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Biomedical subjects

X Chevalier

Publications and source records attributed to X Chevalier.

88 records · Page 5Linked to original sources
PubMed1990

Reversible hearing loss in a patient with cryptococcosis.

A 16-year-old girl had hearing loss, paroxysmal tremor, gait disorders, and psychiatric disturbances as the initial manifestations of a cryptococcal meningoencephalitis. Imaging demonstrated an obstructive hydrocephalus, and neuro-otological explorations showed a retrocochlear deafness and diffuse brainstem involvement. Emphasis is on the deafness, which rarely occurs as a presenting symptom in this condition, and on its dramatic improvement following antimycotic therapy.

Adolescent↗
PubMed1990

Danazol induced pancreatitis and hepatitis.

Danazol, a C17 alkylated anabolic steroid, has been tried as a hormonomodulator in the management of systemic lupus erythematosus. We report the case of a patient receiving 400 mg of danazol per day who developed mild pancreatitis associated with hepatitis, both induced by danazol.

Acetaminophen↗
PubMed1990

[Chordoma of the mobile spine. Report of 9 cases. Review of the literature].

The authors reported 9 cases of chordomas of the mobile spine: 6 lumbars and 3 cervicals. There are 5 men and 4 women. Mean age at diagnosis is 60 years old. Mean delay between the first clinical manifestations and the diagnosis is 22 months. Clinical findings are not specific. Roentgenologic findings show 2 typicals aspects: a lytic lesion on the lateral side of the vertebrae frequently involving more than one cervical vertebrae, a mixed lesion (lytic and sclerotic) or only sclerotic was detected only at the lumbar spine. Magnetic resonance imaging and computed tomography are the most useful investigations to determine the local extension of the tumor. Certitude of the diagnosis is always microscopic. Evolution is difficult to precise in this kind of embryological tumor. Radical surgery at the earliest time is the best guarantee of a better prognosis which still remain severe.

Adult↗
PubMed1990

[Seronegative leukocytoclastic vasculitis preceding the onset of disseminated systemic lupus erythematosus].

We encountered 4 patients (3 women, 1 man) with cutaneous vasculitis: three have a delayed pressure urticaria, two a vascular purpura with which a mixt cryoglobulinemia. Histology show a leukocytoclastic vasculitis. Initially all studies for lupus erythematosus were negative. However, after 3 to 10 years of follow-up, the 4 patients developed clinical, serological and histological features of systemic lupus erythematosus meeting four or more criteria of the American Rheumatism Association for the diagnosis of SLE. In one case there is a moderate renal disease. In three others cases there are a severe visceral injury: one with aseptic valvula's injury treated by surgery, another who died from a septicemic incident. The last who died from a neurological complication of systemic lupus. During the isolated cutaneous vasculitis phasis antinuclear antibodies and antibodies to double stranded DNA were all negative. At the time of SLE's diagnosis anti-DNA antibodies were present with or without ANA. In all four cases hypocomplementaemia was not initially seen which distinguish these cases from others previously reported in the literature. The syndrome recognized in these patients may constitute an "ante" serological and clinical phasis of SLE.

Adult↗
PubMedDate not supplied

A case of destructive polyarthropathy in a 17-year-old youth following pefloxacin treatment.

Joint and muscle pain have been reported with quinolones; however, arthropathies induced by quinolones do not result in erosive changes in humans, although such changes have occurred in animal studies. We report an unusual case of destructive polyarthropathy in a 17-year-old boy after treatment with pefloxacin 800 mg/day for 3 months. Pefloxacin may have accentuated the cartilage damage in this case, even if an underlying joint disease could not be excluded.

Adolescent↗
PubMedDate not supplied

Intra-articular injections of hylan G-F 20 in patients with symptomatic hip osteoarthritis: an open-label, multicentre, pilot study.

OBJECTIVE: To obtain prospective data on feasibility and safety of intra-articular injections of hylan G-F20 in patients with symptomatic hip osteoarthritis (OA). METHODS: Fifty-seven patients with primary hip OA, Kellgren-Lawrence grade II-III, aged > or = 40 and walking pain 50-90 mm on a visual analogue scale (VAS) were enrolled in an open-label, multicentre pilot trial. Hylan G-F20 (2 ml) was injected intra-articularly (IA) in the hip under fluoroscopy at D0, and follow-up visits were performed at D7-30-60-90. The possibility of a second injection at D30-60 or 90 was considered if the reported pain level was equivalent to baseline. Adverse events, walking pain (VAS), WOMAC index, patient and physician's global assessment were recorded at each visit. RESULTS: Twenty-five patients 1 injection and 32 received 2 injections. Transient hip pain was reported following 10.1% of injections, but no patient withdrew from the study because of this. Two mild synovial fluid aseptic effusions occurred after the first injection. No systemic device-related adverse event was reported. Walking pain decreased from 69.3 mm at entry to 39.5 mm at the end point (p < 0.0001). All other outcome measures decreased significantly. CONCLUSION: Viscosupplementation with hylan G-F20 is feasible, easy to perform and well-tolerated in hip OA. A double-blind, controlled study should be performed to confirm data on its efficacy.

