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Biomedical subjects

J L Leroux

Publications and source records attributed to J L Leroux.

At least 19 recordsLinked to original sources
PubMed2006

The role of androgens or growth factors in the bone resorption process in recent spinal cord injured patients: a cross-sectional study.

STUDY DESIGN: This cross-sectional study compared the androgen and growth factor profiles and the bone turnover of patients with spinal cord injury (SCI) versus able-bodied controls (AB). OBJECTIVE: Determine whether androgens, GH, or either IGF-I or IGFBP-3, are implicated in bone turnover alteration in patients with recent SCI. SETTING: Propara Center, Montpellier, France. METHODS: In all, 16 men (31.3 years) with complete SCI, seven paraplegics and nine tetraplegics, who had sustained injury an average of 3 months earlier, and 12 AB who served as controls (27.5 years) participated. Androgens, growth hormone and its mediators were investigated. The bone resorption process was evaluated by urinary and plasma type I collagen C-telopeptide (CTXu, CTXp), while bone formation was evaluated by osteocalcin (OC) and bone alkaline phosphatase. RESULTS: Total testosterone (TT) and the free androgen index (FAI) were significantly lower in the SCI patients, whereas FSH was significantly higher (P<0.05). These hormonal variations were not related to the level of neurological lesion. There was no significant difference in GH, IGF-I, or IGFBP-3 levels. CTXu and CTXp indicated high bone resorption activity in the SCI patients (P<0.05). Regarding bone formation markers, only OC was affected by neurological lesion (P<0.05). Basal hormone levels did not correlate with markers of bone turnover. CONCLUSION: The high bone resorption process observed in SCI patients did not seem directly related to testicular endocrine abnormalities or an altered growth factor profile. Nevertheless, the reduced TT and FAI levels could be aggravating factors in the development of acute bone loss.

Adult↗
PubMed2004

[Resurgence of syphilis: a prospective study at an University Hospital, Nimes].

BACKGROUND: Since 2000, the incidence of syphilis has increased in France. The study objective was to estimate the frequency of syphilis in Languedoc Roussillon region in Southern France. METHOD: The prospective study was conducted between January 1, 2003 and June 30, 2003 in different medical wards in a French University Hospital, Nimes. The diseased patients in this study answered to a questionnaire, providing epidemiological and socio-economic data, symptomatology and treatment-seeking behaviour. Blood specimens were tested for syphilis by the serological methods (TPHA, VDRL, FTA). RESULTS: In 6 months, serologic evidence of syphilis infection was found in 30 patients. Men were more than twice as likely as women to be infected with syphilis. Most men (64.7%) acquired the infection homosexually. Four women acquired infection during pregnancy. The mean age of study population was 46.3 years. 40.7% were married. Out of 27 cases, 70.4% cases had an associated sexually transmitted infection (HIV, hepatitis, herpes, and gonorrhoea). CONCLUSIONS: These data confirm the increase of syphilis in south of France and underline the importance of a permanent monitoring of sexually transmitted infection in target populations to allow a timely diagnosis and an appropriate treatment, and to plan preventive strategies.

Adult↗
PubMed2004

Effects of physical activities that induce moderate external loading on bone metabolism in male athletes.

Sports characterized by little or moderate weight bearing or impact have a low osteogenic effect. However, the action of such sports on bone turnover remains unclear. The objective of this study was to determine the effect on bone remodelling of physical activities that induce moderate external loading on the skeleton. Thirty-eight male athletes aged 18-39 years (cyclists, n = 11; swimmers, n = 13; triathletes, n = 14) and 10 age-matched sedentary controls aged 22-35 years participated in the study. The study combined measurement of bone mineral density by dual-energy X-ray absorptiometry and bone turnover assessment from specific biochemical markers: serum bone-specific alkaline phosphatase, osteocalcin, urinary type I collagen C-telopeptide and calcium. Compared with the controls and swimmers, adjusted bone mineral density was higher (P < 0.05) in triathletes at the total proximal femur and lower limbs. No differences in bone mineral density were found between cyclists, swimmers and controls. Compared with controls, osteocalcin was higher (P < 0.05) in triathletes and swimmers and urinary type I collagen C-telopeptide was higher in swimmers only. Serum bone-specific alkaline phosphatase was lower (P < 0.05) in cyclists than in all other groups. In conclusion, an osteogenic effect was found only in triathletes, mainly at bone sites under high mechanical stress. Bone turnover differed in athletes compared with controls, suggesting that bone turnover may be sport-practice dependent. Despite some encouraging observations, it was not possible to show that changes in the bone remodelling process were sport-discipline dependent.

Absorptiometry, Photon↗
PubMed2003

Testosterone is significantly reduced in endurance athletes without impact on bone mineral density.

