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Biomedical subjects

A Deville

Publications and source records attributed to A Deville.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Congenital toxoplasmosis in the Alpes-Maritimes region. Apropos of 26 cases observed between 1984 and 1990].

Twenty-six cases of congenital toxoplasmosis observed in the department of Alpes Maritimes (Chief Town: Nice) between 1984 and 1990 are reported. All affected children were treated by pyrimethamine and sulfonamide as soon as the diagnosis was established. None of them exhibited serious sequellae. In most cases (58%) there were no clinical manifestations in agreement with other reports. Benign manifestations were observed in 10 cases (38%): 4 chorioretinitis; 4 intracranial calcifications: 1 febrile seizure; 7 hyperproteinorachias: 3 isolated and 4 associated with other signs. In 3 cases, secondary lesions appeared during the treatment period. This confirms the need for active therapeutic research in order to decrease the risk of late ocular complication which is the major problem of the disease.

Child↗
PubMed1991

A study of nineteen immunocompromised patients with extensive skin lesions caused by Pseudomonas aeruginosa with and without bacteremia.

Nineteen immunocompromised patients with extensive skin lesions caused by Pseudomonas aeruginosa with or without P. aeruginosa bacteremia were analysed. Patients whose lesions originated in the skin were in the majority (14 patients). Skin lesions were located at the site of entry of bacteria (apocrine areas in 12 patients). Cutaneous lesions were pleomorphic but the typical picture of ecthyma gangrenosum was common in this group of patients. Only 2 of them developed P. aeruginosa septicemia and the prognosis was relatively good (7.5% mortality rate). These observations confirm that ecthyma gangrenosum may be a primary cutaneous disorder not systematically associated with bacteremia.

Acquired Immunodeficiency Syndrome↗
PubMed1990

CSF drug levels for children with acute lymphoblastic leukemia treated by 5 g/m2 methotrexate. A study from the EORTC Children's Leukemia Cooperative Group.

A multicenter EORTC study was conducted in children with acute lymphocytic leukemia to determine whether 5 g/m2 of methotrexate (MTX) (24 h i.v. infusion, four cycles) is an appropriate dosage for obtaining CSF drug concentrations approaching the critical cytotoxic level of 10(-6) M. A total of 193 cycles were analyzed for 58 patients. At the end of the 24 h infusion, the mean MTX serum level was 65.27 +/- 33.11 microM; the mean CSF MTX level was 1.47 +/- 1.1 microM; no significant difference in CSF MTX levels was observed between patients with (n = 20) and those without i.v. Ara-C (n = 38). The mean CSF MTX/serum MTX ratio was 0.029 +/- 0.027. CSF drug concentrations greater than or equal to 10(-6) M were achieved in 81% of the courses. The highest level was 8.4 X 10(-6) M. Only 5% of patients failed to achieve this drug concentration in at least one cycle. No significant correlation was observed between blood and CSF MTX levels. Mean CSF MTX levels were comparable from one cycle to another.

Adolescent↗
PubMed1990

[Broncho-alveolar lavage in HIV-1 seropositive children].

Sixteen bronchoalveolar lavages (BAL) were performed in 15 children with HIV1 seropositivity, 12 of them being infected by HIV1. BAL was performed during episodes of acute pneumonitis with respiratory distress (group I: three cases) or without severity (group II: five cases), or in the presence of asymptomatic radiological pulmonary abnormalities (group III: seven cases). A specific diagnosis of infection was obtained in five cases of acute pneumonitis and 12 micro-organisms were identified by BAL: three cytomegaloviruses, three respiratory syncytial viruses, two Pneumocytis carinii, one Haemophilus influenzae, one Herpes simplex virus type 1, one Escherichia coli and one group A streptococcus. In three cases two micro-organisms were simultaneously identified. Cytological examination showed a high proportion of polymorphonuclear leukocytes in cases of acute pneumonitis (group II) and alveolar lymphocytosis in clinically asymptomatic children with radiological pulmonary abnormalities (group III). BAL appears to be a reliable tool for the investigation of pulmonary infections in children with HIV1 seropositivity. In addition it has the advantage of revealing latent cytological abnormalities in these patients.

Bronchoalveolar Lavage Fluid↗
PubMed1990

[Value of monoclonal antibody study of lymphocyte subpopulations in newborn infants of HIV1 seropositive mothers].

The outcome of infants born to HIV1 seropositive (HIV1+) mothers is still uncertain is spite of current progress in techniques for viral detection. Using the almost elective tropism of HIV1 virus for CD4 lymphocytes and the central role of these cells in the immune regulation, we studied blood lymphocyte populations with 7 monoclonal antibodies during the first month of life in 28 newborns of HIV1 seropositive mothers. Our data are compared to an age-matched population of 35 control infants. According to our results, the coexistence of a low CD8 lymphocyte percentage together with a high CD4/CD8 ratio seems to be correlated with an unfavourable outcome.

Antibodies, Monoclonal↗
PubMed1989

A prospective study of infants born to women seropositive for human immunodeficiency virus type 1. HIV Infection in Newborns French Collaborative Study Group.

