the condition for 1 and 2 years respectively. Clinical features and course are described. Treatment with isotretinoin in doses of 1 mg/kg/day administered during 6 and 8 months resulted in an 80 p. 100 and 50 p. 100 reduction of the edema respectively.

Acne Vulgaris↗

Sweet's syndrome associated with Crohn's disease.

The first known case involving an association of Sweet's syndrome with Crohn's disease is described. A 36-year-old woman developed a diarrhea, fever, and infiltrated erythematous cutaneous plaques on neck and limbs, consistent with a presumptive diagnosis of Sweet's syndrome. This was confirmed by a skin biopsy showing a dense dermal infiltrate of polymorphonuclear leukocytes. Crohn's disease, extending from the anus to the terminal ileum, was diagnosed as well. Prednisolone treatment resulted in the improvement of both the bowel disease and skin lesions.

Adult↗

[Intravascular malignant lymphoma (malignant angioendotheliomatosis). Apropos of a case with histologic, immunohistochemical and ultrastructural studies].

We report a new case of intravascular malignant lymphoma that arose in an 81-year-old woman. The most prominent symptoms were impressive dermatologic anomalies including painful, diffuse edema over which arborescent telengiectasic lesions could be seen. This clinical picture was associated with the presence, in deep skin biopsy specimens, of mononucleate tumor cells located within the lumen of dermal vessels. Complementary immunohistochemical and ultrastructural studies confirmed that the intravascular tumor growth was lymphomatous in nature. Clinical manifestations of this disease are recalled, and histopathologic features as well as the characteristic location of this malignant lymphoma are analyzed and discussed. Thus, we agree with Félix [3] and Witschi [6] that the cords of cells that will give rise to the follicular cells surrounding the ovocytes originate only from the coelomic epithelium; the primary mesenchyma forms the cortical stroma, and this embryonic type tissue, characterized by enourmous physiologic plasticity, differentiates into endocrine tissue to form the inner theca. the mesonephros plays no part whatsoever in the formation of the ovary.

Aged↗

Psychometric procedures for analysis of memory losses in the elderly.

This study aimed to assess and compare the discriminative validity of two psychometric procedures which have been proposed to investigate memory losses in elderly. The first one relies on the use of the serial position curve paradigm in a test of immediate memory, the second one being a single recognition task. These two procedures were applied to the five following groups of subjects: 95 young-elderly normals, 33 elderly normals, 26 patients with mild senile dementia of the Alzheimer type (SDAT), 17 patients with moderate or moderately severe SDAT and 24 elderly depressed patients. Results from both psychometric procedures confirm the findings of previous studies and support the view that memory impairment associated with SDAT is qualitatively different from that observed in normal aging or in depression. They also suggest that memory loss in elderly depressed patients differs only quantitatively from that of normal controls. However the recognition task seems to have the best validity to qualitatively discriminate the patients with mild dementia from both the normal controls and the elderly depressed patients.

Aged↗

[Cutaneous manifestations of zinc deficiency in ethylic cirrhosis].

Thirty-three patients with alcoholic cirrhosis (AC), selected on widely recognized criteria (16, 57), were investigated prospectively for cutaneous manifestations of zinc deficiency. The patients were divided into 3 groups: group A (n = 12): AC without skin lesions; group B (n = 12): AC with skin lesions responsive to a zinc-free topical treatment or resistant to enteral zinc sulfate intake; group C (n = 9): AC with skin lesions cured by oral zinc replacement therapy alone. The lesions observed in group C were studied microscopically. Data concerning zinc metabolism (Zn concentrations in plasma, red cells, urine and hair; alkaline phosphatase values), biochemical criteria of AC (plasma serum-albumin concentration, IgA/transferrin ratio) and a malabsorption test (xylosemia 120 min after oral absorption of D-xylose 25 g) were compared by the variance analysis method. A control group (D, n = 12) was used as reference. Few cases of cutaneous manifestations of zinc deficiency in AC patients have been published. In more than one half of the 15 or so we found in the literature, an aggravating factor (total parenteral nutrition, digestive tract surgery) had to be taken into account. In this prospective study 9 new cases in which AC was the only cause of zinc deficiency are reported. A clinical picture similar to acrodermatitis enteropathica with peribuccal bullous lesions was observed in only one patient. In all other cases the patients presented with a cracked and reticulated eczema on the extensor aspect of the limbs and (often erosive) in the perianal and genital regions. The eczema was associated with cheilitis, glossitis, stomatitis, alopecia and, seldom, ungual Beau's lines. Disorders of behaviour, diarrhoea and bouts of lever regressing under zinc replacement therapy were frequent. Histology was not very specific, except for the presence of necrotic areas in the stratum germinativum, sometimes associated with small subcorneal pustules containing altered polymorphonuclears. In every case, it was the rapid regression of symptoms under zinc sulfate treatment that confirmed the diagnosis. Plasma zinc concentrations were most significantly decreased in all AC groups as compared to controls (61.2 +/- 19.4 vs 97.8 +/- 10.4 micrograms/100 ml) and also in AC patients with skin manifestations of zinc deficiency as compared to the other AC patients (44.4 +/- 9.2 vs 66.5 +/- 18.8 micrograms/100 ml) table V). Changes in serum-albumin levels and in hepatocellular function were parallel to changes in plasma zinc concentrations.(ABSTRACT TRUNCATED AT 400 WORDS)

Acute Disease↗

Laminar distribution of neocortical senile plaques in senile dementia of the Alzheimer type.

