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Biomedical subjects

P Vinceneux

Publications and source records attributed to P Vinceneux.

At least 19 recordsLinked to original sources
PubMed2002

[Febrile form of ankylosing spondylitis].

INTRODUCTION: Ankylosing spondylitis is a chronic inflammatory disorder that is rarely associated with severe systemic manifestations. EXEGESIS: We report the case of a 29-year-old man presenting with an atypical ankylosing spondylitis. The patient presented with a high spiking fever, a marked weight loss, and an unusual increase of acute phase response markers. Such features are rarely associated with ankylosing spondylitis and the review of the few similar reported cases in the literature showed that this presentation is usually associated with a severe disease course, and an asymmetrical joint involvement that is unresponsive to nonsteroidal anti-inflammatory agents. CONCLUSION: Clinicians should be aware of this unusual presentation of ankylosing spondylitis, which should be included in the list of aetiologies of fever of unknown origin, to avoid useless diagnostic procedures. The severity of the disease course may lead to the consideration of a more aggressive treatment strategy.

Acute-Phase Proteins↗
PubMed2002

[Moving meningitis].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed2001

[Klüver-Bucy syndrome in herpetic meningoencephalitis].

BACKGROUND: Klüver-Bucy syndrome (KBS) is an infrequent condition that includes, in its complete form, often massive amnesia, psychic blindness (so-called visual agnosia), oral tendencies, hypermetamorphosis, changes in emotional behavior and increased sexual activity. Anatomic lesions in KBS involve the temporal lobe cortex bilaterally, and the amygdala as well as temporal white matter. CASE REPORT: A 17-year-old patient treated for herpetic meningoencephalitis developed neuropsychological signs leading to the diagnosis of Klüver-Bucy syndrome. DISCUSSION: KBS can occur in various clinical conditions but herpetic encephalitis is the most frequent cause. KBS may be transient or partially regressive, but severe amnesia that may progress to Korsakoff syndrome is often persistent after herpetic encephalitis. Neuroleptics or carbamazepine can be used for symptomatic treatment.

Adolescent↗
PubMed2000

[Facial diplegias during pregnancy].

BACKGROUND: Facial diplegia is a rare event, most commonly of unknown origin. We report the case of a woman who presented bilateral Bell's palsy a few days after a normal delivery. CASE REPORT: Five days after the delivery of gemellary pregnancy, a 34-year old woman developed complete bilateral facial palsy. No treatment was initially prescribed. She was first seen in our department two weeks after the onset of her illness. The diagnostic work-up was negative and we considered that our patient had bilateral Bell's palsy. Treatment with methylprednisolone and intravenous acyclovir, initiated since admission, have had very limited effect. DISCUSSION: As has already been shown for facial palsy, idiopathic facial diplegia, although exceptional, seems to be more frequent during the last trimester of pregnancy and in the early puerperium. Seven cases have been reported in the literature over the last 30 years. We discuss here the pathophysiology.

Acute Disease↗
PubMed2000

[Undergraduate medical education. Students' perspective and medical school policy].

OBJECTIVES: Student attendance to lectures in French medical schools is often poor. We surveyed undergraduate medical students in our medical school, repeating a similar survey conducted ten years earlier. The results are presented with the conclusions of the faculty seminar that followed this survey. METHODS: A closed item questionnaire was distributed in June, 1998, through the hospital wards where the students were posted. After two reminders, the final response rate was 71% (247/348). RESULTS: Overall, 71% of the students declared that they never, or only occasionally, attended lectures in the medical school. Reasons included lack of time (75%), the curriculum diverging from the program of the selective examination that gives access to graduate specialization programs (59%), or insufficient practical clinical content (36%); 46% believed that this teaching prepared them to practice family medicine (11% some specially), and 92% that the way it was organized was not compatible with preparing for the selective examination. On the other hand, 75% of the students in the final two years of the curriculum declared that attending regularly special preparation seminars for the selective examination, to succeed at this test (91%), but also to prepare for family practice (25%). Respectively, 75%, 68% and 66% declared that undergraduate medical courses should, ideally, prepare them for the selective examination, but also for the practice of family medicine, and for graduate medical education. CONCLUSIONS: These results echoed the difficulties of the faculty of the medical school to reconcile preparing students both for their future medical practice and for the selective examination. Two working groups were asked to identify independently appropriate educational objectives according to each perspective: their conclusions appeared to be quite compatible. Based on these conclusions, institutional objectives were ratified to guide the educational policy of our medical school, including the following: to reinforce the consistency and progressiveness of the curriculum; to promote active and autonomous student learning approaches; to develop faculty teaching skills, curriculum evaluation and recognition of teaching activities.

