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Biomedical subjects

M Janier

Publications and source records attributed to M Janier.

At least 55 records · Page 3Linked to original sources
PubMed1996

Trends in HIV infection among sexually transmitted disease patients in Paris.

OBJECTIVE: To assess trends in HIV infection among sexually transmitted disease (STD) patients. DESIGN: Repeated unlinked anonymous survey, 1991-1993. SETTING: STD clinics in Paris, France. SUBJECTS: Patients (n = 4354) with a new suspected STD. METHODS: HIV antibody testing, using blood from syphilis samples. RESULTS: HIV prevalences were stable over time in all transmission groups. One-third of homo-/bisexual men were HIV-positive. Prevalence was 2.5 times higher among heterosexual patients from Africa or the Caribbean than among those from other countries. Among patients under 25 years of age prevalence significantly decreased from 4.3% in 1991 to 0.8% in 1993 (P = 0.01). Among homo-/bisexual men, despite a 50% reduction in the incidence of STD, the absolute number of those newly HIV-infected remained stable; median age increased from 28 years in 1991 to 32 years in 1993 (P = 0.02). Among heterosexuals, trends in HIV incidence were difficult to assess: recently infected patients were more likely to be identified in 1993 than in 1991, since the proportion of patients who reported a recent HIV-negative test increased over time. CONCLUSION: Prevalence studies contribute to define specific subgroups which should be targeted for prevention (HIV-positive or older homosexuals, heterosexuals from Africa and the Caribbean). Despite a decrease in both overall STD incidence and HIV prevalence among patients aged under 25 years, overall HIV incidence has not decreased, at least among homo-/bisexual men in whom recent HIV infections occurred at a high rate overall, and increased in those aged 35 years or more. Sentinel site-based HIV seroprevalence studies are best interpreted in the light of results obtained from different populations and through routine surveillance of STD.

Adult↗
PubMed1996

Dermatologic findings in HIV-1-infected patients: a prospective study with emphasis on CD4+ cell count.

BACKGROUND: Skin manifestations are common in patients infected with the human immunodeficiency virus (HIV) but the prognostic significance of may of them is not clear. METHODS: Skin disorders were studied in a cohort of 267 HIV-infected patients followed prospectively and were correlated to the CD4+ cell count. RESULTS: Among the most specific to HIV infection, Kaposi's sarcoma, oral hairy leukoplakia, molluscum contagiosum, xerosis and oral candidiasis were statistically associated to a low CD4+ cell count (200-300 CD4+/mm3; p < 0.001). Kaposi's sarcoma, oral candidiasis and molluscum contagiosum were more frequent in homosexual males (p < 0.05). Genital warts were more frequent in intravenous-drug users (p < 0.001). CONCLUSIONS: These results suggest that dermatological findings are useful clinical predictors of the presence or progression of HIV infection.

Adult↗
PubMed1996

[Sexually transmitted diseases in men].

Sexually transmitted diseases (STD) constitute a frequent presenting complaint. The epidemiology of human immunodeficiency virus (HIV) infection is identical to that of STD and must therefore be systematically investigated in the presence of any STD. Chlamydia trachomatis (CT) is involved in the majority of cases of urethritis and epididymitis in young subjects and is present in the urethra of 10% of subjects with a genital ulcer. Genital ulcers are due to either Treponema Pallidum, Haemophilus ducreyi, or Herpes simplex virus: there is little clinicobacteriological correlation and it is therefore essential to perform laboratory examinations in order to establish the diagnosis. The prevalence of venereal vegetations due to HPV viruses has increased markedly over recent years and require effective treatment and surveillance because of the risk of carcinoma induced by viral oncogenesis. Other viral diseases such as hepatitis B are also classified as STD. The main diagnostic techniques used at the present time for each STD are reviewed and the consensually accepted therapeutic protocols are also proposed.

Epididymitis↗
PubMed1995

[Detection of Chlamydia trachomatis infection by PCR in first voided urines in men].

The goal of this study was to evaluate whether the new commercially available PCR-based assay Amplicor C. trachomatis (Roche Molecular Systems) could improve the diagnosis of chlamydial urogenital infections in men, compared with cell culture of C. trachomatis considered as the reference method. A total of 466 men attending the STD clinic were tested by the Amplicor test in urine and by cell culture in urethra. The prevalence of C. trachomatis was 13.7% (64/466) by cell culture and 14.4% (67/466) by the Amplicor test. After resolution of the discrepant results, the sensitivity of culture was 91.4% in male urethral specimens. The resolved sensitivity of the PCR assay was 92.7% in male urine and the specificity was 99.5%. We concluded that this rapid PCR-based assay showed an improvement in quality for diagnosing C. trachomatis infections in men.

