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Biomedical subjects

R Beuscart

Publications and source records attributed to R Beuscart.

At least 73 records · Page 4Linked to original sources
PubMed1988

Cytogenetic studies and their prognostic significance in agnogenic myeloid metaplasia: a report on 47 cases.

Cytogenetic analysis was performed in 47 newly diagnosed patients with agnogenic myeloid metaplasia (AMM); 32 had a normal karyotype (68%, group I), whereas 15 had clonal abnormalities (32%, group II). The most frequent abnormal findings were a 20q- deletion in six cases (either alone or within complex anomalies), interstitial 13q- deletion in three cases (and monosomy 13 in one case), and acquired trisomy 21 or 21p+ in three cases. Four cases exhibited complex aberrations involving several chromosomes, sometimes with a mosaicism. In two patients with an initial abnormal karyotype, further cytogenetic analysis during the disease course showed the appearance of additional clonal anomalies, and particularly of a probable Philadelphia (Ph1) variant in one case. Treatment was essentially supportive. Survival was significantly shorter in group II (median, 30 months) compared with group I (median, not reached at 6 years; P = .015). In univariate analysis, other parameters significantly associated with a poor prognosis (P less than .05) were higher age, anemia, and increased percentage of circulating blasts. However, in a multivariate analysis, only cytogenetic abnormalities and age retained their independent prognostic value.

Acute Disease↗
PubMed1987

Prognostic significance of prolactin receptors in human breast cancer.

Overall survival and relapse free survival (RFS) were studied in 547 patients according to the presence of prolactin receptors (PRL-R), either free or total (after 3 M MgCl2 desaturation). All these patients were surgically treated for locoregional disease in the same institution between 1978 and 1984. In actuarial survival studies, RFS was higher in total PRL-R positive patients in the whole population (P less than 0.02). When the population was divided into two groups, according to either the presence or the absence of node metastasis or the presence or absence of estradiol receptor, the higher RFS was restricted to node positive (P less than 0.001) and to estradiol receptor positive patients (P less than 0.01). The Cox analysis on RFS showed that free PRL-R alone was a significant prognostic factor in estradiol receptor positive patients; total PRL-R alone was never significant; when considered together with steroid receptors, free as well as total PRL-Rs were significant prognostic factors in some subgroups of patients.

Breast Neoplasms↗
PubMed1987

Propafenone versus disopyramide: a double-blind randomized crossover trial in patients presenting chronic ventricular arrhythmias.

In vitro and in vivo electrophysiological studies have shown that propafenone could be classified as a class I antiarrhythmic agent. The aim of this study was to investigate the short-term antiarrhythmic efficacy and safety of propafenone in 10 patients compared to disopyramide in a double-blind randomized protocol. Included patients suffered from ventricular arrhythmias with at least 60 ventricular premature beats (VPB) per hour refractory to at least two other antiarrhythmic agents. At the end of the control period and of the two treatment periods during which patients received either propafenone (300 mg three times a day) or disopyramide (200 mg three times a day), clinical examination, Holter recordings, electrocardiogram, and clinical laboratory tests were performed. The PR interval and the QRS interval were significantly increased with propafenone, but not with disopyramide. The cQT interval was not significantly changed by either propafenone or disopyramide. Heart rate was decreased with propafenone (p less than 0.05) with no change in the diurnal/nocturnal circadian ratio variation. Heart rate was significantly decreased with disopyramide only during the day. Five of nine patients in the propafenone group and two of nine patients in the disopyramide group showed a reduction in ventricular premature beats greater than 80%. Total resolution of severe arrhythmias (repetitive events) was seen in 5 of 8 patients with propafenone; 2 of 8 with disopyramide. Adverse events, when they occurred, were mild (visual disturbances, epigastric discomfort, changes in taste perception, transient atrioventricular block with propafenone, and photophobia with disopyramide), and did not require reduction or discontinuation of study drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Enhanced efficacy of computerized exercise test by multivariate analysis for the diagnosis of coronary artery disease. A study of 558 men without previous myocardial infarction.

