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Biomedical subjects

C Laval

Publications and source records attributed to C Laval.

16 recordsLinked to original sources
PubMed2001

Serious adverse events associated with yellow fever 17DD vaccine in Brazil: a report of two cases.

BACKGROUND: The yellow fever vaccine is regarded as one of the safest attenuated virus vaccines, with few side-effects or adverse events. We report the occurrence of two fatal cases of haemorrhagic fever associated with yellow fever 17DD substrain vaccine in Brazil. METHODS: We obtained epidemiological, serological, virological, pathological, immunocytochemical, and molecular biological data on the two cases to determine the cause of the illnesses. FINDINGS: The first case, in a 5-year-old white girl, was characterised by sudden onset of fever accompanied by headache, malaise, and vomiting 3 days after receiving yellow fever and measles-mumps-rubella vaccines. Afterwards she decompensated with icterus and haemorrhagic signs and died after a 5-day illness. The second patient-a 22-year-old black woman-developed a sore throat and fever accompanied by headache, myalgia, nausea, and vomiting 4 days after yellow fever vaccination. She then developed icterus, renal failure, and haemorrhagic diathesis, and died after 6 days of illness. Yellow fever virus was recovered in suckling mice and C6/36 cells from blood in both cases, as well as from fragments of liver, spleen, skin, and heart from the first case and from these and other viscera fragments in case 2. RNA of yellow fever virus was identical to that previously described for 17D genomic sequences. IgM ELISA tests for yellow fever virus were negative in case 1 and positive in case 2; similar tests for dengue, hantaviruses, arenaviruses, Leptospira, and hepatitis viruses A-D were negative. Tissue injuries from both patients were typical of wild-type yellow fever. INTERPRETATION: These serious and hitherto unknown complications of yellow fever vaccination are extremely rare, but the safety of yellow fever 17DD vaccine needs to be reviewed. Host factors, probably idiosyncratic reactions, might have had a substantial contributed to the unexpected outcome.

Acute Kidney Injury↗
PubMed1998

Spinal cord abscess in a heroin addict: case report.

Spinal cord abscesses are extremely rare, even in intravenous drug abusers. They usually have a poor prognosis unless diagnosed and treated promptly. MRI is the best imaging modality for diagnosis and follow-up. We report a 42-year-old man, an active intravenous drug user, HIV negative, who developed subacute tetraplegia from an intramedullary abscess caused by Staphylococcus aureus. Immediate decompressive surgery and antibiotic treatment led to progressive recovery.

Abscess↗
PubMed1998

Intracranial vascular involvement of brain pathologies and venous occlusions.

In this paper, the authors present the contribution of CT and MRI to the diagnosis of acute stroke caused by arterial or venous occlusion. The term "early" used in this context means within 6 h of the onset of symptoms. Signs of early ischemic edema are subtle and sometimes difficult to detect by CT or MRI. The purpose of this presentation is to familiarize the clinician and the radiologist with the subtle brain parenchymal changes seen within the first 6 h after onset of symptoms, in order to improve detection of early ischemic infarction and to improve patient care.

Acute Disease↗
PubMed1995

Host and viral characteristics affecting the response to interferon therapy in chronic hepatitis C.

