Nodular gastritis associated with Helicobacter helmannii infection.
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Adolescent↗
Biomedical subjects
P Vincent
Publications and source records attributed to P Vincent.
Abnormal avoidance learning in mice lacking functional high-affinity nicotine receptor in the brain.
Nicotine affects many aspects of behaviour including learning and memory through its interaction with neuronal nicotinic acetylcholine receptors (nAChR). Functional nAChRs are pentameric proteins containing at least one type of alpha-subunit and one type of beta-subunit. The involvement of a particular neuronal nicotinic subunit in pharmacology and behaviour was examined using gene targeting to mutate beta 2, the most widely expressed nAChR subunit in the central nervous system. We report here that high-affinity binding sites for nicotine are absent from the brains of mice homozygous for the beta 2-subunit mutation. Further, electrophysiological recording from brain slices reveals that thalamic neurons from these mice do not respond to nicotine application. Finally, behavioural tests demonstrate that nicotine no longer augments the performance of beta 2-1- mice on passive avoidance, a test of associative memory. Paradoxically, mutant mice are able to perform better than their non-mutant siblings on this task.
Animals↗
Transmission and acquisition of Helicobacter pylori infection: evidences and hypothesis.
The role of Helicobacter pylori in gastroduodenal diseases has been established, but many ecological and epidemiological features remain unclear. Although H pylori infection is one of the most common infections in the world, the mode of transmission remains unknown. Uncommon extra-endoscopic isolation raises obstacles to a good understanding of epidemiological patterns, and no rational basis exists for a prophylaxis strategy. This work reviews the data on the reservoir of the bacteria and its ecological niche, the method of excretion from the site of infection and the possible circumstances of acquisition. Many features are completely unknown or still controversial, and interpretation is often speculative. At the present time, it can be assumed that the most likely mode of spread would be from saliva in childhood. However, further works are required to establish, whether or not, fecal transmission co-occurs in low hygiene conditions.
Animals↗
A third locus for hereditary haemorrhagic telangiectasia maps to chromosome 12q.
Hereditary haemorrhagic telangiectasia (HHT) or Rendu-Osler-Weber disease is an autosomal dominant vascular disorder which associates epistaxis, mucocutaneous and visceral telangiectases, and recurrent haemorrhage with chronic anaemia and visceral shuntings. Recently, the tumour growth factor (TGF)-beta binding protein endoglin localized to 9q33-34 was identified as responsible for HHT in several large kindreds with pulmonary arteriovenous malformations (PAVMs). Additional linkage studies demonstrated that HHT is a genetically heterogeneous disorder with families unlinked to this region of 9q. In the families in which HHT was not linked to chromosome 9, less PAVMs were present. Furthermore, in one of these families, HHT was found linked to 3p22, where the TGF-beta II receptor is located. In this linkage study, we have analysed DNA from two families, in which HHT was unlinked to chromosome 9q and 3p, and PAVMs were absent, with a series of genetic markers on the centromeric region of chromosome 12. Using two-point linkage analysis, a significant lod score of Zmax = 7.86 at theta = 0.05 was obtained with the D12S85 microsatellite marker.
Antigens, CD↗
Client characteristics associated with not keeping appointments for public health nursing home visits.
Home visits have been identified as an intervention strategy for high-risk pregnant women. A necessary component of this intervention strategy is for the women to be home for the visit with the nurse. The purpose of this study was to identify factors associated with women not keeping their home visit appointments with a public health nurse. Subjects were 232 low-income high-risk pregnant women who received at least one home visit by a public health nurse. Younger age, more stressful life events, receipt of medical assistance, inadequacy of prenatal care, noncompliance with health recommendations, and longer gestational time were associated with not keeping public health nursing appointments. While this study provides some insight into the factors associated with women not keeping their appointments with the public health nurse, further investigation is warranted to identify strategies to reduce the incidence of not-kept appointments.
Adult↗
[Radiotherapy and concomitant cisplatin in stage III non-small cell bronchial cancer: results of a pilot study].