Multivariate analysis has been proposed to enhance diagnostic accuracy of the exercise test in coronary artery disease. To quantify the improvement given by multivariate analysis in comparison with ST segment depression alone during exercise test, 558 men without previous myocardial infarction were studied retrospectively. All the patients underwent a symptom-limited Bruce protocol with computer-averaged recordings in V5, aVF, V2. Coronary angiography was performed within the following 90 days. Prevalence of coronary artery disease (diameter narrowing of 50% or greater) was 0.56. Among 12 clinical and exercise parameters studied by stepwise multivariate analysis, five were found to reach the maximal accuracy: (1) exercise duration, (2) history of typical angina, (3) typical angina during the test, (4) age, (5) maximal heart rate. In comparison with ST depression, multivariate analysis significantly improves accuracy (74.6 vs. 66.8%, P less than 0.01) by increasing sensitivity (0.68 vs. 0.59, P less than 0.05) without affecting specificity (0.83 vs. 0.76, NS). Thus, in a group of men without infarction and a low prevalence of coronary artery disease, multivariate analysis with five easily collected variables is more accurate than ST segment depression alone during exercise. In addition, ST depression did not appear as discriminant as exercise duration for diagnostic purposes. This finding emphasises the importance of performing a symptom-limited exercise test.

Adult↗
PubMed1987

[Gallium-67 scintigraphic evaluation of primary dilated myocardiopathies in adults].

Myocardiopathy (MCP) is diagnosed by exclusion in patients with congestive heart failure in the absence of lesions of the coronary vessels or cardiac valves. Endo-myocardial biopsies and several cases of clinical improvement under immunosuppressive therapy suggest that it may be due due to an immune mechanism. Gallium-67 is taken up by the myocardium and may be regarded as a scintigraphic marker of myocardial inflammation. It may therefore be used to determine which patients would benefit from immunosuppressants. Our study involved 47 patients (mean age 40.1 +/- 10.2 years) with MCP evidenced by angiography and coronary arteriography. Isotopic ejection fraction (EF) and Ga-67 uptake by the myocardium were evaluated in all cases. A significant Ga-67 uptake was observed in 22 patients, 20 of whom could be divided into two groups: group I received an immunosuppressive treatment (azathioprine plus prednisone); group II did not receive such treatment. A new radionuclide cardiac examination was carried out 5 months after the beginning of treatment. No significant Ga-67 uptake could be detected in either group. Significant improvement of EF was observed in 6 patients of group I and in 2 patients of group II. Four patients had died: 1 in group I and 3 in group II. Thus, a decrease in Ga-67 uptake was noted in all patients 5 months after the initial examination, irrespective of the treatment received, which suggests that this decrease belongs to the natural history of the disease. The effect of immunosuppressive therapy on MCP, therefore, ought to be re-evaluated.

Adult↗
PubMed1987

[Probability of coronary lesions evaluated by the discriminant analysis of clinical and ergometric parameters].

It has been suggested that multivariate analysis can be used to improve the diagnostic value of the conventional exercise tests. In order to evaluate the usefulness of this method in clinical practice, we have conducted a retrospective study of 558 male subjects without history of infarction who had undergone an exercise test and, less than 90 days later, a coronary arteriography. All exercise tests were performed according to Bruce's procedure and with an equipment which provided continuous averaging of ST segment values on V5, V2 and VF leads. The prevalence of significant coronary lesions (more than 50% luminal narrowing) was 56%. The values of 12 clinical and electrocardiographic parameters at rest and during exercise were subjected to a step-by-step multivariate analysis. Compared with the quantitative analysis of ST alone, the multivariate analysis increased the sensitivity (68% vs 59%, p less than 0.05) and specificity (83% vs 76%, NS) of the tests and the percentage of well-classified subjects (74.6% vs 66.8%, p less than 0.01). The best combination was obtained with the first 5 parameters of the final classification, viz.: (i) duration of exercise; (ii) clinical history of angina; (iii) anginal pain during exercise; (iv) age, and (v) maximum heart rate. The validity of the method was demonstrated on a recent series of 200 consecutive patients where the prevalence of coronary lesions was 58%. The discriminant function score enabled 74% of these patients to be correctly classified and improved the sensitivity of their exercise test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Correlation between prolactin receptors (PRL R), estradiol (ER) and progesterone receptors (PgR) in human breast cancer.

