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Biomedical subjects

M Poncet

Publications and source records attributed to M Poncet.

At least 37 records · Page 2Linked to original sources
PubMed1998

Adapalene 0.1% gel and adapalene 0.1% cream stimulate retinoic acid receptor mediated gene transcription without significant irritative effects in the skin of healthy human volunteers.

A randomized, investigator masked, intra individual comparative study was conducted in 30 healthy volunteers to compare the cutaneous effects of adapalene 0.1% gel and adapalene 0.1% cream with their respective vehicles, using tretinoin 0.05% cream (n = 21) or tretinoin 0.1% cream (n = 9) and a tretinoin cream vehicle (n = 30) as controls. The products were applied to hip/buttock skin for 4 days under occlusive conditions. Cytosolic retinoic acid binding protein-II (CRABP-II) mRNA levels were measured using the RT-PCR technique in punch biopsies taken from 10 subjects. Epidermal thickness was assessed using image analysis of haematoxylin and eosin stained sections from another 11 subjects. Erythema was assessed in all subjects both by a visual scoring system and by chromameter. Adapalene 0.1% gel and adapalene 0.1% cream produced similar significant increases in CRABP-II mRNA levels compared to their vehicles (P < 0.01). The two tretinoin formulations also resulted in similar significant increases in CRABP-II compared to the cream vehicle (P < 0.001). However, only the two tretinoin formulations resulted in an increase in epidermal thickness and only the tretinoin 0.1% cream resulted in significant erythema. Adapalene 0.1% gel and adapalene 0.1% cream induce RAR-mediated gene expression to a similar degree in this model, without the irritant effects of tretinoin.

Adapalene↗
PubMed1998

Evaluation of clinical efficacy and safety of adapalene 0.1% gel versus tretinoin 0.025% gel in the treatment of acne vulgaris, with particular reference to the onset of action and impact on quality of life.

A randomized, multicentre, investigator-masked study was conducted in 105 patients with mild to moderate acne vulgaris to compare the efficacy and safety of adapalene 0.1% gel with tretinoin 0.025% gel after three months of treatment, with particular emphasis on reduction in inflammatory lesion counts after one week of treatment and impact on quality of life. In terms of efficacy, adapalene gel was found to be superior to tretinoin gel after one week of treatment, with respect to reduction in inflammatory lesion counts (32% vs. 17%, respectively; P = 0.001), total lesion counts (28% vs. 22%, respectively; P = 0.042) and global severity grade (28% vs. 16%, respectively; P = 0.001). No significant difference between the two treatments was found after 12 weeks of treatment for any of these variables. Evaluation of facial skin tolerance parameters showed significant differences between the two treatments in favour of adapalene for dryness, erythema, immediate and persistent burning and pruritus for at least one time point. One patient in the adapalene group and three patients in the tretinoin group experienced medical events which lead to discontinuation of treatment (skin irritation; NS). Quality of life scores improved more rapidly in the adapalene group than in the tretinoin group, with significant differences (P < 0.05) appearing at week 1 for questions related to problems with partners, close friends or relatives and to skin symptoms. There was also a significantly greater improvement in social and leisure activity in the adapalene group at week 12. Adapalene 0.1% gel reduced inflammatory and total lesion counts more rapidly than tretinoin 0.025% gel, and was also better tolerated. These differences appear to result in an earlier and greater quality of life improvement for the patients receiving adapalene.

Acne Vulgaris↗
PubMed1998

A comparison of the efficacy and tolerability of adapalene 0.1% gel versus tretinoin 0.025% gel in patients with acne vulgaris: a meta-analysis of five randomized trials.

The purpose of this meta-analysis was to determine if adapalene 0.1% gel (Differin) provided superior efficacy and better tolerability than tretinoin 0.025% gel in the treatment of acne vulgaris. All comparative studies, both published and unpublished, from the United States and Europe, that fulfilled rigorous protocol criteria (multicentre, randomized, investigator-blind) were used. Five comparative studies met these criteria. In total, the meta-analysis evaluated 900 patients (450 treated with adapalene 0.1% gel, 450 treated with tretinoin 0.025% gel) with mild-to-moderate acne from the combined clinical trials. To avoid study bias, the meta-analysis used an intention-to-treat analysis. Statistical methodology for the meta-analysis included analysis of covariance, analysis of variance and Cochran-Mantel-Haenszel test. All statistical tests were two-sided, with the 0.05 probability level used to establish statistical significance, and 95% confidence intervals used to assess equivalence. Adapalene demonstrated equivalent efficacy to tretinoin in terms of reducing total lesion count. Adapalene demonstrated more rapid efficacy, as evidenced by a significant difference in the reduction of inflammatory and total lesions at week 1. Adapalene also demonstrated considerably greater local tolerability at all evaluation periods. The findings from this meta-analysis suggest that adapalene 0.1% gel constitutes a pharmacologic advance over such classic retinoids as tretinoin for the treatment of acne vulgaris.

