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Biomedical subjects

M Develoux

Publications and source records attributed to M Develoux.

At least 19 recordsLinked to original sources
PubMed2003

Pneumocystis jirovecii dihydropteroate synthase genotypes in French patients with pneumocystosis: a 1998-2001 prospective study.

Dihydropteroate synthase gene (DHPS) mutations at codons 55 and 57 have been associated with sulfa/sulfone resistance in Pneumocystis jirovecii strains from patients who previously received prophylaxis. To evaluate the prevalence of these mutations, a portion of P. jirovecii DHPS gene was analysed using PCR combined with restriction fragment length polymorphism (RFLP) analysis in 92 bronchoalveolar fluid samples collected between January 1998 and September 2001 from French patients with pulmonary pneumocystosis (PCP). Seventy-six samples contained the wild-type DHPS genotype (82.6%) and 16 contained a mutant genotype (17.4%). Twelve out of the 16 isolates with a mutant DHPS genotype corresponded to patients who had never received sulfa or sulfone prophylaxis, suggesting that DHPS mutants may be acquired de novo. There was no significant difference in favourable or adverse outcome in PCP caused by the wild or mutant DHPS genotypes (P = 0.34).

DNA, Fungal↗
PubMed2003

[Management of mycetoma in West-Africa].

Mycetoma is still endemic in the northern areas of West-Africa. This infection is more common in males, rural inhabitants, between 20 and 40 years of age. Mycetoma is generally easy to identify on clinical presentation, it is a chronic subcutaneous inflammatory tumor with discharging sinuses. The commonest affected site is the foot (70%), leg, knee, thigh, hand and arm are the most frequent extrapodal localizations. Diagnosis must be confirmed by the presence of grains at direct and histological examinations. It is indispensable to distinguish actinomycetoma (caused by aerobic bacteria) and eumycetoma (caused by fungi) as their treatments are different. The main etiological agents in West-Africa: Streptomyces somaliensis, Actinomadura pelletieri, Actinomadura madurae (actinomycetes), Madurella mycetomatis and Leptosphaeria sp (fungi) can be identified in most cases by histological examination of the grain. In the West Sahelian belt actinomycetoma is more frequent than eumycetoma except in Mauritania. When a mycetoma is diagnosed it is fundamental to determine as precisely as possible the extent of the lesion. Bone involvement is the major complication and must be systematically investigated by radiology. Mycetoma has characteristic ultrasonographic features, ultrasonographic technique appears to be very useful in medical centers where no mycological tests can be done. Ultrasonography is also an accurate technique to delimit the extent of the process. Computed tomography is also sensitive to assess the extent of mycetoma in soft tissues and can detect early bone involvement but is more onerous than ultrasonography. Ketoconazole or itraconazole in combination with surgery is recommended for eumycetoma patients. Actinomycetoma responds to antibacterial agents, different therapeutic schemes can be proposed and depend on the etiological agent.

Africa, Western↗
PubMed2001

[Infiltrated cutaneous leishmaniasis and sporotrichosis caused by Leishmania major. First Senegalese case].

We report in Senegal a case of infiltrated cutaneous leishmaniasis and sporothricoid due to Leishmania major MON-74. The diagnosis of our case was based on the cytologic, histologic and immunoparasitological examination. The patient was completely cured by 3 courses of 15 days of glucan-time. Our case completes the spectrum of the clinical presentation of tegumentary leishmaniasis.

Adult↗
PubMed2001

[Griseofulvin].

Griseofulvin is a metabolic product of Penicillium spp. It was the first available oral agent for the treatment of dermatophytoses and has now been used for more than forty years. Griseofulvin is fongistatic, the exact mechanism in witch it inhibits the growth of dermatophytes is doubtful. Several ways are invoked: inhibition of fungal cell mitosis and nuclear acid synthesis, probable interference with the function of microtubules. Griseofulvin is poorly absorbed from the gastrointestinal tract. Absorption is enhanced by administration with fatty meal. Peak plasma occurs four hours after oral administration. Griseofulvin is detected in the outer layer of the stratum corneum soon after it is ingested, it is diffused from the extracellular fluid and sweat. There is no information regarding the mechanism by witch the drug is delivered to nails and hair. Deposition in the newly formed cells could be the major factor. Griseofulvin has also anti-inflammatory properties and some direct vasodilatory effects when it is used in high doses. It is metabolised by the liver microsomial enzyme system and excreted in the urine. The half-life is 9 to 21 hours. Griseofulvine has been used in the therapy of dermatophyte onychomycosis, treatment periods from 6 to 18 months were necessary with disappointing results and numerous relapses. Newer oral antifungal agents are now preferred especially in toenail infections. For many authors griseofulvin is still the treatment of choice of tinea capitis. Doses are 15-20 mg/kg/d for 6 to 8 weeks in children with the microsized form. Clinical response rates have been reported between 80 and 90 p. 100 in controlled studies. Griseofulvin is well-tolerated particulary in children. More frequent side effects are minor: headaches, gastrointestinal reactions and cutaneous eruptions. The major drug interactions has been noted with phenobarbital, anticoagulants and oral contraceptives.