OBJECTIVE: To define parameters determined before and after 4 weeks of interferon therapy (3 MU three times per week for 24 weeks) which could be reliable predictors of a response to therapy. PATIENTS: Thirty-four patients with chronic hepatitis C virus (HCV) infection were investigated prospectively. METHODS: A complete response was defined as the normalization of serum alanine aminotransferase levels (ALT) at the end of treatment. The genotype of HCV was determined and the level of HCV-RNA was quantitated both before and after 4 weeks of treatment. RESULTS: After 4 weeks, 16 out of 20 responders [95% confidence interval (CI) 54-94%] and two out of 14 non-responders (95% CI 2-44%) normalized their ALT levels (P = 0.0002). The prevalence of genotype 1b was significantly (P < 0.04) higher among non-responders (eight out of 10; 95% CI 44-92%) than in responders (four out of 18; 95% CI 4-40%). Before treatment, the viraemia determined by branched DNA was significantly lower in responders than in non-responders (46.4 versus 116 x 10(5) eq virus/ml). After 4 weeks of treatment, the level of viraemia in responders was still significantly lower than that in non-responders (22.8 versus 66 x 10(5) eq virus/ml). In responders, a significant decrease in the level of viraemia was observed after 4 weeks of treatment. CONCLUSION: In a stepwise regression analysis only age and the normalization of ALT levels after 4 weeks of treatment were predictive of response to interferon at the end of treatment.

Adult↗
PubMed1990

[Human papillomaviruses in uterine cervix pathology: clinical implications, detection and type].

Recently, intense interest has been focused on the relation between HPV infection and the precancerous and cancerous lesions of the uterine cervix, as documented in numerous publications on the subject. We carried out a prospective anatomoclinical study on 224 women (HPV positive) in the René Huguenin Centre, from April 1984 to December 1988. Among these patients, cytology, colposcopy and biopsy, where necessary, were performed, concurrently with the detection of HPV on cervical smears using a molecular hybridization method (G Orth). We analysed the anatomo-clinical results and propose practical implications, in taking the evolution of the patients into account. These patients were followed up and treated when necessary for cervical intra-epithelial neoplasia (CIN) or carcinoma, associated or unassociated with HPVs (oncogene in 70% of cases). 24% of the patients where infected by an HPV, without any lesion. This virus disappeared spontaneously during the follow-up period. It can be concluded therefore that HPV infection, even oncogene, does not necessarily carry on CIN. Among CIN 1-2, associated or unassociated with HPV, the adequate treatment cured the patients and the virus disappeared. In some cases, a simple follow-up showed spontaneous regression of the lesion and the virus--CIN 3 was removed when necessary with a systematic pathological examination of the endocervix and the surgical sample limits. In a few cases, the virus persisted without lesion. HPV infection did not modify our protocol in the invasive carcinoma. These observations are available in a Centre with a well-trained anatomo-clinical team. In our opinion, the major priority involved in the recognition of cervical HPV infection is to perform a more systematic colposcopy (even for normal smears with subtle atypia), allowing the detection of early precancerous lesion, clinically occult. On the other hand, the oncogene HPV notion has caused us to take more aggressive action regarding treatment of some CIN 1-2, but may not be of benefit to the patient. We remain convinced that the CIN, with or without HPV, or not oncogene with HPV, must only be treated based on the clinical extension and the pathological gravity of the lesions.

Adolescent↗
PubMed1990

[Human papillomavirus infections of the cervix uteri. Clinical implications, indications of typing].

Recently, intense interest has focused on the relation between HPV infection and precancerous and cancerous lesions of the uterine cervix, as witnessed by the numerous publications on the subject. We carried out a prospective anatomo-clinical study on 224 HPV positive women followed in the Rene Huguenin Centre, from April 1984 to December 1988. Among these patients, cytology, colposcopy and biopsy were performed, when necessary, concurrently with the detection of HPV on cervical smears using a molecular hybridization method (G. ORTH). This study analysed the anatomo-clinical results and suggested the practical implications, taking into account the progress of the patients. These patients were followed up and treated when necessary for cervical intra-epithelial neoplasia (CIN) or carcinoma, associated or not with HPVs (oncogene in 70% of cases). 24% of this population was infected by an HPV, without any lesion. This virus disappeared spontaneously during follow-up; therefore, HPV infection even oncogene, did not necessarily carry onto CIN. Among CIN 1-2, associated or not with HPV, adequate treatment cured the patients with the virus disappearing. In some cases, a simple follow-up showed a spontaneous resolution of the lesion and of the virus. CIN 3 was removed when necessary with systematic pathological examination of the endocervix and of the surgical sample limits. In a few cases, the virus persisted without lesion. HPV infection did not modify our protocol for invasive carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Ovarian seminoma and pregnancy. Apropos of a new case].