AIMS: To compare the basal plasma reproductive hormonal profile in three groups of athletes involved in different training programs, and to define the relationship between androgen level and bone mineral density (BMD) in male athletes. METHODS: Basal serum total testosterone (TT), free androgen index (FAI), sex hormone-binding globulin (SHBG), cortisol, cortisol to TT ratio, luteinizing hormone (LH), estrogen and BMD were evaluated in cyclists (CY; n = 11), triathletes (TR; n = 14) and swimmers (SW; n = 13) and compared with less active controls (n = 10). RESULTS: TT and FAI levels were lower (p < 0.05) in CY and TR, whereas the ratio of cortisol to TT was increased in CY only (p < 0.05). No alteration in serum LH, SHBG, estrogen or cortisol concentration was observed. BMD was higher in the proximal femur in TR (p < 0.05). No BMD or hormonal differences were found in SW. CONCLUSION: Only the endurance training of CY and TR induced androgen deficiency without apparent alteration of BMD.

Adult↗
PubMed1999

[Anatomy, physiology and clinical examination of the shoulder].

Shoulder pain is usually caused by periarthritis. Impingement syndrome and frozen shoulder (adhesive capsulitis) are the more frequently clinical aspect observed. A shoulder standardised clinical examination often give a precise lesional diagnostic. Complementary examinations are useful to distinguish other cause of shoulder pain.

Diagnosis, Differential↗
PubMed1999

Neurological complications in insufficiency fractures of the sacrum. Three case-reports.

Three cases of nerve root compromise in elderly women with insufficiency fractures of the sacrum are reported. Neurological compromise is generally felt to be exceedingly rare in this setting. A review of 493 cases of sacral insufficiency fractures reported in the literature suggested an incidence of about 2%. The true incidence is probably higher since many case-reports provided only scant information on symptoms; furthermore, sphincter dysfunction and lower limb paresthesia were the most common symptoms and can readily be overlooked or misinterpreted in elderly patients with multiple health problems. The neurological manifestations were delayed in some cases. A full recovery was the rule. The characteristics of the sacral fracture were not consistently related with the risk of neurological compromise. In most cases there was no displacement and in many the foramina were not involved. The pathophysiology of the neurological manifestations remains unclear. We suggest that patients with sacral insufficiency fractures should be carefully monitored for neurological manifestations.

Aged↗
PubMed1998

Tophaceous gout of the navicular bone as a cause of medial inflammatory tumor of the foot.

A case of tophaceous gout of the navicular bone in a 24-year-old woman is reported. Emphasis is placed on the conditions that might have been precipitating, i.e., anorexia nervosa and alcoholism, and the mechanisms by which increased uric acid level may be explained. The main radiographic patterns of tophaceous gout of the foot are recalled to avoid unnecessary surgery in future cases.

Adult↗
PubMed1995

Multiple psoas abscesses after posterior spinal fusion.

STUDY DESIGN: A case of multiple psoas abscesses after Dove lumbar spine fixation is reported. OBJECTIVES: To review the diagnosis and treatment of deep infection after internal spinal fixation. METHODS: The possibility of septic complications after spinal surgery that may present with a degenerative pattern is examined. The clinical and computed tomographic findings of a psoas abscess are recalled. RESULTS: Surgical drainage of the purulent collection was performed along with prolonged parenteral antibiotic treatment. CONCLUSION: Infection should be considered as a cause of recurrence of pain after internal fixation of the lumbar spine.

Female↗
PubMed1995

Enhancement of leukotriene A4 biosynthesis in neutrophils from patients with rheumatoid arthritis after a single glucocorticoid dose.

Human blood polymorphonuclear cells (PMN) from seven patients with active rheumatoid arthritis (RA) were compared for their capacities to produce leukotrienes ex vivo before (D0) and 24 hr (D1) after glucocorticoid pulse therapy. The present study shows for the first time that endogenous arachidonic acid metabolism via 5-lipoxygenase pathway is significantly increased after glucocorticoid administration, leading to increased generation of the unstable precursor leukotriene A4 (LTA4) followed by predominant non-enzymatic LTA4 opening and leukotriene B4 (LTB4) omega-hydroxylation pathway. These results are unexpected since usually glucocorticoids are usually thought to decrease inflammatory mediator biosynthesis and, moreover, they work to the detriment of the clinical improvement of the patient. The results are discussed in terms of product inactivation and cellular cooperation with monocytes and endothelial cells.

Arachidonate 5-Lipoxygenase↗
PubMed1995

Conversion of endogenous arachidonic acid to 5,15-diHETE and lipoxins by polymorphonuclear cells from patients with rheumatoid arthritis.

