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Biomedical subjects

R Laurent

Publications and source records attributed to R Laurent.

At least 55 records · Page 3Linked to original sources
PubMed1995

The ability of computed tomography to identify a painful zygapophysial joint in patients with chronic low back pain.

STUDY DESIGN: A prospective cross-sectional analytic study. OBJECTIVES: To assess in patients with chronic low back pain whether the presence or absence of pain originating from the lumbar zygapophysial joints correlates with changes seen on computed tomography. SUMMARY OF BACKGROUND DATA: Results of studies have been divided as to whether or not radiologic imaging is able to predict those patients with pain originating from the zygapophysial joints. METHODS: Sixty-three patients with low back pain lasting for longer than 3 months underwent computed tomography and blocks of the zygapophysial joints at L5-S1, L4-L5, and L3-L4. The zygapophysial joints of all images were scored by three independent, masked radiologists. RESULTS: Interobserver agreement was poor with intraclass correlation coefficients of 0.34-0.66 using total joint scores for all three assessors. Using the results of a repeat assessment with two radiologists there was no statistically significant difference in joint scores between those with and those without pain originating from the zygapophysial joint. CONCLUSIONS: Computed tomography has no place in the diagnosis of lumbar zygapophysial joint pain.

Adult↗
PubMed1995

Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain.

OBJECTIVES: To determine the prevalence of pain arising from the zygapophysial joint in patients with chronic low back pain and to determine whether any clinical features could distinguish patients with and without such pain. METHODS: Sixty three patients with chronic low back pain were studied prospectively. All patients underwent a detailed history and physical examination as well as a series of intra-articular zygapophysial joint injections of 0.5% bupivacaine starting at the symptomatic level to a maximum of three levels or until the pain was abolished. They also received injections of normal saline into paraspinal muscles to act as controls. RESULTS: All patients proceeded with the injections. Twenty (32%; 95% confidence interval (CI) 20 to 44%) obtained greater than 50% relief of their pain following the administration of saline. Fifty seven patients completed the study; 23 of them (40%; 95% CI 27 to 53%) failed to obtain relief following the injection of saline but obtained relief following one or more intra-articular injections of local anaesthetic. None of the historical features or clinical tests could discriminate those patients with and those without zygapophysial joint pain. CONCLUSION: Pain originating from the zygapophysial joint is not uncommon, but this study failed to find any clinical predictors in patients with such pain.

Aged↗
PubMed1995

Detection of human cytomegalovirus in female and male anogenital lesions with papillomavirus-associated dysplastic changes.

The aim of the study was to determine the presence of human papillomavirus (HPV) and cytomegalovirus (CMV) DNA in lesions from mucosal and keratinized cutaneous epithelium of the anogenital tract. One hundred ninety-eight women and 55 men with anogenital lesions were enrolled for the study. Biopsies were prepared for histological analysis and in situ hybridization using biotinylated probes. Potential oncogenic HPV were found in 15% of samples showing no outward signs of HPV infection or inflammation. They were detected in 40% of samples showing low grade squamous intra-epithelial lesions (SIL) and in 95 to 100% of lesions showing high-grade SIL. Cytomegalovirus DNA was detected twice as frequently in women as in men, and was preferentially associated with high-grade SIL. A significant relationship between high-risk HPVs and the presence of CMV was observed in the low-grade lesions. Our data suggest that the CMV genome in the host epithelial cells might act as a permissive factor upon which oncogenic HPV could interact over time to increase the frequency and severity of cervical, penile, and anal dysplasia.

Anus Neoplasms↗
PubMed1994

[Acquired syphilis and HIV infection].

The currently observed increased prevalence of syphilis in subjects with human immunodeficiency virus (HIV) infection could be an expression of an increase in sex-related risks or could result from facilitated viral transmission via ulcerations of the genital organs. In addition, viral-immunological interactions related to HIV infection could affect the natural history of syphilis suggesting that the clinical pictures of the past may be making a comeback due to modified response to syphilis infection. These observations would suggest revising a certain number of the classical diagnostic and therapeutic criteria for syphilis in HIV positive patients. The consequence of these interactions on response to treatment may be the key to the increased number of unsuccessful treatments observed recently and to the increased frequency of early neurological and ocular manifestations of syphilis. Clinicians should revise their therapeutic schemes which have become unadapted to the new situation caused by HIV infection.

France↗
PubMed1994

A comparative study of the safety and efficacy of dysprosium-165 hydroxide macro-aggregate and yttrium-90 silicate colloid in radiation synovectomy--a multicentre double blind clinical trial. Australian Dysprosium Trial Group.

