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Biomedical subjects

L Vaillant

Publications and source records attributed to L Vaillant.

246 records · Page 14Linked to original sources
PubMedDate not supplied

[Lymphedema of the limb: predictors of efficacy of combined physical therapy].

BACKGROUND: Limb lymphedema results from incompetence of the lymphatic system, and treatment of both primary and secondary forms involves manual lymphatic drainage and support. The effectiveness of treatment varies from patient to patient and can be unpredictable. OBJECTIVE: To investigate clinical and paraclinical criteria able to predict responses to combined physical treatment (lymphatic drainage and multilayered support) during hospitalization. PATIENTS AND METHODS: A retrospective study was performed in 45 patients admitted for one week's intensive treatment of limb lymphedema in the Lymphology Unit of the Department of Dermatology of the University Hospital of Tours. Lymphoscintigraphy was performed for all patients on admission. Loss of volume in affected limbs was studied to evaluate the effectiveness of treatment. RESULTS: Two criteria were predictive of resistance to combined treatment, i.e. venous insufficiency and continuing lymph node evidence of scintigraphic activity four hours after lymphoscintigraphy. The two factors were significantly related. CONCLUSION: Failure of combined physical treatment for lymphedema appears to be related to venous insufficiency. It is therefore essential to investigate and treat venous insufficiency, particularly in patients with continuing evidence of scintigraphic activity in lymph nodes.

Adult↗
PubMedDate not supplied

[Hormone replacement treatment and skin aging].

Ageing of the skin results from the synergistic effects of intrinsic ageing (due to age and genetic factors), photoageing (due to ultraviolet radiation) and, for women, hormonal ageing (due to oestrogen deficiency in postmenopausal women). Oestrogens receptors and metabolism or inactivation of oestradiol have been demonstrated in the skin, and the pilosebaceous unit is a target for sexual steroids. Could hormonal replacement therapy (HRT) be a treatment for the symptoms of skin ageing (dryness, roughness, burning and atrophy of the skin, itching, cold intolerance, wrinkles, hyperpilosity, alopecia)? In some experimental studies oestrogens increase the activity of fibroblasts and water, hyaluronic acid and collagen dermal contents. Some studies have demonstrated that oestrogen treatment increases skin thickness, mitotic activity of keratinocytes, and dermal collagen content in postmenopausal women. Thus HRT could theoretically treat skin ageing. It has been shown that HRT alleviates some symptoms of skin ageing (dryness of hair and skin) and that flushes disappear. We demonstrated that non-invasive measurements of physical parameters of the skin can reveal increase in skin thickness (+10 to +20 per cent) in women treated by HRT vs non treated, especially in the application area of oestrogen and in the non-sun-exposed areas. In our study HRT alleviated the hyposeborrhoea usually seen after menopause and could contribute to the amelioration of some complaints of post menopausal women such as roughness or dehydrated skin. Hormonal ageing is quantitatively less than actinic ageing, but its treatment is easier. Moreover HRT increases skin thickness, contributing to the prevention of atrophy (with fragile and fading skin) due to intrinsic ageing, and it limits the masculinization of facial hair and skin experienced by women as a sign of ageing. In conclusion HRT treats oestrogen deficiency and can be used to treat skin ageing.

Estrogen Replacement Therapy↗
PubMedDate not supplied

HLA-DRB1 and HLA-DQB1 genes in susceptibility and resistance to cicatricial pemphigoid in French Caucasians.

Cicatricial pemphigoid (CP) is a chronic, autoimmune, subepithelial blistering disease, characterized by the presence of antibasement membrane antibodies (BMZ) against anchoring filaments components. An association between the HLA-DQB1*0301 allele and ocular cicatricial pemphigoid has been previously reported in North American Caucasians. In this study, we compared high resolution typing HLA-DRB1 and -DQB1 alleles in 25 CP patients (50 haplotypes) with 106 geographically matched, healthy controls (212 haplotypes), who were all French Caucasians. As in American Caucasians, we confirmed a positive association of CP with the HLA-DQB1*0301 allele which was present in 54% of CP haplotypes (27/50); by contrast 21.7% (46/212) of the matched normal individuals carried the DQB1*0301allele (Pc = 7 x 10(-5); RR = 4.23). HLA-DQB1*0301 is in linkage disequilibrium with several DRB1 alleles. Only the DRB1*1101 DQB1*0301 haplotype frequency was significantly increased (24.0% in CP, 6.6% in control, Pc = 0.002). Furthermore, we observed a decrease of the frequency of the DQB1*02 allele (6% vs 25% in the control group, Pc = 0.05; RR = 0.19). The negative association corresponds to a significant decreased frequency of the DRB1*0701 DQB1*0202 haplotype (0% in CP vs 12.7%, Pc = 0.07 PC) and a non-significant decrease of DRB1*0301 DQB1*0201 (4% in CP vs 12.3%). HLA-DQB1*0301 encodes a negative charge at position DQ 57 (Asp), a critical position in peptide binding to the HLA-DQ molecule groove and therefore we speculate that this molecule may play a role in the selection of BMZ peptides in CP.

Alleles↗