Biomedical subjects

P Gallien

Publications and source records attributed to P Gallien.

At least 37 records · Page 2Linked to original sources

PubMed2000

Clinical experience with functional electrical stimulation-assisted gait with Parastep in spinal cord-injured patients.

STUDY DESIGN: Clinical evaluation of the Parastep method, a six-channel transcutaneous functional electrical stimulation device, in spinal cord-injured patients. OBJECTIVES: To investigate the motor performances of this new technique regarding energy expenditure and to evaluate its advantages and limitations, especially in social activities involving ambulation. METHODS: This study was conducted in 15 thoracic spine-injured patients. The lesion was complete except in two patients. The gait ability and the functional use were judged clinically. Energy cost was evaluated from heart rate, peak oxygen uptake, and lactatemia. RESULTS: Thirteen patients completed the training (mean: 20 sessions) and achieved independent ambulation with a walker. The mean walking distance, without rest, was 52.8 +/- 69 m, and the mean speed was 0.15 +/- 0.14 m/sec. One patient with incomplete lesion, who had been nonambulatory for 8 months after the injury, became able to walk without functional electrical stimulation after five sessions. The follow-up was 40 +/- 11 months. Five patients pursued using functional electrical stimulation-assisted gait as a means of physical exercise but not for ambulation in social activities. The patients experienced marked psychological benefits, with positive changes in their way of life. In three subjects, a comparison of physiologic responses to exercise between a progressive arm ergometer test and a walking test with the Parastep (Sigmedics, Inc., Northfield, IL) at a speed of 0.1 m/sec was performed, showing that the heart rate, the peak oxygen uptake, and lactatemia during gait were close to those obtained at the end of the maximal test on the ergometer. CONCLUSIONS: In spite of its ease of operation and good cosmetic acceptance, the Parastep approach has very limited applications for mobility in daily life, because of its modest performance associated with high metabolic cost and cardiovascular strain. However, it can be proposed as a resource to keep physical and psychological fitness in patients with spinal cord injury.

Adolescent↗

PubMed2000

Characterization of shiga toxin-producing Escherichia coli strains isolated from calves in Poland.

Fecal samples from 67 3-5-months-old calves with diarrhea were screened for the presence of shiga toxin-producing Escherichia coli (STEC). Several accessory virulence factors genes were also tested. Among 192 E. coli isolates tested, 15 (7.6%) were found to harbour the shiga toxin 1 or 2 (stx1 or stx2) genes. The stx2-carrying samples were further subtyped by PCR for the stx2c, stx2d, and stx2e toxin variants. It was shown that stx2-positive bacteria mainly possessed the stx2c shiga toxin type gene. The enterohemolysin (hlyA) and intimin (eae) genes were found in seven (46.7%) STEC strains whereas the cytotoxic necrotizin factor 1 and 2 or the P fimbrial genes were detected in two isolates only. This study confirmed that calves are a reservoir of STEC strains (with all pathogenicity genes) that may be virulent for humans.

ADP-Ribosylation Factors↗

PubMed1999

The use of polymerase chain reaction for determination of virulence factors of Escherichia coli strains isolated from pigs in Poland.

E. coli strains isolated from pigs with postweaning diarrhea or edema disease were tested by phenotypic and genotypic methods for the presence of virulence antigens and genes, respectively. The slide agglutination and ELISA analyses were used for determination of F4, F5, F6, F17, and F41 fimbriae whereas the prevalence of fimbrial fedA and toxin eltI, estI, estII, stx1, stx2 and stx2e genes were recorded by the means of PCR. Only F4 antigen (ac variant) was found in strains of the serogroup O149:K91 isolated from pigs with diarrhea. PCR analyses showed that the fedA gene encoding F18 fimbriae was present in 61.9% of strains isolated from pigs with diarrhea and in 84.2% of strains isolated from pigs with edema disease. The eltI genes encoding heat-labile toxin I (LTI) were present only in 9 out of 21 strains recovered from pigs with diarrhea. Shiga toxin 2 variant (stx2e) genes were found in six isolates from edema disease and also in one strain from diarrhea. The PCR test used in the study was a sensitive and valuable method for determination of virulence factors of E. coli strains.

Animals↗

PubMed1999

Sensory-motor and genito-sphincter dysfunctions in multiple sclerosis.

Multiple sclerosis is a chronic demyeliniting disease of the central nervous system which is characterized by an extreme multiplicity of clinical features. Multiple sclerosis can have a profound impact on the quality of life of patients. The induced handicap varies from one patient to an other, and depends on the location of the demyeliniting lesions. Among the symptoms, sensory-motor disorders and genito-sphincter dysfunctions are some of the more disabling. Thus, up to 70% of patients suffer from urinary troubles, and 15 years after the onset of the illness, 50% of patients have difficulties for deambulation. A good knowledge of these pathologies is necessary to improve the management of patients suffering from multiple sclerosis.

