PubMed Health⌕ Search

Biomedical subjects

A M Fournier

Publications and source records attributed to A M Fournier.

At least 19 recordsLinked to original sources
PubMed1992

Increased oxidative metabolism in PMA-activated lymphocytes: a flow cytometric study.

Flow cytometry and the fluorescent dyes DCF and R123 were used to examine oxygen metabolite production in human leukocytes and T-lymphoblastoid Jurkat cells, activated by PMA or by FMLP. When unseparated leukocytes were activated by PMA, oxidative products were generated not only in PMN and monocytes but also to a lower extent in lymphocytes. These responses were correlated with protein kinase C activation. PMA did not, however, induce the synthesis of reactive oxygen species in isolated lymphocytes. FMLP did not affect lymphocyte oxidative metabolism when added to the whole leukocyte mixture, but activated only the phagocyte populations. Similarly, Jurkat cells which alone were unresponsive to PMA, became strongly fluorescent when they were mixed with PMN and treated with this activator. In all cases, they did not respond to FMLP. Superoxide dismutase and catalase addition did not prevent the lymphoid cell response in the presence of phagocytes, whereas Desferal did. These data indicate that under physiological conditions, activated lymphocytes are capable of oxidative metabolism and also evidence some close relation between the leukocyte populations. We discuss the putative mechanism of oxygen metabolite generation in lymphocytes and the role of these metabolites in the immune response.

Flow Cytometry↗
PubMed1992

The relationship of total lymphocyte count to CD4 lymphocyte counts in patients infected with human immunodeficiency virus.

A simple, inexpensive alternative to CD4 counts would facilitate the management of asymptomatic and early symptomatic patients with HIV infection. In this report, a high correlation was found between CD4 counts and total lymphocyte counts calculated from complete blood counts in a cohort of ambulatory HIV-infected patients. Using these data, patients with CD4 counts above and below 500 cells/mm3, 200 cells/mm3, and those with and without symptoms can be identified with a high degree of predictive value. The availability and lower cost of lymphocyte counts make them an attractive alternative to CD4 counts in managing asymptomatic and early symptomatic patients with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Courvoisier's sign revisited: two patients with palpable gallbladder.

More than a century ago, Courvoisier published his observation on the significance of a palpable gallbladder in the differential diagnosis of obstructive jaundice. We have described two patients with newly described conditions--AIDS-associated cholangiopathy and diet-induced cholecystitis--who had a palpable gallbladder and have discussed possible pathogenetic mechanisms.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Spontaneous in vitro secretion of antibody to cytomegalovirus (CMV) by human peripheral blood mononuclear cells: a new approach to studying the CMV-immune system interaction.

The in vitro secretion of cytomegalovirus (CMV)-specific antibodies by peripheral blood mononuclear cells (PBMC) was analyzed in patients with acute CMV infection and CMV-seropositive patients infected with human immunodeficiency virus. This active and spontaneous in vitro secretion was not affected by the depletion of T cells or adherent cells. The number of anti-CMV antibody-secreting cells was estimated to be 28-176/10(6) PBMC; 30%-65% of the total in vitro antibody production was CMV-specific. This secretion seemed to be independent of in vitro polyclonal B cell activation, in vitro antigen-specific lymphocyte stimulation, or in vivo Epstein-Barr virus-induced B cell transformation. In vitro anti-CMV antibody production may therefore result from an in vivo stimulation of the immune system by CMV antigens and might indicate CMV replication in the host.

Acute Disease↗
PubMed1991

The impact of National Health Service Corps physicians in the lowering perinatal mortality rate in Dade County, Florida.