From July 1989 to July 1991, 73 previously untreated patients with histologically proven stage III inoperable non-small cell lung cancer have been treated with standard fractionation radiation therapy and concomitant cisplatin by continuous infusion. Thoracic irradiation was delivered at a dose of 40 grays in 20 fractions over 4 weeks to the entire mediastinum, ans was followed after a two-week rest by a boost of 30 grays in 15 fractions over 3 weeks with oblique fields sparing the spinal cord. Continuous infusion cisplatin was given during the second week or each radiation therapy sequence at a dose of 20 mg/sqm/24 hours during five days (120 hours) with usual hyperhydratation and antiemetic measures. Toxicity was essentially hematologic and gastro-intestinal but there was only 4.1% grade 3 or grade 4 complications. Radical surgery became feasible after the first cycle of treatment in 10 patients (13.7%). Complete response rate as determined by CT-scan and fiberoptic bronchoscopy was 61.6%. At a median follow-up of 26 months, actuarial overall survival at 1, 2 and 3 years was 46.6%, 27.7% and 24.5%, respectively. There were no local recurrence or distant relapses after 3 years, which will hopefully result in long-term survival in one quarter of these patients. These results compare favorably with other studies combining radiation therapy and concomitant cisplatin with different dosage and schedule. Local control appears substantially improved by this combined modality treatment over radiation therapy alone. However, the incidence of distant metastasis remains significant, especially during the first year of follow-up. Further improvement of early and long-term survival could possibly result from the incorporation in this protocol of a second drug active against subclinical dissemination.
Actuarial Analysis↗
[Stage III non-small cell lung cancers: prospects of concomitant radiochemotherapy].
The prognosis of stage III non small cell lung cancer is reportedly poor, particularly in patients with mediastinal lymph node involvement. These patients may be either good surgical candidates, marginally resectable, or inoperable for technical or medical reasons, but, in any case, surgery and/or radiotherapy are curative in only a minority of them. The high incidence of early distant failures underscores the need for early and effective systemic therapy in association with local treatment, since occult metastatic disease is present in most patients at the time of diagnosis. Recent phase III trials have demonstrated significant benefit to induction chemotherapy prior to irradiation or surgery in reducing the distant metastasis rate. However, poor local control remains a major issue in these locally advanced tumors. In patients with inoperable disease, the concomitant use of chemotherapy along with radiotherapy substantially improves local control. For operable patients, induction chemotherapy with concomitant moderate-dose radiotherapy improves local control as well, and may facilitate surgical resection in marginally operable cases. Currently, a number of phase II clinical trials report encouraging results with concomitant chemoradiotherapy used either prior to surgery or with curative intent in locally advanced non small cell lung cancer.
Antineoplastic Agents↗
Bedrest compliance for women with pregnancy problems.
Bedrest has long been recommended for high-risk pregnancies, but recent studies question its effectiveness in improving pregnancy outcomes. To be effective, the women for whom bedrest is recommended must practice it. This study examined degree of compliance and reason for noncompliance in women for whom bedrest was recommended, and outcomes of pregnancy among high-risk women who complied compared with those who did not. The subjects were 326 high-risk pregnant women who were prescribed bedrest for preterm labor, blood pressure problems, or bleeding problems. Of that group, one-third did not comply with the bedrest recommendation. These women had more children, were not currently married, had more stress, did not attend prenatal classes, continued drinking alcohol during pregnancy, and were not trying to get pregnant compared with women who complied. Reasons for noncompliance included the need to care for children, not feeling sick, household demands, lack of partner or family support, need to work, and discomfort. The pregnancy outcomes for the women who complied were similar to those of the women who did not comply. These findings support the importance of more research on the practice of prescribing bedrest to improve pregnancy outcomes.
Bed Rest↗
Trends in bacterial infections in febrile neutropenic patients: 1986-1992.
