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P Thomas

Publications and source records attributed to P Thomas.

At least 55 records · Page 3Linked to original sources
PubMed2005

[Topical haemotherapy as treatment for necrotic angiodermatitis: a pilot study].

INTRODUCTION: Necrotic angiodermatitis is a variety of leg ulcer, characterized by very painful and rapidly spreading lesions. Healing takes time, a mean of 4 to 11 months. Current treatment is difficult and rarely satisfactory. Only early skin grafts lead to rapid sedation of pain and stop the lesion from extending. However, this technique, performed during a progressive phase, enhances the risk of losing a certain number of grafts. We wanted to confirm the efficacy of local auto-haemo-therapy proposed in 2 non-controlled studies. PATIENTS AND METHODS: Eleven patients with necrotic angiodermatitis were included in our non-controlled prospective study. The topical hemotherapy was applied three times a week for one month, with initial hospitalization for 15 days. The criteria of assessment were: evolution of pain, surface of the ulcer, colorimetric scale and the date of disappearance of the purple halo. RESULTS: Ten patients were relieved by the treatment, with progressive withdrawal of the analgesics. The progression of the lesion had stopped and the purple halo had disappeared in general by D6 (range: 2 to 21 days). The percentage of granulation tissue with regard to the surface of the ulcer was of 45.4 p. 100 on D0, 80 p. 100 on D14 and 85 p. 100 on D28. CONCLUSION: Topical hemotherapy applied during the initial phase of treatment would reduce the pain and prepare the lesion for a secondary skin graft.

Administration, Topical↗
PubMed2005

[Nail abnormalities and scleroderma-like lesions on the face associated with systemic amyloidosis].

INTRODUCTION: Mucocutaneous involvement in systemic amyloidosis occurs in 29 to 40 p. 100 of cases. Nail abnormalities are infrequent in AL amyloidosis. We report an original case of AL amyloidosis associated with cutaneous and integument alterations and scleroderma-like infiltration of the face. CASE REPORT: A 73 year-old woman was hospitalized because of weight loss and asthenia. She had been treated 4 years earlier with chemotherapy for a IgG-type multiple myeloma with complete resolution of the underlying monoclonal gammapathy. Cutaneous examination showed nail dystrophy of all fingernails associated with scleroderma-like skin changes on the chin and lips. Histopathologic study of a chin biopsy confirmed the presence of amyloid deposits in the dermis. Laboratory data were normal, without signs of recurrence of multiple myeloma. DISCUSSION: We report an original case of a patient who developed two unusual cutaneous manifestations associated with AL amyloidosis. Moreover, there was no correlation between the severity of the cutaneous lesions and the extent of the underlying hematological disease.

Aged↗
PubMed2005

Are there specific care requirements for patients with schizophrenia and diabetes or with a risk of diabetes?

An interactive workshop was held to discuss the risk of diabetes in patients with schizophrenia, to evaluate the available data concerning how such patients should be managed in terms of minimising the risk of diabetes and of optimising their care where diabetes to develop. The subjects discussed covered monitoring of risk factors, education about lifestyle and the risk of diabetes, patient care and treatment options, and interfaces between psychiatry and diabetology. The workshop noted that all patients with a diagnosis of schizophrenia had an elevated risk of developing diabetes and that this needed to be reflected in the follow-up of the patients in order to reduce the chances of the emergence of disease. The risk of diabetes is complicated by the presence of other risk factors and the intensity of the diabetes prevention programme needs to reflect adequately the overall risk. The most important prevention methods relate to lifestyle changes that patients with schizophrenia may be spontaneously unlikely to adopt and therefore necessitate the implementation of specific education measures aimed at patients and their families. The workshop proposed follow-up intensities, monitoring procedures and prevention programmes stratified according to the risk of developing diabetes. It was not considered that there was sufficient data available to orientate treatment choices between individual antipsychotic drugs according to the potential risk of developing diabetes.

Blood Glucose↗
PubMed2005

Number of repetitions to maximum in hop tests in patients with anterior cruciate ligament injury.