In some parts of Dade County, Florida, perinatal mortality rates have revealed serious problems in the delivery of health care to poor pregnant women. From 1982-1985, the reported perinatal mortality rates varied from 32-36 per 1000 live births, more than double the national average. Under the leadership of the Primary Health Care Consortium of Dade County (a federation of community health centers and other primary care providers), National Health Service Corps obstetricians and pediatricians served inner-city, medically needy patients as part of a coordinated perinatal plan from 1987-1989. Data on fetal and neonatal deaths, collected from census tracts adjacent to the community health centers, were used to study the impact of Corps obstetrician and pediatrician placement. The respective perinatal mortality rates were compared with those of 1986 as historic controls. Within a year, the overall perinatal mortality rate was reduced by 45%. As a result, an estimated 320 lives were saved between 1987-1989. This public health achievement represents a measurable impact due to assignment of National Health Service Corps physicians and can be used as a working model to reduce perinatal mortality in medically underserved communities in the United States.

Evaluation Studies as Topic↗
PubMed1989

Preoperative screening for HIV infection. A balanced view for the practicing surgeon.

Routine preoperative screening for human immunodeficiency virus (HIV) infection is becoming increasingly prevalent. Reasons in favor of routine screening include the following: (1) Knowledge of HIV status may allow the surgeon to decrease risk of infection. (2) The patient may benefit, because HIV infection may alter the risk-benefit ratio of a procedure. (3) Knowledge of HIV status will not affect how the patient is treated. Arguments against routine screening include the following: (1) Since the risk during individual procedures is low, it is unlikely that knowledge of HIV status can actually reduce risk. (2) Patient care may be negatively affected. (3) There is a possibility of false-positive results. (4) The accepted ethical standards of autonomy, confidentiality, and informed consent are not always adhered to. We explore these issues in detail. Recent work has framed the risk of surgeons and defined the reliability of diagnostic screening tests. All of these factors must be weighed before a surgeon can decide for or against a policy of routine preoperative screening.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Tuberculosis and nontuberculous mycobacteriosis in patients with AIDS.

Thirty-six patients with AIDS and culture-proven nontuberculous mycobacteriosis were compared to 20 patients with acquired immunodeficiency syndrome (AIDS) and tuberculosis with regard to clinical signs, symptoms, and diagnostic methods. Patients with nontuberculous mycobacteriosis were more often younger and homosexuals, while patients with tuberculosis were usually Haitian-American or users of intravenous drugs. A majority of patients with tuberculosis presented with fever and weight loss. These symptoms were seen in approximately 50 percent of the patients with nontuberculous mycobacteriosis. A distinct syndrome of dyspnea, chills, hemoptysis, and chest pain was seen in a significant minority of patients with nontuberculous mycobacteriosis. Lymphadenopathy was seen almost exclusively in patients with tuberculosis. Pulmonary sources (expectorated sputum or bronchoscopy specimens) were the most common source of diagnosis in both groups. Patients in both groups in whom the diagnosis was obtained from pulmonary sources frequently had negative chest x-ray films on presentation. Cavitary disease was absent from both groups.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Blood pressure, insulin, and glycemia in nondiabetic subjects.

The relation of blood pressure to fasting (basal) insulin and glycosylated hemoglobin (hemoglobin A1) was examined in 248 nondiabetic subjects (137 women and 111 men). None of the subjects was taking antihypertensive medication. There were statistically significant associations of systolic and diastolic blood pressure with insulin levels (r = 0.24, p less than 0.01; r = 0.30, p less than 0.01) and hemoglobin A1 levels (r = 0.28, p less than 0.001; r = 0.22, p less than 0.05) in women. These blood pressure indexes were also related to insulin levels in men (r = 0.23, p less than 0.05; r = 0.02, p less than 0.05). In a multiple regression analysis, the association between blood pressure and insulin level was diminished with an allowance for adiposity; however, it remained statistically significant. These data indicate that blood pressure is related to insulin levels in nondiabetic subjects and suggest that insulin may be a physiologic determinant of blood pressure.

Blood Glucose↗
PubMed1986

Body stature as a risk factor for diabetic sensory neuropathy.

