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Biomedical subjects

A Lévy

Publications and source records attributed to A Lévy.

At least 19 recordsLinked to original sources
PubMed2006

[Buschke-Löwenstein tumour: diagnosis and treatment].

Buschke-Löwenstein tumour is classified as a verrucous carcinoma. It presents like an exophytic tumour of the genital or peri-anal area, with ulceration and sometimes fistulae and sinuses. It is preferentially seen in men and immunocompromised patients. Histological appearance is not far from condyloma acuminata, but with a tendency to compress and displace deeper tissues, without basement membrane disruption. HPV types 6 or 11 are regularly found in association with this tumour. Other STI have to be searched. Physical examination and precise imagery are useful to chose the right treatment regimen. Radical excision is recommended to avoid malignant transformation, but has to be large because of the high number of recurrences. Other treatment modalities such as chemotherapy or imiquimod could be of interest to avoid mutilating surgical interventions. A regular follow-up is necessary because of frequent recurrences and possible malignant transformation.

Anus Neoplasms↗
PubMed2005

Up-regulation of rat myometrial phospholipases C{beta}1 and C{beta}3 correlates with increased term sensitivity to carbachol and oxytocin.

In the present study, we compared rat uterine contractility and myometrial inositol phosphate (InsP) production in response to activation of muscarinic and oxytocin receptors during pregnancy and at term. The level of myometrial phospholipase (PL) Cbeta was also determined by Western blotting at different stages of pregnancy and following administration of oestradiol, progesterone or vehicle. The results showed an increased potency of carbachol (CCh), a cholinergic muscarinic agonist, and oxytocin (OT) to enhance myometrial InsP production at term. This correlated with an increased potency of both agonists to induce contraction of the circular but not the longitudinal muscle. For both InsP production and contractile activity, the maximal response of CCh was unaltered, while that of OT was significantly increased. Interestingly, the increased responsiveness to CCh and OT was associated with an up-regulation of PLCbeta1 and PLCbeta3 enzymes. Such regulation is under the control of oestradiol since administration of this steroid to pregnant rats increased the amount of both enzymes by 200-260%. In contrast, progesterone administration was without effect. The present study presents the first evidence that the expression of rat myometrial PLCbeta1 and PLCbeta3 is under the positive control of oestradiol. This could participate in the enhancement of myometrial InsP accumulation and uterine contraction at term in response to CCh and OT. Based on contraction studies, we also propose that the longitudinal and circular uterine muscles differ in the regulation of the PLC pathway during pregnancy.

Animals↗
PubMed2001

[Black tumor].

Explore the source record for details and available documents.

Adult↗
PubMed2000

[Severe obstetric complications nescessitating hospitalization and intensive care: a ten year retrospective study].

OBJECTIVES: To assess the serious maternal morbidity during pregnancy, delivery and post partum, which led to an hospitalization in a medical or surgical intensive care unit. STUDY DESIGN: A Retrospective study was carried out on a period of ten years, from July 1986 to July 1996, in the University Teaching Hospital of Besançon. PATIENTS: The criterions of inclusion come from the definition of the serious maternal morbidity decided by the Inserm: any admission of a pregnant woman in a medical or surgical intensive care unit in the 42 days of the post-partum, whatever the term of the pregnancy and the type of the post-partum, extra uterine pregnancy, spontaneous miscarriage and medical or voluntary abortion. METHODS: Forty-six patient's medical file hospitalized in a medical or surgical intensive care unit between July, 1st 1986 and July, 31st 1996, have been studied. RESULTS: The analysis of the cause underline the gravity of the pathologies handled with young patients and initially healthy, the short length of controlled ventilation and hospitalization, the avoidability of great number of transfer in an intensive care unit, and the lack of hospitalization due to anaesthesia. The frequency of hospitalisation in an intensive care unit during and after the pregnancy was estimated at 0.17% of lives births. CONCLUSION: The serious maternal morbidity could be an indicator of the quality of the obstetrics cares which would complete the study of the maternal mortality. The potential gravity of the complication of the pregnancy and the delivery require better care of this patients.

Adult↗
PubMed2000

Early biliary pseudolithiasis during ceftriaxone therapy for acute pyelonephritis in children: a prospective study in 34 children.