Curriculum↗
PubMed2000

Helicobacter cinaedi septic arthritis and bacteremia in an immunocompetent patient.

We report on the first case of documented Helicobacter cinaedi septic arthritis in an immunocompetent heterosexual young man. The patient presented no identified risk factor except for contact with animals that have been incriminated as a possible source of infection, particularly for these patients. Despite prolonged bacteremia, the response to long-term therapy with ciprofloxacin and rifampin was excellent.

Adult↗
PubMed2000

[Livedoid vasculopathy (white atrophy) associated with anticardiolipin antibodies].

BACKGROUND: Livedoid vasculopathy is an uncommon condition that affects young patients. It must be clinically distinguished from cutaneous vasculitis. CASE REPORT: A 27-year-old man presented pain and skin eruptions involving the lower limbs, hands and trunk. The skin eruption predominated on the feet with purpuric lesions producing a livedoid pattern, ulcerations on both ankles and white atrophic scars on the dorsum of the feet. Skin biopsy showed dermic vessel thrombosis without leukocytoclasia. These features favored livedoid vasculopathy rather than vasculitis. Anticardiolipin antibodies were positive. The patient was started on antithrombotic therapy. The skin ulcerations regressed and no recurrence has been observed at 7-months follow-up. DISCUSSION: Livedoid vasculopathy is characterized by painful purpuric lesions that generally occur on the lower limbs, and frequently ulcerate and heal leaving porcelain white atrophic scars (atrophic blanche). The histology evidences a thrombotic process. Livedoid vasculopathy is normally described as occurring as a sole entity, however thera have been reports of an association with anticardiolipin antibodies. This suggest a possible link with antiphospholipid syndrome.

Adult↗
PubMed2000

Adhesive capsulitis of shoulder and treatment with protease inhibitors in patients with human immunodeficiency virus infection: report of 8 cases.

OBJECTIVE: To describe our experience with human immunodeficiency virus (HIV) infected patients receiving protease inhibitor therapy who presented with adhesive capsulitis of the shoulder. METHODS: Between July 1996 and December 1999, 8 HIV-infected patients (7 male) treated with protease inhibitors who presented with adhesive capsulitis of the shoulder were retrospectively identified. Diagnosis of adhesive capsulitis relied on clinical features including shoulder pain and both active and passive restricted range of motion (ROM). All available clinical and radiographic data were reviewed. RESULTS: Onset of symptoms was insidious, and at presentation, patients complained of shoulder pain, which was bilateral in 4 of the 8 cases. Physical examination showed global restriction of active and passive ROM of the glenohumeral joint. The mean delay between initiation of HIV protease inhibitors and onset of shoulder pain was 14 months (range 2 to 36). The protease inhibitor therapy always included indinavir. No underlying condition associated with secondary adhesive capsulitis of the shoulder, including shoulder trauma, diabetes mellitus, thyroid disease, pulmonary or cardiac diseases could be identified. In all 8 patients, despite continuation of therapy with indinavir, both shoulder pain and restricted ROM completely resolved, after a mean disease course of 7.4 months. CONCLUSION: Adhesive capsulitis of shoulder seems to be a new adverse event of HIV protease inhibitor therapy. In all reported cases, patients were treated with indinavir. Further observations will be necessary to confirm adhesive capsulitis as a side effect.

Adult↗