Free (n = 432) and total (n = 387) prolactin receptors (PRL R) (after 3 M MgC12 desaturation) as well as estradiol (ER) and progesterone receptors (PgR) were measured in 547 breast cancer patients surgically treated in the Oscar Lambret Centre. Free PRL-R were found in 43% of the cases, total PRL R in 72%, ER in 81% and PgR in 55%. A statistically significant correlation was found by the Spearman test between ER on the one hand free PRL R (P less than 0.02) and total PRL R (P less than 0.001) on the other and between PgR on the one hand, free PRL-R (P less than 0.05) and total PRL R (P less than 0.01) on the other. A linear correlation test could be done on subgroups of values, excluding zero values, of each of the receptor type; a statistically significant correlation could be found between ER and total PRL R (P less than 0.001) and between PgR and total PRL R (P less than 0.05). These results confirm, on a large series, the relation between PRL R, ER and PgR in breast cancer.

Breast Neoplasms↗
PubMed1986

Plasma fibronectin in severe infectious purpura of children.

Plasma fibronectin levels were determined in 34 children admitted with severe infectious purpura. Fibronectin concentration was decreased in severe infectious purpura as in other sepsis, but there was no significant difference between shock and nonshock patients. Fibronectin levels were lower in children with ecchymotic or necrotic purpura on admission than in those with petechial purpura; they were lower in those who developed cutaneous sequelae, but it is not known if correction of fibronectin deficiency may limit the extent of purpura and prevent the cutaneous sequelae.

Child↗
PubMed1986

A double blind controlled study of the hormonal and clinical effects of bromocriptine in the polycystic ovary syndrome.

Previous studies on the efficacy of bromocriptine for the treatment of patients with the polycystic ovary syndrome failed to include control groups. This study, therefore, was undertaken to determine the clinical and endocrine effects of bromocriptine and a placebo (given in a random double blind fashion) in 55 patients with PCOS. The plasma levels of estrone, estradiol, testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, and serum PRL and gonadotropins (LH and FSH) were measured before treatment. In addition the serum PRL response to TRH and the serum LH and FSH response to GnRH were determined. The effects of acute administration of bromocriptine (2 X 2.5 mg at 12-h intervals) on serum gonadotropins and their response to GnRH were studied to explore the possibility that this test might predict the response to chronic bromocriptine treatment. Bromocriptine then was given at an initial dose of 1.25 mg twice daily. If no clinical improvement occurred 2.5 mg were given twice daily for at least 6 months. Hormonal measurements and dynamic tests were repeated after 3 and 6 months of therapy. The endocrine profile of the two groups was not different before treatment. The clinical results were not better in the treatment group than in the placebo-treated patients: therapy was successful (restoration of ovulatory cycles of less than 35 days duration) in 12 of 28 patients taking bromocriptine vs. 8 of 27 taking placebo. Slight improvement (1 or 2 ovulations) occurred in 3 of 28 vs. 3 of 27, and failure (no clinical change) in 13 of 28 taking bromocriptine vs. 16 of 27 taking placebo, respectively. Serum PRL fell significantly in the bromocriptine group, and there was a significant fall in the serum LH response to GnRH in both groups. No hormonal measurement or response predicted the clinical response to treatment. The only significant effect of chronic bromocriptine therapy (5 mg/day) in patients with the polycystic ovary syndrome was to lower the serum PRL concentration.