Acne Vulgaris↗
PubMed1998

Separate visual pathways for perception of actions and objects: evidence from a case of apperceptive agnosia.

Recognition of different kinds of visual stimuli was studied in a patient who acquired apperceptive visual agnosia after a bilateral occipitotemporal lesion which partially spared the primary visual cortex. Impairment in recognising static objects perceived visually sharply contrasts with the relatively well preserved ability to recognise objects from gestures illustrating their use, and to recognise actions shown in line drawings. It is suggested that the occipitoparieto-frontal pathway is involved in the recognition of actions, and in the recognition of objects when sensorimotor experience is evoked.

Aged↗
PubMed1998

Progressive loss of speech: a neuropsychological profile of premotor dysfunction.

Several patients with 'progressive loss of speech output' or 'progressive anarthria' of degenerative origin have been reported in the literature. We report 5 clinical cases with slowly progressive loss of speech output and initially no deficit in other cognitive domains. The early clinical features were analysed in an attempt to identify the anatomo-functional systems implied in the degenerative process. The first phase of the disorder was characterised by impaired articulation consistent with speech apraxia, telegraphic style and a difficulty to elaborate a series of orofacial or hand movements. It is argued that these symptoms result from an impairment of complex motor processing due to dysfunction of the ventral premotor system. In the second phase, a decrease in spontaneous speech and self-initiated action was combined with exaggerated dependency on external stimuli, interpreted as dysfunction of the dorsal premotor system. We suggest that the neuropsychological profile of the disorder may result from progressive degeneration of the premotor cortex.

Aged↗
PubMed1998

[Diagnostic dyspraxia and frontal syndrome].

A 27-year-old ambidexter woman experienced a clinical and psychometric frontal syndrome associated with a partial callosal syndrome following transcallosal surgery for an intraventricular neurocytoma. She also complained of difficulties with her left hand which realized a particular form of diagnostic dyspraxia: there were specific features of an isolated dysfunction of the control of the realization of a program.

Adult↗
PubMed1997

Category-specific anomia: implication of different neural networks in naming.

The occurrence of anomia specifically affecting the ability to name animals is described in three patients. This deficit is contrasted with their capacity to name actions and tools. It is suggested that it is easier to access the names of 'operative' items, which were learned through both visual and sensorimotor experience, than the names of 'figurative' items, which were primarily learned through the visual modality. This hypothesis is consistent with the infero-temporal location of brain damage in these patients. Their ability to retrieve knowledge about operative items is assumed to be due to the sparing of the occipito-parietal area. Because the impairment also involves the recognition of animals, the likely locus of damage is the semantic component of the processing system.

Aged↗
PubMed1997

Three-dimensional MRI of hemifacial spasm with surgical correlation.

MRI was used to investigate 100 patients with hemifacial spasm, using 3D-FT T2-weighted (CISS) and contrast-enhanced 3D-FT T1-weighted (turbo-FLASH) sequences in all cases. MR angiography was performed in 54 patients, using 3D-MT FISP images. Decompression of the facial nerve through a retromastoid craniotomy was performed in all patients. Hemifacial spasm caused by tumours in the cerebellopontine angle was not included. Vascular contact with the facial nerve root-exit zone or at the internal auditory canal was present in 96 of 100 patients with hemifacial spasm. The vessel responsible was the vertebral artery (VA) in 18 cases, the posterior inferior cerebellar artery (PICA) in 23, the anterior inferior cerebellar artery (AICA) in 22, the VA and PICA in 24, VA and AICA in 3, PICA and AICA in 1, VA, PICA and AICA in 4, and a vein in 1 case. CISS images showed compressive vascular loops better than contrast-enhanced turbo-FLASH images alone. The sensitivity of MRI was high, since only one false-negative case was found among the 100 patients who underwent surgery.

Adult↗
PubMed1997

Optic aphasia: evidence of the contribution of different neural systems to object and action naming.

Visual stimulus naming was studied in a 66-year-old male patient with optic aphasia subsequent to left occipito-temporal infarction. While having difficulty in naming objects perceived visually, he was able to name objects by viewing gestures illustrating their use, and to name actions shown in pictures. These results suggest that naming performance depends on the kind of stimulus that is visually presented (object vs. action). The present findings lend support to congnitive models which postulate the existence of visual and functional semantic systems.