Assessment of the risks of transmission of infection with human immunodeficiency virus type 1 (HIV-1) from mother to newborn is difficult, partly because of the persistence for up to a year of maternal antibodies transmitted passively to the infant. To determine the frequency of perinatal transmission of HIV infection, we studied from birth 308 infants born to seropositive women, 62 percent of whom were intravenous drug abusers. Of 117 infants evaluated 18 months after birth, 32 (27 percent) were seropositive for HIV or had died of the acquired immunodeficiency syndrome (AIDS) (n = 6); of the 32, only 2 remained asymptomatic. Another 76 infants (65 percent) were seronegative and free of symptoms, whereas 9 (8 percent) were seronegative but had symptoms suggestive of HIV-1 infection. The infants infected with HIV-1 did not differ from the others at birth with respect to weight, height, head circumference, or rate of malformations, but as compared with newborns who were seronegative at 18 months, their serum IgM levels were higher (78 +/- 81 mg per deciliter vs. 38 +/- 39 mg per deciliter; P less than 0.03) and their CD4 lymphocyte counts were lower (2054 +/- 1221 per cubic millimeter vs. 2901 +/- 1195 per cubic millimeter; P less than 0.006). Neither maternal risk factors nor the route of delivery was a predictor of seropositivity at 18 months; however, 5 of the 6 infants who were breast-fed became seropositive, as compared with 25 of 99 who were not (P less than 0.01). We conclude that approximately one third of the infants born to seropositive mothers will have evidence of HIV-1 infection or of AIDS by the age of 18 months, and that about one fifth of this group will have died.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Metastatic neuroblastoma: consolidation treatment with 2 courses of high-dose chemotherapy followed by a bone marrow autograft].

Among 62 children over 1 year of age at diagnosis who were treated for stage IV neuroblastoma, 33 entered remission after conventional therapy. They received high-dose chemotherapy and in vitro purged bone marrow transplantation as consolidation therapy. Fifteen patients received one course and 18 two courses. At present, 16/33 grafted patients are alive in CR with a median follow-up of 28 months. Toxicity of this regimen was tolerable. Under this treatment, actuarial disease free survival is improved compared with that observed under conventional therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Effect of dose and repeat intravenous 24 hr infusions of methotrexate on cerebrospinal fluid availability in children with hematological malignancies.

This pharmacokinetic study examined the relationship between methotrexate (MTX) dose and drug concentrations in blood and cerebrospinal fluid (CSF) during repeated 24 hr infusions. Two regimens were used: an intermediate dose (ID) of 0.5 g/m2 (7 patients, 23 cycles) and a high dose (HD) of 2.5 g/m2 (8 patients, 39 cycles). Inter-patient variability in the drug concentration was apparent in serum and CSF for both doses. The dispersion was particularly wide in CSF for HD MTX. Considering median values, serum and CSF MTX were linked to dose escalation. Individual CSF/serum drug ratios were not modified by the dose (1.1% for ID MTX versus 1.4% for HD MTX). A potentially cytotoxic drug level in CSF (10(-6) M) was never obtained for ID MTX cycles, but was achieved in 44% of HD MTX cycles: for HD MTX, this corresponded to 88% of patients (7/8). Total body clearance did not modify the degree of CSF MTX passage. A positive, significant correlation (r = 0.62, P less than 0.05) was observed for ID MTX between individual serum and CSF MTX; no such relationship was seen with HD MTX. Individual cycle-to-cycle variations in the MTX concentration were particularly marked in CSF and for HD MTX, without strict concordance with blood levels.

Adolescent↗
PubMed1987

Repeated high-dose chemotherapy followed by purged autologous bone marrow transplantation as consolidation therapy in metastatic neuroblastoma.

Among 62 children over 1 year of age at diagnosis, who were treated for stage IV neuroblastoma, 33 entered complete remission (CR) or good partial remission (GPR) after conventional therapy and received high-dose chemotherapy (HDC) with in vitro purged autologous bone marrow transplantation (ABMT) as consolidation therapy. The HDC was a combination of carmustine (BCNU), teniposide (VM-26), and melphalan. Thirty-three patients received one course of this regimen, and 18 received two courses. At present, 16 of the 33 grafted patients are alive in continuous CR, with a median follow-up of 28 months. Toxicity of this regimen was tolerable, principally marked by bone marrow depression and gastrointestinal (GI) tract complications. Four complication-related deaths were observed. Relapse post-ABMT occurred most often in the bone marrow. Under this treatment, actuarial disease-free survival is improved compared with that observed under conventional therapy.

Abdominal Neoplasms↗
PubMed1986

[Alloimmune neonatal neutropenia in homozygotic female twins].

Female homozygous twins presented with alloimmune neonatal neutropenia due to a maternal neutrophil-specific anti-NA2 antibody. The disease is usually benign, but when accompanied by severe infection it may require exchange transfusion and transfusion of granulocytes free of the antigen involved in the immunological conflict. Owing to the risk of relapse in subsequent pregnancies, the haemogram of the following infants must be supervised.

Agranulocytosis↗
PubMed1983

[Retroperitoneal neuroblastoma diagnosed in utero. Apropos of 1 case].

The authors present a rare case of a retroperitoneal neuroblastoma discovered during a routine pregnancy check in the 29th week of amenorrhea and showing up as a 1.4 cm dia. hyperechoic nodule. A follow-up sonogram, obtained one month later, showed the lesion had increased in size. Following birth, the diagnosis was confirmed during surgery. The overwhelming importance of early diagnosis of this tumor for a favorable prognosis points out the value of systematic examination of the suprarenal regions of the foetus in the course of the last U.S. examination during pregnancy.

Adult↗