Female Urogenital Diseases↗

PubMed1999

[Utilization of nylon membranes for the specific isolation of Escherichia coli O157 with DNA probes and checking for relationship to the shiga toxin Escherichia coli (STEC) group].

A method for specific isolation of Escherichia coli strains of serotype O157 is given. DNA-hybridization technique by using DIG-labeled specific O157 PCR-amplificates as probes is the basis. These investigations can be used for the detection and isolation of shigatoxin-producing Escherichia coli (STEC) of this serotype in combination with other tests for detection of shigatoxin genes (stx). No background is seen by using 'DIG Easy Hyb' solution and Nylon membranes for colony-and plaque-hybridization (Roche Diagnostics Boehringer Mannheim). Dark brown spots (E. coli colonies) are visible on the membranes after staining. After comparing the membrane with the masterplate it is possible to isolate the colonies from the masterplate, respectively. It is necessary to make proof that the isolates possess the rfb-genes (verification of serotype O157) and the stx-genes (test for belonging to the STEC-group). Both tests could be done by using PCR. In case of positive results other virulence factors of the isolates can be detected.

Bacterial Toxins↗

PubMed1999

[Detection of pas gene in shiga toxin producing Escherichia coli (STEC)].

Results of detection of the pas gene in 10 shigatoxin-producing Escherichia coli strains (STEC) isolated from foods (raw milk, certified milk, and beef) and in 18 enterohaemorrhagic Escherichia coli strains (EHEC) isolated from stool samples of patients suffering from HUS, diarrhea or from carriers without symptoms are given. All isolates showed the eae gene coding for intimin. We could make sure by using PCR that all isolates showed the pas gene, too. This gene is a factor mainly responsible for proteinsecretion and for the attacing and effacing phenomenon. A correlation of pas to other virulence factors was not given. The detection of the pas gene makes further characterization of STEC/EHEC-Isolates possible.

Animals↗

PubMed1998

Detection of Brucella species in organs of naturally infected cattle by polymerase chain reaction.

A polymerase chain reaction (PCR) assay was used to detect Brucella species in the uterus, udder, spleen, lymph nodes, kidney and liver of three cows which had been naturally infected in an outbreak of brucellosis, and the results were compared with the results of bacteriological investigations. All 18 samples reacted positively in the PCR, but five samples had weak bands after the electrophoretic separation of PCR mixtures. No Brucella strains could be detected in these five samples by bacterial cultivation, but all the other samples gave positive results. A pre-enrichment procedure was necessary for the PCR. A PCR with DNA from eight Yersinia strains gave no amplification product.

Animals↗

PubMed1998

Vesicourethral dysfunction and urodynamic findings in multiple sclerosis: a study of 149 cases.

OBJECTIVE: Vesicourethral dysfunction is common in people with multiple sclerosis and results in significant impairment. We studied the clinical and urodynamic findings in such patients to define risk factors for incontinence and upper urinary tract infections. DESIGN AND SETTING: A cohort study of 149 patients with multiple sclerosis and urinary symptoms seen in our urodynamic laboratory. INTERVENTION: A complete urodynamic study of each patient with urethrocystometry and continuous recording of the urethral sphincter electromyography and assessment of postvoid residual. RESULTS: Detrusor hyperreflexia and sphincter dyssynergia were the main dysfunctions. No significant relation between clinical features and urodynamic patterns was found. Women with low maximal urethral pressure were particularly prone to incontinence, which occurred in 69% of the patients. Pyelonephritis was associated with a postvoiding residual urine of > 30% of the functional detrusor capacity, and was found more often in the male population. CONCLUSION: Urodynamic assessment of bladder function is critical to direct therapy for urinary complaints in people with multiple sclerosis.

Adult↗

PubMed1998

Treatment of detrusor sphincter dyssynergia by transperineal injection of botulinum toxin.

Detrusor-sphincter dyssynergia is an involuntary contraction of the external urethral sphincter during the detrusor contraction. It causes voiding dysfunction and can lead to urologic complications such as hydroureteronephrosis and renal failure. Patients with spinal cord injuries are particularly vulnerable. Botulinum toxin has been used via cystoscopy to decrease the activity of the external urethral sphincter. This report describes the treatment of 5 tetraplegic patients by single transperineal injections of botulinum toxin for detrusor-sphincter dyssynergia, proved by a urodynamic study with electromyography. A total of 15 injections was given, resulting in improved bladder function in all patients. Urodynamic assessment after treatment showed an increase of the functional detrusor capacity and a decrease of the maximal detrusor pressure during voiding. These results confirm the consideration of botulinum toxin as a treatment for detrusor sphincter dyssynergia. A single transperineal injection is a valuable, less invasive treatment using a cystoscopic technique.