Adult↗
PubMed2000

Detection and genetic polymorphism of human herpes virus type 8 in endemic or epidemic Kaposi's sarcoma from West and Central Africa, and South America.

Kaposi's-sarcoma-associated herpesvirus(KSHV)/human-herpes-virus-8(HHV-8) sequences originally detected in AIDS-associated Kaposi's sarcoma have been found in almost every KS tested, whether endemic, classic, iatrogenic or epidemic. Most of the studies on African KS involved East African patients. We report herewith the study of 17 African or Guyanan KS patients, 3 with epidemic KS (EKS) from Central African Republic, 3 from Senegal (2 EKS and 1 endemic KS), 3 EKS from Cameroon and 8 from French Guiana (3 EKS and 5 endemic KS). Serum-specific antibodies directed against latent and/or lytic HHV-8 antigens were present in 16 of them (94%), detected either by immunofluorescence assay and/or by immunoperoxidase. Polymerase chain reaction (PCR), using specific primers for HHV-8 ORF26 (233 bp) and ORF75 (601 bp), was carried out on DNA extracted from KS cutaneous biopsies, clinically uninvolved skin biopsies and peripheral-blood mononuclear cells (PBMC). HHV-8 DNA was detected in 16 out of 16 (100%) KS biopsies, regardless of their origin or clinico-pathological sub-type, in 7 out of 15 (47%) normal skin samples and 7 out of 16 (44%) PBMC. Comparative PCR, carried out in 7 patients, regularly found a much higher viral load in KS biopsies than in autologous normal skin and PBMC samples. Sequencing of fragments of the ORF26 and of the ORF75 demonstrated that the 16 HHV-8 strains were of the A, B or C sub-type. Furthermore, sequences of the entire ORF K1 of 4 strains showed that these HHV-8 strains of African origin were of the A5 or the B sub-type.

AIDS-Related Opportunistic Infections↗
PubMed2000

[Tumoral mycetoma of the buttock].

BACKGROUND: Mycetomas are actinomycosic or fungal infections where the infectious agent produces grains. We report an atypical case of fungal mycetoma presenting as a tumoral formation on the buttock. CASE REPORT: A 56-year-old unemployed man from the Diourbel region of central Senegal consulted in February 1997 for a fistulalized tumor of the right buttock which had developed spontaneously and progressed for 5 years. The patient's general health remained satisfactory. Physical examination showed a voluminous 25 cm tumefaction extending from the right buttock to the perineum. The tumor showed a few areas of fistualization which discharged black grains under pressure. There was a 1.5 cm right inguinal node which did not appear to be inflammatory. The remainder of the physical examination was normal. Pathology reported inflammatory connective tissue surrounding a brownish polycyclic grain composed of spores and mycele filaments. The diagnosis of fungal mycetoma was retained and surgical excision under general anesthesia was performed. DISCUSSION: This is an atypical case of fungal mycetoma because of its tumoral form and gluteal localization. The differential diagnosis was cutaneous neurofibroma, myoma, or Darier-Ferrand dermatofibrosarcoma. The frequency of extrapodal red grain mycetomas has been pointed out by several authors from Senegal, but extrapodal black grain forms as seen in our case are more exceptional.

Buttocks↗
PubMed1999

[Crusted scabies in Dakar apropos of 11 cases seen in a year].

We reported 11 cases of crusted scabies observed during one year in our department. The mean age of the patients was 33 years with extremes at 14 and 49 years. The sex ratio was 1,2. HIV infection was the most common associated disease (45% of the patients). Ten patients had been treated with Ivermectin (200 micrograms/kg). The drug was efficient and well tolerated. For these reasons, we recommend to use Ivermectin as a drug of choice in the treatment of crusted scabies.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Mycetomas in Mali: causative agents and geographic distribution.

Although Mali is situated in the African zone endemic for mycetomas, no report has been published on the characteristics of the disease in this country. We report a series of 54 cases observed in Bamako. The causative agents were Madurella mycetomatis in 20 patients, Leptosphaeria sp. in one patients, Actinomadura madurae in 12 patients, A. pelletieri in 15 patients, and Streptomyces somaliensis in three patients. In this series, the observed geographic distribution of the causative agents was in agreement with data on the causative agents and their geographic distribution in neighboring countries, and with those suggesting a relationship between the type of infectious agent and the annual rainfall.

Adult↗
PubMed1996

[Hydatidosis in Africa in 1996: epidemiological aspects].

Hydatidosis is hyperendemic in most north African countries and in several areas of East Africa. The cycle of infestation involves dogs, ruminants and man. While sheep and goats appear to be the most common domestic intermediate, camels appear to act as the intermediate in some parts of North and East Africa. Hydatidosis is considered to be essentially rural but urban cycles have been reported in North Africa. During the last decade, echotomographic, and serologic screening for human hydatidosis were carried out in Tunisia and in nomadic populations from East Africa. These surveys have provided reliable accurate prevalence data showing that hydatidosis is a major public health problem in these areas. The highest worldwide incidence in man is in the Turkana district of Kenya. This high incidence is related to promiscuity between humans and dogs in Turkana. A pilot program to control hydatid disease was started in Turkana over 10 years ago. For unknown reasons human infestation is rare in West and Southern Africa despite the presence of hydatidosis in cattle.

