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Biomedical subjects

P Halfon

Publications and source records attributed to P Halfon.

69 records · Page 4Linked to original sources

[Risk of transmission of hepatitis C virus by digestive endoscopy].

OBJECTIVE: In 30 to 50% of cases, the route of transmission of virus C remains unknown. The aim of this study was to investigate the effectiveness of manual cleaning and disinfection procedures after endoscopic examinations in highly infected patients. METHODS: In 39 patients with chronic hepatitis C and a high level of replication, a gastroscopy with biopsy was performed with a fully submersible endoscope. Cleaning and disinfection were carried out with the following protocol: cleaning with detergent solution (Sekulyse), rinsing, 3 to 5 min immersion into a glutaraldehyde disinfectant solution (Sekucid) and final rinsing. One hundred mL of sterile water was flushed through the biopsy channel immediately after removal of the endoscope (T1), after cleaning (T2), and after final disinfection (T3). These 100 mL were collected in aliquots for viral and bacterial screening. Virus C particles were searched for in the effluent of the biopsy channel using two methods of polymerase chain reaction. RESULTS: Virus C particles were found in 2 of 39 patients in T1 aliquots collected before washing. Routine cleaning with a detergent eliminated all viral particles, as tests were negative at T2 and T3. The usual bacteria (Pseudomonas, Streptococcus, Neisseria...) were detected at T1 and had disappeared after total disinfection at T3. CONCLUSION: Virus C hepatitis could be transmitted during endoscopic examination, but cleaning and disinfection procedures effectively eliminated all viral particles.

Disinfection↗

[Mental representation of drugs: construction of two questionnaires to study patients treated with psychotropic or oral hypoglycemic drugs].

We have built two questionnaires in order to study the representation of drugs. Questionnaires have been established according to the results of an open study involving 78 subjects, whether receiving a treatment or not. These questionnaires were applied on a sample of 126 (psychiatric or diabetic) patients. In the future, we expect the questionnaires to help studying relationships between drugs representation and compliance.

Adult↗

Detection of five different human papillomavirus types in cervical lesions by in situ hybridization. A study of 110 cases using sulfonated probes.

Several findings suggest an etiologic relationship between genital tract squamous cell carcinoma and certain types of human papillomavirus (HPV). Detection of these HPV types in cervical lesions considered as preneoplastic states (ie, cervical intraepithelial neoplasia or CIN) is extremely important but difficult because the morphology of these states is highly heterogeneous and clinical course is rarely predictable. In situ hybridization (ISH) is the only technique allowing correlation between HPV type and tissue or cell morphology. In this report, 110 biopsy specimens from uterine cervix lesions were studied: 66 CIN, 10 invasive carcinoma, 28 metaplasia, and six condyloma acuminata. A new ISH technique based on direct modification of DNA probes by sulfonation was used. The hybridized DNA was revealed first by a specific monoclonal antibody against sulfonated DNA, and then by an alkaline phosphatase system. In order to determine the sensitivity level of this method, 14 biopsy specimens were also submitted to Southern blot hybridization. Five probes were used separately (HPV 6, 11, 16, 18, and 33) for each biopsy specimen. Results of ISH were correlated with morphologic criteria such as number of koilocytes and mitoses. Oncogenic HPV was found exclusively in CIN. The number of labeled cells varied with CIN grade. These data suggest that, whatever the grade, CIN represents a unique preneoplastic process, and that HPV replication depends on the squamous maturation of the pathologic epithelium.

Blotting, Southern↗

Correlation between amount of carbohydrate in mixed meals and insulin delivery by artificial pancreas in seven IDDM subjects.

The effects of mixed meals containing varying amounts of carbohydrate (CHO) on blood glucose levels and insulin delivery by an artificial pancreas were studied in seven insulin-dependent diabetes mellitus subjects. Each patient received, at random over 3 consecutive days, three mixed meals containing 60, 80, and 140 g complex CHOs. There was a high and linear correlation between total amount of insulin delivered to restore blood glucose values and amount of CHO consumed: 12.1 +/- 1.3 to 31.2 +/- 5.2 U insulin were needed for 116 +/- 16 to 198 +/- 24 min. However, neither the time lapse between the beginning of meal intake and blood glucose increase nor the peaking time for blood glucose variation were significantly different between meals. We suggest that some of the data obtained in this study might be useful in programming an open-loop insulin-infusion system.