The unilateral horizontal, triple cross-over and vertical hops are commonly used as outcome measures after knee injury but there is little knowledge of the number of repetitions needed to reach maximum performance. Seventy subjects who had either an anterior cruciate ligament deficient or reconstructed knee participated in this study. Unilateral vertical, horizontal, and triple cross-over hop testing was applied to each leg until two consecutive decrements in performance occurred. The number of repetitions to reach maximum during these tests were calculated. Fifteen repetitions of the horizontal and vertical hops, and 10 repetitions of the triple-crossover hop enable distances to be achieved that are acceptably close to maximal levels in these knee-injured patients. In order to increase the likelihood of finding a patient's maximum hop performance after knee injury, more repetitions are suggested than has been reported in the literature.

Adult↗
PubMed2005

Increase in infectivity of targeted Moloney murine leukemia virus-based gene-delivery vectors through lowering the threshold for fusion.

Many research groups have developed targeted vectors for gene therapy based on Moloney murine leukemia virus (MoMLV). Despite proper binding of the targeted vector to the target molecule, little or no infectivity of human cells expressing the target molecule has been achieved in most studies. One of the reasons for this lack of infectivity may be steric hindrance within the targeted envelope glycoprotein (Env), impeding the conformational changes required for fusion and infection. Here, attempts were made to solve this problem by mutating key residues within Env of two targeted MoMLV-based vectors, MoMLV-E-Sel and MoMLV-FBP. Selection of key residues was based on an Env with reduced threshold for fusion, that of the CD4-independent human immunodeficiency virus type 2 isolate ROD/B. It was shown here that vectors bearing MoMLV-FBP Env with a V512M substitution had higher titres and faster kinetics of entry than vectors bearing parental targeted Env proteins. This could be due to the partial release of steric constraints that result in an Env with a reduced threshold for fusion.

Amino Acid Sequence↗
PubMed2005

Coagulation and inflammatory markers in Alzheimer's and vascular dementia.

Alzheimer's disease is classified as a degenerative dementia while vascular dementia is known to be associated with atherothrombosis and classical vascular risk factors. However, over the last decade, there is increasing evidence of the role of haemostatic factors and inflammatory mechanisms in the pathogenesis of Alzheimer's disease. Serum markers of hypercoagulability and markers of inflammation could lead to thrombosis, accelerated atherogenesis and resulting dementia of both Alzheimer's and vascular dementia. In this case control study, we studied these serum markers of coagulation and inflammation in patients suffering from dementia.

Alzheimer Disease↗
PubMed2005

Effects of porcine circovirus type 2 (PCV2) maternal antibodies on experimental infection of piglets with PCV2.

To determine the effects of porcine circovirus type 2 (PCV2) maternal antibodies on and response to experimental PCV2 infection, 24 piglets were divided into four groups on the basis of the enzyme-linked immunosorbent assay titers of PCV2 maternal antibodies: group A (n = 6; sample/positive [S/P] ratio, <0.2), group B (n = 5; S/P ratio, >0.2 to <0.5), and groups C (n = 8) and D (n = 5) (S/P ratio, >0.5). Piglets in groups A, B, and C were inoculated with PCV2 at day 0 and challenged with PCV2 at day 42. Group D piglets were not exposed to PCV2 at day 0 but were challenged at day 42. Before challenge, seroconversion to PCV2 antibodies occurred in five of six group A piglets, and the antibody level rose above the cutoff level in one of five group B piglets. Viremia was detected in five of six, four of five, and two of eight pigs in groups A, B, and C, respectively. After challenge, PCV2 DNA was detectable from 7 to 21 days postchallenge in the sera from six of six, four of five, three of eight, and five of five pigs in groups A, B, C, and D, respectively. The results indicated that protection against PCV2 infection conferred by maternal antibodies is titer dependent: higher titers are generally protective, but low titers are not.

Animals↗
PubMed2005

Decreased VEGF concentration in lung tissue and vascular injury during ARDS.

