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Biomedical subjects

M Lévy

Publications and source records attributed to M Lévy.

At least 37 records · Page 2Linked to original sources
PubMed1995

Dilution assessment of cervicovaginal secretions obtained by vaginal washing for immunological assays.

Local immunological defense mechanisms in the cervicovaginal mucosa currently remain incompletely defined, especially from a quantitative point of view. Addition of an inert substance, lithium chloride (LiCl), into the washing buffer used to carry out the vaginal washing for collecting cervicovaginal secretions and measurement of its concentration with a flame absorption spectrophotometer, before and after the specimen is sampled, permits the quantification of the volume of cervicovaginal secretions collected and the approximation of the dilution factor of a soluble component introduced by the washing. Lithium, at a concentration of 10 mM, gives the best precision of measurement and has no effect on the results of the immunoassays. In a population of 27 nonpregnant women (age range, 18 to 45 years), the volume of cervicovaginal secretions collected by vaginal washing with 3 ml of LiCl-phosphate-buffered saline was 12% +/- 3.2% (mean +/- standard deviation) of the total volume and showed large interindividual variations (range, 5.6 to 18.8%); the mean dilution factor of a soluble component from the vaginal secretions was 9.9% +/- 2.8% (range, 6.3 to 18.8%). According to the date of the menstrual cycle, the mean volume of collected cervicovaginal secretions was significantly increased in the luteal phase in comparison with the follicular phase; conversely, the mean dilution factor of a soluble component was more important in the follicular than in the luteal phase. These features strengthen the need to quantify accurately the dilution factor introduced by vaginal washing when studying cervicovaginal immunity.

Adolescent↗
PubMed1995

Prosthetic relining and dietary counselling in elderly women.

A reduced consumption of hard-textured fibrous foods may promote the development of digestive disturbances in more susceptible elderly people who wear prostheses having deficient masticatory function. The purpose of this study was to evaluate the effects of a program combining denture relining and dietary counselling on the masticatory performance, fibre intake, and prevalence of digestive symptoms in elderly women with low chewing efficiency. This program was provided to 55 women between 55 and 74 years of age. Chewing ability was assessed quantitatively with the Swallowing Threshold Test Index (STTI), and qualitatively according to the participants' experience in chewing five specific foods. Nutritional data were collected using a food frequency questionnaire. The mean value of the STTI was significantly increased at three weeks and at six to nine months after completion of relining by 37 and 31 per cent, respectively. Subjects included one more food in their diet at the end of the six- to nine-month period only. Fibre intake from vegetables was significantly increased by 18 per cent, while colonic and gastrointestinal symptoms were both reduced. Prosthetic relining increased the masticatory performance of elderly women, but not to a functional level. In addition, dietary counselling stimulated subjects to eat foods that had previously been avoided. These observations suggest that the improvement of chewing efficiency, combined with dietary counselling, could reduce the presence of digestive symptoms.

Aged↗
PubMed1995

[Diagnosis of cystadenomas and cystadenocarcinomas of the pancreas. Study of 35 cases].

OBJECTIVES: The aims of this study were to assess the circumstances of diagnosis and accuracy of imaging procedures in patients with cystic pancreatic tumours. METHODS: Thirty-five consecutive patients with cystic pancreatic tumours (serous cystadenomas: n = 19, mucinous cystadenomas: n = 9, cystadenocarcinomas: n = 7) were studied from 1988 to 1993. Respective diagnostic values of ultrasonography, endoscopic ultrasonography, CT scan and analysis of cyst fluid were evaluated. RESULTS: The circumstances of diagnosis were abdominal pain (74%), weight loss (23%), jaundice (8%), abdominal mass (6%), asymptomatic (6%). Initial diagnosis of cystadenoma was correctly made by ultrasonography, CT scan and endoscopic ultrasonography in 63%, 77% and 84%, and the type of cystadenoma was correctly diagnosed in 20%, 51% and 55%. A pseudocyst was falsely diagnosed in 28%, 12% and 3%, respectively. After blind review of CT scans and endoscopic ultrasonography records, the type of cystadenoma was correctly diagnosed in 82% by both procedures. Cytological examination of cyst fluid of 18 cystic tumours gave correct diagnosis in 10 cases with sufficient material. A low CEA (P < 0.002), Ca 19.9 (P < 0.003) and absence of mucins (P < 0.002) in cyst fluid was evocative of serous cystadenoma. CONCLUSIONS: Abdominal pain was the main circumstance of diagnosis in cases of pancreatic cystadenomas. The type of cystadenoma was correctly diagnosed in 82% by CT scan and endoscopic ultrasonography. Cytological examination, tumoural marker and mucin levels in cyst fluid were helpful for an accurate diagnosis of cystic tumours.