Adult↗

Multifocal central nervous system lesions in three patients with trichinosis.

Three patients with trichinosis developed central nervous system complications. Cerebral computed tomography showed multifocal hypodense lesions in two patients. The lesions were associated with contrast enhancement and cortical gyral enhancement in the first case, suggesting hypoxia and infarction. In the second patient, magnetic resonance imaging showed multiple high-signal-intensity lesions. Early cerebral computed tomography was normal in the third patient. All patients recovered after treatment with antiparasitic drugs and corticosteroids. We suggest that neurologic complications of trichinosis should be treated by corticosteroids and flubendazole.

Adult↗

[Salmonella paratyphi A urinary infection in Schistosoma mansoni bilharziasis].

The authors report a case of urinary tract infection caused by Salmonella paratyphi A in a patient with Schistosoma mansoni bilharziasis and describe the symbiotic relationship between these two micro-organisms. The association was not fortuitous: schistosomes behave as reservoirs of bacteria and can cause bacterial discharges followed by a long carrying period.

Adult↗

Lack of detectable deleterious effects on metabolic control of daily fructose ingestion for 2 mo in NIDDM patients.

The effects of a daily intake of 30 g fructose on blood glucose regulation, erythrocyte insulin receptors, and lipid metabolism have been studied in type II (non-insulin-dependent) diabetic subjects. Eight well-controlled patients received, in a randomly assigned crossover design over two 2-mo study periods, 30 g of fructose in exchange for an isocaloric amount of starch. Fructose could be taken at any time during the day as part of the 1400-1600 kcal allowed diet (50% carbohydrate, 30% fat, 20% protein). No significant difference was observed concerning body weight, HbA1c, fasting plasma glucose, fasting plasma insulin, uric acid, total cholesterol, high-density lipoprotein cholesterol, and triglycerides, nor was there any change in insulin binding to erythrocytes between the fructose and the control starch period. However, the mean plasma triglyceride levels after the fructose period, although still in the normal range, were significantly higher than baseline values (P less than .05). We conclude that moderate amounts of fructose incorporated into the diet of well-controlled type II diabetic subjects have no significant deleterious effect on glycemic control, insulin receptors of erythrocytes, or lipid metabolism.

Blood Glucose↗

[Validation of a French version of the General Health Questionnaire (GHQ-28) in a diabetic population].

The contrast between the great importance of psychiatric disorders and the fact that they are often not identified as thus in medical and surgical units has been emphasized during the last ten years. The prevalence of depression disorders in an hospitalised population of medical patients is generally estimated between 15% and 30%. It is admitted that one third to two third of theses cases are not diagnosed by non psychiatrist physicians. It is the reason why self questionnaires have been finalized in order to detect psychiatric troubles in medical populations. The General Health Questionnaire (GHQ), constructed by Goldberg, is surely the most internationality used, but no validation study has yet been undertaken in France. This study means the validation of a french version of GHQ-28 items, set on 46 diabetics (type 1 and type 2) selected in a week hospital. This validation is based on the comparison of the two principal scoring methods: "GHQ" (0,0,1,1); "CGHQ" (0,1,1,1 for negative items) and the determination of the best cut-off score in this specific population. The referring DSM III-R diagnoses were assessed by the Composite International Diagnostic Interview (CIDI; Robins et al., 1988), which is a highly structured psychiatric interview developed by the World Health Organisation. Sixteen patients out of the 46 diabetics showed criterions of depressive and/or anxious disorders, 6 of them presenting both. The analysis of the answers to the questionnaires was based upon the technic of the Relative Operating Characteristic (ROC) curves which takes all the sensitivity-specificity couples bound to each of the possible threshold-score into account.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