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Biomedical subjects

J Denis

Publications and source records attributed to J Denis.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Hydatid cyst of the interventricular septum. Apropos of a case].

A cardiac tumour of the interventricular septum was detected in a young woman presenting with an ejectional systolic murmur. Surgical ablation was carried out before a precise diagnosis was made. Histopathological analysis of the surgical specimen confirmed a hydatid cyst. The main complication was complete atrioventricular block. This case underlines the difficulty of making the diagnosis of intracardiac hydatid disease in a non-specific context, because of the long period of clinical latency, despite the considerable aid of echocardiography and other medical imaging techniques (CT scan and magnetic resonance imaging.

Adult↗
PubMed1994

[Rheological parameters in hemorrhoid pathology].

The authors studied erythrocyte aggregation in 62 patients suffering from hemorrhoidal disease, distributed on the basis of proctoscopy findings between three groups (recent uncomplicated congestive attack, recent thrombosed hemorrhoid, stage IIb or III chronic prolapse). This hemorheological parameter is a sensitive marker of circulatory stasis. Values measured were compared with those obtained in 21 healthy subjects. Erythrocyte aggregation index was significantly higher in patients than in controls (31.6 +/- 6.8 versus 27.7 +/- 4.4) (p < 0.05). This difference was due essentially to increased values in patients with acute hemorrhoid problems. A parallel increase in blood fibrinogen was found in these same patients. Hemorheological changes could predispose to worsening of venous stasis in the hemorrhoidal circulation and participate in the onset or spread of thrombotic processes.

Acute Disease↗
PubMed1993

Cross-resistances to antiviral drugs of IUdR-resistant HSV1 in rabbit keratitis and in vitro.

The emergence of cross-resistance to various antiviral drugs was investigated both in vivo and in vitro for herpes simplex virus type 1 (HSV1) resistant to idoxuridine (IUdR 0.24%) obtained by seven successive passages (from P0 to P7) in rabbit keratitis treated by IUdR. The viral population obtained at the seventh IUdR passage (P7) showed an activity of the thymidine kinase (TK) reduced to 5.6% of the parental strain (PO); moreover, most of the clones of P7 showed an altered TK phenotype determined by the [125I]iododeoxycytidine (IDC) procedure. In rabbit keratitis, IUdR-resistant viral population P7 showed cross-resistance to bromovinyl desoxyuridine (BVDU) (0.5%) and to acyclovir (ACV) (3%). Under trifluorothymidine (1%) treatment, P7 showed an intermediate sensitivity. HSV1 at P7 remained sensitive to adenine arabinoside (Ara A) (3%) and to dihydroxy-propoxymethylguanine used at high concentration (3%). The in vitro sensitivity determination to various antiviral drugs was investigated by dye-uptake assay for the initial viral population PO and for HSV1 collected under IUdR treatment at the third (P3) and the seventh (P7) passages. Cross-resistance to TK-dependent drugs, such as IDC, BVDU, and ACV were found at P7. P7 remained sensitive to Ara A and to phosphonoformic acids antiviral drugs known not to be dependent on viral TK.

Animals↗
PubMed1992

Anorectal lesions in human immunodeficiency virus-infected patients.

In a prospective study, we analysed the anorectal lesions observed in 148 human immunodeficiency virus-infected patients and compared the data with those reported in the literature. The majority of the patients (97.3%) were homosexual or bisexual men. The mean age of the population was 34.2 years. A history of previous sexually transmitted diseases was found in 79.7% of the male patients. The stage of HIV-related disease, according to the Centers for Disease Control classification, could be determined in 141 patients: 54.6% were stage II, 3.5% stage III and 41.8% stage IV. Anal condylomata were the most frequent manifestation, affecting 29.7% of the patients, 7.1% of whom showed moderate to severe dysplasia. The types were mainly 6, 11, 16 and 18, but types 31, 35 and 39 were also observed. Ulcerations were the most frequent non-condylomatous lesions, occurring in 41 patients; most (60%) were due to herpes viruses, and a large minority (21%) to cytomegalovirus. The etiology could not be determined in five cases. Anal sepsis was present in 11.4%, haemorrhoidal disease in 16.8% and fissures in 6%. Six patients developed Kaposi's sarcoma and seven, non-Hodgkin's lymphoma. No anal cancers were observed. Finally, wound healing was slowed in the patients operated on for haemorrhoids, fissures and suppuration. No statistical analysis could be performed because of the small number of patients.

Adult↗
PubMed1992

Oral acyclovir for herpes zoster ophthalmicus.