Adolescent↗
PubMed1986

[Anti-Coxsackie antibodies and congestive cardiomyopathies].

During a 4-years period 122 patients admitted to the cardiologic hospital in Lille presented a significative positivity of serological reaction against Coxsackievirus B. Among these patients 19 suffered from acute pericarditis, 4 from cardiac arrhythmias, 3 from Bornholm syndrome and 14 from apparently primary congestive cardiomyopathy. In most of these 14 patients representing 18.4% of congestive cardiomyopathies investigated at the same time, hemodynamic studies and heart scanning with radioactive gallium were performed. 7 of these patients had a chronic (group A) and 7 an acute evolution (group B). In group A the scans were negative 4 times out of 5, whereas in group B they were positive in 5 out of 5 examinations. The control group including 3247 patients coming from the Institut Pasteur exhibited serological positivity in 4.6% of cases. Comparison of this group with that of cardiomyopathies shows a significant difference (p less than 0.001). The authors draw the attention to the frequency of positive serodiagnosis in congestive cardiomyopathy and stress the importance of gallium scintiscanning.

Adult↗
PubMed1986

[Caloric intake and weight gain according to the shift schedule of shift workers].

Survey involved 84 workers matched for age, socio-occupational and families status and divided into 3 groups : A : 27 shift workers on 3 days rotating shift, B : 47 shift workers on 5 days rotating shift, C : 20 days workers. Each subject was submitted to dietary survey by means of 24 hours recall, realised 3 times for shift workers and once for control. All workers were interviewed about caloric intake of the preceding day off caloric intake. Annual weight gain was studied through the use of occupational health service records. There was no significant difference between the 3 groups for working day caloric intake. Day-off intake was lower (p less than 0.05) in group A (day-off any day of the week). Annual weight gain was not different between the 3 groups. Shift workers with faster weight gain had a higher caloric intake on day-off and after evening meal.

Adult↗
PubMed1985

Prognostic factors of severe infectious purpura in children.

The French Club of Pediatric Intensive Care has prospectively studied 90 cases of infectious purpura which were hospitalized in 1981; the purpose of this study was to determine prognostic factors. The statistical study (X2 test) of all these cases is in agreement with data in the literature and shows that the mortality is significantly higher when there is: shock (p less than 0.001), coma (p less than 0.05), ecchymotic or necrotic purpura (p less than 0.01), temperature less than 36 degrees C (p less than 0.05), no clinical meningism (p less than 0.001), white cell count less than 10,000/mm3 (p less than 0.05), thrombocytopenia less than 100,000 (p less than 0.01), fibrinogen less than 1.5 g/l (p less than 0.001), kalemia greater than 5 mEq/l (p less than 0.01), spinal fluid cell count less than 20/mm3 (p less than 0.01). Because shock is one of the main prognostic factors (23 deaths in 55 shocked patients, versus 2 in 35 non-shocked) we have performed another statistical study (with the Benzecri method) to determine a prognostic index for patients in shock. For its determination, five initial parameters are used: age, kalemia, white cell count, clinical meningism, platelet count. The predictive value for survival is 91%. The predictive value for death is 87%. The score was applied on the patients hospitalized in shock in 1982: the predictive value for survival is 75%, the predictive value for death is 61%.

Child↗
PubMed1985

[Small oscillations in fetal cardiac rhythm: a sign of well-being? A new approach to the diagnostic value of spontaneous recordings of fetal cardiac rhythm in pregnancy].

The authors suggest an indirect evaluation of the electrocortical activity of the fetus by looking at evidence of cyclical variations in fetal cardiac rhythm. These are shown up by periodic changes in the variability of the rhythm. The narrow association that has been established between small changes in episodes of cardiac rhythm and deep sleep--which is itself evidence of satisfactory cortical development--make this type of tracing, under certain conditions, an excellent sign of fetal wellbeing. This means that the value of small variabilities in fetal heart rhythm takes on greater importance as a prognostic feature.

Animals↗