The prolonged biological half-life of Ceftriaxone, allowing once-daily dosing, has contributed to the large diffusion of this third-generation cephalosporin in children. Ceftriaxone is known to induce reversible precipitates in the gallbladder of adults and children. A prospective study was conducted during 1997 in 34 children admitted for the treatment of acute pyelonephritis. Ceftriaxone (intravenous daily single-dose of 50 mg/kg under 2g/day) was initially used. A first gallbladder sonogram, performed before the first or second injection, was normal in all cases. A second evaluation was performed before the fifth and last injection. On this second evaluation the presence of one (n = 3) or two gallstones was recorded in 5 children (15%) on a sonogram made after 3 (n = 4) or 5 (n = 1) injections. Their median age was 7 years (range 4 months to 11 years). All five children remained symptom-free and the normalization of the sonographic patterns was constant on the last sonogram performed 2 (n = 1), 3 (n = 2) and 5 months (n = 2) after discontinuation of Ceftriaxone. This study confirms the possibility of precocious biliary lithiasis under Ceftriaxone therapy in childhood and their spontaneous dissolution after discontinuation of the drug. They seem unpredictable and independent of the age, sex in a cohort homogeneous for the nature of the infection, modality of a short- and low-dose therapy. Clinicians and radiologists should be aware of this complication as an etiology of a so-called primary cholelithiasis and to prevent anxiety or unnecessary cholecystectomy. The antibacterial and pharmacokinetic benefits of Ceftriaxone outweigh the problem of reversible biliary pseudolithiasis with this drug.

Acute Disease↗
PubMed1999

Disclosure of HIV seropositivity.

Deciding whether or not to disclose one's HIV-positive status to another person is an important decision: the way each person experiences and copes with the illness is reflected in this choice. We conducted a study of 174 patients (29.3% of women) to examine how the decision to disclose or conceal was made, as well as its subjective and social consequences. We discovered that only 3.5% of the individuals remained silent about their illness. Most spoke about it, regardless of how they had been infected or of the advice they had received to be discrete. The confession often did not bring them the relief they sought. Revealing one's HIV-positive status is not a sign of social responsibility, or of a special trust in someone, but rather a compulsive act to release suppressed tension. Individuals who do not confess need attention; their silence is a sign of their inability to adapt to their illness, as well as of their self-imposed exclusion from society.

Adaptation, Psychological↗
PubMed1998

Outpatient care in emergency departments: feasibility and comparison of three strategies for follow-up.

The outpatient population using the emergency department (ED) is increasing and so is the risk of not admitting people who need it. There is, thus, one important question: are the services delivered appropriate to the needs of these ED outpatients? Follow-up of non-admitted patients after a visit to the ED is a prerequisite for the evaluation of these health services. A multicentric follow-up study was thus performed in order to assess the possibility of contacting outpatients after a visit to the ED. Three randomized follow-up methods were compared: (1) telephone call 1 week after the emergency department visit; (2) telephone call 2 weeks after the visit; (3) telephone call 4 weeks after the visit. The follow-up rate did not change depending on whether patients were contacted at 1, 2 or 4 weeks after the visit. The success rate was 78.6%, 85.6% and 74% respectively (NS). In each strategy, 50% of patients were contacted at the first telephone call, 20% at the second telephone call and 10% by mail. Thus, in a group of outpatients who gave their consent to be called, the follow-up was found to be feasible with a high success rate whatever the time between the visit and the phone recall.

Adolescent↗
PubMed1997

Idiopathic thrombocytopenic purpura in two mothers of children with DiGeorge sequence: a new component manifestation of deletion 22q11?

The phenotypic spectrum caused by the microdeletion of chromosome 22q11 region is known to be variable. Nearly all patients with DiGeorge sequence (DGS) and approximately 60% of patients with velocardiofacial syndrome exhibit the deletion. Recent papers have reported various congenital defects in patients with 22q11 deletions. Conversely, some patients have minimal clinical expression. Ten to 25% of parents of patients with DGS exhibit the deletion and are nearly asymptomatic. Two female patients carrying a 22q11 microdeletion and presenting with idiopathic thrombocytopenic purpura are reported. Both had children with typical manifestations of DGS.

Adult↗
PubMed1997

[Selection criteria of candidates for lung transplantation].

Amongst the elements which contributed to the success of the early lung transplants at the beginning of the 1980's we feel that the careful selection of candidates probably played a predominant role. If some of the selection criteria initially described remain somewhat intangible, others have either been eased or have been invalidated. The experience acquired over the last 15 years has enabled to precise the optimal moment to include patients on the waiting list and to refine the choice for the type of surgical procedure according to the underlying disease. This article aims to review the different selection criteria for candidates for transplantation and stresses those which have recently undergone change.

Adrenal Cortex Hormones↗
PubMed1995

Excess of deletions of maternal origin in the DiGeorge/velo-cardio-facial syndromes. A study of 22 new patients and review of the literature.

