Search PubMed⌕ Search

Biomedical subjects

M Jouan

Publications and source records attributed to M Jouan.

16 recordsLinked to original sources
PubMed2000

[Mycobacterium avium complex disease in HIV seropositive patients: incidence and risk factors before and after the introduction of highly active antiretroviral treatments. Clinical Epidemiology Group of the Information and Care Center for Human Immunodeficiency].

The objective of this study was to determine the risk factors of the first occurrence of Mycobacterium avium complex disease (MAC) infection among human immunodeficiency virus (HIV)-infected subjects during two different time periods: before and after the introduction of protease inhibitor (respectively, period 1: 1 January 1992 to 31 December 1995, and period 2: 1 January 1996 to 30 June 1998). This study was performed using the French Hospital Database on HIV (FHDH). Subjects were included when their CD4+ cell count was less than 100/mm3. If they did not die or develop MAC within the first 6 months after the inclusion, their follow-up had to be longer than 6 months to be included. Cox's model was used to calculated the relative hazards (RH) of MAC occurrence according to the age and time-dependent variables, such as CD4+ below 50/mm3, previous occurrence of tuberculosis, cytomegalovirus (CMV) infection and other acquired immunodeficiency syndrome (AIDS)-defining disease, nature of antiretroviral treatment and MAC prophylaxis. Among the 14,779 subjects followed during period 1, 1,710 (11.6%) had a diagnosis of MAC infection during their follow-up (incidence: 8.4 +/- 0.2 for 100 persons per year), while only 453 (4.4%) among 10,239 subjects presented this infection during period 2 (2.8 +/- 0.1 for 100 persons per year). Rifabutin regular prescription was a protective factor of MAC occurrence during period 1 (RH = 0.51 95% confidence interval (CI) = [0.37-0.69]), whereas this protective effect was not observed during period 2 (RH = 1.05 CI = [0.63-1.67]). Thus, during the HAART period, the results that we present do not indicate an interest into continuing MAC prophylaxis.

Adult↗
PubMed1999

Determinants of paradoxical CD4 cell reconstitution after protease inhibitor-containing antiretroviral regimen.

OBJECTIVES: We evaluated the parameters influencing CD4 cell reconstitution after the introduction of highly active antiretroviral therapies in real life, as well as the frequency and the determinants of the discrepancies occurring between virus and CD4 cell count evolution. DESIGN AND METHODS: A total of 317 pre-treated patients starting a protease inhibitor (PI)-containing regimen were prospectively followed for 2 years on an intent-to-treat basis for CD4 cell counts and viral loads. RESULTS: The CD4 cell counts rapidly increased from baseline (50/mm3) by a median of 50/mm3 at month 2 (+0.72 CD4 cells/mm3/day) and up to 137/mm3 at the last follow-up (second slope: +0.16 CD4 cells/mm3/day). Two independent major factors among five parameters tested significantly affected the first phase, which was negatively correlated to the slope of CD4 cell decline before PI initiation, and was positively correlated to baseline CD4 cell counts (P = 0.0001); the second phase was mostly affected by the mean viral load reduction over time (P = 0.0001). Paradoxical CD4 cell reconstitution (15% of cases) was defined by a rapid or slow CD4 cell increase contrasting with a minor or strong viral reduction, respectively. The role of previous CD4 cell decline and the low effect of viral load reduction during the first 2 months explain the early paradoxical CD4 cell responses. The major influence of viral load reduction on the long-term reconstitution, however, reduces such paradoxical responses at 2 years. CONCLUSIONS: Early paradoxical CD4 cell reconstitution after the introduction of a PI are explained by the major influence of previous disease progression on the early CD4 cell increase, whereas the magnitude of viral load reduction over time reduces such paradoxical evolutions in the long term.

Adult↗
PubMed1999

Management of CMV retinitis in the era of highly active antiretroviral therapy.

Although the epidemiological features of CMV retinitis is changing in patients receiving highly active antiretroviral therapy (HAART), continued attention must be paid to detect and treat earlier CMV infections in AIDS patients to prevent severe ophthalmic complications. Initial therapy must be based on characteristics of the CMV retinitis and patient conditions. Long term therapy of HAART must be pursued, even in patients with increased CD4 and undetectable HIV viral load, until results from large controlled studies are available. reserved.

AIDS-Related Opportunistic Infections↗
PubMed1998

Quantitative analysis of cholesterol and cholesteryl esters in human atherosclerotic plaques using near-infrared Raman spectroscopy.

Raman spectroscopy is a non-destructive analytical technique and previous results have shown that qualitative analysis of the lipid component of human atheromatous arteries is feasible. In this paper, we describe a quantitative analytical method for cholesterol and cholesteryl esters in human atherosclerotic plaques, combined with Raman spectroscopic results, using partial least-squares (PLS) regression, a statistical multivariate method based on factorial analysis. Twenty-nine human atherosclerotic pooled samples were studied and the results of Raman spectroscopy coupled with the PLS method were compared to biochemical results. The standard error of prediction was 16.1, 13.6, 1.9, 3.3 and 3.4 mg/g for total cholesterol, free cholesterol, palmitate cholesteryl, oleate cholesteryl and linoleate cholesteryl, respectively. The repeatability of Raman spectroscopy was found to be excellent. Our results show that Raman spectroscopy is a promising technique to obtain a consistent and non-destructive quantitative analysis of cholesterol and cholesteryl esters in human atherosclerotic lesions. In situ and in vivo analysis is a possibility in the near future.