Endothelial injury is an important prognostic factor in acute respiratory distress syndrome (ARDS). Decreased production of vascular endothelial growth factor (VEGF) in ARDS may favour vascular lesions, since VEGF promotes endothelial survival by inhibiting apoptosis. This study sought to document low VEGF levels in lung tissue from ARDS patients, to determine whether the cause was injury to alveolar type II cells (the main pulmonary source of VEGF) and to evaluate the vascular consequences. Lung specimens were obtained by open biopsy or autopsy from 29 patients with severe ARDS (two survivors) and five controls. As compared with controls, homogenates of lung tissue from ARDS patients contained less VEGF (median (interquartile range) ARDS 8.2 (4.7-12.2) versus controls 28.4 (9.9-47.1) ng x g(-1) protein). Increased immunostaining with surfactant protein B was seen in ARDS lungs. Extensive cellular apoptosis (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labelling staining), including endothelial and alveolar type II cells, was demonstrated, and vascular bed density (CD31 immunostaining) decreased in ARDS lungs as compared with controls. VEGF levels were negatively correlated to apoptotic endothelial cell counts. In conclusion, decreased vascular endothelial growth factor levels in lung tissue may participate in the decrease in lung perfusion in acute respiratory distress syndrome.

Aged↗
PubMed2004

Identity of an estrogen membrane receptor coupled to a G protein in human breast cancer cells.

Although nonclassical estrogen actions initiated at the cell surface have been described in many tissues, the identities of the membrane estrogen receptors (mERs) mediating these actions remain unclear. Here we show that GPR30, an orphan receptor unrelated to nuclear estrogen receptors, has all the binding and signaling characteristics of a mER. A high-affinity (dissociation constant 2.7 nm), limited capacity, displaceable, single binding site specific for estrogens was detected in plasma membranes of SKBR3 breast cancer cells that express GPR30 but lack nuclear estrogen receptors. Progesterone-induced increases and small interfering RNA-induced decreases in GPR30 expression in SKBR3 cells were accompanied by parallel changes in specific estradiol-17beta (E2) binding. Plasma membranes of human embryonic kidney 293 cells transfected with GPR30, but not those of untransfected cells, and human placental tissues that express GPR30 also displayed high-affinity, specific estrogen binding typical of mERs. E2 treatment of transfected cell membranes caused activation of a stimulatory G protein that is directly coupled to the receptor, indicating GPR30 is a G protein-coupled receptor (GPCR), and also increased adenylyl cyclase activity. The finding that the antiestrogens tamoxifen and ICI 182,780, and an environmental estrogen, ortho,para-dichlorodiphenyldichloroethylene (o,p'-DDE), have high binding affinities to the receptor and mimic the actions of E2 has important implications for both the development and treatment of estrogen-dependent breast cancer. GPR30 is structurally unrelated to the recently discovered family of GPCR-like membrane progestin receptors. The identification of a second distinct class of GPCR-like steroid membrane receptors suggests a widespread role for GPCRs in nonclassical steroid hormone actions.

Adenylyl Cyclases↗
PubMed2004

New York City syndromic surveillance systems.

New York City's first syndromic surveillance systems were established in 1995 to detect outbreaks of waterborne illness. In 1998, daily monitoring of ambulance dispatch calls for influenza-like illness began. After the 2001 World Trade Center attacks, concern about biologic terrorism led to the development of surveillance systems to track chief complaints of patients reporting to emergency departments, over-the-counter and prescription pharmacy sales, and worker absenteeism. These systems have proved useful for detecting substantial citywide increases in common viral illnesses (e.g., influenza, norovirus, and rotavirus). However, the systems have not detected more contained outbreaks earlier than traditional surveillance. Future plans include monitoring school health and outpatient clinic visits, augmenting laboratory testing to confirm syndromic signals, and conducting evaluation studies to identify which of these systems will be continued for the long term.

Bioterrorism↗
PubMed2004

The unusual binding properties of the third distinct teleost estrogen receptor subtype ERbetaa are accompanied by highly conserved amino acid changes in the ligand binding domain.

