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Biomedical subjects

L Belec

Publications and source records attributed to L Belec.

70 records · Page 4Linked to original sources
PubMed1990

Cytomegalovirus encephalopathy in an infant with congenital acquired immuno-deficiency syndrome.

A female infant born pre-term to a HIV seropositive mother presented at birth with seropositivity for HIV and CMV viruria. At five months of age she developed an AIDS-related complex. Six months later she died from rapidly progressive diffuse encephalopathy. Post mortem examination revealed generalized CMV infection. Neuropathological examination showed a nodular encephalitis with occasional cytomegalic cells containing characteristic CMV inclusion bodies. There was no evidence of HIV encephalitis; immunostaining for HIV antigen (gp 41) was negative. Opportunistic infections in infants with congenital AIDS are the exception. To our knowledge, only one case of CMV encephalitis in an infant with congenital AIDS has been reported previously. In that case, as in the present one, a reactivation of a congenital CMV infection is likely.

AIDS-Related Complex↗
PubMed1990

[Cytomegalovirus (CMV) and human immunodeficiency virus (HIV) co-infection, of multinucleated giant cells in acquired immunodeficiency syndrome (AIDS) encephalopathy].

A 31-year-old HIV-1-seropositive Haitian male presented with HIV-nephropathy and typical features of subcortical dementia. He died 4 months after the onset of neurological signs. Neuropathological examination revealed HIV encephalitis with diffuse progressive leukoencephalopathy, diffuse poliodystrophy and massive calcifications of white matter, basal ganglia and dentate nuclei probably partly related to renal failure. It was associated with focal, subependymal CMV encephalitis. In the periventricular regions, morphologically characteristic multinucleated giant cells, positive for CD68, and negative for GFAP, contained early CMV antigens (E13) in their nuclei and HIV antigens (gp41 and p24) in their cytoplasm. The co-infection of a single cell by both viruses was confirmed by electron microscopy. The finding that HIV and CMV can co-infect in vivo the same cell raises the question of a direct cooperation of both viruses at the single cell level, and suggests the possibility of a role for CMV as co-factor in the pathogenesis of HIV encephalopathy.

AIDS Dementia Complex↗
PubMed1990

[Seroprevalence of HIV infection in a population of neurological patients in the Central African Republic].

In order to evaluate the predictivity of neurological signs and symptoms in african patients, in Bangui's National Hospital Center (Central African Republic), 79 inpatients (aged 15-65 years) presenting with neurological manifestations (vascular attack, proved metabolic coma, or neuro-paludism excluded), and 64 age and sex matched controls in the same ward, without neurological or AIDS-related symptoms, were tested for the presence of HIV1-antibodies. 51/79 (65%) patients with neurological manifestations were HIV1-seropositive, and 10 (16%) of 64 controls (P less than 0.001). The positive predictive value (PPV) for HIV1 was 100% for patients with cutaneous zona (9 cases), Bell's palsy (4 cases) or cryptococcal meningitis (8 cases). The PPV for HIV1 was less important for the other neurological disorders: 43% for purulent meningitis (21 cases), 62% for major involvements of the central nervous system, without diagnosed etiology (32 cases; in which 13 were meningo-encephalitis, 16 focal deficits and 3 possible meningeal tuberculosis). In central Africa, the predictivity of neurological manifestations is high for HIV1 infection that emphasises the need for including neurological signs in clinical case definitions of AIDS in Africa.

Adolescent↗
PubMed1989

Extension of multiple drug resistant Plasmodium falciparum malaria in Africa: report of a Central African case.

A 24-year-old Caucasian male, living in the Central African Republic, presented with fever due to Plasmodium falciparum infection, although he steadily took chloroquine and sulfadoxine-pyrimethamine chemoprophylaxis. Despite treatment with the same drugs at high doses, the parasitaemia persisted. Clinical and parasitological recovery was obtained by the use of quinine. Chloroquine-resistant Plasmodium falciparum strains have spread in all tropical areas. Multiple drug resistance, already described in Asia, has also begun to appear in Africa.

Adult↗
PubMed1989

Antibodies to human immunodeficiency virus in vaginal secretions of heterosexual women.