We have determined the parental origin of the deleted chromosome 22 in 29 cases of DiGeorge syndrome (DGS) using a CA-repeat mapping within the commonly deleted region, and in one other case by using a chromosome 22 short arm heteromorphism. The CA-repeat was informative in 21 out of 29 families studied and the deleted chromosome was of maternal origin in 16 cases (72%). When these data are pooled with recent results from the literature, 24 de novo DGS, velo-cardio-facial syndrome (VCFS) and isolated conotruncal cardiac disease deletions are found to be of maternal origin and 8 of paternal origin, yielding a chi 2 of 8 with a probability level lower than 0.01. These data, and review of the literature on familial DGS/VCFS and isolated conotruncal cardiopathies suggest that there is a strong tendency for the 22q11.2 deletions to be of maternal origin.

Chromosome Deletion↗
PubMed1995

[Hospital discharge planning and length of hospital stay in elderly patients admitted through the emergency department].

A prospective study was organized in two teaching hospitals in Paris, including 426 elderly patients aged 75 and more, who had been hospitalized through the medical emergency department. The goal of the study was to assess the influence of difficulties of orientation at discharge on the length of stay, independently of other risk factors. The mean length of stay was 18.3 +/- 15.4 days. Orientation at discharge toward a social or a nursing care institution was associated with a 12 days longer mean length of stay than a home discharge. A longer length of stay was also associated with: a strictly social problem at admission, the diagnoses of dementia, confusion, social problem, fall or general health impairment, a short or long-term fatal prognosis, a poor mental status, refusal of home discharge as expressed by the referent person. Multivariate analysis showed that discharge toward a social or a nursing care institution was the first explanatory factor, explaining 12% of variance. These results suggest that the hospital discharge management has a major influence on the elderly length of hospital stay. Therefore, an interdisciplinary care management, including social and geriatric evaluation as soon as the patient is admitted at the emergency department, should be evaluated, in order to avoid problems of orientation that may occur at discharge.

Age Factors↗
PubMed1993

[Anonymous and free-of-charge centers for screening for HIV infection. Results of 30 months of activity in Public Assistance in Paris hospitals].

The results of 30 months of activity of anonymous and free-of-charge HIV detection centres in Paris hospitals are presented. During this period (April 1988 to December 1990), 15805 subjects were seen. This population accounts for about 11 percent of all French anonymous and free detection centres in 1990, and for 26 percent of the number of subjects consulting in detection centres of the same type. Risk factors could be listed in 8132 consulting subjects: 73 percent were heterosexuals and not drug-addicts; 19.5 percent were homo- or bisexuals; 6 percent were drug-addicts; 0.6 percent were both homosexuals and drug-addicts; 29 percent of the 7806 persons questioned about their use of condoms stated that they used them often or always. A total of 15271 blood samples were taken. The percentage of seropositivity was 4.73 percent with a significant fall from 5.87 percent in 1988 to 4.38 percent in 1990; 23.4 percent of homosexual drug-addicts, 17.6 percent of heterosexual drug-addicts, 9.3 percent of homo- or bisexuals and 1.3 percent of heterosexuals were seropositive. In the seropositive population, 46.4 percent were homo- or bisexuals, 29.8 percent were drug-addicts, 19.7 percent were heterosexuals and 3.7 percent were homosexual drug-addicts. Three subjects had been contaminated by blood transfusion. The percentage of seropositive subjects in our study was superior to the mean found in other anonymous and free detection centres (4.73 percent versus 3 percent in 1990), this probably reflecting the high prevalence of the infection in the Paris region. The seropositive subjects usually belonged to the categories primarily affected by the HIV. The percentage of seropositivity in our drug-addicts (17.6 percent) was much lower than that usually reported in French drug-addicts (30 to 40 percent).

Acquired Immunodeficiency Syndrome↗
PubMed1989

[54 cases of infectious endocarditis seen in 32 years in a population of 2038 congenital heart diseases].

A longitudinal study of a 32-year period (1954-1987) involving 2038 patients with congenital heart defects followed by the same physician yielded 54 cases of infective endocarditis (IE). Complex cyanogenic cardiopathies were particularly exposed to the risk of infection (8.2 IE for 1000 patient-years), then came ventricular septal defects (2.4), tetralogy of Fallot (2.3), aortic stenosis (2.0) and atrioventricular canal (1.7). The risk was smaller in patients with Eisenmerger complex (1.2), persistent arterial canal (1.4) and coarctation (0.7). Patients under 10 years of age (16.7%) were less affected than young adults in the 20-29 years age-group (33.4%). The organisms most frequently isolated were streptococci (42%); staphylococci ranked second (23%). Less common organisms were found in 14% of the cases, and blood cultures were negative in 21%. Systemic prophylaxis with penicillin V, introduced 16 years ago, seems to have almost halved the incidence of infective endocarditis due to penicillin-sensitive organisms.