Three forms of estrogen receptor: ERalpha, ERbeta (ERbetab), and a second ERbeta, ERbetaa (formerly ERgamma) are present in teleost fish. All ERbetaas share amino acid changes in the ligand binding domain that may influence ligand specificity and receptor function. We compared binding specificities of the three ERs of the teleost fish, Atlantic croaker Micropogonias undulatus. Bacterially expressed Atlantic croaker (ac) ERalpha, -betab, and -betaa fusion proteins showed specific, high affinity binding to 17beta-[(3)H]estradiol, with K(d) values of 0.61 +/- 0.013, 0.40 +/- 0.006, and 0.38 +/- 0.059 nm, respectively. Rank orders of binding were: diethylstilbestrol >> ICI182780 > 4-hydroxytamoxifen > ICI164384 > estradiol >/= zearalenone > moxestrol > tamoxifen > estrone >/= 17alpha-estradiol > estriol > 2-hydroxyestrone = genistein >> RU486 for acERalpha; ICI182780 > diethylstilbestrol > 4-hydroxytamoxifen > estradiol > ICI164384 > genistein > moxestrol > tamoxifen > zearalenone = estrone > estriol = 17alpha-estradiol > 2-hydroxyestrone >> RU486 for acERbetab; and estradiol >/= diethylstilbestrol > 4-hydroxytamoxifen > ICI182780 > ICI 164384 > estriol >/= genistein > moxestrol > zearalenone > estrone > 17alpha-estradiol > RU486 >/= tamoxifen > 2-hydroxyestrone for acERbetaa. acERbetaa showed higher relative binding affinities for estradiol, estriol, and RU486 and lower relative binding affinities for synthetic estrogens and antiestrogens than previously characterized ERs. Mutation of the conserved teleost substitutions (acERbetaaPhe(396)) to the ERalpha or ERbetab counterpart shifted diethylstilbestrol and tamoxifen affinities toward those of wild-type acERalpha and acERbetab, supporting the hypothesis that the positions with conserved residue changes in teleost ERs are important to ER structure and function.

Amino Acid Sequence↗
PubMed2004

[Bilateral localized osteolysis after cemented total hip replacement].

The incidence of focal progressive osteolysis after THR is about 8% and 56%. Most often osteolysis is correlated with macrophage-induced osteoclastic bone resorption as a sequel of inflammatory reaction to wear particles. Recently these findings were published in respect to allergic reactions to implants, their alloying constituents, or bone cement. We report about a patient who developed bilateral localized osteolysis just below the cement mantle 5 years after cemented THR with a Müller straight stem. In the middle of the osteolysis small fragments of bone cement could be detected. Epicutaneous testing showed no reaction against cobalt, chromium, or nickel. Further epicutaneous testing in respect to ingredients of the bone cement were refused by the patient. Histological examination revealed a histiocytic reaction to wear particles and surrounding giant cells. To our knowledge, this is the first case of bilateral localized osteolysis after cemented total hip replacement. Taking all results of the current case into account, it is still unclear if a lymphocytic allergic contact reaction did contribute to the sequel of this case. Reports of immunologically induced incompatibility to components of bone cement, the development of extended testing procedures, and further scientific research should contribute to optimizing the care of patients.

Bone Cements↗
PubMed2004

The many forms of bipolar disorder: a modern look at an old illness.

Bipolar disorder continues to be underrecognized, despite being known for 2000 years. Mania, the fullest expression of the disease affects approximately 1% of the population; the less-than-manic forms of the disease dominated by depressive episodes have recently been found to be more common, affecting 4-5% of the population. In reviewing the international literature on this broadened bipolar spectrum, this paper pays particular tribute to the French EPIDEP and EPIMAN studies and Italo-American collaboration which have generated the largest set of systematic data on the new clinical portrait of bipolar disorders. Early detection is crucial, because untreated bipolar disorder has a high mortality rate. A review of the diagnostic criteria for the various subtypes of bipolar disorder has identified several factors that interfere with making an accurate diagnosis. These include age at onset, ethnic differences, co-morbidity (particularly substance abuse and alcoholism), and the broad range of clinical presentations. Moreover, symptoms frequently overlap with those of other psychiatric disorders including schizophrenia, attention-deficit disorder and personality disorders. Misdiagnosis is a major factor leading to a poor outcome for patients. Accurate identification and diagnosis of the different forms of mania can lead to specific treatment choices that may improve prognosis. Particularly important are recent data indicating reduced mortality with a variety of psychopharmacologic agents including, but not limited to, lithium and valproate.

Bipolar Disorder↗
PubMed2004

Evidence that 4-pregnen-17,20beta,21-triol-3-one functions as a maturation-inducing hormone and pheromonal precursor in the percid fish, Gymnocephalus cernuus.