Adult↗
PubMed1993

How frequent are hepatitis B virus markers in adult patients with glomerular diseases in a low endemic country? A French study from Paris and Saint-Brieuc.

In order to appreciate the frequency of hepatitis B virus (HBV) infection in patients with glomerular diseases in France, a low endemic country, we reviewed the series of patients biopsied in the years 1983-1989 in 2 departments of nephrology differing by the characteristics of the population. In Saint-Brieuc, where the population is almost exclusively Caucasian, with nearly no immigrant, HBsAg was not detected in any of the 86 patients. In Paris, a large number of patients come from highly or intermediately endemic regions. HBsAg was detected in 3 of 209 patients, 2 of the 75 patients with membranous nephropathy and 1 of the 32 patients with minimal-change nephrotic syndrome. These patients came from Africa and Asia. Therefore, in low endemic countries, the role of HBV infection in the etiology of glomerulonephritis is minimal. But, because of the late severity of the disease, screening remains essential in patients belonging to the high-risk groups.

Adolescent↗
PubMed1993

[Catecholamine induced ventricular tachycardia: a cause of severe syncope during adolescence].

A 15-year-old female teenager had recurrent syncopes and had been unsuccessfully treated for 6 years for seizures and hysteria. Syncopes were always triggered by emotions, or efforts, but electrocardiograms were normal between the episodes. A 24-hour-monitoring during a syncope, and provocative tests (exercise testing and isoprenaline administration) showed severe ventricular arrhythmias with premature polymorphous beats, followed by ventricular tachycardia and then ventricular fibrillation. These "catecholamine-induced" ventricular tachycardias are very rare but are always fatal without treatment. Syncopes are stress-induced and the diagnosis is almost always delayed, because the patients have a normal electrocardiogram, with normal QT interval. The arrhythmia appears beyond a "threshold" sinus rate and is easily reproducible by exercise testing. Betablockers are the only efficient treatment to prevent sudden death.

Adolescent↗
PubMed1990

Evidence for phosphatidylinositol anchorage of opioid binding proteins in rat brain.

Treatment of rat brain sections and of thalamic and striatal membranes with phosphatidylinositol phospholipase C (PIPLC), an enzyme known to hydrolyse only phosphatidylinositol and its derivatives, significantly alters the specific binding of mu- and delta-opioid ligands on their receptors. These results suggest that some opioid binding proteins are membrane-anchored by a glycosylphosphatidylinositol (GPI) linkage.

Animals↗
PubMed1990

[Evaluation of the reagent strip method to detect urinary tract infections. In hospital patients].

Asymptomatic urinary tract infections (UTI) are frequent in hospital patients. Two prospective studies were carried out to evaluate the reagent strip method used to detect these infections. The diagnosis of UTI rested on cytobacteriological examination of urine. Detection by reagent strip was performed either in the microbiology laboratory (study 1:976 samples) or at the patient's bedside and in the laboratory (Study 2:312 samples). The strips were examined visually and by an automated device. There was no significant difference between the results obtained with these two reading methods. Study 1 showed that the reagent strip is more useful to exclude the diagnosis of UTI by using the leucocyte zone alone or combined with the nitrite zone (negative predictive value 98 percent) than to assert this diagnosis. Study 2 showed that the nitrite zone was less sensitive when it was examined at the laboratory than at the patient's bedside. Analysis of discordances between reagent strip and cytobacteriology in the light of data supplied by the patient's medical records made it possible to improve the negative predictive value of the tests. (100 percent). Thus, 60 percent of cytobacteriological examinations might be avoided if this type of examination was performed only in urine with positive leucocyte or nitrite zones. This means a 15 percent saving in B-coded examinations performed in hospital microbiology laboratories.

Hospitals↗
PubMed1990

[Evaluation of the detection of urinary tract infection by the reagent strip method in hospitalized patients].