BACKGROUND: Bacterial infection is a major cause of morbidity and mortality in neutropenic patients. AIMS: (1) To review patterns and trends in bacterial infections in three cohorts of febrile neutropenic patients managed by a single unit over a seven year period. (2) To relate any changes to the use of central venous (Hickman's) catheters and high-dose cytosine arabinoside chemotherapy. METHODS: Retrospective review of the results of initial bacteriological work-up performed on 344 episodes of febrile neutropenia. The three cohorts were 1986-87 (n = 102), 1989-90 (n = 92) and 1991-92 (n = 150). RESULTS: (1) The ratio of gram-negative to gram-positive bacteraemias fell from 1.36 in the first cohort to 1.05 in the second and 0.40 in the third (p = 0.03). There was a fall in both percentage and number of gram-negative isolates coupled with a rise in the frequency of gram-positive isolates. (2) Coincidentally there was a rise in the frequency of positive cultures from Hickman catheter entry wounds and an increasing frequency of simultaneous isolation of the same organism from the catheter entry site and the blood. The types of organisms isolated from catheter entry wounds showed a trend towards fewer gram-negative and more gram-positive. (3) A relationship was observed between the use of high-dose cytosine arabinoside chemotherapy and the incidence of bacteraemia (p = 0.025) but not with the change in types of organisms. CONCLUSIONS: Over seven years we have documented a major change in the types of infections, particularly bacteraemias, seen in febrile neutropenic patients. In our institution the more widespread use of intravenous catheters and high-dose cytosine arabinoside chemotherapy have been identified as two possible contributing factors.
Bacteremia↗
A randomised dosage study of ceftazidime with single daily tobramycin for the empirical management of febrile neutropenia in patients with hematological diseases.
A single-institution, randomised trial was conducted to compare the clinical and microbiological efficacy of two different doses of ceftazidime in combination with a single daily dose of tobramycin for the empirical management of febrile neutropenic patients with hematologic disorders (absolute neutrophil count < 1 x 10(9)/l). Upon the development of fever or signs of sepsis, patients received either 2 g ceftazidime every 8 h plus a single daily dose tobramycin (5 mg/kg/day) (C2T, n = 73) or 1 g ceftazidime every 8 h plus a single daily dose of tobramycin (C1T, n = 77). In addition, flucloxacillin (1-2 g every 4 h) could be added if there was clinical suspicion of staphylococcal infection. Analysis was performed for the whole group and for the subset which did not receive flucloxacillin. When evaluated at 96 h, 70% (95% CI, +/- 11%) of patients randomised to C2T and 60% (95% CI, +/- 11%) randomised to C1T had responded (chi 2 = 1.27, P = 0.26). The response rates at 96 h for those who did not receive flucloxacillin were 77% (+/- 12%) and 74% (+/- 13%), respectively (chi 2 = 0.01, P = 0.92). Overall, 68 (93% +/- 6%) and 72 (94% +/- 6%) patients, respectively, eventually became afebrile (chi 2 = 0.06, P = 0.81). Renal function, as judged by serum creatinine, was unaffected by either antibiotic schedule. Within 10 days of antibiotic commencement there was one death in each arm and overall there were five deaths in each arm.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[Treatment of obstructive bronchial cancers with high dose, endobronchial curietherapy. Technical aspects and clinical results].
Between September 1990 and September 1991, 35 patients with mainly recurrent or residual endobronchial carcinoma were treated with 91 high-dose-rate endobronchial brachytherapy applications. Treatment technique was fairly simple and could easily be performed on an outpatient basis. Endoscopic placement of one or two applicators is followed by computerized dosimetry and irradiation during a median time of 10 minutes. Treatment included 3 sessions of 10 grays measured at 10 mm from the center of the radioactive source at 2-week intervals. Response rate was 81.8% including 51.5% complete clinical response. There were 12 microscopically complete response out of 14 patients biopsied. Immediate tolerance was excellent in 90% of cases. However, late complications were severe in 25% of cases. Ongoing radiobiological research should determine an optimal therapeutic approach in term of efficacy and long term toxicity before using endobronchial brachytherapy as a part of the initial management of unresectable lung cancers.