The case of a 35-year-old primigravida with a 21-week intrauterine gestation and concurrent dysgerminoma of the ovary (stage Ic) is presented. A total hysterectomy with bilateral salpingo-oophorectomy was performed, followed by postoperative chemotherapy using cisplatin, bleomycin and vinblastine. The patient has done well since treatment, and is without evidence of recurrent disease 19 months later. Both radiation and chemotherapy are highly effective treatment modalities for dysgerminoma. For those patients with disease presenting in stages Ib, Ic, II and III who wish to maintain fertility, unilateral oophorectomy followed by combination chemotherapy may be curative and spare ovarian function.

Adult↗
PubMed1986

[Human papillomaviruses in the epithelial cells of the cervix uteri: frequency of types 16 and 18. Preliminary results of a clinical, cytologic and viral study].

Between April 1 and June 30 1984, cervical scrapes were taken from 381 women attending the Gynecology Department of the Anticancer Center René-Huguenin. The scrapes were examined for the presence of human papillomavirus (HPV) DNA, by a molecular hybridization method, at the Pasteur Institute. The four HPV types involved in genital pathology, HPV 6, HPV 11, HPV 16 and HPV 18, were studied. Twenty four specimens (6.3%) were found positive: 19 for HPV 16, 3 for HPV 18, 2 for HPV 6 or HPV 11. Results of molecular hybridization were compared with cytological findings. HPV 6 or HPV 11 were detected in cases of mild dysplasia. HPV 16 or HPV 18 were mainly detected in cases diagnosed as severe dysplasia or carcinoma in situ (9 out of 14, i.e. 64.3%), and invasive carcinoma (3 out of 5 cases). The results were further confirmed when virological data obtained with cervical scrapes were compared with the histological diagnosis on biopsies: 14 out of 15 cases of severe dysplasia or carcinoma in situ (93%) and 3 out of 6 cases of invasive squamous carcinoma had been found positive for HPV 16 or HPV 18. Interestingly, four "normal" women (1.3%) with a negative cytology were found positive for HPV 16 or HPV 18. The data obtained by this sensitive and reliable method are useful to the clinician to identify women presenting a high risk of subsequent cervical intraepithelial neoplasia or invasive carcinoma, and, thus, to adapt the treatment and the follow-up of these patients.

Adult↗
PubMed1983

[Proposal for a surgical evaluation index card for ovarian cancers].

The authors propose a computer card for registering the main information required in the management of ovarian cancers. The data include a detailed description of the lesions noted at operation, the surgical procedure, and postoperative lesions. They concern both the initial laparotomy and any second-look operations.

Computers↗
PubMed1979

[Results of radiotherapy of 406 carcinomas of the cervix (T2 distal and T3). Comparison between classical irradiation in one phase and split-course irradiation (author's transl)].

Between 1963 and 1971, a total of 406 inoperable cases of cervical cancer were treated by high-dose radiotherapy at the Centre René-Huguenin. Most of the patients (243) were irradiated by continuous therapy. In the other group (163) there was a 3-week interval in the middle of the treatment. The five-year survival rates (direct method) were respectively 60 and 39 per cent for the patients staged as T2 and T3. Local cure rates were 85 per cent for T2 and 65 per cent for T3. Unfortunately a high rate of complications was noted (12%), 4 per cent of which were fatal. Classical radiotherapy proved to be more beneficial than "split-course" technique considering survival rates. Yet, the rate of local cure is identical in both procedures, and the large rate of death in "split-course" seems to be irrespective of the method. Nevertheless, we have abandoned the "split-course" because the incidence of sequelae had not improved and in as much as the total dose had been reduced, the continuation of such therapy was less justified.

Adult↗