Adult↗

PubMed1998

Influence of urinary management on urologic complications in a cohort of spinal cord injury patients.

OBJECTIVE: To study urologic complications in patients with spinal cord injury (SCI) in relation to their bladder management. DESIGN AND SETTING: A cohort study of patients with SCI in a rehabilitation center. PARTICIPANTS: One hundred eighty-two patients were studied; demographic data, disease characteristics, and urologic history were obtained for each. INTERVENTION: Patients responding to a questionnaire were given a clinical exam. Their medical records were reviewed, with particular attention given to the following urologic complications: lithiasis, urinary infections, orchiepididymitis, urethral trauma, vesicorenal reflux, and renal failure. RESULTS: Results are reported for 123 patients. Time since SCI was 8 years. Intermittent catheterization was the main method of bladder management. Only 32 patients had changed their method of vesical voiding. Urinary complications had developed in 75% of patients. The most common complication was urinary infection. Vesicoureteral reflux occurred in 26% of patients using percussion. Trauma related to catheterization was the main problem with intermittent catheterization, responsible for a high rate of orchiepididymitis. CONCLUSION: Intermittent catheterization is the most-used method of bladder management, but with a nonnegligible rate of urethral trauma in men. Percussion and Credé maneuver appear to be acceptable techniques of bladder management if the patient is closely monitored.

Adult↗

PubMed1997

[Verotoxin-producing E. coli (VTEC) in feces from cattle slaughtered in Germany].

In man, EHEC infections may result in severe disease. Cattle and foods derived from this animal species are considered as a source of infection. The presence of VTEC being potential EHEC was studied. For analysis, feces samples were examined which had been taken from 204 heads of cattle slaughtered in various regions of Germany. VTEC could be isolated from 97 animals (47.6%). This indicates a presence of VTEC in slaughtered cattle being 5 times higher than known for Germany so far. The aeaA gene could be demonstrated in a mere 23 out of 667 VTEC isolates. The CVD 419 sequence was present in 55.3% of the VTEC isolates. Ehly was found in 61% of them. Consequently, both markers were unsuitable for the detection of VTEC in faeces samples from cattle and in foods with faecal contamination. The VTEC isolates belonged to 54 different serotypes of E. coli, VTEC 0157 have not been found so far. Some of the VTEC serovars found in this study have already been described as associated with human disease following EHEC infection. The presently available laboratory methods do not permit to exclude a risk for humans from bovine VTEC reliably. For this reason, bovine VTEC should be further on considered as potential EHEC and an infection of humans by such agents be avoided.

Abattoirs↗

PubMed1997

[Present problems in detection of sources of infection and chains of infection with enterohemorrhagic E. coli (EHEC)].

In the context of the detection of the haemolyticuraemic syndrome (HUS) and of enterohaemorrhagic E. coli (EHEC) in 13 persons, 372 faeces samples from 13 herds of cattle in northern Bavaria were examined for the presence of EHEC. 128 (34.4%) of the faeces samples were found to be VT-positive. From 78 of these samples (61%), verotoxin-producing E. coli strains (VTEC) could be isolated. During these examinations, E. coli strains with combinations of markers (VT, eae A, EHEC haemolysin) being typical of EHEC were found in 3 samples from animals belonging to the same herd. In 2 cases, these could be assigned to O157:H-, in one, to O118:H16. It has not been possible to detect possible sources of infection and chains of infection assumed to exist in association with the detection of HUS and EHEC infections in humans because most cases had been diagnosed on the basis of verotoxin detection in stool specimens. Moreover, corresponding isolates for a comparative onward differentiation from verotoxin-producing E. coli isolates from animals were not or could not be made available.

Animals↗

PubMed1997

Detection of STEC and epidemiological investigations in surrounding of a HUS patient.

