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Biomedical subjects

J Guillemette

Publications and source records attributed to J Guillemette.

At least 19 recordsLinked to original sources
PubMed2000

Telangiectasia macularis eruptiva perstans and multiple myeloma.

The association of mast cell diseases and some hematologic malignancies, usually myeloproliferative disorders, myelodysplastic syndromes, and acute leukemia is well recognized. We report the case of a patient with telangiectasia macularis eruptiva perstans, a rare form of cutaneous mastocytosis, and multiple myeloma, an association that has been described only twice in the literature. Parallel improvement of both conditions was observed under chemotherapy regimens for multiple myeloma. Pathogenesis remains unclear, although the abnormalities in the c-kit pathway may play a role in the proliferation of cells from both lineages.

Aged↗
PubMed1998

Natural bright light exposure in the summer and winter in subjects with and without complaints of seasonal mood variations.

BACKGROUND: Considering the success of bright light therapy in seasonal affective disorders, it was suggested that seasonal mood disorders are triggered by decreased exposure to bright light in the winter; however, no previous studies have used objective measures to assess seasonal patterns of bright light illumination in subjects with seasonal mood variations. METHODS: Eleven subjects reporting seasonal mood variations and 8 control subjects had their levels of natural bright light (BL) exposure measured for 5-6 days with an ambulatory monitor during both the summer and winter, at a latitude of 45 degrees 31'N. RESULTS: Both groups received significantly more BL in the summer than in the winter, but there was no difference between the two groups for the pattern of BL exposure, including total duration, daily distribution, and amplitude of seasonal variation. CONCLUSIONS: These results suggest that complaints of seasonal mood variations are not caused by a differential pattern in bright light exposure compared to normals. It is possible, however, that some individuals are more sensitive than others to variations in natural bright light. Whether an increased vulnerability is due to a more fragile affective state or to a lower sensitivity to light remains to be determined.

Adult↗
PubMed1998

[Cutaneous malacoplakia: a pediatric case].

INTRODUCTION: Cutaneous malakoplakia is an inflammatory disease characterized by granulomatous accumulation of distinctive phagocytic macrophages. It occurs mainly in visceral or orificial areas; the condition is rarely purely cutaneous, and appears to be extremely rare in childhood. CASE REPORT: A facial cutaneous crusted lesion was diagnosed as cutaneous malakoplakia in an immunocompetent child. The lesion had been excised twice and it had recurred, and the diagnosis was made possible only with a third biopsy, after a 2-year chronic expansion. This third biopsy revealed a dense granulomatous inflammation with numerous phagocytic histiocytes containing abundant fine granules and round Michaelis-Gutmann bodies, both staining with PAS, Perls and von Kossa. Biopsy cultures revealed only growth of two different streptococcus (group B) strains. The lesion resolved after a 4-month period of antibiotic therapy, including roxithromycin, ampicillin and trimethoprim-sulfamethoxasole. DISCUSSION: Diagnosis of malakoplakia is mainly made by histopathologic examination of tissue excision or biopsies. There are no specific clinical features. Most reported cases of this uncommon phagocytic reaction to common bacteria have developed in the genitourinary areas (71 p. 100); purely cutaneous localisation, as in our patient, are rare (4 p. 100). Intracytoplasmic granules may result from phagolysosomes and incomplete bacterial killing, with subsequent deposit of iron and calcium in the phagocytic macrophages. A number of reported cases have affected immunocompromised patients with either congenital immunodeficiency or secondary immunodeficiency. The most effective treatment option is based on a protracted antibiotherapy, using drugs that easily permeate the macrophages, e.g. quinolones and trimethoprim-sulfamethoxasole. Lesion may recur after surgical excision.

Biopsy↗
PubMed1996

[Dietary treatment of mild to moderate hypercholesterolemia. Effectiveness of different interventions].

