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Biomedical subjects

C Durand

Publications and source records attributed to C Durand.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Invasive pulmonary aspergillosis in neutropenic patients. Analysis of a series of 36 cases: contribution of thoracic scanners and itraconazole].

In neutropenic patients, one way of improving invasive pulmonary aspergillosis (IPA) prognosis is an earlier initiation of the antifungal treatment. We report our experience with 36 cases of IPA in 35 patients with haematological malignancies. When aspergillosis was diagnosed, all but 2 patients were neutropenic (PMN < 500; median duration = 20 days). The most frequent clinical signs were cough (100%), chest pain (78%) and haemoptysis (58%). Before the diagnosis of IPA, Aspergillus antibody test was positive in 60% of cases. A thoracic CT-scan was performed in 23 patients and demonstrated highly suggestive images in 22 cases (96%) with presence of CT halo sign (n = 13) or CT air-crescent sign (n = 9). Moreover, Aspergillus antigen test was positive in 13 of 28 tested patients. IPA diagnosis was determined to be definite in 23 cases and probable or possible in 13 cases. Thirty-five patients were treated: in 3 cases with amphotericin B (2 failures) and in 32 cases with itraconazole (7 failures and 25 successes or improvements). In 7 cases (including 5 emergencies) surgical resection was successfully combined with the medical treatment. In neutropenic patients with fever, we consider that thoracic CT-scan and repeated biological tests (Aspergillus antibody and antigen tests) can be used to establish the diagnosis of aspergillosis. Early treatment with itraconazole and surgical resection appears to improve prognosis.

Adult↗
PubMed1994

[Use of tissue plasminogen activator in the treatment of aortic thrombosis in newborn infants].

BACKGROUND--Aortic thrombosis is more frequent since the use of umbilical artery catheters in neonatal intensive care units. Some drugs or surgery are proposed to prevent complications; experience with tissue plasminogen activator (tPA) is still limited. CASE REPORT NO 1--A neonate, weighing 2400 g, developed respiratory distress requiring insertion of a catheter into her umbilical artery at H12. Ultrasonography on day 3 showed aortic thrombosis extending to the right renal artery which was confirmed by angiography. tPA 0.1 mg/kg was administered through the catheter, followed by 0.3 mg/kg/h for 3 hours and heparin, 100 IU/kg/hour for 54 hours. Angiography, performed 18 hours later, showed complete disappearance of the thrombosis. CASE REPORT NO 2--A neonate, weighing 2520 g suffered at 12 hours of life from seizures, apnea and bradycardia which required insertion of a catheter into her umbilical artery. Cyanosis of the right leg with weakening of femoral pulsations, 14 hours later, lead to the diagnosis of aortic thrombosis which was confirmed by aortography. The patient was given tPA 0.1 mg/kg followed by 0.3 mg/kg/h for 3 hours and heparin 100 IU/kg/hour for 6 hours. Amplitude of femoral pulsations strikingly increased within 6 hours with the disappearance of cyanosis. CONCLUSION--These results suggest that tPA can be useful in neonates presenting with aortic thrombosis.

Aorta↗
PubMed1994

[Ultrasonographic survey of the effect of umbilical arterial catheterization in newborn infants].

BACKGROUND: Incidence of aortic thromboses in the neonatal period is significantly increased after umbilicar artery catheterization. POPULATION AND METHODS: Fourty neonates (GA: 34.7 +/- 7.2 wks and birth weight: 2377 +/- 786 g) were prospectively studied in order to assess frequency and natural history of aortic thromboses due to umbilical artery catheterization. Investigation was based on serial real-time ultrasonography (2.3 times/week). Presence of aortic thrombus was correlated with the existence of clinical complications and the results of biological findings (prothrombin and fibrinogen levels; hematocrit) and platelet number. RESULTS: Aortic thrombosis was found in six patients (15%); it was clinically asymptomatic in two (5%). A vascular wall-fixed catheter was shown in ten infants (25%); this finding was associated with thrombosis in five cases and preceded thrombosis in one other. The presence of thrombus and/or abnormal position of the catheter was not correlated with gestational age, birth weight, duration of catheterization, blood hemostasis and results of bacteriological cultures of the tip of the catheter. CONCLUSIONS: Ultrasonographic control must be repeated after umbilical artery catheterization. It permits evaluation of renal flux and can lead to removal of catheter and/or peculiar therapeutic measures.

Aorta↗
PubMed1993

[Lissencephaly. Clinical, electroencephalographic and radiological aspects].

We report 2 cases of lissencephaly and review the cardinal symptoms: microcephalia, mental retardation, pyramidal syndrome and generalized epilepsy. CT-Scan and MRI show the anatomical abnormalities of this malformation: microcephalia, smooth cortex reducing the surface of white matter and lack of sulci and gyri. The fact that the myelin is normal on MRI suggests that this major disorder of neuronal migration does not come from radial glial fibers.