Asymptomatic urinary tract infections (UTI) are frequent in hospital patients. Two prospective studies were carried out to evaluate the reagent strip method used to detect these infections. The diagnosis of UTI rested on cytobacteriological examination of urine. Detection by reagent strip was performed either in the microbiology laboratory (study 1: 976 samples) or at the patient's bedside and in the laboratory (Study 2: 225 samples). The strips were examined visually and by an automated device. There was no significant difference between the results obtained with these two reading methods. Study 1 showed that the reagent strip is more useful to exclude the diagnosis of UTI by using the leucocyte zone alone or combined with the nitrite zone (negative predictive value 98 percent) than to assert this diagnosis. Study 2 showed that the nitrite zone was less sensitive when it was examined at the laboratory than at the patient's bedside. Analysis of discordances between reagent strip and cytobacteriology in the light of data supplied by the patient's medical records made it possible to improve the negative predictive value of the tests. (100 percent). Thus, 60 percent of cytobacteriological examinations could be avoided if this type of examination was performed only in urine with positive leucocyte and nitrite zones. This means a 15 percent saving in B-coded examinations performed in hospital microbiology laboratories.

France↗
PubMed1990

[Continuous veno-venous hemofiltration in acute renal insufficiency].

A fully pump-assisted continuous veno-venous hemodiafiltration system (CVVHDF) was studied in 10 acute renal failure patients. A counter current pump system ensured slow dialysis at a mean flow rate of 24.6 +/- 0.6 ml/min (single pass) and guaranteed recovery of 97% of dialysate. Ultrafiltration rates were controlled by a separate occlusive pump, connected to the dialysate compartment. Blood was circulated by mean of a third pump at flow rates ranging form 100 to 150 ml/min. Mean duration of CVVHDF was 197 +/- 32 h (range 96-336). Mean serum creatinine and urea before initiation of CVVHDF were 525 +/- 52 mumol/l and 36 +/- 14 mmol/l and stabilized after 4-7 days of CVVHDF at 280 +/- 27 mumol/l and 14 +/- 3 mmol/l. Hemodynamic parameters remained stable. Glucose and phosphate removal by CVVHDF was 296 +/- 42 mmol/day and 33 +/- 6 mmol/day respectively. Fractional losses of aminoacids given by parenteral nutriton averaged 8 +/- 1%. An 69 filters induced no significant changes in leucocyte and thrombocyte counts and only a slight decrease in pO2 (-0.78 +/- 0.30 K Pa at 60 min). We conclude that CVVHDF is a safe, efficient and reliable treatment modality, allowing a good control of the fluid balance.

Acute Kidney Injury↗
PubMed1989

[Role of myocardium scintigraphy with thallium dipyridamole in the evaluation of arterial disease of the legs].

Thirty-eight consecutive patients with severe arterial disease of the lower extremities benefited from an exploration of the coronary reserve by myocardial scintigraphy with thallium dipyridamole. With this examination, it has been possible to screen 20 p. cent of asymptomatic patients and at least modify the perioperative treatment or even the very indication for surgery.

Adult↗
PubMed1989

[Improvement in the quality of health: new perspectives].

Recent advances in understanding the factors that affect the development and progression of carious lesions have not been widely adopted by the profession. Traditional diagnostic and restorative principles may be incompatible with quality care and could contribute to the imposition of unnecessary dental treatment. Quality care should be based on appropriate standards of care as well as specific diagnostic and treatment criteria consistent with current scientific knowledge.

Dental Care↗
PubMed1988

Community-acquired pneumonia. Importance of initial noninvasive bacteriologic and radiographic investigations.

During a one-year epidemiologic survey of acute community-acquired pneumonia, we prospectively investigated in 116 adult nonimmunocompromised patients (a) the importance of initial noninvasive investigations (ie, blood culture and quantitative sputum culture) and the value of the initial radiologic type of pneumonia in diagnosing of the etiologic agent, and (b) the management of pneumonia. Quantitative sputum culture or blood culture (or both) permitted bacteriologic diagnosis in 44 percent of the cases. The radiologic types found were segmental or alveolar densities in 75 patients (65 percent), patchy alveolar densities in 11 (9 percent), mixed opacities in 26 (22 percent), and interstitial infiltrates in four (3 percent). We observed that (a) the prognosis was identical whether a bacteriologic diagnosis was made or not, (b) the Gram stain, an inexpensive procedure, was as contributive for bacteriologic diagnosis as quantitative sputum culture, diagnosis as (c) blood cultures were poorly contributive in patients without severe infections, and (d) alveolar densities were associated with a bacterial infection in 90 percent of the cases of known etiology. On the basis of these results, a pragmatic strategy of initial management of community-acquired pneumonia is proposed.

