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Biomedical subjects

C Brégeon

Publications and source records attributed to C Brégeon.

At least 19 recordsLinked to original sources
PubMed2001

[Total inverted shoulder prosthesis and rotator cuff insufficiency: evaluation and determination of anatomical parameters predictive of good functional outcome in 21 shoulders].

OBJECTIVE: Evaluation of the functional results of the Delta 3 inverted shoulder prosthesis and determination of a radio-anatomical index predictive of best functional outcome. PATIENTS AND METHODS: Retrospective analysis of 19 patients (21 shoulders). Clinical (pain, satisfaction, amplitudes, Constant index) and radiological (acromio-epiphyseal distance) evaluation at a mean follow up of 13.6 months. RESULTS: Outcomes concerning pain, quality of life and Constant index were good and similar to other series. Few complications were observed. An increase of the acromio-epiphyseal distance of 33 to 50% compared to the non operated side is associated with a good functional result. CONCLUSION: Our results confirm those of other series and show that Delta 3 inverted prosthesis is an efficient therapeutic alternative in arthropathy with rotator cuff tears. Rehabilitation is fairly short and easy. The increase of the acromio-epiphyseal distance determines the tension of the deltoid muscle and could predict a favorable outcome.

Acromion↗
PubMed1996

Bacterial endocarditis revealed by infectious discitis.

A study of 30 patients admitted for infectious discitis identified four cases with concomitant bacterial endocarditis. All four patients were male and had concomitant streptococcal septicemia. Two patients had known aortic valve disease. The vertebral infection was located to the thoracic or lumbar spine. Ultrasonography disclosed aortic lesions in all four patients and mitral lesions in two. Management consisted of intravenous antimicrobial therapy for four weeks followed by a three-month course of oral antimicrobial therapy. The outcome of the discitis was favorable within the usual period of time. However, the endocardial lesions continued to progress, and three patients rapidly required valve replacement. Analysis of available data in the 30 patients with discitis showed that half the patients with streptococcal discitis also had bacterial endocarditis and that the latter condition developed in all the patients with streptococcal discitis and a history of valve disease. A number of risk factors were identified. An echocardiogram should be done routinely in patients with infectious discitis and risk factors for bacterial endocarditis.

Adult↗
PubMed1996

Validation of the French version of the arthritis impact measurement scales 2 and comparison with the french version of the Nottingham Health Profile. "Quality of Life in Rheumatology" Task Force.

Appropriate attention can be directed to quality of life indices in the evaluation of therapeutic interventions only if reliable, valid measurement tools with good sensitivity to change are available. The goal of this study was to validate the French version of the Arthritis Impact Measurement Scales 2 (AIMS2), called EMIR (Echelle de Mesure de l'Impact de la polyarthrite Rhumatoïde) and to compare it with the validated French version of the Nottingham Health Profile, called ISPN (Indicateur de Santé Perceptuelle de Nottingham). The French version of the AIMS2 (37 items, 12 dimensions) was obtained via several independent translations and back-translations, followed by selection of the most relevant items by a panel of experts and a preliminary evaluation in rheumatoid arthritis patients. The measurement properties of EMIR (reliability, validity and sensitivity to change) were investigated in a cohort of rheumatoid arthritis patients who were put under methotrexate therapy and followed up for six months. Reliability was evaluated by test-retest at a ten-day interval (intraclass coefficients of correlation). Principal component factorial analysis was used to study construct validity and Cronbach's alpha coefficients to study internal consistency. Convergent validity was evaluated based on correlations between the quality of life scores obtained in selected dimensions of the EMIR and a number of other parameters (number of painful/swollen joints, pain severity score on a visual analog scale, erythrocyte sedimentation rate). Sensitivity to change after three and six months was determined by calculating mean standardized response means. The EMIR and ISPN were compared based on scores and sensitivity to change for the dimensions that investigated the same concepts. One hundred twenty-seven rheumatoid arthritis patients scheduled for methotrexate therapy were entered into the study. Principal component analysis established that all dimensions of the EMIR were independent from one another, except the "walking and bending" dimension. Internal consistency was satisfactory for each of the 12 dimensions, with Cronbach's alpha coefficients ranging from 0.70 to 0.90. Most correlations between quality of life scores and clinical or laboratory parameters were significant, indicating satisfactory convergent validity. The reliability study also yielded satisfactory results, with intraclass coefficients ranging from 0.65 to 0.90. Sensitivity to change after three and six months was significant for 11 of the 12 dimensions (mean standardized responses, 0.30 to 0.77). Sensitivity to change was slightly better for the EMIR than for the ISPN. Analysis of scores demonstrated that these two instruments did not measure quality of life in exactly the same way but complemented each other.

Adult↗
PubMed1996

Validity, reliability, and sensitivity to change of a French version of the arthritis impact measurement scales 2 (AIMS2) in patients with rheumatoid arthritis treated with methotrexate.