Cerebral Cortex↗
PubMed1993

[Hepatic abscess due to Yersinia in a child with thalassemia].

A 15-year-old boy with thalassaemia major treated with desferrioxamine, experienced fever associated with digestive disorders. These symptoms led to the discovery of multiple liver abscesses. Therapy included antibiotics (third generation cephalosporin and aminoglycoside) and desferrioxamine discontinuation. Recovery occurred within one month approximately. Systemic yersiniosis was further confirmed by the finding of antibodies to Yersinia enterocolitica O5. The systemic diffusion of Yersinia is favoured by iron-overload and iron-chelating agents.

Adolescent↗
PubMed1992

Effects of mediodorsalis thalamic nucleus lesions on vigilance and attentive behaviour in cats.

In this study performed on 10 cats we analysed the effects of limited lesions of nucleus medialis dorsalis of the thalamus (MD) on behaviour and on some specific electrocorticographic (ECoG) patterns, known from previous works to accompany various states of waking attentiveness. The animals were tested during 90 min in three distinct behavioural situations; a neutral one (NS) where they simply explored their environment and then usually went to sleep; a second one (FA) where they could watch a mouse (but not catch it), which favoured 'focussed' attentiveness accompanied by the development of rhythmic ECoG activities in the anterior frontoparietal cortex ('beta rhythms' at 40 Hz); a third one (EX) with a hidden mouse whose appearance the cat was waiting for ('expectancy') which rather than favouring the development of beta rhythms elicited the appearance of another rhythmic activity dominating in somatic area SI, 'mu rhythms' at 14 Hz. The duration of each waking behaviour and its ECoG concomitant as well as that of slow wave and of paradoxical sleep were compared in each cat before and after lesion. Our results showed that MD lesions situated in the posterior part of the nucleus tended to increase the time occupied by focussed attentive behaviour and the accompanying beta rhythms. On the other hand, anteriorly located MD lesions elicited a concomitant reduction of both manifestations, behavioural and electrocortical. No such contrasting effects could be systematically noticed for the durations of expectancy, of slow sleep and of paradoxical sleep. These findings were discussed considering previous data showing that at least two systems project upon MD, that play distinct--in a way even antagonistic--roles in focussed attention upon a target. Both originate from the ventral tegmental mesencephalic area; one reaches MD through the ventral striatum (nucleus accumbens), the other one through the amygdala. The MD nucleus thus receiving contrasting information may participate in a final adjustment of the attentive state of the animal to its environment.

Animals↗
PubMed1992

Role of aluminium in skin reactions after diphtheria-tetanus-pertussis-poliomyelitis vaccination: an experimental study in rabbits.

The occurrence of subcutaneous nodules at the injection site is one of the complications of diphtheria-tetanus-pertussis-poliomyelitis vaccination, but the causes and mechanisms involved are still poorly understood. An experimental study in the New Zealand rabbit enabled us to determine the frequency of occurrence of these nodules, how long they persist and the histopathologic features of the cells involved. Aluminium (Al) assays by electrothermal atomic absorption spectrometry allowed us to study concentrations both in nodules and the organism (serum, normal skin). The results show an absence of Al diffusion outside nodules, a correlation between infiltrate intensity and Al concentration in nodules and modifications in the histological constituents of nodule cells. The histological picture indicates a foreign body reaction to Al. All these data underscore the role of Al in the formation of early postvaccinal nodules at the injection site.

Aluminum↗
PubMed1992

[Parameningeal cervical rhabdomyosarcoma in the neonatal period].

A case of parameningeal cervical rhabdomyosarcoma with severe bone destruction is reported in a 3 month-old infant; symptoms were present at birth. The treatment consisted of exclusive intensive chemotherapy. The outcome was favourable with complete tumor regression and vertebral bone reconstruction. The child was on complete remission without sequellae two years later.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

A dose-finding study with remoxipride in the acute treatment of schizophrenic patients.

Two hundred and forty-two patients with acute schizophrenia were enrolled in a double-blind, comparative, dose-finding study of a novel antipsychotic, remoxipride. Remoxipride was evaluated in a low (30 to 90 mg), medium (120 to 240 mg) and a high (300 to 600 mg) dose range and compared with a haloperidol (15 to 45 mg), which was administered to a similar group of patients. The results support the antipsychotic effect of remoxipride, with maximum efficacy occurring at daily doses between 120 mg and 600 mg. Side-effects were more frequent at doses of remoxipride over 300 mg. In all groups, remoxipride caused consistently fewer extrapyramidal side-effects than haloperidol. The antipsychotic effect of remoxipride may be derived from specific blockade of dopamine D2 receptors in the mesolimbic tract. The findings also suggest that remoxipride may have a therapeutic effect on negative symptoms of schizophrenia.

