Search PubMedSearch

Biomedical subjects

O Brugiere

Publications and source records attributed to O Brugiere.

5 recordsLinked to original sources

Isolated pulmonary arteries involvement in a patient with Takayasu's arteritis.

Pulmonary arteries involvement is well described in Takayasu's arteritis (TA), a condition which is mainly associated with involvement of the systemic arteries. We report a case of TA with documented isolated pulmonary arteries involvement. Symptoms were quite similar to those encountered in chronic thromboembolic disease. A pulmonary angiogram showed bilateral stenosis and occlusion of pulmonary arteries. Diagnosis of TA was suspected, and as such a complete aortogram was made but proved to be normal. Massive haemoptysis suddenly occurred, which resulted in death. Autopsy disclosed characteristic pathological lesions of TA in pulmonary arteries and confirmed the lack of involvement of the aorta and its branches. The frequency of such a clinical form could be underestimated, given the difficulties of diagnosis and features similar to those of chronic thromboembolic disease.

Adult

Progressive obstructive lung disease associated with microscopic polyangiitis.

Small airway involvement and progressive severe airflow obstruction are unexpected features in patients with microscopic polyangiitis. We report the case of a patient with microscopic polyangiitis and circulating anti-neutrophil cytoplasmic antibodies (ANCA), who developed pulmonary hyperinflation and airflow obstruction over a 7-yr period. Systemic manifestations of this vasculitis improved under corticosteriods and cyclophosphamid therapy, a treatment that did not influence either the very high level of anti-myeloperoxidase antibodies or the ventilatory impairment. Small airway involvement was suspected on the basis of pathologic small airway lesions and a mild emphysematous pattern on computed tomography (CT) scan, which was out of proportion with the severity of the obstructive lung disease.

Airway Obstruction

[Evaluation of Amplicor MTB PCR assay for the detection of Mycobacterium tuberculosis in specimens by means of negative direct microscopic examination].

The reliability of the Roche Amplicor Mycobacterium tuberculosis test (Amplicor MTB) was evaluated by testing smear-negative specimens from patients with clinical and radiological characteristics of tuberculosis. A total of 364 clinical samples including biopsies and fluids from 153 patients was tested using the Amplicor MTB and the results were compared with those of culture. After discrepancy resolution and patients chart review, sensibility, specificity, positive predictive value and negative predictive value were 44.7%, 99.7%, 94.4% and 93.9% respectively. Our study indicates that Amplicor MTB, despite its low sensibility and for its high specificity can bring a valuable complement for improving the laboratory diagnosis of tuberculosis.

Cells, Cultured

Comparison of the efficacy of amphotericin B and fluconazole in the treatment of cryptococcosis in human immunodeficiency virus-negative patients: retrospective analysis of 83 cases. French Cryptococcosis Study Group.

We retrospectively analyzed clinical outcome of meningeal and extrameningeal cryptococcosis in HIV-negative patients treated with amphotericin B (43 patients) or fluconazole (40 patients). Amphotericin B and fluconazole were prescribed equally to patients with neoplastic diseases and no risk factor, but organ transplant recipients and patients with other diseases were mostly given fluconazole and amphotericin B, respectively. Patients with more severe infections (i.e., meningitis, neurological disorders, or higher levels of antigen in cerebrospinal fluid) were more frequently treated with amphotericin B. A cure rate of > 70% was achieved regardless of the initial treatment and the severity of the infection. A Cox regression analysis showed that age of > 60 years, neoplastic disease, abnormal mental status, disseminated infection at the time of diagnosis, and therapeutic failure were independent predictors of death. Although fluconazole appears to be as effective as amphotericin B, only a prospective multicenter study will determine the best treatment regimen for patients with cryptococcal meningitis who do not have AIDS.

Adult

Diffuse panbronchiolitis in an Asian immigrant.

Diffuse panbronchiolitis (DPB) is a disease with chronic inflammation exclusively located in the region of the respiratory bronchiole. It is largely restricted geographically to the Far East, and cases in Western countries are exceptional, even among Asian immigrants. A patient of Asian origin with DPB who had been living in France for 10 years is described. Only re-examination of the initial open lung biopsy specimen after an eight year period allowed this rare disease to be diagnosed correctly. The known efficacy of low dose erythromycin in DPB was again confirmed after failure of long term high dose corticosteroid therapy administered before an accurate diagnosis had been made.

Adult