Adolescent↗
PubMed1987

[Trichothiodystrophy].

Trichothiodystrophy is a congenital dysplasia of hairs characterized by: a pathognomonic image of the hair shaft under polarized light (the hair is plaited with alternately dark and light oblique bands) and trichoschisis with a clear-cut break; a deficiency of sulphurated aminoacids in the hair. We report a case where trichothiodystrophy was associated with abnormalities of the nails, teeth and eyes, growth and mental retardation, neurological syndrome and hypogonadism. From this case and a review of the cases published so far the following points emerge: 1. Congenital abnormalities of the neuroectodermal system are frequent. They include: skin lesions, such as ichthyosis, photosensitivity and atopic eczema; ungueal dysplasia; dysmorphic syndrome; growth and mental retardation; hypogonadism; neurological and ophthalmic abnormalities. 2. The condition seems to be transmitted as an autosomal recessive trait. A common element, dysplasia, enables us to include in the same nosological group as trichothiodystrophy a number of other pathological conditions, viz.: syndromes hitherto described under various names but almost identical, such as Brown's syndrome and BIDS syndrome (brittle hair, intellectual deficit, decreased fertility, small stature); IBIDS and PIBIDS syndromes which, in addition to the former, comprise ichthyosis and photosensitivity, as well as Tay's syndrome (characterized by the presence in all cases of ichthyosis associated with hair dysplasia); and perhaps some anecdotic cases with either a pathognomonic image under polarized light or a suggestive biochemical profile. Finally, since typical trichothiodystrophy has been reported in patients with Siemens' syndrome or with Marviesco-Sjögren syndrome, these two syndromes may perhaps also be classified in the same category, as borderline forms of the disease.

Abnormalities, Multiple↗
PubMed1986

[Routine use of 6-month antitubercular treatment in 300 patients].

Over a 2-year period, all patients with incipient tuberculosis seen in a hospital unit were given a 6-month treatment consisting of rifampicine, isoniazide, pyrazinamide and ethambutol. A retrospective study of these 300 patients showed that the treatment was effective, with no failure if taken for more than 2 months. Relapses were rare when the drugs were taken regularly, the responsible M. tuberculosis strain was sensitive, and there was no associated malignancy (present in 1.4% of the cases). The drugs were moderately well tolerated, and treatment had to be modified because of side-effects in 4.6% of the patients. It also appeared that 57% of the patients fully complied with the prescription, and 16% were lost sight of by the hospital unit. Treatment was altered in 36% of the cases, but in 16% changes were introduced by private doctors for reasons which retrospectively proved to be without medical grounds. It is concluded that this 6-month chemotherapeutic regimen was effective in more than 98% of the cases, and that the main problem in management of tuberculosis is the patient's compliance with treatment.

Adolescent↗
PubMed1984

[Unstable angina caused by monotruncular stenosis of the anterior interventricular artery (87 cases). Results of medical and surgical treatment].

The aim of this study was to compare the medium-term results of medical therapy and aortocoronary bypass surgery in 87 patients selected on the following criteria: Clinical: unstable angina, defined as effort and/or resting angina appearing for the first time or increasing in severity within the previous 3 months, the last attack of chest pain occurring less than 8 days before admission to the Coronary Care Unit, with no signs of myocardial infarction before hospital admission and at coronary angiography. Coronary angiography: proximal isolated left anterior descending artery stenosis (greater than 70%). Thirty five patients were treated medically and 52 underwent coronary bypass surgery on the LAD artery: the results were compared at 18 and 24 months. Six patients were lost to follow-up, 2 from the medical group; the other 33 patients comprised group A. Four surgical patients were lost to follow-up, the other 48 patients comprised group B. The two groups had comparable clinical and epidemiological features. They differed in the incidence of hypertension which was more common in group A (p less than 0.01), in the better quality of the distal LAD artery in group B (p less than 0.01), and in the coexistence of less than 50% stenosis on the right coronary and left circumflex arteries which was commoner in group A (p less than 0.05). The mean follow-up period was comparable in the two groups (group A: 20.5 +/- 4.6 months; group B: 19.8 +/- 5.5 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