OBJECTIVE: To develop and validate a cross cultural version of the Arthritis Impact Measurement Scales 2 (AIMS2) to be used by French speaking populations. METHODS: A French version of the AIMS2 was obtained using back translation, committee review, and pretesting. The French AIMS2 was studied in 127 patients with rheumatoid arthritis (RA) about to receive therapy with methotrexate (MTX). Construct validity of the questionnaire was assessed by factor analysis. Convergent validity was evaluated by correlation coefficients with joint counts, pain assessment, and sedimentation rate. Reliability was assessed by test-retest procedure at a 10-day interval, Cronbach's coefficients of internal consistency, and within scale factor analyses. Sensitivity to change after 12 and 24 weeks of therapy with MTX was assessed with computation of standardized response means (SRM) and paired t test comparisons. RESULTS: Factor analyses of the French version clearly identified the same scales of the AIMS2, except for the walking and bending scale which loaded on several factors. Convergent validity of the physical and symptom components of the instrument was demonstrated by significant correlations with clinical and laboratory features. All the scales were reliable (intraclass correlation coefficients: 0.65 to 0.90; percentage of explained variance larger than 50% in all but one scale; Cronbach's alpha: 0.70 to 0.90). Sensitivity to change was demonstrated in 11 of the 12 scales (SRM: 0.30 to 0.77). Most of the improvement was noted by Week 12. CONCLUSIONS: This cross cultural adaptation of AIMS2 in French is valid, reliable, and responsive in patients with RA in whom MTX therapy is instituted. It would permit international comparison studies. This study provides evidence for construct validity and responsiveness of the original version of the AIMS2, not demonstrated previously.

Activities of Daily Living↗
PubMed1996

Minocycline related lupus.

The determination of a factor triggering lupus-like symptoms could yield new insights into the management of rheumatic disease. We describe a case of minocycline related lupus in a young patient positive for HLA-DR2 who was prescribed minocycline 4 times for mild acne and developed rheumatic symptoms each time. We review 8 other cases.

Acne Vulgaris↗
PubMed1995

Iliac osteosarcoma in a patient with SAPHO syndrome.

Extrathoracic sclerotic bone involvement of SAPHO syndrome are sometimes very difficult to differentiate from a bone infection or bone tumor. The authors report the case of a 46-year-old patient with a history of palmo-plantar pustulosis, recurrent suppurative hidradenitis, and bilateral sternocostal arthropathy who was evaluated for a sclerotic lesion in an iliac wing. The clinical course, computed tomography findings, and histologic features of a surgical biopsy specimen established the diagnosis of osteoblastic osteosarcoma with SAPHO syndrome.

Arthritis, Psoriatic↗
PubMed1995

Adult Still's disease: part I. Manifestations and complications in sixty-five cases in France.

DESIGN: a retrospective multicenter study conducted in France identified 65 cases of adult Still's disease. Data were recorded on a standardized questionnaire validated by the Inflammatory Joint Disease and Immunorheumatology Committee of the Société Française de Rhumatologie. OBJECTIVES: (1) To compare clinical and laboratory findings in our patients with those reported in earlier studies, particularly two large series from Canada and Japan, respectively; (2) to describe the systemic and visceral complications associated with adult Still's disease. RESULTS: as compared with the two above-mentioned series, our study group included more patients who had experienced onset of their disease after the age of 35 years and fewer patients with involvement of the liver, spleen, or lymph nodes. Rates of occurrence of arthritis, myalgia, sore throat, pleuritis, pericarditis, and abdominal pain were significantly higher in the Canadian series than in the other two series. Arthritis was absent in one fourth of our patients. Life-threatening complications included "Still's hepatopathy", disseminated intravascular coagulation (with hemophagocytosis in some cases), and "Still's myocarditis". CONCLUSION: differences in the expression of adult Still's disease were found between patients from Canada, France, and Japan. Adult Still's disease can be responsible for life-threatening complications.

Adolescent↗
PubMed1995

Adult Still's disease. Part II. Management, outcome, and prognostic factors.

DESIGN: a multicenter study conducted in France identified 65 cases of adult Still's disease. Follow-up exceeded one year in 52 cases. OBJECTIVES: were as follows: 1) to describe treatments used; 2) to analyze disease course patterns; 3) to study joint alterations; 4) to determine whether any characteristics present within the first six months of onset were of prognostic significance. RESULTS: aspirin was ineffective. Indomethacin ensured satisfactory control in eight patients. Corticosteroid therapy was required in 88% of cases. Among patients followed up for more than one year, half developed radiologic joint alterations; 23% had monocyclic systemic disease, 38.5% had polycyclic systemic disease and 38.5% had chronic articular disease. More than half of the patients (58%) had more than one systemic flare. Polyarthritis at onset and involvement of the proximal limb joints were significantly predictive of chronic articular disease, whereas isolated arthralgia was predictive of monocyclic or polycyclic systemic disease. Oligoarthritis was not predictive of the outcome. CONCLUSION: the knowledge that polyarthritis or proximal limb joint involvement within six months of onset is predictive of chronic joint disease may have important therapeutic implications.

Anti-Inflammatory Agents↗
PubMed1994

[Palindromic rheumatism disclosing Whipple's disease. Study of 2 personal cases].