The aim of our study was to compare the safety and efficacy of a new preparation, Dysprosium-165 Hydroxide Macroaggregate (165Dy) with Yttrium-90 Silicate (90Y) for radiation synovectomy of the knee in patients with RA and OA. A multicentre double blind clinical trial with subjects randomized to receive 165Dy or 90Y was undertaken in Sydney, Melbourne and Perth. Seventy knees of 59 patients were studied, using as clinical end point measurements, pain in the knee on walking, pain in the knee at rest and stiffness in the knee after rest. Cytogenetic damage, knee retention and extra-articular spread of the radionuclide to regional lymph nodes, liver, urine and blood were evaluated. There was no significant difference in clinical response in the two treatment groups for either RA or OA. Chromosomal changes occurred with equal frequency and the knee retention and extra-articular leakage of radiocolloids to regional lymph nodes and liver were comparable in the two groups. For radiation synovectomy of the knee, 165Dy is at least as safe and as effective as 90Y and has the advantage of a short half-life (2.334 h) and hence requires a shorter period of post-injection immobilization and hospitalization.

Aged↗
PubMed1994

Evaluation of Biohit HPV Screening and Typing kits in detection of human papillomavirus DNA from lesions of anogenital tract.

The Biohit HPV Screening and Typing kits for in situ hybridization of human papillomavirus (HPV) DNA are now commercially available. The HPV Screening kit contains a cocktail of HPV probes, and the Typing kit contains separated hybridization probes for HPV 6, 11, 16, 18, 31, and 33. They were evaluated by comparison with an in situ hybridization (ISH) method, using the Pathogene HPV probes 6/11, 16/18, 31/33/51. One hundred anogenital biopsies from 78 women and 22 men were tested. Among them, 43% showed normal or inflammatory mucosa, 44%, koilocytosis or mild dysplasia, and 13%, moderate to severe dysplasia. Altogether, 60 specimens were positive with the ISH reference method: 17 with the HPV 6/11 probe, 12 with the HPV 16/18 probe, 16 with the HPV 31/33/51 probe, and 15 had mixed infections. The agreement between the Screening test and the homemade ISH is 91%. The Screening test has a sensitivity of 93% and a specificity of 87%. As for the Biohit Typing test, four false-negative samples, and partial or total discordance in nine and four samples, respectively, were observed when compared to our reference method. Thus the agreement between both typing ISH tests is 92%. The sensitivity of the Biohit Typing test is 93%, and the specificity, 91%. The sensitivity decreases to 72% when the 31 and 33 probes are evaluated separately. The Biohit Screening assay is simple, reliable, reproducible, and suitable for rapid routine screening. The Biohit Typing test allows the detection of a specific type of HPV DNA and also permits, in mixed HPV infection, definition of the type of associated HPV DNA.(ABSTRACT TRUNCATED AT 250 WORDS)

Anus Diseases↗
PubMed1994

Oncogene activation: an informative marker for the human papillomavirus-lesions severity.

The aim of this study was the detection of c-Ha-ras and c-myc activation and p21ras and p62myc expression in anogenital HPV-associated lesions. Thirty-two women with cervical and vaginal lesions and forty men with anal or penile warts were enrolled for the study. Biopsies were subjected to histological assessment, in situ hybridization with biotinylated probes, and immunohistochemistry. In both women and men, most of the biopsies showing no major histological abnormalities were negative for HPV detection. The low-grade squamous intraepithel-)ial lesions (SIL) harbored HPV in more than 50% of cases. The high-grade SIL contained mostly oncogenic HPV. C-Ha-ras and c-myc activation was detected in 31/41 HPV-positive lesions, especially in lesions harboring HPV 31/35/51 or multiple HPV. Simultaneous activated oncogenes were found in 7 out of 9 high-grade SIL and in 21 out of 45 low-grade SIL. In most of the lesions, we demonstrated concurrent detection of p21ras and p62myc proteins and oncogene activation. Our study shows that c-Ha-ras and c-myc activation is correlated with oncoprotein expression and associated with the presence of oncogenic HPV. Such activation might play a role in the development of high-grade anogenital dysplasia.

Anus Diseases↗
PubMed1994

[Cutaneous tertiary syphilis with neurological symptoms].