Adult↗
PubMedDate not supplied

Questionnaire survey of management and prescription of general practitioners in knee osteoarthritis: a comparison with 2000 EULAR recommendations.

OBJECTIVE: A large-scale questionnaire survey on the way to handle and treat knee osteoarthritis (OA) was conducted with French general practitioners (GPs). Results of this questionnaire were compared with the 2000 EULAR recommendations on the treatment of knee OA. RESULTS: There was a high response rate among GPs (70%). Major findings included a high request rate for radiological examinations even if not required (about one-third of GPs in the case of a non-inflammatory condition); the under-utilization of non-pharmacological treatments as a first line approach; the prescription of paracetamol as the first-line drug; the co-prescription of non-steroidal anti-inflammatory drugs in 40% as a first-line approach; and a low rate of corticoidsteroid prescription. CONCLUSIONS: There is reasonable agreement between the results of this survey and EULAR 2000 recommendations. However, non-pharmacological approaches are under-utilized and should be reinforced.

Evidence-Based Medicine↗
PubMedDate not supplied

Nerve root pain secondary to posterior articular cysts: a report of 6 cases and review of the literature.

The authors report 6 cases of posterior articular cysts responsible for nerve root pain, generally in the form of sciatica. Cysts of the posterior intervertebral joints are a rare cause of nerve root compression. Plain x-rays demonstrate posterior inter-apophyseal osteoarthritis. Demonstration of the posterior articular cyst requires the use of computed tomography with contrast injection and/or MRI. Arthrography of the posterior inter-apophyseal joint allows the cyst to be opacified and treated by infiltration of a corticosteroid.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Iatrogenically induced vertebral osteomyelitis due to Pseudomonas aeruginosa.

We report three cases of iatrogenically induced vertebral osteomyelitis due to Pseudomonas aeruginosa. One case was a post-nucleotomy and post-operative complication of herniated disk treatment, one was related to infection of an epidural catheter in a patient suffering from rheumatoid arthritis and the third followed urinary investigation in a patient with prostate cancer. Infection was cured in all patients with antibiotic treatment. These case reports shed light on the possibility of infections with pseudomonas aeruginosa, in addition to the more common infections such as by staphylococci, especially following iatrogenic maneuvers.

Adenoma↗
PubMedDate not supplied

Elastase activity in cartilage extracts and synovial fluids from subjects with osteoarthritis or rheumatoid arthritis: the prominent role of metalloproteinases.

OBJECTIVE: Polymorphonuclear leukocyte (PMN) elastase is able to degrade the extra-cellular matrix components of cartilage. However, in vitro several proteinases can degrade elastin. The purpose of this study was to evaluate the role of the serine proteinases and metalloproteinases in the elastase activity measured in cartilage extracts from patients with osteoarthritis (OA), as well as in synovial fluid (SF) from patients with rheumatoid arthritis (RA) and OA. METHODS: Elastase activity was determined using synthetic low molecular weight substrates and radiolabelled insoluble elastin. Aminophenyl mercuric acetate was used to activate the prometalloproteinases. RESULTS: Elastase activity, measured using synthetic substrates, was higher in BA SF (0.76 + 0.03 microU/ml, n = 12) than in OA SF (0.14 + 0.04 microU/ml, n = 12) (p < 0.001). This activity was inhibited by metal chelating agents: 86% inhibition in OA and 75% inhibition in RA. However, in RA SF the inhibitor of serine proteinase (PMSF) also induced a 40% inhibition. Elastase activity, measured using radiolabelled elastin, in OA SF and RA SF samples and in OA cartilage extract was very low, but increased following activation by mercurial agents. Again this activity was inhibited by metal chelating agents. CONCLUSIONS: Taken together these results indicate that elastase activity (measured by standard methods) in OA and RA SF is mainly due to metalloenzymes.

Adult↗