Aged↗
PubMed1997

Adapalene 0.1% gel has low skin-irritation potential.

BACKGROUND: Adapalene is a new naphthoic acid derivative with potent retinoid and antiinflammatory properties, developed for the topical treatment of acne vulgaris. OBJECTIVE: We compare the cutaneous safety of adapalene in different gel vehicles with tretinoin 0.025% gel. METHODS: A total of 42 healthy human subjects were enrolled in two randomized, double-blind, controlled, intraindividual studies. In the first study (study A), adapalene aqueous 0.03% and 0.1% gels were evaluated for their 21-day cumulative irritation potential compared with vehicle alone, patch alone, and tretinoin 0.025% gel under occlusion. In the second study (study B), adapalene aqueous (0.03% and 0.1%) gels and adapalene alcoholic (0.03% and 0.1%) gels were evaluated for their 5-day cumulative irritation potential compared with their respective vehicles and tretinoin 0.025% gel. Transepidermal water loss (TEWL) was measured daily at each visit. RESULTS: In study A, adapalene had a slight irritation potential that was in the same range as the gel vehicle and the patch alone, whereas tretinoin 0.025% gel was a severe irritant. In study B, no irritation was seen with either adapalene aqueous gels or adapalene gel vehicles or patch alone. The adapalene alcoholic gels were slightly irritating, and tretinoin gel produced intense irritation reactions in the majority of subjects. TEWL increased fourfold at the tretinoin site but remained unchanged at all adapalene sites. CONCLUSION: Adapalene 0.1% gel was significantly less irritating than tretinoin 0.025% gel.

Adapalene↗
PubMed1997

Adapalene 0.1% gel is better tolerated than tretinoin 0.025% gel in acne patients.

BACKGROUND: Adapalene is a new naphthoic acid derivative developed for the topical treatment of acne vulgaris. OBJECTIVE: We describe the results of a combined safety analysis of two multicenter trials conducted in the U.S. and Europe in which adapalene 0.1% gel was compared with tretinoin 0.025% gel in the treatment of mild to moderate acne vulgaris. METHODS: A total of 591 acne patients were enrolled in these investigator-masked, randomized, controlled, parallel group studies. In the two studies, each patient was randomly assigned to receive topical adapalene 0.1% gel or tretinoin 0.025% gel once daily at bedtime, for 12 weeks. In addition to assessments of efficacy and facial skin tolerance, data on adverse events were recorded at each visit or at any other time the patient reported problems. We extracted data concerning adverse reactions (i.e., adverse events judged to be related to the study treatment) from both studies and combined the results to obtain a global comparison of safety of the two products. RESULTS: A total of 15 of 296 patients (5.1%) reported 19 adverse reactions in the adapalene-treated groups, compared with 27 of 295 patients (9.1%) reporting 39 adverse reactions in the tretinoin-treated groups (p < 0.05). The number of patients discontinuing the study because of adverse events was approximately twice as low with adapalene (1.3% compared with 2.4%). Most adverse reactions for both products were related to skin irritation. No systemic adverse reactions were reported. CONCLUSION: The results of these two multicenter clinical studies indicate that adapalene gel is better tolerated than tretinoin gel.

Acne Vulgaris↗
PubMed1997

The PREMAP Study: prevalence and risk factors of dementia and clinically diagnosed Alzheimer's disease in Provence, France. Prevalence of Alzheimer's Disease in Provence.

The PREMAP Study investigated the prevalence and risk factors of dementia and Alzheimer's Disease (AD) in a random sample of 1062 residents 70 year old or more, living in south-eastern France (private homes and institutions). All persons living in institutions for the elderly (n = 258) and community dwellers (n = 804) scoring less than 24 points on the MMSE (18.4%) were invited to undergo a medical evaluation at home by a qualified neurologist using the CERAD battery. We found 177 cases of dementia (9.2%), including 82 cases of AD (5.5%). Prevalence of AD increased significantly with age and was higher among women (OR: 4.24) and persons with no formal educational level (OR: 2.47). While a MMS score less than 24 was more frequent among persons with a foreign native language (OR: 3.05), the OR and AD was not significantly associated with native language. The proportion of AD among persons suffering from senile dementia was 45% among elderly living in institutions and 69% among those living in the community. Prevalence rates in south-eastern France are similar to the average rates for Europe. This study underlines the need to investigate the relationships between native language, MMSE and AD on the one hand, and the link between a low MMSE score and institutionalisation of patients suffering from AD on the other.