To study the local immune response to human immunodeficiency virus type 1 (HIV-1) in women infected by or exposed to HIV-1, 75 women were studied: 15 were IgG-seropositive but clinically asymptomatic, 15 had acquired immune deficiency syndrome (AIDS), 15 were IgG-seronegative with seropositive husbands, and 30 were healthy seronegative women who were selected as controls. Serum samples and vaginal secretions were tested for antibodies to HIV-1 IgG and IgA by Western blot analysis. Antibodies of the IgG and IgA classes were detected in serum samples and vaginal secretions from healthy seropositive women and from women with AIDS. Local IgG antibodies to all viral proteins were detected by Western blot tests. Genital IgA antibodies were mainly directed to the core proteins p18 and p25, the p68 reverse transcriptase, and the gp160 and gp41 glycoproteins; IgA antibodies to the glycoprotein gp120 were rarely recovered. Antibodies of both the IgG and IgA classes in genital secretions were directed to all viral proteins, including surface glycoproteins, and could play a role in limiting the virus infectivity on normal mucosa.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Extensive oxidative metabolism of dextromethorphan in patients with almitrine neuropathy.

Almitrine bismesylate can induce a stereotypical sensory peripheral neuropathy probably through a toxic mechanism. High plasma concentrations of almitrine have been reported in a patient with neuropathy. Since large inter-individual variations in plasma drug concentrations are found it is possible that the development of toxicity may be linked to genetically determined polymorphic oxidation of the drug. Oxidation phenotyping was performed in fifteen patients with almitrine neuropathy using dextromethorphan, a test compound subject to oxidative metabolism similar to that of debrisoquine. All patients were of the extensive metaboliser phenotype. This result shows that, in contrast to perhexiline neuropathy, almitrine neuropathy is not related to slow oxidation of the compound with regard to the particular P-450 iso-enzyme involved in dextromethorphan and debrisoquine metabolism.

Aged↗
PubMed1988

Tumor-simulating giant serpentine aneurysm of the posterior cerebral artery.

A case of a giant aneurysm of the proximal segment of the posterior cerebral artery is reported. Complete neuroradiologic (computed tomography scan, angiography, magnetic resonance imaging) and pathological studies were performed. This type of aneurysm is extremely rare and may be difficult to differentiate from a cerebral tumor, both clinically and on computed tomography scan. Vertebral angiography is usually necessary to make, or confirm, the diagnosis.

Aged↗
PubMed1988

[Pigmentary orthochromatic leukodystrophy. Van Bogaert and Nyssen disease].

A 43 year old woman with a strong likelihood of familial history, developed progressively a spastic tetraparesis associated with intellectual deterioration and terminal epileptic fits. She died 11 years after onset of the clinical disorders. Neuropathological study revealed an orthochromatic leukodystrophy. Macrophages and glial cells of the white matter contained a brown-yellow, autofluorescent pigment which stained positively with PAS, Perls stain for iron and Masson-Fontana. Electron microscopy showed electron dense, membrane bound intracytoplasmic lamellar inclusions with curved or straight parallel arrangement or fingerprint pattern, in white matter macrophages, astrocytes and oligodendrocytes. Cortical cells contained lipofuscin which was normal in type and amount. This suggests that the material in white matter glial cells and macrophages is ceroid pigment; however, the distribution is not that seen in ceroid-lipofuscinosis. Similar inclusions have been found in oligodentrocytes in other forms of orthochromatic leucodystrophy. Ten similar cases of pigmentary type of orthochromatic leucodystrophy have been reported previously; only one had had an ultrastructural study.

Adult↗
PubMedDate not supplied

[Pseudotumoral naso-sinusal aspergillosis stabilized by itraconazole].

A 25 year-old non-immunocompromised African man showed a sino-orbital aspergillosis involving mostly the sphenoïd sinus, presenting as a growing tumour. Histopathologic study of the specimen biopsy revealed granulomata with intracellular septum branching hyphae. The electrosyneresis demonstrated serum antibodies to Aspergillus flavus. Initial treatment consisted of only surgical debridement in association of standard antifungal therapy (miconazole). After 14 months, a recurrence of the aspergillosis was stopped by the administration of itraconazole, an oral triazole antifungal. This treatment was performed during a period of 12 months and marked clinical improvement was observed. No adverse effects were noted. Itraconazole may be useful in therapy for extra-pulmonary aspergillosis when standard therapy has failed.

Adult↗