Behavioral, biochemical, and electrophysiological studies suggest that the trihydroxylated progestin steroid, 4-pregnen-17,20beta,21-triol-3-one (20beta-S) stimulates oocyte maturation and pheromone release in the Eurasian ruffe, a freshwater percid fish. Behavioral observations found that female ruffe undergoing oocyte maturation (OM) release a pheromonal cue that stimulates swimming activity and social interactions among conspecific males. Neither vitellogenic nor ovulated females released the cue. Pheromone production was directly associated with elevated plasma levels of 20beta-S in maturing female ruffe which in vitro incubation suggested to be a possible maturation-inducing hormone (MIH) in this species along with 4-pregnen-17,20beta-diol-3-one (17,20betaP). However, neither of these steroids appear to be the pheromone because electrophysiological and behavioral studies found them to lack olfactory (EOG) and behavioral activity. Instead, studies of the odor of steroid-injected fish suggest the pheromone is a metabolite of 20beta-S. In particular, inter-peritoneal injection of 20beta-S (but not 17,20betaP) consistently induced release of a urinary cue with strong behavioral activity. The pheromone may be a highly polar and novel metabolite because it could not be extracted using octadecylsilane resin (C18) which has proven effective for other teleost hormonal pheromones.

Animals↗
PubMed2004

[Treatment of solar urticaria by intravenous immunoglobulins and PUVA therapy].

BACKGROUND: Solar urticaria is a rare form of urticaria occurring a few minutes after solar exposure. It is particularly incapaciting because it limits outdoor activities. Antihistamine and phototherapy are sometimes disappointing. CASE REPORT: A 32 Year-old woman had been suffering from severe solar urticaria since November 2000, which was confirmed by photobiological data. High-dose antihistamine treatment (fexofenadine 180 mg twice a day) was inefficient. Despite a first UVA desensitization, PUVAtherapy produced only a partial improvement and short lasting for protection, with an important handicap in daily life. In March 2002, among the others treatments, we chose intravenous immunoglobulins: 0.5 g/kg the first day then 1 g/kg the second and the third days. The minimal urticaria dose was raised from 1 J/cm2 in UVA before perfusion up to 15.6 J/cm2 48 hours later and in UVB from 100 mJ/cm2 up to 2,200 mJ/cm2. Clinically the improvement was significant but partial in daily activities. It was possible to reintroduce PUVAtherapy without UVA-desensitization and, for the first time, to obtain complete remission for more than 2 Months with an association of intravenous immunoglobulins, PUVAtherapy and antihistamine treatment. In July 2002, treatment was successfully repeated. DISCUSSION: First intention treatments (antihistamine and PUVAtherapy) are sometimes inefficient. Others treatments (plasmapheresis, ciclosporin, doxepin, cimetidine) are restrictive, not always efficient and can induce severe side-effects. We report the second case of solar urticaria improved by intravenous immunoglobulins. In spite of the cost, intravenous immunoglobulins seem to be an interesting treatment, at least by avoiding UVA-desensitization in severe cases of solar urticaria.

Adult↗
PubMed2004

[Prognostic indicators in stage I non-small cell lung cancer].

INTRODUCTION: Determinating the prognosis of patients with stage I non-small cell lung cancer (NSCLC) is a challenge. Since up to 30% of patients who have undergone surgical resection experience recurrence, generally in distant organs, it is reasonable to postulate that neo-adjuvant or adjuvant treatments might be useful. Better knowledge of prognostic factors could perhaps define which patient populations should be targeted with such treatments. STATE OF THE ART: Numerous potential prognostic factors, relating to the disease (TNM classification, histology, tumor size, blood vessels invasion, micro-metastasis, serum or molecular markers), the patient (gender, age, co-morbidity) as well as the treatment (delay, resection, lymph node dissection, neo-adjuvant and adjuvant treatments), are discussed. PERSPECTIVES: These prognostic factors should be integrated into the design of future clinical trials of chemotherapy and/or radiotherapy attempting to evaluate the effectiveness of various combinations of neo-adjuvant or adjuvant therapies. CONCLUSIONS: These factors may offer the opportunity to clinically and biologically characterize the different subgroups of patients, leading to a more rational, and perhaps individualized, choice of therapy.

Biomarkers, Tumor↗