BACKGROUND: Reports on the natural history of herpes zoster ophthalmicus stress its high morbidity related to vicious scars on eyelids, ocular complications, and post-herpetic neuralgia. Early treatment with oral acyclovir is effective, but the optimal duration of treatment has not been defined. METHODS: The authors performed a bicentric, prospective, randomized, double-masked study of 86 patients with acute herpes zoster ophthalmicus, within 72 hours of skin eruption, who received oral acyclovir (800 mg 5 times daily), either for 7 days (plus 7 days oral placebo) or for 14 days. All patients concomitantly received ophthalmic 3% acyclovir ointment; follow-up was at least 6 months. RESULTS: Statistical analyses of subjective symptoms, skin lesions, and ocular complications showed no significant differences between the groups, suggesting that a 7-day course of treatment was sufficient. Drug tolerance was good. Pooled data from both groups corroborated earlier reports that prompt treatment with oral acyclovir reduces the severity of the skin eruption, the incidence and severity of late ocular manifestations, and the intensity of postherpetic neuralgia. At 6 months, late ocular inflammatory complications were seen in 29.1% of our 86 patients, versus 50% to 71% of untreated patients described by others. Only 13% of our patients experienced post-herpetic neuralgia, which in no case required the use of analgesics. CONCLUSION: The authors believe it is not useful to prolong treatment with 800 mg of oral acyclovir 5 times daily for more than 7 days in herpes zoster ophthalmicus. This study confirms the efficacy of oral acyclovir not only against skin lesions and ocular complications, but also against postherpetic neuralgia in herpes zoster ophthalmicus.

Acyclovir↗
PubMed1991

[Osteocalcin in chronic alcoholism].

In order to investigate the mechanism by which the inorganic content of the bone is reduced in chronic alcoholism, the authors assayed osteocalcin in 60 chronic alcoholics. The level was significantly lower than in control subjects. There was no significant difference between levels in cirrhotics and in non-cirrhotic alcoholics. There was a negative correlation between osteocalcin and gamma GT levels. There was no correlation between osteocalcin and blood calcium, blood phosphorus, ALAT, ASAT, alkaline phosphatase, 5'-nucleotidase, albumin or bilirubin levels, or with the prothrombin time. These results suggest a direct impact of alcohol on the osteoblast.

Adult↗
PubMed1991

Kaposi's sarcoma of the colon in a young HIV-negative woman with Crohn's disease.

We report a case of isolated colonic Kaposi's sarcoma in a 36-year-old HIV-negative woman with refractory Crohn's disease of the colon and perineum following 11 months' treatment with azathioprine. The clinical features of this case are quite different from those classically described in Kaposi's sarcoma. Among the known risk factors, iatrogenic immunosuppression would appear to be the most probable.

Adult↗
PubMed1991

Formal strategy in public hospitals.

This paper suggests that the difficulties associated with the application of formal strategic planning in public professional service organizations may have been underestimated in much of the literature. A survey of written strategic plans produced by Canadian hospitals showed that these plans were often heavily oriented towards expansion, ambiguous and rather loosely integrated, leading to questions concerning their realism and utility as a basis for strategic decisions. This phenomenon seems symptomatic of the complex (and often highly political) decision making environment faced by hospital administrators (and by managers of other professional service organizations such as universities and social service agencies). It is concluded that the benefits of formal planning may be different and less tangible for these organizations than for private business.

Canada↗
PubMed1991

Emergence of cross-resistant herpes simplex virus following topical drug therapy in rabbit keratitis.

The acquisition of drug resistance in vivo was investigated by 7 serial passages (from P0 to P7) of herpes simplex virus (HSV-1) in rabbit cornea treated with either IUdR (idoxuridine), IDC (idoxycytidine), ACV (acyclovir), TFT (trifluridine), or Ara A (adenine arabinoside). Therapeutic failure was acquired gradually: at P3 for IUdR, at P4 for ACV and at P5 for TFT. At P7, viral thymidine kinase (TK) activity was reduced to 5.6% of the parental strain for IUdR, to 7.5% for ACV and to 4.6% for TFT treatment. No signs of clinical unresponsiveness occurred with IDC or Ara A. The in vitro determination of antiviral drug sensitivity performed by the dye-uptake assay on HSV isolates at each passage showed a correlation between the increase in the 50% effective dose (ED50) and the increase of ulcer area grade at each passage under antiviral drug (p less than 0.1). Both IUdR- and TFT-resistant HSV1 developed cross-resistances to TK dependent drugs. However ACV-resistant HSV1 did not show cross-resistance to other antiviral TK dependent drugs. The acquisition of the cross-resistances is discussed, and the practical implications in case of therapeutic failures are suggested.