The conversion of endogenous arachidonic acid (AA) by polymorphonuclear cells (PMN) from patients with rheumatoid arthritis (RA) was studied before (D0) and one day (D1) after antiinflammatory drug therapy. The biosynthesis of 5,15-diHETE and lipoxins (LXS), were investigated ex vivo, after PMN stimulation by ionophore A23187 without exogenous addition of 15-HETE. The eicosanoids were resolved by RP-HPLC and simultaneously detected at 246 and 302 nm respectively. Large amounts of 5,15-diHETE (50 to 400 ng/10(7) PMN) and significant levels of LXS (from 2 to 20 ng/10(7) PMN) were produced with individual differences between donors. Metabolite levels varied between patients but this work showed for the first time a linear relationship between the amounts of 5,15-diHETE and LXS. Moreover LXS production after treatment may be related to long-term clinical improvement of patients.

Adult↗
PubMed1995

Diagnostic value of clinical tests for shoulder impingement syndrome.

Results of three clinical tests for detecting shoulder impingement syndrome (Neer's, Hawkins', and Yocum's tests) and four tests for determining the location of the rotator cuff lesion (Jobe's test [supraspinatus], Patte's test [infraspinatus], lift-off test [subscapularis], and palm-up test [long head of the biceps brachii]) were compared to intraoperatively observed anatomic lesions in 55 consecutive patients who had surgery for Neer's syndrome. For Jobe's and Patte's tests, both pain (denoting tendinitis) and functional impairment (denoting tendon rupture) were evaluated. All clinical tests were done by the same examiner and all surgical procedures (acromioplasty with or without rotator cuff repair) by the same surgeon. The location and extent of the lesions (size of the tear in the 34 patients with rotator cuff defects) were determined intraoperatively. The sensitivity, specificity, and positive and negative predictive values of each test were calculated. Sensitivity was satisfactory but specificity was poor, in particular for determining the location and type of rotator cuff lesions. The severity of functional impairment during Jobe's and Patte's maneuvers was not correlated with the size of the tear.

Adult↗
PubMed1995

Postoperative shoulder rotators strength in stages II and III impingement syndrome.

In healthy subjects, the shoulder internal rotator muscle strength overrides the external rotators. This has been confirmed in different isokinetic studies showing the ratio of the relative strengths of the internal to external rotators to range from 1.3 to 1.5 points, depending on the study. The authors previously reported a decrease in the relative strength ratio of the internal to external rotators to close to 1 in patients suffering from Neer's impingement syndrome. The aim of the present study was to assess, long after surgery (mean, 44.5 months), the isokinetic strength performance of shoulder rotator muscles in 72 patients who had had operative treatment for chronic subacromial impingement using anterior acromioplasty, sometimes combined with cuff repair surgery. Tests were conducted with a Biodex Multi-Joint System in the plane of the scapula and in 45 degrees abduction at 60 degrees and 180 degrees per second. Peak torque and average power were calculated. The mean ratios of relative strengths of the internal to external rotators ranged from 1.3 to 1.6 points depending on the parameter studied and the test speed. These results indicate that surgery restores normal muscular balance between shoulder rotator muscles affected by the impingement syndrome.

Acromion↗
PubMed1994

[Inferior glenohumeral subluxation: an indirect sign of sepsis of the shoulder].

Drooping shoulder is a roentgenographic abnormality consisting in a discontinuity in the scapulo-humeral arch due to inferior subdislocation of the humeral head. Drooping shoulder is commonly seen in patients with injuries to the shoulder or neurological loss. Two cases of drooping shoulder due to staphylococcal arthritis (after local corticosteroid injections) are reported herein. The mechanism of the downward humeral displacement in septic arthritis is discussed. The other causes of drooping shoulder are reviewed. Precautions needed to avoid increasing the displacement during rehabilitation therapy are outlined.

Adult↗
PubMed1994

Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome.

The purpose of this study was to determine whether imbalance of the internal and external rotator musculature of the shoulder were etiological factors implicated in impingement syndrome. Shoulder torque measurements were obtained from 15 asymptomatic volunteers and 30 patients with chronic impingement syndrome, 15 of whom were evaluated after arthroscopic anterior acromioplasty. Isokinetic strength was assessed using the Biodex system in a modified position (in the plane of the scapula and in 45 degrees abduction) with test speeds of 60 degrees and 180 degrees per second. Internal and external rotator strength values and ratios were calculated for both peak torque and average power. Shoulder rotational strength values and the internal rotator/external rotator ratio were significantly higher in the dominant and nondominant control group shoulders than in the involved and uninvolved impingement shoulders for operated on and nonoperated on patients. These data demonstrate that primary change in the normal internal rotator/external rotator ratio of the shoulder is an etiological factor implicated in impingement syndrome not modified by anterior acromioplasty.

Acromion↗