Two patients with palindromic rheumatism were diagnosed with Whipple's disease 5 years after onset of the joint symptoms. Twenty-one previously published cases of Whipple's disease with palindromic rheumatism as the first manifestation were identified. Statistically significant differences were found between palindromic rheumatism in patients with and without Whipple's disease. Patients with Whipple's disease were more likely to be male and to exhibit fever and elevated erythrocyte sedimentation rates during joint symptom flares, whereas they were less likely to have involvement of the metacarpophalangeal and proximal interphalangeal joints. None of the patients with Whipple's disease had either skin manifestations of palindromic rheumatism (nodules or paraarthritis) or positive tests for rheumatoid factor. Patients with palindromic rheumatism exhibiting these features should have an intestinal biopsy to look for Whipple's disease.

Arthritis, Rheumatoid↗
PubMed1993

[Migratory algodystrophy of the lower limbs involving the foot and complicated by two fatigue fractures. An histological bone study].

A 62 year old male developed transient osteoporosis algodystrophy successively in several sites of the lower limbs (8 episodes of involvement of one or two sites over an 8-year period) three years after surgery for a chromophobic pituitary adenoma. Two stress fractures developed, during the sixth and seventh years, respectively, in bones previously affected by osteoporosis. A biopsy specimen from the distal tibia showed thin bone trabeculae and reduced cellular activity. The only etiologic factor was the patient's psychological profile characterized by anxiety and introversion.

Bone and Bones↗
PubMed1991

[Epidemiological and clinical aspects of gout in equatorial Africa. Apropos of 60 cases followed in the Department of Rheumatology of the Teaching Hospital Center in Brazzaville].

Between December 15, 1988 and November 30, 1990, the application of Rome and New York criteria enabled the diagnosis of 60 cases of gout among patients with arthritis or hyperuricemia seen as out-patients or hospitalised in the Department of Rheumatology of the Brazzavile T.H.G. There were 57 men and 3 women, with a mean age of 51. Gout is the primary form of inflammatory arthropathy in adults in the Congo. Affecting all socio-professional groups, it is diversely associated with obesity, alcoholism, hypertension and diabetes. Initial involvement affects the big toe. Oligo and polyarticular forms predominate because of the absence or delay in specific treatment. This series included 30 per cent of cases of chronic gout. Evidence of renal impairment was found in one third of patients. However, urate lithiasis was absent. Tophi were found preferentially over the elbows. Sickle cell disease was responsible for one case of tophaceous gout. In contrast with the results of studies undertaken before the 1980s, gout is seen to be a common condition in equatorial Africa.

Adult↗
PubMed1991

[Prospective study of rheumatic manifestations in human immunodeficiency virus infection. Apropos of 26 cases in Congo].

A 12-month prospective study of the osteo-articular complaints in HIV infected patients was carried out in the Department of Rheumatology, Brazzaville, Congo. Positivity of the HIV serology was systematically researched. And so the authors have observed rheumatic disorders in 26 patients, 12 males, 14 females, with a mean age of 36 years (ranged from 13 to 78). These disorders are as follow: linked to HIV oligo or polyarthritis, 18 cases; septic arthritis 3 cases; destructive spondylodiscitis 2 cases; bilateral sciatica with paralysis 3 cases; tropical myositis 2 cases. Contamination was heterosexual in 23 patients, iatrogenic in 3 other ones. HIV infection was at the CDC stades II (7 patients) or IV (19 patients). The prevalence of osteo-articular manifestations in HIV infected patients who are admitted in the hospital of Brazzaville, Congo is evaluated at only 4%.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Treatment by nucleolysis using chymopapain of disk hernias of purely lumbalgic form].

16 patients suffering from a herniated disc with purely lumbalgic manifestations were treated with chymopapain nucleolysis. The results were very good in 5 cases, good in 6 cases and poor in 5 cases. These data, along with those scattered in the literature, led us to consider nucleolysis as a treatment, probably valid, of a herniated disc in its purely lumbalgic form.

Adult↗
PubMed1987

[Pancreatic cytosteatonecrosis].

If cutaneous panniculitis, made of dermo-hypodermic nodules, is the most constant manifestation of pancreatic cytosteatonecrosis, articular and bony localizations are quite frequent and sometimes the first manifestation of the disease. Articular lesions: monoarthritis, oligo-arthritis and mostly polyarthritis, often assume a very inflammatory picture; the synovial fluid is oily or puriform, and has a high content of polynuclear cells or macrophages with a foamy cytoplasm, lipid droplets, triglycerides, non-esterified fatty acids, and pancreatic enzymes; the most typical synovial lesion is a cytosteatonecrosis with adipocytes showing a huge lipidic vacuole. The bony lesions are mostly osteolytic, microgeodic lesions, or more extended ones, pseudo-tumoral without soft tissue invasion: more rarely, there is a periosteal thickening, bony infarctions, or epiphyseal osteonecrosis; these lesions do not always demonstrate a hyperfixation on scintigrams. The physiopathology of these various lesions is usually linked to a diffusion of pancreatic lipases, but other enzymes or enzymatic inhibitors also intervene, as well as a cytotoxic and local inflammatory activity of the fatty acids themselves. Surgical treatment of the pancreatic lesions, when possible, is the only treatment that is truly effective.

Adult↗