A prospective longitudinal study was undertaken in a geriatric hospital on women over 75 years of age, clinically diagnosed as either intellectually normal or having senile dementia of the Alzheimer type (SDAT) of varying degrees of severity. Mental impairment was assessed prospectively. Fifteen brains from this population were studied to evaluate quantitatively the distribution of senile plaques (SP) in relation to cortical lamination. SP density in four neocortical areas (first temporal gyrus; supramarginal gyrus calcarine area; precentral gyrus) was significantly correlated with the degree of mental impairment. SP distribution in the cortical layers was evaluated by an indirect method and appeared to be fairly constant from one case to another. Significantly higher SP densities were observed in layers II and III of the temporal and occipital samples, while minimal values were noted in layer I. Lower densities of SP were found in layers V and IV of the occipital and temporal lobes. These data suggest a selective vulnerability of some areas of cortical projections in SDAT.

Aged↗

[Neuropathological study of 12 centenarians: the incidence of Alzheimer type senile dementia is not particularly increased in this group of very old patients].

The brains of 12 patients aged more than 100 years were studied neuropathologically. These were all women who had been long-stay patients at the Charles Foix Hospital, Ivry. On the basis of a retrospective examination of the clinical records the patients were classified as demented or non-demented. No attempt was made to evaluate their mental status more precisely because of the prevalence of deafness (in 10) and blindness (in 7) and also because of the difficulty in assessing mild cognitive changes in institutionalized patients. Three patients were considered to have been demented according to the criteria of the DSM3 (1980). In the brain of one demented case the pathology was that of Alzheimer's disease, in one there were multiple infarcts and in the third there were both senile and vascular changes. The findings in this study are in accordance with the reports of others and indicate that the incidence of senile dementia of the Alzheimer type is not increased in people of very advanced age. Neuropathological findings included reduced brain weight; neurofibrillary tangles in hippocampal neurons of every case as well as in neocortical neurons (absent from neurons of the substantia innominata in only 1 case); senile (neuritic) plaques were found commonly in the hippocampus, less so in neocortical areas (senile plaques totally absent in only one case); granulovacuolar degeneration in hippocampal neurons in every case; amyloid angiopathy present in 9 and mineralization of vessels in 10 cases; hyaline change in vessel walls and abundant lipofuscin in neurons and astrocytes were constant findings. No Lewy bodies were seen.

Aged↗

[Lasers in dermatology].

Lasers are mainly used in therapeutics for their thermic effects. In dermatology, the most appropriate is the argon laser and its only uncontroverted indication is part-wine stain. The blue-green radiations of the argon laser are selectively absorbed by the haemoglobin pigment, so that coagulation necrosis is maximum in the dysplastic vessels. Since the non-pigmented surrounding tissues and, more precisely, skin appendages are relatively respected, healing is rapid and of good quality. Following the often protracted treatment, a satisfactory downgrading of colour is obtained, without scar in 60-80% of cases. The best results are observed in dark portwine stains located on the face or trunk in adults. All other indications are open to discussion since the superiority of laser over other treatments remains to be demonstrated or confirmed. Interesting indications are spider angioma and telangiectasis of the face (argon laser), extensive ano-genital verrucosis (CO2 laser or argon laser), mucosal leukoplasia and some cases of Bowen's disease affecting the genitalia.

Argon↗

Cortical atrophy in senile dementia of the Alzheimer type is mainly due to a decrease in cortical length.

A prospective study was undertaken to select mentally normal old subjects and patients with senile dementia of the Alzheimer type (SDAT). The test score of Blessed et al. (1968) (BTS) was used to determine the severity of mental impairment. A pathologic study confirmed the diagnosis of either SDAT or normal brain aging at postmortem examination in 12 cases. The cortical area and the cortical perimeter of the different cerebral lobes were measured on 1-cm-thick coronal sections using a semiautomatic image analyzer. Cortical length and thickness were calculated using perimeter and area values. BTS was significantly correlated with both the area (r = 0.7695, P = 0.003) and the length (r = 0.7421, P = 0.006) of the temporal cortex. There was no significant correlation between BTS and thickness of the temporal cortex (r = 0.559, P = 0.059). These results show that reduction of length is one of the major determinants of cortical atrophy. Although this has to be confirmed by histological study, they favor the hypothesis of a column-selective atrophy in SDAT which should be considered in the interpretation of the microscopic data.

Aged↗

[Mathematical approach to bacterial identification].

The identification of Enterobacteriaceae is examined in the context of the recent field of research assisted by multi-criteria decisions. In particular, the authors discuss the limitations of two approaches of assisted identification based on completely different mathematical concepts: the calculation of the probabilities (used in commercial centres) and the aggregation of pre-orders by a model of assisted decision such as Electra II. In order to reduce the errors of interpretation inherent in the use of any model, the authors propose the use of computer assisted systems of bacterial identification in bacteriology laboratories.

Bacteriological Techniques↗

[Dermatomyositis and colonic cancer. Review of the literature apropos of a case].

The authors report the case of a 56 year-old woman presenting with dermatomyositis revealing a cancer of the colon at the ganglial dissemination stage. Exeresis led to the regression of the dermatomyositis and allowed an attenuation of the steroid therapy. The muscular and cutaneous signs reappeared within six months, evidencing a metastatic hepatic dissemination. Death came within six months of the appearance of the dermatomyositis. The authors review the literature concerning dermatomyositis associated with cancers of the digestive tract in general, and of the colon in particular. This association is found in about 6 to 35% of cases of dermatomyositis, which is the most common paraneoplastic skin associated with cancers of the colon.

Colonic Neoplasms↗