Risk factors for vibratory perception threshold abnormalities were studied in 200 diabetic patients between the ages of 21 and 70 years and 62 control subjects of similar age. Vibratory perception (measured with the Biothesiometer) was absent over one or both halluces in 18 percent of the patients. In a stepwise multiple logistic regression analysis, height was the variable most strongly associated with absent vibratory perception (coefficient +/- SE, 0.501 +/- 0.097/inch; p less than 0.0001). Duration of diabetes (p less than 0.001), age (p less than 0.05), and ethanol use (p less than 0.05) were also associated. The prevalence of absent vibratory perception in the lower, middle, and upper thirds of the height distribution was 0.05, 0.08, and 0.40, respectively. Among the control subjects, there was no association of vibratory perception with either height or ethanol use. These data strongly suggest that body stature is a major risk factor for diabetic sensory neuropathy.

Body Height↗
PubMed1986

High-density lipoprotein and glycosylated hemoglobin in nondiabetic individuals.

We investigated associations of high-density-lipoprotein (HDL) cholesterol, apolipoprotein A-I, and triglyceride levels with hemoglobin A1 (HbA1) and insulin levels in nondiabetic subjects (137 women and 111 men). In women, HDL cholesterol, apolipoprotein A-I, and log-triglyceride values were significantly correlated with those of HbA1 and log-fasting insulin. These univariate associations persisted when age and Quetelet's index were included as covariates in multiple regression analyses. Conversely, univariate associations of HDL cholesterol and log-triglyceride levels with Quetelet's index were diminished by the addition of insulin values to multivariate models. Insulin levels and Quetelet's index were highly correlated. Although there were weaker associations in men, apolipoprotein A-I and HbA1 values were inversely related. These data suggest that HDL cholesterol and apolipoprotein A-I levels are closely linked to glucose metabolism in nondiabetic individuals.

Adult↗
PubMed1985

Systemic necrotizing vasculitis seen initially as hypertensive crisis.

Necrotizing vasculitis is not usually considered in the differential diagnosis of hypertensive crisis. Three cases are presented in which hypertensive crisis with encephalopathy was the principal initially seen manifestation of systemic necrotizing vasculitis. The correct diagnosis was suspected because of the patients' young age, elevated ESRs, and evidence of previous exposure to hepatitis B virus and was confirmed by renal angiography. All three patients had metabolic alkalosis, and two of the three patients had hyponatremia and hypokalemia. The literature presents a picture of hypertension in necrotizing vasculitis as insidious, relentless, and progressive. Our cases illustrate that it can be a dramatic, life-threatening initial manifestation. A renal angiogram can be justified in similar patients, since effective therapy for necrotizing vasculitis exists. In these patients control of BP ultimately depends on successful treatment of the underlying vasculitis.

Adult↗
PubMed1983

Opportunistic infections and Kaposi's sarcoma among Haitians: evidence of a new acquired immunodeficiency state.

Twenty Haitian patients, hospitalized from 1 April 1980 to 20 June 1982, had Pneumocystis carinii pneumonia, central nervous system toxoplasmosis, esophageal candidiasis, cryptococcosis, disseminated cytomegalovirus, progressive herpes simplex virus, chronic enteric coccidiosis, or invasive Kaposi's sarcoma. Ten patients died. Opportunistic infections were frequently multiple and were recurrent in three patients. In seven patients disseminated tuberculosis preceded the other infections by 2 to 15 months. There was no evidence of an underlying immunosuppressive disease, and no history of homosexuality or intravenous drug abuse. At least three patients probably acquired the syndrome in Haiti. Lymphadenopathy was common. Seventeen patients tested had anergy, and 18 had lymphopenia. Monoclonal antibody analysis of peripheral-blood T-cell subsets done on 11 patients showed a marked decrease in T-helper cells and an inversion of the normal ratio of T-helper cells to T-suppressor cells. This syndrome among heterosexual Haitians is strikingly similar to the syndrome of immunodeficiency described recently among American homosexuals.

Acquired Immunodeficiency Syndrome↗