Aged↗
PubMed1996

The effects of age-induced changes in communicative abilities on the type of aphasia.

The purpose of this study was to explore the possibility that some normal age-related changes in aspects of conversational discourse could account for the recurrent finding in aphasiology that fluent aphasics are approximately a decade older than their nonfluent counterparts. Normal subjects taken from two age groups representative of the mean age of fluent and nonfluent aphasics were submitted to an interview similar to the one used with aphasic patients in order to evaluate fluency. Results showed that, in answer to both closed and open questions, older subjects' discourse was made up of more than three times as many morphemes as younger subjects' discourse. The increase in fluency was more marked for men than it was for women. Thus, discourse-expressed changes in communicative strategies among the elderly could contribute to the semiology of language impairments in such a way that nonfluent aphasias would be more frequent. The reasons for this change in normal controls are still unknown but have been proposed to range from biological to sociological age-related characteristics of the individual.

Age Factors↗
PubMed1996

[Recurrent idiopathic facial paralysis and other cranial nerve involvements in 2 members of a family].

We report 2 cases of the same family who presented with alternating recurrent episodes of peripheral facial palsy, associated in one case with ipsilateral trigeminal neuropathy and preceded in the other case by incomplet Miller-Fisher syndrom. All laboratory and radiological investigations were normal except the electrodiagnostic tests. The etiopathogenetic mecanisms implied and the distinction between familial recurrent Bell's palsies and recurrent cranial nerve palsies are discussed.

Adult↗
PubMed1995

Silent brain infarct after carotid artery surgery: incidence and prevention.

To determine the prevalence and mechanisms of postoperative silent brain infarct, brain CT was routinely performed before and after carotid endarterectomy during the same period of hospitalization. Between June 1991 and May 1993, 69 patients who underwent 74 carotid endarterectomies (five two-staged bilateral procedures) were enrolled in the study. Ipsilateral brain infarct was observed on the preoperative CT scans in 25 cases. Of these 25 infarcts, three occurred in 20 patients (15%), without symptoms, 13 in 41 patients (32%) with transient ischemic attacks (TIAs), and 9 in 13 patients (70%) with cerebrovascular accident. After surgery, two patients (2.7% of procedures) had monoparesia of an upper limb with no corresponding abnormality seen on CT scans, and two (2.7%) had TIAs, associated with CT evidence of a new lesion in one patient. Five silent brain infarcts (6.8%) were detected, including four in the hemisphere contralateral to the restored carotid artery. These study results indicate there is no correlation between the occurrence of postoperative silent brain infarct and the presence of ulcerated stenosis of the carotid artery documented by Doppler ultrasound examination. Silent infarct was not observed in any of the 24 patients (32%) in whom a shunt had been used during the procedure. After a review of the literature, we propose wider use of intraoperative shunts to prevent postoperative silent brain infarct.

Aged↗
PubMed1995

A pure reversible amnesic syndrome following tuberculous meningoencephalitis.

The authors report the case of a 33-year-old right-handed man who developed a pure classical amnesic syndrome during the course of a probable tuberculous meningitis. This amnesic syndrome occurred 3 months after the onset of the illness, after the patient had stopped the treatment and it regressed completely after the antituberculous treatment had been recommenced. The neuroradiological investigations suggested that both the mamillary bodies and the medial temporal lobe regions were involved in this amnesic syndrome.

Adult↗
PubMed1995

[Progressive severity of left unilateral apraxia in 2 cases of Alzheimer disease].

Two patients presented with progressive left unilateral motor apraxia and progressive visuo-spatial difficulties, including constructional apraxia, dressing apraxia, spatial dysgraphia and dyslexia, spatial acalculia and neglect of the left side, without significant changes in the other cognitive functions. In both patients, radiological tests demonstrated cortical atrophy, more marked in the retrorolandic areas. A diagnosis of Alzheimer's disease was made in the first patient by cortical biopsy and in the second patient by post-mortem examination. The second patient died from an intercurrent neoplastic condition early in the course. Post-mortem examination of her brain showed the atrophy to be predominantly in the superior parietal gyri. In these areas, in addition to neuritic plaques and neurofibrillary tangles, these was also severe gliosis and superficial spongiosis. These two cases were clinically different from cortico-basal degeneration, where the motor difficulties are associated with occulo-motor problems, extrapyramidal signs and involuntary movements of the "alien hand" type. These data confirm the presence of focal forms of Alzheimer's disease. The motor apraxia seen in our patients resembles the kinesthesic apraxia described by Luria.

Alzheimer Disease↗