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Biomedical subjects

J C Bertrand

Publications and source records attributed to J C Bertrand.

At least 19 recordsLinked to original sources
PubMed1995

[Justification of routine puncture of ascites in cirrhotic patients admitted to emergency hospital units].

OBJECTIVES: Spontaneous bacterial peritonitis (SBP) is a frequent, serious, recurrent complication, occurring in 10 to 30% of cirrhotic patients hospitalized with ascites. The key to diagnosis of SBP is ascites paracentesis and polymorphonuclear count in ascitic fluid. The purpose of our study was to evaluate sensitivity and specificity of clinical and biological criteria in diagnosis of 5 BP. METHODS: We prospectively reviewed 30 adult cirrhotic patients admitted in our emergency department with ascites. Ascites paracentesis was performed in each patient, and SBP diagnosis was based on either positive bacteriological culture or polymorphonuclear count above 250/mm3 in ascitic fluid. Classical criteria for SBP were recorded: blood pressure under 90 mm of Hg, abdominal pain, temperature above 38.5 or under 36.5, jaundice, encephalopathy, increased serum bilirubin or creatinine, leukocyte blood count about 12 G/l. We evaluated sensitivity and specificity of those criteria in SBP, and compared their frequency in patients with SBP or sterile ascitic fluid. RESULTS: Thirty patients were included in our series, and in 14 of them a SBP was diagnosed. A significant difference was observed between spontaneous bacterial peritonitis and sterile ascitic fluid for abdominal pain and temperature abnormalities, but specificity and sensitivity of these criteria were very low. Moreover, SBP was asymptomatic in 7%. CONCLUSION: Due to the high rate of mortality in patients with SBP we recommend diagnostic procedures for this frequent complication as soon as patient is admitted in emergency department. This diagnosis must be based on ascitic fluid paracentesis, which has to be performed, in the emergency department, in every cirrhotic patient admitted with ascites. Indeed, SBP is often asymptomatic, and no clinical or bacteriological criteria can be considered as completely reliable for the diagnosis of spontaneous bacterial peritonitis.

Ascites↗
PubMed1995

[Fracture of the medial wall of the orbit. Apropos of 4 cases].

Fractures or the medial wall of the orbit are uncommon and clinical signs are often discreet. This report was focused on isolated fractures of the medial wall of the orbit. Blow-out trauma is usually the cause. In these cases the clinical signs ranged from simple ecchymosis to blindness by haematoma of the orbital cone. Computed tomography is a major tool for diagnosis and making therapeutic indications for these fractures. Treatment depends on the oculomotor involvements as measured by forced duction tests.

Blindness↗
PubMed1995

[Orbital paraganglioma. Apropos of a case and review of the literature].

Paragangliomas are exceptional in the orbit. Among the 47 cases reported in the world literature more than 1/3 has been classified as alveolar soft part sarcoma. Diagnosis of paraganglioma was confirmed on the basis of pathology reports in only 10. We observed a case in a 46-year-old woman who presented with a tumour of the orbit. The histology examination and the ultrastructure determined by electron microscopy confirmed the diagnosis of paraganglioma. Characteristic histologic features are discussed together with a review of the literature.

Chromogranins↗
PubMed1995

[Uncommon fungal maxillary sinusitis of dental origin due to Scedosporium prolificans].

This is the first case report of an exceptional maxillary infection due to Scedosporium prolificans. This recently discovered fungus was identified in the sinus. In the literature, it has been observed at different locations. Identification requires careful sample taking for mycology and pathology studies emphasizing the importance in maxillary surgery. This pathogenic fungus is very invasive, particularly in immunodepressed or immunocompromised patients. Therapeutic modalities vary with the patient's immune status.

Adult↗
PubMed1995

[Malignant xanthogranuloma of the mandible. Presentation of a case and review of the literature].

A malignant xanthogranuloma located in the mandible presented as a tumefaction of the alveolar crest with labiomental hypoaesthesia in a 52-years-old woman. The patient was treated with combined chemoradiotherapy and remained in complete remission for 14 years. Epidemiologic features (age, sex, race) of this tumour are discussed in light of the 24 cases reported in the literature. Histology features and possible treatment protocols as well as observed results are discussed. Five-year survival rate in malignant cervicofacial xanthogranulomas is estimated at 48%.

Combined Modality Therapy↗
PubMed1994

Pentosan polysulfate-induced thrombocytopenia and thrombosis.

Pentosan polysulfate is a low-molecular-weight sulfated polysaccharide used as an antithrombotic drug. We present two patients who developed thrombocytopenia and venous thrombosis during treatment with pentosan polysulfate. The relationship between pentosan polysulfate and thrombocytopenia is supported by platelet aggregation and serotonin release tests. In the light of the literature and our two cases, it appears that pentosan polysulfate alone as standard heparin and low-molecular-weight heparin can induce thrombocytopenia and thrombosis. Platelet counts should therefore be periodically monitored during pentosan polysulfate treatment. In the case of pentosan polysulfate-induced thrombocytopenia, it seems that heparin or low-molecular-weight heparin should not be instituted during the acute phase even if platelet aggregation studies are negative, because of their low sensitivity. After remission of thrombocytopenia, whether or not glycosaminoglycans can be reinstituted, at least temporarily, after antibody had disappeared is still an open question.

