Biomedical subjects
S Vignes
Publications and source records attributed to S Vignes.
[Mechanisms and clinical expression of graft rejection and graft-versus-host disease].
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[Still disease].
Adult onset Still's disease is a systemic disorder of unknown etiology. The diagnosis is difficult and based upon Yamaguchi's criteria after exclusion of infectious diseases, hematologic process or autoimmune diseases. Clinical manifestations are various. Functional prognosis depends essentially on articular involvement. Vital prognosis depends on either hepatic failure or hematological or infectious complications, or amyloidosis. Ferritinemia is an important biological parameter which is not included in current criteria. Treatment is not well codified but steroids represent the most efficient therapy to control fever and systemic manifestations. Search for new treatments and specific markers of adult onset Still's disease are needed.
[Current indications of low-molecular-weight heparins].
Low-molecular-weight heparins (LMWH) have different properties than non-fractionated heparins. Bioavailability is better after subcutaneous administration and a longer halflife allows a single daily injection. Efficacy is equivalent for postoperative thromboembolism prophylaxis for all types of surgery. In most reports, low-molecular-weight heparins are more effective than non fractionated heparin and lead to fewer episodes of hemorrhage and thrombocytopenia. For treatment of deep vein thrombosis, low-molecular-weight heparins are as effective as non-fractionated heparins after two, or even one, daily injection without hemostasis tests. Other on-going studies are evaluating LMWH indications in pulmonary embolism, artery disease, pregnancy or other medical conditions.
[Mononucleosis syndrome in dengue].
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[False elephantiasis].
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[Oculopharyngeal myopathies: value of myotomy of the superior sphincter of the esophagus. Apropos of a case].
Since 3 years, a 74 year-old man suffered of swallowing impairment, weight loss, bilateral ptosis and proximal muscular weakness. Electron microscopy disclosed intranuclear tubular filaments and confirmed the diagnosis of oculopharyngeal muscular dystrophy. Upper oesophageal sphincter myotomy was performed with complete improvement. Four months after surgery, swallowing disorders were not recurrent and weight gain was substantial.
Ramipril-induced superficial pemphigus.
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Retinal arterial occlusion associated with resistance to activated protein C.
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Critical influence of timing of administration of granulocyte colony-stimulating factor on antibacterial effect in experimental endocarditis due to Pseudomonas aeruginosa.
The effect of human recombinant granulocyte colony-stimulating factor (hrG-CSF) in rabbits with aortic endocarditis due to Pseudomonas aeruginosa was investigated. hrG-CSF significantly increased the number of polymorphonuclear neutrophils in blood and in cardiac vegetations and the expression of the adhesin molecule CD11b on the surface of polymorphonuclear neutrophils compared with those of animals that had not received hrG-CSF. When treatment was started 72 h after bacterial challenge, hrG-CSF alone had no antibacterial effect and did not enhance the efficacy of ciprofloxacin when used in combination, even with the higher dosing regimen used (50 micrograms/kg of body weight subcutaneously every 12 h for 4 days), in terms of number of positive blood cultures, bacterial counts in vegetations, and survival. In contrast, when treatment was started 30 min prior to bacterial challenge, hrG-CSF (50 micrograms/kg injected every 12 h) decreased bacterial titers in vegetations 72 h later (6.5 +/- 0.9 versus 7.9 +/- 0.9 log10 CFU/g of vegetation for hrG-CSF and controls, respectively; P = prophylactic administration of hrG-CSF did not increase the antibacterial effect of ciprofloxacin. We concluded that the antibacterial effect of hrG-CSF in experimental endocarditis was related to the timing of its administration since hrG-CSF demonstrated a significant but transient antimicrobial effect only when treatment was initiated before bacterial challenge.
[Major hypereosinophilia disclosing colonic cancer].
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[Resolution under anticoagulant therapy of a large left atrial floating thrombus in a patient with mitral valve stenosis].
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Acquired hemophilia: a rare complication of Sjögren's syndrome.
Acquired hemophilia is associated with diverse conditions such as post-partum period, autoimmune diseases, cancers, and lymphoproliferative diseases. We report a case of acquired hemophilia occurring in Sjögren's syndrome which was treated with corticoid therapy. A review of the different treatments of acquired hemophilia is presented.
Intravenous immunoglobulin in adult Still's disease refractory to non-steroidal anti-inflammatory drugs.
OBJECTIVE: Adult onset Still's disease (AOSD) is a systemic disorder with an uncertain outcome at the time of diagnosis. The clinical response to nonsteroidal antiinflammatory drugs (NSAIDs) is often unsatisfactory in adult patients. Chronic use of steroids is frequently required, but may result in severe side effects. We report the results of an uncontrolled, unblinded trial of intravenous immunoglobulin (IVIG) in 7 patients with AOSD. METHODS: Seven consecutive patients unresponsive or poorly responsive to NSAIDs were enrolled. None of them had received steroids previously. AOSD was defined by the Yamaguchi criteria (J Rheumatol 1992; 19: 424). IVIG were administered every 4 weeks. NSAIDs were initially maintained. A positive response was defined by the disappearance of fever and arthritis within 2 weeks after the first IVIG infusion. RESULTS: Two patients failed to respond. Five patients initially considered to be good responders were given a total of 4 to 6 IVIG infusions. One of them relapsed at the time of the fourth IVIG infusion. The four others had a favourable clinical and biological course. At the time of evaluation 3 patients were symptom-free and off therapy, while one was still receiving low dose NSAIDs. CONCLUSION: This short, uncontrolled, unblinded study suggests that IVIG might represent a potential alternative to classical steroid therapy in patients with AOSD refractory to NSAIDs. These preliminary results need to be confirmed, however, in a double-blind randomized study.