Adult↗
Helicobacter pylori infection in early infancy.
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Endoscopy, Gastrointestinal↗
Serum prostate-specific antigen in monitoring the response of carcinoma of the prostate to radiation therapy.
In order to assess the value of serum prostate-specific antigen (PSA) levels in the monitoring of patients with localized prostatic carcinoma undergoing radical radiation therapy, 146 previously untreated patients were entered into this study. Sixty to 70 Gy were administered to the prostate over 8 to 9 weeks. Serum PSA levels were measured prior to radiotherapy, every 3 months during the first year and every 6 months thereafter. Median follow-up was 28 months. Pretreatment PSA values exceeded 10 ng/ml in 62% (91/146). Initial PSA values were correlated with tumor size and Gleason score. Six months after completion of radiation therapy, PSA levels decreased as compared to initial value in 88.3% of the patients. It had fallen to 10 ng/ml or less in 54 (59%) out of the 91 patients with initial abnormal PSA levels. Patients whose initial PSA exceeded 50 ng/ml attained levels of 10 ng/ml or less in only 19% of the cases (6/32). Only 3 of the 55 patients (5.5%) with both initial and 6-month PSA values less than or equal to 10 ng/ml developed metastasis. Out of the 91 patients with initial PSA values over 10 ng/ml, 54 (59.6%) had a 6-month PSA level of 10 ng/ml or less, and only 4/54 (7.4%) relapsed. By contrast, 13 of the 37 patients (35.1%) with a 6-month PSA value persistently above 10 ng/ml relapsed. The 3-year relapse-free survival is 85.1% for patients with a 6-month PSA level less than or equal to 10 ng/ml, and 50.2% for patients with persistently elevated PSA values.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenocarcinoma↗
Cationic channels sensitive to extracellular ATP in rat lacrimal cells.
1. Responses of isolated rat lacrimal cells to local applications of ATP were studied using tight-seal whole-cell recording and/or Fura-2-derived calcium concentration measurements. 2. In cells where variations in Ca2+ concentration were prevented by use of a strong Ca2+ buffer, ATP was found to induce an inward current response at negative holding potentials. With 10 microM-ATP, the current amplitude ranged between 20 and 200 pA. The reversal potential of this ATP-induced current was close to 0 mV with normal external solution and shifted to -19 +/- 3 mV (mean +/- S.D.) when the concentration of external monovalent cations was halved. These results indicate that the channels have a cationic selectivity. The response amplitude decreased markedly from trial to trial, indicating a desensitization process which was irreversible on the time scale of the recordings. 3. Steady state I-V curves for the ATP-induced current in normal saline showed a marked inward rectification. This rectification appeared to be linked to a time-dependent activation of the channels, as hyperpolarizing voltage jumps elicited a time-dependent current increase. This relaxation could be fitted by a double-exponential function, with time constants (at -120 mV) of 0.9 +/- 0.3 ms and 110 +/- 6.4 ms. 4. Variance analysis of the ATP-induced current gave a single-channel current value of 0.34 pA at -60 mV. The single-channel current amplitude varied linearly with potential, with a slope close to 6 pS. The relation between noise covariance and time could be fitted by a double-exponential function, with time constants (at -60 mV) of 0.8 +/- 0.4 ms and 6.8 +/- 3.4 ms (mean +/- S.D.). 5. In an isotonic Ca2+ solution, 10 microM-ATP induced an inward current at -60 mV with a calculated single-channel current amplitude obtained from noise analysis close to 0.2 pA. In an external solution containing 10 mM-calcium and no sodium, 50 microM-ATP elicited a current with a reversal potential of -19 mV. 6. Fura-2 measurements were performed in intact cells or in cells dialysed with a low concentration of Ca2+ buffer (e.g. 0.5 mM-EGTA). Under such conditions ATP induced increases of the internal Ca2+ concentration with very variable amplitudes. In some cells Ca2+ rises of 50 nM or lower were found. Minimal activation of Ca(2+)-dependent channels was then observed. In other cells large Ca2+ rises (up to 500 nM) were observed and were then correlated with marked activation of Ca(2+)-dependent channels.(ABSTRACT TRUNCATED AT 400 WORDS)
Adenosine Triphosphate↗
Inhibitory synaptic currents in rat cerebellar Purkinje cells: modulation by postsynaptic depolarization.
