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Biomedical subjects

M Le Bras

Publications and source records attributed to M Le Bras.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Joint manifestations and parvovorus B19 infections: 8 cases].

Human Parvovirus B19 (PB19) may cause joint manifestations. We report eight cases of polyarthritis associated with PB19 IgM: six cases of acute polyarthritis spontaneously resolving within a few days, and two other cases suggesting that PB19 should be responsible for accutisation of chronic disease (lupus with Kikuchi's disease and HLA B27 related arthritis).

Adult↗
PubMed1993

[A rare etiology of spinal cord compression: Gaucher disease].

Gaucher's disease is a sphingolipidosis transmitted as an autosomal trait. Bone lesions are frequent in type 1 of the disease (i.e. the adult type without neurological manifestation). We report the case of a 70-year old woman suffering from spinal lesions with vertebral collapse and spinal cord compression. Our diagnosis was based on the finding in bone samples of Gaucher cells looking like large macrophages, and on the enzymatic assay of glucocerebrosidase. New treatments, such as replacement of the deficient enzyme by placental glucocerebrosidase, are currently being evaluated.

Aged↗
PubMed1993

[Environment and malaria in Burundi. Apropos of a malaria epidemic in a non-endemic mountainous region].

In March 1991, an unusual increase of the consultations for fever and/or cephalgias was reported by the Health Centre of Muhanga. At the same time, the administrative authorities worried about the increase of death registration in some hills, located around the big swamp of Ruvubu, and next to this Health Centre. In this area, hypoendemic for malaria, the epidemic was belatedly recognized, entailing a gross death rate between 25.6 and 31.5/1000 person/year in 1991, in the three most hit hill-areas whereas this rate is 18/1000 person/year for the national level. The initiation of the epidemic was favoured by the set up of Anopheles funestus and gambiae because of the modification of the hydro-agricultural milieu at high altitude, due to the extension of the ricefields and piscicultural ponds. Otherwise, there was a light rise of the medium temperature in this area in March 1991. In a non-immune population, the bouts of malaria were severe, especially in the age group from 0 to 4 years and in the pregnant women. By modifying the environment, the leaders of socio-economic development programs must consider the consequences on the population's health and to make the health employees a partner in.

Altitude↗
PubMed1993

[Simultaneous vaccination against hepatitis A and yellow fever].

Simultaneous vaccination against hepatitis A and yellow fever has been studied in our unit: Santé-Voyage, Bordeaux. This randomised study included 108 healthy subjects: 36 received hepatitis A vaccine (Havrix, SKF), 36 received yellow fever vaccine and 36 received both. For hepatitis A vaccine protocol comprised one injection at day zero, one at D15, and one booster dose at 6 months. Those who received yellow fever vaccine had it at D0. Simultaneous vaccination is well tolerated and immunogenicity is as good as it is for each vaccine separately. This is particularly interesting for tropical travellers who are at risk for hepatitis A.

Hepatitis A↗
PubMed1993

[Ventricular arrhythmia and halofantrine intake. Probable deleterious effect. Apropos of 3 cases].

Incidence and malignant forms of imported Plasmodium falciparum malaria are increasing, and chemoprevention is more and more replaced by stand-by treatment and radical cure in preventing access on return from malaria areas. Halofantrine is recommended for this radical cure: it's an habitually well-tolerated amino-alcohol with very few side-effects. We report three cases of long QT-interval due to halofantine: three different young women coming back from Africa took halofantrine (500 mg (2 tablets) six hourly for three doses on the first and the seventh day) and all presented with syncopal episodes. Serum electrolyte concentrations and echocardiograms were normal. In one case only, a diagnosis of Plasmodium falciparum malaria was made, without severe manifestations, and in the two other cases, treatment was a radical cure. In two cases, several bursts of torsades de pointes ventricular tachycardia due to halofantrine were proven and electrophysiological cardiac tests concluded that they had a congenital long QT-interval/Romano-Ward syndrome). So far halofantrine cardiac toxicity was unknown with single dose of 24 mg/kg/d. This phenomenon can be very severe in case of preexisting cardiopathy. In spite of the rarity on the congenital Romano-Ward syndrome, systematic electrocardiogram is necessary before giving halofantrine.

Adult↗
PubMed1992

[First observations on the main plasma parameters of oxidative stress in homozygous sickle cell disease].

The present study report 7 cases of sickle homozygous disease which have been analysed using markers of the oxidative-stress, 26 african male subjects were studied: 7 Hb SS subjects (age: m = 20) and 19 control subjects (Hb AA, age: m = 40). Plasma concentrations of F-MDA, T-MDA, TBARS, alpha tocopherol, retinol and beta carotene were measured. Plasma MDA and TBARS mean levels increased in sickle homozygous patients more than in controls. However, only TBARS mean concentrations were significantly increased between patients and controls: TBARS: 4.14 +/- 1.49 nMol/ml for Hb SS versus 2.10 +/- 1.21 nMol/ml for Hb AA (P less than 0.005). Vitamin A and vitamin E concentrations were significantly lower in Hb SS than in Hb AA. Beta carotene was significantly increased in patients vs controls. The significant increase of TBARS explains the great importance of the oxidative damage, whereas the significant decrease of vitamins A and E, may contribute, at least for a part, to maintain the autoxidation process or reveals its intensity in these patients.

Adolescent↗
PubMed1991

Failure of falciparum malaria prophylaxis by mefloquine in travelers from West Africa.