INTRODUCTION: The tertiary cutaneous syphilis is now extremely rare. We report a case of tubercular cutaneous syphilis associated with neurological dysfunction. We emphasize the difficulties to interpret serologic and CSF tests for the diagnosis of neurosyphilis. CASE REPORT: A 63 year-old-woman had nodular, purplish and painless cutaneous lesions on forehead and forearm for 6 months. The biopsy showed a dermohypodermic lymphoplasmocytic granuloma, without necrosis, with endothelitis. Syphilis serologic tests were positive: VDRL = 512 U; TPHA = 40,960 U; FTA abs: IgG = 72,000 U; IgM = 1,350 U; Nelson test = 100 p. 100 (1,200 U). HIV test was negative. There was a past history of a positive syphilis serologic test when the patient was 20-year-old. The patient complained of shaking and her family spoke of gradual mental deterioration and behaviour troubles. The neurological examination showed a major frontal syndrome, cerebellar dysfunction with dysarthria and a major labial and lingual tremor. There is no lymphocytosis nor increased protein in the CSF; VDRL test was negative, TPHA test was positive, FTA abs = 4,000 U (IgG), and TPHA was increased. Penicillin G 16 millions units/day was given intravenously for 20 days; a slow increase was made in association with steroids at the beginning. The cutaneous lesions regressed in 14 days, but the neurologic state did not change. Six months later, there was still no IgM, TPHA decreased and VDRL was unchanged. DISCUSSION: While the diagnosis of tertiary cutaneous syphilis was correct, the neurological abnormalities are difficult to classify. The symptoms were those of general paresis, but there is no argument favouring biological CSF activity (no increase in protein or lymphocytosis, negative VDRL). Nevertheless, in the context of very positive serologic tests and tertiary cutaneous syphilis, we treated this case as a neurological syphilis. The treatment regimen and the need of current cures are still under discussion.

Facial Dermatoses↗
PubMed1993

Treatment of scleroderma with oral 1,25-dihydroxyvitamin D3: evaluation of skin involvement using non-invasive techniques. Results of an open prospective trial.

1,25-dihydroxycholecalciferol (1,25 (OH)2 D3) causes dose-dependent inhibition of fibroblast growth and collagen synthesis and has numerous immunoregulatory activities. We assessed the effects of oral 1,25 (OH)2 D3 in the treatment of patients with systemic sclerosis (SS). Eleven patients with SS entered an open prospective study. Oral 1,25(OH)2 D3 was given at a mean dose of 1.75 micrograms/day. The effects of the treatment were evaluated using clinical examination and physical measurements. After the treatment period (6 months to 3 years), a significant improvement, as compared with baseline values, was observed. No serious side-effects were observed. These results suggest that high-dose 1,25 (OH)2 D3 may be a useful therapeutic agent for scleroderma.

Administration, Oral↗
PubMed1993

[Septicemic cutaneous localization of cryptococcosis following renal transplantation in a female].

Cryptococcosis is a systemic disease caused by the yeast-like fungus Cryptococcus neoformans. Cutaneous manifestations, although rare, may precede other organ involvements. A case of cutaneous cryptococcosis is described herein. The skin lesions in our patient (a 47-year old female with renal transplant) consisted of acute cellulitis over her left and right thighs, revealing a septicemic infection. The patient received immunosuppressive drugs (prednisone, azathioprine). Clinical, mycological and histopathological data are described in details. Amphotericin B and fluconazole were initially successful, but a relapse with Cryptococcus meningitis required the adjunction of itraconazole to treatment. This case report underlines the insufficient effectiveness of fluconazole and the success of itraconazole.

Antifungal Agents↗
PubMed1993

[Anogenital papillomavirus lesions in humans with or without HIV infection. Comparison of colposcopic, histopathological and virological results].

Anal and genital lesions caused by human papilloma virus (HPV) may be associated with severe dysplasia and cancer, chiefly in cases of "high risk" HPV types 16, 18, 31, 35, 51. The frequency of HPV infections and the severity of genital cancers seem to be increased in patients with human immunodeficiency virus (HIV) infection. PATIENTS AND METHOD. The distribution of different HPV types was compared with the anatomical and clinical features of the lesions in two populations, one HIV+ (n = 40) and the other HIV- (n = 48), who had anal and genital lesions. The HPV DNA was determined by molecular hybridization in situ, using biotinylated probes which recognized HPV types 6/11, 16/8 and 31/35/51 on 99 lesions. RESULTS. HIV+ subjects differed from HIV- subjects in that a higher proportion of them had anal lesions (50 p. 100 vs 10 p. 100) and condyloma latum (80 p. 100 vs 50 p. 100). Koilocytosis without dysplasia was more often found in HIV- subjects (12.5 p. 100 vs 55 p. 100). Conversely, dysplasia was more frequent among the lesions of HIV+ subjects: grade I 39.5 p. 100 vs 17.5 p. 100; grade II 25 p. 100 vs 4 p. 100; grade III 12.5 p. 100 vs 0 p. 100. Koilocytosis was preferentially associated with condyloma acuminatum. In HIV+ subjects the DNA of HPV, detected in 73 p. 100 of the lesions, was "high risk" HPV DNA in 86 p. 100 of the cases, whereas in HIV- subjects 51 p. 100 of the samples were positive in hybridization, and 61.5 p. 100 had "low risk" HPV DNA. In subjects of all groups "high risk" HPV was found in dysplastic lesions. CONCLUSION. HIV seropositive subjects show an imbalanced distribution of HPV with predominance of "high risk" HPV. This suggests that immunodepression encourages infection by this oncogenic virus, thereby contributing to the frequency of cancer in HIV+ subjects.

AIDS-Related Opportunistic Infections↗