Aged↗
PubMed1992

Hydrocarbons and fatty acids in surficial sediments (French Mediterranean coastal zones).

A detailed study has been made of hydrocarbons and fatty acids in nine surficial Mediterranean sediments. The hydrocarbon concentrations are generally low. The nature and the distribution of the hydrocarbons found in these sediments indicate that they originate from several different sources (terrestrial, biogenic, pyrolytic) and petroleum inputs are usually not the main source of hydrocarbons. Fatty acid concentrations vary in the range 2-52 mg.kg-1 dry sediment. Fatty acid distributions, between C14 and C20 show the biogenic autochthonous inputs. Branched and cyclopropanic fatty acids reflect a bacterial origin. These distributions are markedly different in oxic and anoxic sediments.

Chromatography, Gas↗
PubMed1992

Marinobacter hydrocarbonoclasticus gen. nov., sp. nov., a new, extremely halotolerant, hydrocarbon-degrading marine bacterium.

On the basis of phenotypical characteristics and analysis of 16S rRNA sequence, a new species belonging to a new genus is described, and the name Marinobacter hydrocarbonoclasticus is proposed. This organism, isolated from Mediterranean seawater near a petroleum refinery, is a gram-negative, aerobic, rod-shaped bacterium. It grows at NaCl concentrations of 0.08 to 3.5 M and uses various hydrocarbons as the sole source of carbon and energy. Its DNA has a guanine-plus-cytosine content of 52.7 mol%. The 16S rRNA analysis shows a clear affiliation between M. hydrocarbonoclasticus and the gamma group of the phylum Proteobacteria. A close phylogenetic relationship appears among the species Marinomonas vaga, Oceanospirillum linum, Halomonas elongata, and Pseudomonas aeruginosa. Because of the impossibility of finding a single most closely related species, we suggest that this bacterium be assigned to a new genus, at least temporarily. The possibility of a revision of this status when new data appear is, however, not excluded. The type strain is M. hydrocarbonoclasticus SP.17 (= ATCC 49840).

Bacteriolysis↗
PubMed1992

[Mandibular fractures. Our patient enrollment during the past 2 years].

The method of patient referral; the patient's physical predisposition, the localization and the treatment undertaken for the different mandibular fractures seen by SOS Face over the past two years were analyzed. The 312 mandibular fractures were used to reevaluate the commonly accepted statistics concerning these parameters.

Adolescent↗
PubMed1992

[Cervical Castleman's disease in a 12 year-old child].

A case of unifocal cervical Castleman's disease without systemic manifestations occurring in a 12 year-old child is reported. Histological examination showed the characteristic features of angiofollicular lymph node hyperplasia. The results of immunological and in situ hybridization studies are also reported. A local IL6 secretion in the interfollicular areas was demonstrated.

Castleman Disease↗
PubMed1992

[Mandibular reconstruction by a free peroneal transfer].

After an anatomical study of the osteo-septo-cutaneous fibular flap, we reported 4 reconstructions of segmental mandible defects by this procedure, published in 1989 by D. Hidalgo. 2 patients presented mandibular defects associated with intraoral soft- tissue loss, following resection for epidermoid carcinoma with pre or post-operative radiation. The third patient had a multirecurrent ameloblastoma associated with extraoral soft-tissue extension. The fourth patient presented a complex loss of soft tissue and mandible following a war injury. The flaps survived in all patients. The osteo-septo-cutaneous fibular flap for mandible reconstruction has presented several advantages. The flap has been elevated under a tourniquet, the distant donor site has allowed a two-team approach. The osteo-septo-cutaneous blood supply has been adequate to support a skin island for intra or extraoral soft-tissue replacement. Biomechanical properties of the fibula have allowed fixation with miniplates and no postoperative intermaxillary fixation. Osteointegrated implants (Branemark) for dental rehabilitation were done for one patient. There was no long-term donor-site morbidity.

Adult↗
PubMed1991

Thrombotic thrombocytopenic purpura related to ticlopidine.

4 patients had typical features of thrombotic thrombocytopenic purpura (TTP) after 3 to 8 weeks of ticlopidine therapy. In 2 ticlopidine was the only medication taken before TTP; in another, rechallenge with drugs other than ticlopidine that the patient had been taking did not produce relapse. In all patients the delay between start of ticlopidine and TTP was in the same range as the latent period before ticlopidine-induced neutropenia. No relapse occurred in the 4 to 43 months of follow-up in the 3 surviving patients.

Aged↗