Due to the spread of chloroquine-resistant strains of Plasmodium falciparum in French speaking parts of Africa, we have found it necessary to prescribe mefloquine for antimalaria prophylaxis to travelers to this area. Weekly doses of 125 or 250 mg have been recommended for short journeys. In spite of this regimen, 16 documented cases of falciparum malaria in travelers have been recorded in the Bordeaux hospital center since October, 1988. Fifteen of these patients were tourists returning from West African countries, and one was an Ivorian student who had been on vacation to his home country. Nine of these patients were evaluated and found to have high plasma mefloquine levels. This report strongly supports the existence of mefloquine-resistant falciparum malaria in West Africa, especially in Sierra Leone, Burkina Faso, and Cote d'Ivoire.

Adult↗
PubMed1991

[Imported malaria in Bordeaux: evaluation of the risk of infection with Plasmodium falciparum as a function of country visited].

This study of imported cases of malaria, which was carried out in Bordeaux (France) in 1987-89, emphasizes the major part played by Plasmodium falciparum, especially in areas lying south of the Sahara in Africa, from where falciparum malaria is mainly imported to other countries. The study of these imported cases is strengthening our understanding of the epidemiology of malaria in relation to the country or area, whether the transmission occurs without interruptions or seasonally. The number of cases of P. falciparum per 1000 travellers (seen for vaccination against yellow fever at Bordeaux) gives an index for evaluating the risk of malaria. This risk changes with the epidemiological profile of falciparum malaria in the three major African ecosystems (rain forest, savannah, and sahelian belts), and is related to the progression of chloroquine resistance in Africa and influenced by the type of chemoprophylaxis proposed to travellers. The use of mefloquine for stays shorter than one month in Central Africa reduced the risk of malaria in 1988 and 1989, compared to 1987. [Editorial note. Recent data indicate some undesirable side-effects of mefloquine, e.g., its use during early pregnancy could lead to congenital defects.] Appropriate chemoprophylaxis and advice to travellers to areas lying south of the Sahara are therefore more and more necessary in order to arrest the increase in the number of imported falciparum malaria cases and reduce the number of serious cases, which are costly in terms of public health.

Adult↗
PubMed1991

[Multiple pitted nodule images in AIDS. Apropos of a case].

A new semiological aspect of Pneumocystis carinii pneumonia is reported in an AIDS patient. This pneumopathie is unusual because of its pitted nodules and its occurrence in a patient under prophylactic aerosol pentamidine therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Imported malaria in Bordeaux in 1989. Epidemiologic, clinical and therapeutic study of 71 cases].

In 1989 there were 71 cases of imported malaria admitted to the hospital in Bordeaux. This is 16.5% and 29% lower than in 1988 and 1987 respectively, thanks to the widespread use in Africa of mefloquine chemoprophylaxis. Sub-Saharan Africa is involved in 95% of cases, mainly West Africa (70% of cases), unlike the situation in 1987, and the first cases of paludism despite mefloquine chemoprophylaxis appeared during the second semester from the seasonal mid-summer recrudescence onwards, in travellers returning from this region. The most frequent species is still Plasmodium falciparum (80% of declared cases). This imported disease especially affects young adults despite regular prophylaxis in 59% of cases. It is therefore important to recommend rigorous protection against anopheles. Male predominance (sex ratio: 5.5) was greater in 1989 than in the previous two years, and French nationals represented 85% of the population. Falciparum malaria presents symptoms in 95% of cases before the end of the month following the patient's return to France, while for P. ovale the time for symptoms to appear is between 39 days and two years after return. Management of patients on their return poses a problem of information, since in 40% of cases diagnosis is made more than a week after the first symptoms. Attacks are mild in most cases (93%); among the serious cases death occurred in a 3-year-old child. Thrombopenia is the most frequent biological sign (22.5% of cases), followed to a lesser degree by anaemia and leukopenia. Mild attacks respond well to classical treatment (halofantrine, mefloquine, quinine, chloroquine), while two cases of more complicated symptoms required exchange transfusion.

Animals↗
PubMed1990

[Information campaign in Aquitaine about protection against malaria for travelers going to tropical regions].

The incidence of imported malaria is increasing in France, in relation to the increasing frequency of travel to tropical areas and the extension of chemoresistant strains of Plasmodium falciparum throughout the world. Worsening morbidity and mortality due to this parasite in the last 5 years is having an impact in socioeconomic terms; this is all the more prejudicial in that a young healthy population is concerned. Traditional chemoprophylaxis is at present insufficient for adequately controlling this recrudescence. Both the public and general practitioners should be made more aware of the measures to be taken during, and especially after foreign travel, in order to reverse the present tendency concerning imported malaria, and to improve travellers' protection.

Animals↗
PubMed1990

[The inhibiting effect of anticholera vaccination carried out simultaneously or at short intervals on yellow fever immunization. Is it real or assumed? Results of a retrospective study].

121 serum samples from African adults previously immunised with 17 D yellow fever vaccine alone (control group) or simultaneous yellow fever and cholera vaccines were tested for yellow fever antibodies by seroneutralization and haemagglutination inhibition assays. Comparison of the rates of seroconversion and antibody titers between the groups vaccinated the same day or into a short (less than or equal to 10 days) or a long time interval with both vaccines and the control group gave no significant difference. The association of cholera and yellow fever vaccines do not influence the long-term efficiency of yellow fever vaccination.

Adult↗