Animals↗
PubMed1991

[Trachoma in Ouarzazate: clinical and biological study].

A conjunctival sample for the research of chlamydiae was made on 87 persons (44 patients and 43 control persons). Clinical examination shows that 27 patients (61.4%) were suffering from a Trachoma. Direct examination with IF was positive for 9 patients (20.4%) and negative for all control people (P 0.001). A link between the positivity of the direct examination and the serology was found for 9 patients. The antibody anti-chlamydiae rate was higher or equal to 1/256 for 12 patients (44.4%).

Adolescent↗
PubMed1990

Rectal stenosis due to Veganine suppositories.

A new case of rectal stenosis due to the chronic use of suppositories of associated analgesic drugs is reported. Surgical treatment was conservative. This observation outlines the dramatic consequences of chronic self-treatment and the difficulties of ensuring long-term withdrawal.

Acetaminophen↗
PubMed1990

Anal ulcerations due to cytomegalovirus in patients with AIDS. Report of six cases.

Lesions due to cytomegalovirus (CMV) are frequent in the immunocompromised patient. This is particularly the case in patients with AIDS, where the colon and rectum are the regions most often involved. The authors report six cases of anal ulcerations due to CMV in patients with AIDS. These lesions, confirmed histologically, were either isolated or associated with other localizations. Treatment is based on specific antiviral agents but resistance and recurrence can occur. The current report underlines the importance of histologic examination of anal lesions in HIV-infected subjects.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Treatment of superficial herpes simplex keratitis with vidarabine (Vira A): multicenter study of 100 cases].

The efficacy of 3% Ara-A ophthalmic ointment (Vira A) has been evaluated on 100 epithelial herpetic keratitis; the poor intra-ocular penetration of Ara-A explains the exclusion of stromal keratitis and kerato-unveitis. Patients were treated 5 times a day until complete epithelial healing of ulcers, then twice a day during 7 days. Healing was obtained within 10.6 days for 87% of the patients, who have been treated by Ara-A at first (n = 77) or after failure of IDU or of IDC (n = 23). The healing rate was higher for the 52 first ocular episodes (92%) than for the 48 recurrences (81%); it decreases to 77% for recurrences after failure of IDU or IDC. Geographic ulcers heal in 76% of cases only. Their length has no influence on their healing. The longest healing time, 10.6 days, can be explained by the long period of time before beginning to apply Ara-A, 12.8 days: significative correlation between both periods of time is highlighted and shows the advantage of an early treatment. The need for a local corticotherapy (n = 8) does not hinder healing in 15.5 days. Two weeks after discontinuation of the treatment, 3 patients presented a relapse, sensitive to a 2nd Ara-A course; a maintenance treatment, superior to 7 days, is necessary. Tolerance to Vira A ointment is good. Indications of Ara-A during ocular herpes are superficial keratitis, especially those resistant to IDU or, from experimental data, to ACV, and their prevention by a possible long term treatment.

Adult↗
PubMed1989

[Idiopathic portal hypertension associated with connective tissue disease similar to systemic lupus erythematosus].

A case of idiopathic portal hypertension associated with connective disease resembling systemic lupus erythematosus is described. The patient was a 50-year-old woman with splenomegaly, ascites, esophageal varices, and pancytopenia, but without extrahepatic portal obstruction or cirrhosis of the liver. Electron microscopy of the liver showed perisinusoidal fibrosis. High titers of autoantibodies against proliferating cell nuclear antigen (PCNA) were found in the sera as well as in ascites; anti-DNA antibodies appeared after anti-PCNA antibodies and remained thereafter at a moderate titer. The possibility of an immunological process in the pathogenesis of idiopathic portal hypertension is discussed.

Antibodies, Antinuclear↗
PubMed1988

[Pharmacokinetics of netilmicin in cirrhotic patients with or without ascites].

The pharmacokinetics of netilmicin after intramuscular injection (2 mg/kg) was investigated comparatively in cirrhotic patients with or without ascites, and in healthy subjects. In patients with ascites, the same pharmacokinetic parameters were measured after the ascites had been cured. Twenty-four hours after intramuscular injection, the residual levels in cirrhotic patients were moderately higher than in controls, showing that liver failure or ascites did not significantly modify the pharmacokinetics of netilmicin. Serum concentrations were bactericidal. The ascitic fluid level was lower than the therapeutic range, but it was sustained for nearly 24 hours after intraperitoneal injection (2 mg/kg). These results indicate that netilmicin may be administered to cirrhotic patients without peritoneal infection using the same regimen as in healthy subjects. The peritoneal route may be preferable in case of peritoneal infection.

Adult↗