1. Synaptic currents were recorded in voltage-clamped cerebellar Purkinje cells using the tight-seal whole-cell recording technique. Cells were dialysed with a CsCl solution and were held at -60 or -70 mV. Inhibitory interneurones (basket and stellate cells) were stimulated using an extracellular pipette positioned in the molecular layer. Blockers of excitatory glutamatergic synapses were included in the bath solution. 2. Evoked synaptic currents were observed after a latency of 3-4 ms. The time course of synaptic currents could in most cases be fitted to a biexponential curve, with a rise time constant, tau on, of 1-3 ms and a decay time constant, tau off, of 7-13 ms. These currents were blocked by bicuculline. 3. The mean amplitude of evoked synaptic currents increased in discrete steps when the voltage applied to the stimulating pipette was increased. At each level, very prominent fluctuations of the amplitude were observed among trials. 4. Complex synaptic currents corresponding to repetitive activity of the presynaptic interneurone were occasionally observed, particularly with high intensity presynaptic stimulation. This repetitive activity could lead to bursts of synaptic currents lasting for several seconds. 5. Following a depolarizing voltage train in the postsynaptic Purkinje cell, the amplitude of evoked synaptic currents was first inhibited, and then potentiated. The inhibition was accompanied by a small but consistent increase in tau off and by no alteration in tau on. When using small intensity presynaptic stimuli, it was found that the probability of failures was greatly enhanced. The inhibitory phase lasted for about 1 min before giving way to potentiation. The potentiation returned to the control with a time to half-decay of 12.9 +/- 0.9 min. 6. The present results give further evidence to a previously proposed hypothesis that the inhibition produced by Purkinje cell depolarization is mainly presynaptic. The longer lasting potentiation, on the other hand, has most probably a postsynaptic origin. Cerebellar Purkinje cells receive inhibitory GABAergic inputs from two classes of interneurones located in the molecular layer (reviewed in Palay & Chan-Palay, 1974; Ito, 1984). Basket cells are closest to the Purkinje cell layer and address their inhibitory signal primarily to the soma and to the main dendrites. Stellate cells are more externally located and have contacts with the more distal part of the dendritic arborization of Purkinje cells.(ABSTRACT TRUNCATED AT 400 WORDS)
Animals↗
Carbamazepine-induced atrioventricular block.
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Carbamazepine↗
[Pathological gambling: literature revue].
This paper summarizes the current literature on pathological gambling. Interest in gambling has been present in every society but treated as an object of sociopolitical or literary interest. It is only from the beginning of this century that psychiatry began to look at pathological gambling, first with Freud and his writing on Dostoïevsky then with other theories like the learning theory, studies on substance dependence, the links with affective syndromes and the psychobiological studies. These studies are presented and discussed. Finally, the authors offer some guidelines for an approach to a pathological gambler.
Behavior, Addictive↗
[Dysmorphophobia (body dysmorphic disorder)].
This article reviews the historical and terminological origins of dysmorphophobia from Herodotus to today. It explains the differences pointed out by many authors, including the DSM-III-R, between body dismorphic disorder and delusional disorder somatic type, which are referred to as monosymptomatic hypochondriacal psychoses in Europe. Epidemiological data, clinical characteristics and outcome are discussed. Explicative theories and neurobiological, developmental and analytical aspects of body image are presented. The association between body dismorphic disorder and other disorders is analyzed, and treatment possibilities are discussed. The authors suggest that body dismorphic disorder be classified with obsessive compulsive disorder, whatever the intensity of symptomatology, rather than with somatoform or delusional disorder, and treated with serotonin uptake inhibitors or neureptics that have been proven to be effective for the treatment of this disorder, such as pimozide.
Body Image↗