After occurrence of a case of HUS infection in a 2-year-old infant from a dairy farmer's family living near Oldenburg, investigations were performed in the infant's surrounding in order to elucidate the route of infection. Since hospitalization took place at a late stage, it was not possible to isolate EHEC from the patient's stool samples. However, E. coli O157 antibody determinations in serum were positive. Since STEC of serogroup O157 were found in faeces from the 34 dairy cows of the farm, stool samples were taken from 6 members of the child's family and examined. Non-O157 STEC could be isolated from the stools of 2 family members. Determination of other virulence factors and other characteristics such as serotype, biotype and phage type showed identity of the agent for 3 isolates (2 from animals, 1 from humans). By means of pulsed-field gel electrophoresis of the restricted DNA of the isolates and by means of RAPD-PCR it was not possible to establish any differences in the band patterns. It can be assumed, therefore, that the organisms had been transmitted from animals to humans.

Animals↗

PubMed1997

[Detection and occurrence of verotoxin-forming and/or shigatoxin producing Escherichia coli (VTEC and/or STEC) in milk].

Raw milk contaminated with VTEC was described as a source of human EHEC infection. Diagnosis of VTEC from milk is complicated by the low number of VT-positive cells in the total bacterial count, the great variety of serovars with different combinations of virulence markers and the lack of characteristic biochemical properties for the cultural detection of all VTEC. The graduated procedure presented and used for the examination of milk samples is based on VT detection in suitable enrichment cultures and the selective isolation of VTEC by means of VT-specific monoclonal antibodies using the VT-colony immunoblot. This method was used to examine 127 samples of raw milk and 146 samples of certified raw milk (Vorzugsmilch) from 5 different regions in Germany. 3.9% of the raw milk samples and 2.1% of the certified raw milk samples were VTEC-positive. Except for one O157:H- isolate from a raw milk sample, the VTEC found belonged to the group of non-O157 VTEC. They were assigned to 5 different serovars with different combinations of virulence markers. Therefore, raw milk and certified raw milk will continue to present a potential source of EHEC infection. It is recommended to use the procedure presented for the elucidation of the route of infection and for the improvement of detection of VTEC and EHEC-strains in milk in order to obtain comparable data for diagnosis in the official food control laboratories of the federal lands.

Animals↗

PubMed1997

[Optimization of the polymerase chain reaction (PCR) for detection and characterization of shigatoxin producing Escherichia coli (STEC) in food].

The polymerase chain reaction (PCR) was improved to detect shigatoxin producing Escherichia coli (STEC) in milk. Numbers of colony forming units (cfu) in test samples, concentrations and types of primers, amount of MgCl2, types of thermostable DNA-Polymerase, and cycling programs were modified up to obtain the cleanest electrophoretic pattern and the highest sensitivity. Experimental conditions for further characterization of STEC-isolates by means of PCR are given by summarizing data from literature.

Animals↗

PubMed1995

Prevalence of the fimbrial antigens F18 and K88 and of enterotoxins and verotoxins among Escherichia coli isolated from weaned pigs.

Until recently, the fimbrial F18 antigen has been provisionally designated F107, 2134P, or 8813. Using the slide agglutination test, this antigen was shown to be present on 139 of 160 Escherichia coli strains of type O139:K82 and on all of the 146 K88-negative strains of the other pathogenic porcine serotypes. These strains were isolated from weaned pigs which in most cases had died from postweaning colibacillosis. All strains were haemolytic. With only three exceptions, they produced verotoxin and/or enterotoxin. The F18ab variant strongly predominated on the O139:K82 strains and was found on about half of the O138:K81 strains and a few O157 strains, whereas the other strains carried the F18ac variant. In serotypes which can carry either F18 or K88 fimbriae, closer clonal relationships between the strains associated with F18 and those associated with K88 were missing.

Animals↗

PubMed1995

Restoration of gait by functional electrical stimulation for spinal cord injured patients.

In this clinical study, we report the results of functional electrical stimulation for the ambulation of paraplegic patients without long leg braces (LLB), according to the Parastep approach. Of 13 SCI patients with complete neurological lesions included in this trial, 12 progressed to independent ambulation with the aid of the Parastep. The average walking distance was 76 m, with a maximum of 350 m, and the mean speed 0.2 m s-1. Compared to the situation with long leg braces, which in fact are given up by most paraplegic patients, long term home use seems to be much more important. Tolerance of this method is satisfactory. The psychological benefits of the device are remarkable. From this experience, it is concluded that this method is valuable for the restoration of standing and walking in the long term management of spinal cord injury patients.

Adolescent↗

PubMed1995

The reflex sympathetic dystrophy syndrome in patients who have had a spinal cord injury.

Patients suffering from a spinal cord injury often present with a pain syndrome. Although the reflex sympathetic syndrome is a common diagnosis in some forms of neurological disease such as patients with a stroke, it is less frequent in those with a spinal lesion. The authors report eight patients with reflex sympathetic dystrophy who had a spinal cord injury. The diagnosis and treatment are discussed along with a review of literature.

Adult↗