Aged↗
PubMed1998

[Opportunistic infections in patients under highly concentrated antiretroviral therapy].

UNLABELLED: VARIABLE RESULTS: The restoration of immunological competence following Highly Active AntiRetroviral Therapy (HAART) has led to promising results concerning cytomegalovirus viremia, atypical mycobacterium infections, and survival in patients treated for non-Hodgkin's lymphomas. The beneficial effect of introducing antiproteases is less clear for other opportunistic infections such as tuberculosis and pyogenic infections. PROPHYLAXIS: In patients with a CD4 count above 240/mm3, it would appear possible to stop primary prophylaxis against Pneumocystis carinii and toxoplasmosis.

AIDS-Related Opportunistic Infections↗
PubMed1996

Autologous bone marrow transplantation in relapsed HIV-related non-Hodgkin's lymphoma.

There are few reports of salvage chemotherapy for HIV-related non-Hodgkin's lymphoma (NHL). We report a relapsed HIV-related high-grade NHL which was treated successfully with ESHAP chemotherapy followed by high-dose chemotherapy and autologous bone marrow transplantation (ABMT). ABMT may later have triggered opportunistic infections in this patient.

AIDS-Related Opportunistic Infections↗
PubMed1986

Assessment of exposure to lead of the general population in the French community through biological monitoring.

The aim of the council directive of 29 March 1977 of the European Community (1) is the screening for non-work-related lead exposure levels in the general populations of European (member) countries. In France, such testing was carried out in eight metropolitan areas (having more than 500,000 inhabitants), another eight "critical" areas surrounding industrial emission sources and one area (Vosges) having a high level of lead contamination in the water. In view of the reference values (maximum 35 micrograms/dl in an individual blood sample) adopted by the directive, the situation is most serious in the area where the exposure is due to the lead contamination in the water. Individuals here run a seven times greater risk of exceeding the 35 micrograms/dl blood-lead limit relative to urban populations where the lead comes mostly from vehicle emissions into the atmosphere (i.e. 9.3% of the blood-lead values of the Vosgian sample exceed 35 micrograms/dl; 3.5% for the industrial complexes which deal with lead and 1.4% for the urban zone). While these vehicle exhausts are the subject of much current concern, in perspective, the problem of lead pipe contaminated drinking water appears to be of far greater importance.

Adolescent↗
PubMedDate not supplied

Mercury exposure in French Guiana: levels and determinants.

Mercury is used widely for gold extraction in French Guiana and throughout the entire Amazon basin. To evaluate contamination among the general population, the authors chose individuals who attended 13 health centers and maternity hospitals dispersed geographically across the territory and served Guiana's different populations. Five hundred individuals (109 pregnant women, 255 "other" adults, and 136 children) who received care at one of the centers were selected randomly for this study. Each individual answered a questionnaire and provided a hair sample. The authors determined mercury in hair with atomic absorption spectrometry. The following mean levels of mercury were observed: 1.6 microg/g (95% confidence interval [CI]=1.3, 1.9) among pregnant women; 3.4 microg/g (95% CI=3.0, 3.9) among other adults; and 2.5 microg/g (95% CI=2.1, 3.0) among children. Diet factors contributed the most to mercury levels, especially consumption of freshwater fish (mean=6.7 microg/g for individuals who ate fish more than 5 times/wk) and livers from game. Other factors, including age, dental amalgams, use of skin-lightening cosmetics, and residence near a gold-mining community, did not contribute significantly to mercury levels. Overall, 12% of the samples contained mercury levels in excess of 10 microg/g, but in some Amerindian communities up to 79% of the children had hair mercury levels that exceeded 10 microg/g. The results of this study indicated that (a) diet played a predominant role in total mercury burden, and (b) in some communities, mercury contamination exceeded safe levels.

Adolescent↗
PubMedDate not supplied

[Filariasis].

Explore the source record for details and available documents.

Filariasis↗
PubMedDate not supplied

[Infant esophageal pH monitoring (author's transl)].

The authors expound their experience of the infant esophageal pH monitoring from a 100 cases statistic. The digestive radiography is necessary for the vomiting infants but the efficiency of radiology is inadequate to diagnose the reflux and particularly to give a sufficient assessment of its intensity. The esophageal pH monitoring performed during a period of 3 hours is a tremendous learning experience; is allows the clinician to take mild reflux and severe reflux into account; performed in several positions, it shows interesting variations that we can turn to account by giving the therapeutic advices. That test is innocuous, easy, little costly, easily repeated; it must have its place beside other investigations and make us advance in the knowledge of a so often found disorder development.

Bronchitis↗