Biomedical subjects
Publications and source records attributed to P Travade.
A case of chronic myelogenous leukemia (CML) in a young woman with a new variant Ph1-translocation--i.e., t(8;22) (q24;q12)--is described. The clinical and biological aspects of the disease did not seem to differ from those of the usual cases of CML.
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A three-year-old girl who had for two months suffered bruising after minimal injury was admitted because of diffuse ecchymoses and a large haematoma hindering elbow movement. These symptoms were attributable to the development of antifactor VIII inhibitor. No definite etiology was evident despite repeated immunological investigation. Although the inhibitor still persisted at high levels after two years, no further haemorrhage occurred, excepted haematomas three months after the onset of symptoms, in association with mumps.
Fibrin stabilising factor (FSF) was studied in the circulating blood of 196 children. These 196 children comprised three groups: 131 controls (group A), 20 children with diseases of potential repercussion on FSF determination (group B), and 45 children with Schönlein-Henoch syndrome (group C). Determinations from groups A and B produced normal values, but results from group C were significantly lower at the onset of the vasculitis. Seventeen children with Schönlein-Henoch syndrome have had complications, in 7 of whom these were severe. The decrease in FSF levels was correlated with the severity of such complications, and an increase in FSF was associated with recovery. Determination of FSF activity appears to help in the diagnosis of Schönlein-Henoch vasculitis, as well as helping to monitor the course of the disease and assessing the risks of complications.
A new procedure for the NBT slide test for peripheral blood neutrophils has been tested. 255 neonates were studied of which 63 served as control cases. Among the 114 term infants, 37 were patently infected, 30 suspicious and 47 non-infected. The latter did not significantly differ from control cases, whereas suspicious and infected infants were credited with significantly higher NBT scores. 78 infants were preterm, 31 of which were patently infected, 22 suspicious and 25 non-infected. NBT scores of infected and suspicious infants were significantly higher than those of non-infected infants, but, as previously reported, scores of preterm infants were systematically and significantly lower than those of full-term infants of the same bacteriological class. Threshold values are suggested; they could represent an accurate diagnostic aid in the early differentiation of healthy infants from high-risk infants regarding bacterial infections.
The authors report the results of a prospective test of NBT carried out by an original method already described, and now used for seventy newborn babies. Eleven of them (group I) were tested by simultaneously taken samples from the cord and the heel in the labour ward. The levels obtained according to the position from which the samples were taken showen no significant difference. In 59 other infants (group 2) three successive tests were carried out in the first two weeks of life. These results were classified according to whether the children were: infected, perhaps infected and non-infected. The results confirm correlations between raised levels and infections. Giving antibiotic therapy does not alter significantly the levels in non-infected babies, nor the high positive scores in infected babies that were revealed in the four days after the start of treatment. Following this delay, levels of infected babies' blood did drop significantly, which was a probable indication of the efficacy of the antibiotic therapy.
A new method for carrying out the nitroblue tetrazolium test (NBT) has been used on micro-specimens taken from 116 newborn infants for the purpose of carrying out a prospective enquiry into neonatal infection. 44 children aged from 1 to 6 days were selected at random from a population that was said to be normal in the maternity unit and were the control group. 72 children of less than 48 hours of age were made to object of a prospective study of neonatal infection, an enquiry that allowed them to be divided into 3 groups: non-infected, infected and suspect. The study showed a very strong correlation between raised scores (higher than 100) and the presence of an infection, whereas scores in the controls and the non-infected infants were low. This test, which is hardly invasive and easy to introduce as a routine when carried out early is a good screening test for infection and can be best used on the newborn population in a maternity unit.
A study of the prognosis of two series of chronic lymphocytic leukemia (CLL) patients (99 from a retrospective series and 196 from a prospective series) has led us to propose a three-stage classification (A, B, C), requiring only a clinical examination and a haemogram. For stage A patients (comprising 50% of the CLL patients), survival rates are similar to those in the French general population of the same age and sex; median survival time is six years for stage B patients (comprising 35% of CLL) and two years for stage C patients (comprising 15%). Several methodological difficulties were encountered with the data and the statistical strategy, and these are discussed. The staging system has been justified, since the results have now been confirmed in four other series, totalling 611 CLL patients.
The CLL 80 clinical trial of treatment for chronic lymphocytic leukemia was designed using a three-stage prognostic classification. Within each stage patients received one of two treatments allocated by randomization, two adjacent stages having a common treatment. The fixed-sample design required 850 patients entered over a period of 8.5 years. Active patient recruitment led to 741 patients being randomized in four years. The first interim analysis, carried out at this point, showed a treatment difference in one stage which was statistically significant (p = 0.001) and justified an early termination of the protocol. This paper discusses practical aspects of patient accrual and interim analysis in this study.
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Explore the source record for details and available documents.