OBJECTIVE: To compare the efficacy of brief dietary intervention by family physicians in their daily practice and in group sessions to standard dietetic treatment in mild to moderate hypercholesterolemia. DESIGN: Randomised clinical trial. SETTING: Family practice clinic in a remote community. PARTICIPANTS: Between September 1, 1991 and September 30, 1992, 135 men and women between 20 and 60 years old with mild to moderate hypercholesterolemia were recruited and randomly assigned to three treatment groups to be taught the American Heart Association low fat diet. Each participant had an LDL-C reading higher than the desirable level set by the Canadian Consensus Conference on Cholesterol. INTERVENTIONS: The three treatment groups received different interventions: individual consultations with a family physician in his office (phase I); group sessions with a physician and a dietician (phase II); and individual consultations with a dietician (phase II). Participants were followed for 6 months with visits and blood tests every 2 months. MAIN OUTCOME MEASURES: Reduction in serum levels of total cholesterol, LDL-C, HDL-C, and triglycerides was measured after 2, 4, and 6 months of dietary treatment. Changes in risk factors (smoking, weight, level of physical activity) and patients' cholesterol/saturated fat index were also measured. RESULTS: Ninety-nine subjects completed the 6-month regimen. The mean reduction in serum LDL-C was 0.08 mmol/L (1.8%) in Group I, 0.07 mmol/L (1.6%) in Group II, and 0.28 mmol/L (6.3%) in Group III (P = 0.94). An LDL-C reduction of 10% or more relative to initial level was observed in 27% of participants in Group I and approximately 40% of subjects in the other two groups (P = 0.41). Counseling resulted in a decrease in body weight, smoking, and dietary fat consumption and an increase in physical activity. CONCLUSIONS: Treatment by a dietician achieved better results and should remain the standard. Physicians should focus on the detection and control of other heart disease risk factors.

Adult↗
PubMed1994

[Multifocal epithelioid hemangioendothelioma with partial remission after interferon alfa-2a treatment].

INTRODUCTION: Epithelioid hemangioendothelioma (EHE) is a rare vascular tumour of the soft tissue having an intermediate malignancy. Cutaneous presentations have exceptionally been reported. OBSERVATION: A young woman, initially affected by an EHE with cutaneous and bone involvement, then with pulmonary and hepatic localizations, was in partial remission after one year of treatment with alpha 2a interferon. DISCUSSION: In a critical review of the literature, we describe the main features of this tumour and the difficulties to classify this entity in the vascular tumors' spectrum. Histologically, epithelioid hemangioendothelioma has a very characteristic appearance and is clearly different from other vascular tumors as angiolymphoid hyperplasia with eosinophilia and Kimura's disease. The assumption of a multicentric or a metastatic origin when multiple tumor deposits are found, is still not elucidated. Different therapeutic approaches are proposed: surgery, interferon, interleukin-2, retinoids. Randomized studies would be necessary to confirm our results with alpha 2a interferon but are probably difficult to realize because of the lack of cases.

Adult↗
PubMed1992

Differences between obstetricians in caesarean section rates and the management of labour.

OBJECTIVE: To determine if interobstetrician variation in caesarean section rates was associated with different approaches to the management of labour. DESIGN: A retrospective cohort study. SETTING: A tertiary care teaching hospital in Quebec, Canada. SUBJECTS: 546 nulliparae in spontaneous labour at term were grouped according to the rate of caesarean sections for dystocia of their obstetrician (high: women of two obstetricians with rates of 13.2% and 15.0%; and low: women of three obstetricians with rates of 6.0%, 6.2% and 6.5%). MAIN OUTCOME MEASURES: Frequency and timing of oxytocin, epidural, amniotomy, forceps. SECONDARY OUTCOME MEASURES: Indicators of neonatal asphyxia and trauma. RESULTS: No difference between groups was observed in the frequency or timing of use of oxytocin or epidural analgesia. Amniotomy was practised earlier by the obstetricians in the high group. Differences in section rates for dystocia were greatest in the second stage (low-2.4%, high-7.9%). Obstetricians in the low group intervened earlier with forceps or vacuum extractor. Nine babies (all in the low group), 8 of whom had had an instrumental vaginal delivery, suffered trauma (5 clavicular fractures, 4 facial palsies) (Fisher's exact test, P = 0.0139). CONCLUSION: The practice patterns of the two groups are distinguished by differences in management of the second stage. Although lower section rates were associated with an increase in mild neonatal trauma, this appears to have been mediated by the earlier use of forceps in this group.

Adult↗
PubMed1991

[Neonatal lupus].

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Age Factors↗
PubMed1982

[Hyperkeratosis of the keratotic plug type in patients with chronic renal failure and metabolic diseases].

We have noticed in eight male patients transepithelial keratotic plugs which appeared preferentially on zones of supporting points. These plugs evoked in a more or less accurate way, Kyrle's disease or other related syndromes, particularly reactive perforating collagenosis and perforating folliculitis. Seven cases were associated with chronic and severe renal failure complicating a serious diabetes in four cases, one of them with a viral hepatitis. One case has been observed during an important denutrition with digestive disorders.

Adult↗
PubMed1980

[Urticaria-oike follicular mucinosis (author's transl)].

Attention is drawn to a new clinical and pathological syndrome, part of the follicular mucinosis group, which is a cyclic, urticarial rash, of the head and neck, occurring in man, without follicular plugging and alopecia, and of benign course. 10 cases are presented here. All patients are middle aged men. Rash is pruritic and recurrent. Clinical aspects and histological findings are described.

Adult↗