Dose-Response Relationship, Drug↗
PubMed1991

[Severe hypercalcemia after rhabdomyolysis and acute renal failure].

Two cases of rhabdomyolysis with renal failure followed by hypercalcaemia are reported. Both had major hyperphosphataemia and hypocalcaemia, requiring haemodialysis. Hypercalcaemia developed during the diuretic phase, when renal function was still abnormal, and before phosphate blood levels had returned to normal. Soft tissue calcifications occurred in one of the patients. The pathogenesis and treatment of this condition are discussed. Increased levels of serum calcitriol may play an important role in the genesis of hypercalcaemia, which may last for several months. Giving calcium salts and or vitamin D to these patients during the hypocalcaemic phase is dangerous, and should be avoided. The usual treatment for hypercalcaemia my remain ineffective. Mithramycin can lower the serum calcium concentration but the new diphosphonates (sodium etidronate) are very effective in the treatment of this hypercalcaemia. However, in serious or urgent cases, hypocalcaemic haemodialysis may be required, with the simultaneous administration of calcitonin and diphosphonates.

Acute Kidney Injury↗
PubMed1991

Using ultrapure water in hemodialysis delays carpal tunnel syndrome.

Since 1977, our patients have undergone chronic HD with ultra-pure dialysate (UPD), defined as having endotoxin levels below 0.008 ng/ml and less than 1 bacteria/ml of dialysate. We evaluated the incidence of carpal tunnel syndrome (CTS) in three groups of patients. Group I (GI), 84 patients, dialysed for 6.1 +/- 3.2 years (mean +/- SD) with UPD only; Group II (GII), 39 patients, first dialysed for 3.7 +/- 2.3 years with non-UPD and afterwards for 8.4 +/- 2.1 years with UPD; Group III (G III), 103 patients treated for 6 +/- 5.9 years exclusively with non-UPD. All patients were dialysed with cuprophan or cellulose acetate membranes. Results, expressed by Kaplan-Meier actuarial survival curves as the percent of patients without CTS, show that CTS occurred significantly less in GI than in GIII. This may be due to less stimulation of monocytes resulting from the absence of bacteria, endotoxins and pyrogens in the dialysate, which would reduce the stimulation of cytokines release, interleukin 1 and 6, and tumor necrosis factor, known to stimulate beta 2 microglobulin synthesis.

Actuarial Analysis↗
PubMed1991

[Practical role of ultrasonography and clinical examination for the diagnosis of acute appendicitis. Prospective study].

The aim of this 100-patient prospective study was to compare three types of investigations in the diagnosis of acute appendicitis: initial clinical examination, initial appendicular ultrasound examination, and final results of repeated clinical examinations carried out within the first 48 hours. Final results included initial evaluation, obvious clinical results and definitive results from patients under 48 hour observation for uncertain diagnosis. Clinical initial or appendicular ultrasound examinations were poorly contributive to diagnosis (overall accuracy: 76 percent). On the contrary, repeated clinical examinations yielded a 100 percent sensitivity, a 94 percent specificity, a 94 percent positive predictive value, a 97 percent negative predictive value and a 97 p. 100 overall accuracy. No morbidity was noted in observing patients for 48 hours. Unwarranted appendectomies were carried out in 3 percent of cases. Ultrasonography of the appendix seems useful for the differential diagnosis of acute appendicitis.

Acute Disease↗
PubMed1991

[Brain stem tumors in children].

Gliomas involving the brain stem represent 10% of pediatric central nervous system neoplasms. They result in multiple cranial nerve involvement, long tracts signs, cerebellar signs, usually with no evidence of raising in intracranial pressure. The diagnosis is established by computed tomographic scan and magnetic resonance imaging. Classic management consists in conventional radiation therapy but the prognosis is very dismal with a five year survival rate about 30%.

Brain Neoplasms↗
PubMed1990

Action of tianeptine on focalization of attention in cat.

Tianeptine, an antidepressant substance devoid of sedative action, was investigated for its effects on focalization of attention in cats, using combined behavioural and electrocorticographic (ECoG) observations. The ECoG index was the presence of 40 Hz frontoparietal rhythmic cortical activities, developing while the animal displayed a behaviour suggesting focused attention. Cats were observed in two conditions: a "neutral" one, with no specific target, and another one, "of focused attention" where a live mouse placed in a transparent box was present in the recording room, each test lasting for 90 min. After treatment the animals displayed increased attention even in the neutral situation, where the cat, instead of sleeping like during control sessions, payed sustained attention to its environment. Conversely, at corresponding doses, amitriptyline, another antidepressant drug chosen as a reference, induced uninterrupted slow sleep even in the situation of focused attention.

Amitriptyline↗