Africa↗
PubMed1996

[Pathologies associated with HTLV-1 virus in Dakar (1992-1995)].

A clinical and laboratory study was conducted in Dakar (Senegal) to assess the involvement of HTLV-1 virus (human T lymphotrophic virus type 1) in various diseases. Patients were enrolled at three locations: the Dermatology Department of the Fann University Hospital Center (845 patients) from 1992 to 1995, the Dermatology Department of the Le Dantec University Hospital Center and the Oncology Department of the Principal Hospital (7 patients) in 1994 and 1995. The incidence of involvement of human retroviruses in neurologic complications seemed low (HTLV-1: 2%, HIV: 3%) and only 6 cases of tropical spastic paraparesis associated with specific anti-HTLV-1 antibodies were diagnosed in 3 men and 3 women with a mean age of 51 years. These cases which were identical to those previously described cases in the West Indies and Japan confirms the existence of this disease in Senegal. In addition 3 cases of isolated facial paralysis were observed in HIV positive patients. Combined HIV/HTLV-1 infection was observed in 3 cases and was not associated with special clinical findings. Adult T-cell leukemia/lymphoma (ATL) was detected in 4 patients including leukemia with proliferation of CD4 and CD25 in two cases and lymphoma in one case. In one case of ATL two proviruses were identified in circulating tumor cells. These are the first cases of ATL to be reported in Senegal. Molecular characterization of part of the envelope gene (gp 21) from patients with PST hospitalized in a neurology ward showed that the virus present in Senegal belonged to the universal HTLV-1 A type. This study indicates that two types of diseases are associated with HTLV-1 infection in Senegal. Further epidemiologic studies will be needed to evaluate the incidence of the virus and of the diseases associated with it. Prevention will depend partly on screening blood donors as has now been started at the Blood Transfusion Center of Dakar.

Adult↗
PubMed1995

Hepatitis B, C, and D virus infections in patients with chronic hepatitis, cirrhosis, and hepatocellular carcinoma: a comparative study in Niger.

Eighty-nine Sahelian African patients with chronic active hepatitis (CAH) (14), cirrhosis (49), hepatocellular carcinoma (HCC) (26), and 47 controls were tested for hepatitis B virus (HBV, hepatitis B surface antigen [HBsAg]) and hepatitis D virus (HDV, anti-HDV antibody). Seventy-three percent of the patients were positive for HBsAg versus 29.8% of the controls (P < 0.0001). With anti-HDV test, 55.0% of the patients were positive versus 17.0% of the controls (P < 0.0001). To assess the prevalence of antibody to hepatitis C virus (HCV), we used an enzyme-linked immunosorbent assay for screening (anti-HCV2): 19.1% of the patients were positive versus 6.4% of the controls (P < 0.05). An association between HBsAg and anti-HDV-positive test results was found in 46.1% of the patients versus 6.4% of the controls (P < 0.0001). A combination of HBsAg and anti-HCV2-positive test results was found in 13.5% of the patients versus 2.2% of the controls (P < 0.05). Anti-HDV and anti-HCV2 test results were positive in 13.5% of the patients versus 2.2% of the controls (P < 0.05). Triple-positive test results (HBsAg, anti-HDV, and anti-HCV2) were found in 11.2% of the patients but in none of the controls (P < 0.025). Triple-negative test results were found in 14.6% of the patients versus 57.4% of the controls (P < 0.0001). The predominant association of the chronic HBV infection with CAH, cirrhosis, and HCC is confirmed in Sahelian Africa. The HDV superinfection (chronic HBV plus HDV infections) may be a major etiology.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[The prevalence of anti-hepatitis C antibodies in pregnant women and blood donors in Bénin].

In order to precise if the hepatitis C virus (HCV) represents a potentially important infection for public health in Benin, the authors have studied the seroprevalence rate of this virus in august 1991, among two groups of population in Cotonou: 349 donors of blood (including 321 males); mean of ages: 28.7 y.-o., 149 pregnant women (mean of ages: 24.5 y.-o.). They have used an ELISA test (Innotest HCV Innogenetis NV, Antwerpen, Belgium) and retested the positive serums by LIA (Line Immuno Assay, Inno LIA HCV). A serum reacting with at least one peptide has been considered as positive. In the donors of blood and the pregnant women, a prevalence rate of respectively 2.3% (+/- 1.2) and 0.7% (+/- 0.9) has been established. These rates are worthy to be compared to those reported in Niger among the same types of population and with the same serologic tests. They are much inferior to those noted in East Gabon or South Cameroon: respectively 6.5% and 9.8%. This preliminary study has to be enlarged by investigations, which may precise the consequences of HCV presence in Benin for public health in this country.

Adult↗