Adolescent↗
PubMed1995

[Balanitis and infectious agents. A prospective study of 100 cases].

INTRODUCTION: The aim of this study was: 1) to evaluate the rate of micro-organism isolation in 100 patients consulting for balanitis at the Centre of sexually transmitted diseases at the St. Louis Hospital in Paris in comparison with that of micro-organisms isolated in 60 men without balanitis; 2) to search for a possible correlation between the clinical aspect of the disease and the nature of the infectious agent identified. METHODS: One hundred consecutive patients were included in the study. All underwent a clinical examination and samples were taken for bacteriology, mycology and virology examinations. Sixty healthy volunteers served as controls. Two samples were taken from the balanopreputial groove in search for fungi and bacteria. RESULTS: Candida albicans (CA) was isolated in 33 p. 100 of the patients. A pathogenic bacteria (beta-haemolytic streptococci, Staphylococcus aureus, Klebsiella), or a potentially pathogenic germ (Haemophilus parainfluenzae, anaerobic bacteria, Gardnerella vaginalis, Streptococcus milleri, group HB5) was found without CA in 28 p. 100 of the cases, a commensal flora (enterobacteria, group D streptococci) was found without CA in 8 p. 100 and in 31 p. 100 of the cases non causal agent could be identified. DISCUSSION: This series confirms the non-pathogenic nature of commensal bacteria: the number of isolations was similar in the subjects with and without balanitis (p < 0.9). The role played by the other bacteria in the development of balanitis is discussed: saprophytic association or direct pathogenesis? The significant difference in the rate of bacteria isolations in patients with balanitis compared with controls (p < 0.001) is in favour of a pathogenic role. The clinical presentation was not predictive of the presence of any particular micro-organism excepting the presence of pustules which were highly suggestive of candidiasis.

Adult↗
PubMed1994

Chicken pox and acute monocytic leukaemia skin lesions in an HIV-seropositive man.

Lymphoid neoplasia is now well known to occur in patients with human immunodeficiency virus (HIV) infection but the first case of acute monocytic leukaemia in an HIV-seropositive man has been only recently described. We report the case of an HIV-infected patient who simultaneously developed skin lesions of acute monocytic leukaemia and chicken pox. We suggest that HIV may produce a malignant transformation of monocytic cells.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Buschke-Ollendorff syndrome].

The Buschke-Ollendorff syndrome (BOS) is a rare connective tissue disorder inherited in an autosomal dominant pattern characterized by cutaneous lesions, dermatofibrosis lenticularis disseminata, and osteopoikilosis. We report a new case of this syndrome in a 66 year old man, interesting by its association with a protein C deficiency, another rare genetically transmitted disease. Diagnosis of the BOS is difficult on the mere cutaneous lesions; it is therefore important to systematically practice bone X-rays in the presence of atypical pseudoxanthoma elasticum, disseminated collagenoma or disseminated connective tissue or elastic nevi. The radiologically detectable osteopoikilotic bone lesions, evoking Paget's disease, easily sign the diagnosis. In our case, the association of a protein C deficiency with the BOS may not be fortuitous because both the elastin and protein C genes are localized on chromosome 2q.

Aged↗
PubMed1993

Absence of enhancement of spontaneous echocardiographic contrast by thrombocytosis in a patient with left ventricular aneurysm, primary thrombocythemia, and von Recklinghausen neurofibromatosis: a case report.

A thirty-eight-year-old man with primary thrombocythemia, von Recklinghausen neurofibromatosis, and myocardial-infarction-related left ventricular aneurysm with spontaneous echocardiographic contrast was followed up, suggesting that: 1. Neurofibromatosis may promote silent myocardial infarction or ischemia. Whether involvement of cardiac sensory nerves is a possible underlying mechanism remains nevertheless uncertain. 2. Platelets, whose role in the genesis of spontaneous echocardiographic contrast has been advocated, are probably not involved in this phenomenon, even in large numbers.

Adult↗
PubMed1992

[Asymptomatic carriage of Chlamydia trachomatis in men consulting for condylomata acuminata].

A search for Chlamydia trachomatis by cell culture was carried out in the urethra of 82 male patients consulting for condyloma acuminata at the Clinical and Biological Centre for Sexually Transmissible Diseases of the Saint-Louis hospital, Paris. Three patients had discreet urethral signs, but none had urethral discharge. Cell culture was positive for C. trachomatis in 36 of the 82 patients (44 percent). This high prevalence suggests that C. trachomatis should systematically be looked for in the urethra of male patients consulting for condylomata acuminata. If this cannot be done, then a systematic treatment with tetracyclines should be instituted.

Adult↗