Adult↗
PubMed1988

[Right coronary artery issuing from the pulmonary artery: review of the literature apropos of a case].

A new case of right coronary artery abnormally issued from the pulmonary trunk is reported. The patient was an asymptomatic young man in whom a continuous cardiac murmur was discovered by chance and an angiographic examination disclosed the coronary abnormality. A review of the literature yielded 37 cases of this anomalous origin which was either isolated, as in the case reported here, or associated with another congenital or acquired cardiopathy. The diagnosis may be suspected on the presence of a continuous murmur in an usually asymptomatic subject and is confirmed by angiography. The abnormality is generally well tolerated owing to an inter-coronary collateral circulation resulting in retrograde perfusion of the right coronary artery from the left coronary artery. This good tolerance explains why an isolated abnormality of that type is often discovered belatedly, in contrast with the anomalous origin of the left coronary artery from the pulmonary trunk, which is usually revealed at birth by clinical signs of acute coronary insufficiency. However, the likelihood of either cardiac failure due to the left-to-right shunt in elderly people or, chiefly, acute myocardial ischaemia by coronary steal with a risk of sudden death in young people makes it imperative in such cases to perform reimplantation surgery.

Adult↗
PubMed1987

Long-lived B cells: mitogen reactivity as a tool for studying their life-spans.

A population of noncycling small lymphocytes has been selectively enriched in mice by treatment with hydroxyurea (HU) over 4 consecutive days. This cell population, present in the spleen of HU-treated mice, contained a high frequency of lipopolysaccharide (LPS)-reactive cells and this could be used as a functional marker to follow their persistence after transfer to LPS-nonresponder recipient mice. The results reported here show that cells selected after a long-term HU treatment have considerably less decay, after transfer in recipient mice, than normal spleen cells. Furthermore, they demonstrate that HU-selected B cells survive in the recipient mice for periods up to 3 months, and are, consequently, true long-lived lymphocytes.

Animals↗
PubMed1987

The majority of "natural" immunoglobulin-secreting cells are short-lived and the progeny of cycling lymphocytes.

Treatment of mice with hydroxyurea to selectively kill all cycling cells has been used to study population dynamics and life expectancy of "natural" immunoglobulin-secreting cells in the bone marrow and spleen of nonimmunized animals. The results show that 50 to 90% of those cells are eliminated 2 to 3 days after one cycle of hydroxyurea administration, demonstrating their recent origin from cycling precursors. Using a protocol of long-term hydroxyurea treatment which abrogates cell production from the cycling precursors compartments, it was shown that "natural" immunoglobulin-secreting cells have a very short half renewal time, in the range of 15-60 h.

Aging↗
PubMed1987

Renal involvement in juvenile chronic arthritis: clinical and pathologic features.

Over an 18-year period, renal involvement was diagnosed in 13 patients, who represent 1% of the total juvenile chronic arthritis population referred to us. All had severe arthritis. This study illustrates the importance of renal biopsy and indicates that renal involvement in juvenile chronic arthritis is a heterogeneous group of diseases, with a variety of causes. In eight patients with nephrotic syndrome, renal biopsy revealed amyloidosis. One rapidly died of diffuse amyloidosis and infection. The other seven received chlorambucil. Disappearance of proteinuria was noted in three of them. Four patients have persistent proteinuria but normal serum creatinine. It is suggested that, despite the long-term oncogenic risk of the drug, chlorambucil may be beneficial in patients with amyloid deposits. In one patient, the nephrotic syndrome was attributed to systemic lupus erythematosus, and in another, the chance association of an arthritis and nephrotic syndrome with minimal glomerular changes was considered. Although drug responsibility is difficult to determine in these patients receiving several medications in association, the renal involvement presented by the remaining three patients was probably related to drug(s). Moreover, it is possible that the effect of the association of medications is deleterious to the kidney. Drug-induced nephropathy is usually reversible when drugs are stopped. Unfortunately, because of persistent joint pain, these patients will continue to require pain-relieving drugs over prolonged periods.

Amyloidosis↗