Difficulty with MEDLINE searches for randomised controlled trials.
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Biomedical subjects
Publications and source records attributed to C Lefebvre.
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The observation of a 62 year-old woman who had been suffering from arthritis for several years and in whom treatment with high doses of acetylsalicylic acid resulted in severe acute hepatitis is reported. Clinical and serological findings led to the diagnosis of systemic lupus erythematosus complicated by acute drug induced hepatitis.
Self-reported weights and heights of 82 adults were compared with measured weights and heights 1 to 3 years after participation in community weight loss programs. The mean self-reported weight was 2.3 +/- 1.9 kg lower than measured weight (P < .05). Differences in underreporting were not significant for gender or age group. Heavier individuals misreported their weight to a greater extent (P < .05) than lighter persons, and individuals who had not recently weighed themselves underreported their weight to a greater extent than those who had weighed recently (P < .05). On the average, height was overreported by a mean of 1.8 +/- 2.7 cm. Overreporting increased with increasing height, and men overestimated their height to a greater extent than women (P < .05). Younger subjects reported their height more accurately than those older than 60 years. Results of our study are similar to those of previous investigations that examined self-reporting bias in subjects enrolled in weight loss programs. The mean discrepancy in body weight, however, was greater than that reported in samples drawn from the general population. Our findings indicate that self-reported weight and height values in overweight populations should be interpreted with caution.
The Pawtucket Heart Health Program, a research effort testing a process of community activation for cardiovascular risk factor behavior change, risk factor change, and coronary heart disease event rate change, utilizes risk factor behavior change programs for the entire population of a northeastern city. A diversity of nutrition programs designed to teach new skills and to alter the nutrition environment have been delivered. These include group programs, highlighting restaurant menus, labeling grocery shelf items, screening for blood cholesterol levels accompanied by nutritional counseling, and provision of programs in schools. In addition to standard curricula, the Heart Healthy Cook-Off for both junior high school and high school students has been developed. Students select recipes, make substitutions to lower fat, saturated fat, and cholesterol content, analyze original and substitution recipe nutrient content using a microcomputer and nutrient analysis software, and prepare the food. A panel of judges assesses presentation, taste, and health-promoting characteristics. In one junior high school class, cholesterol measure before and after the cook-off decreased by 10.7% among those with elevated cholesterol. The Heart Healthy Cook-Off is an education program that influences the culinary practices of children in an enjoyable, challenging format.
We describe a white French family in which 12 subjects presented with hereditary elliptocytosis (HE) or hereditary pyropoikilocytosis (HPP). Eight of these subjects were shown to be heterozygous for a spectrin (Sp) alpha I/74 variant, as demonstrated by analysis of partial tryptic digestion fragments of spectrin. This abnormal peptide pattern was associated with a decreased ability of Sp dimers to self-associate. In this kindred, in which four generations were available for study, the clinical expression varied from mild HE to HPP with an intermediate status of hemolytic HE. The severity of the disease appeared to be correlated both with the estimated amount of variant Sp (42% to 65%) and the excess of Sp dimers found in the membrane (30% to 51%, with a normal value of 3.7% +/- 1.6%). Reassociation studies using isolated Sp alpha and beta chains from an affected patient and an unaffected control subject showed that the Sp alpha I/74 Kd abnormal tryptic peptide resulted from a defect in the Sp alpha chain. Partial amino acid sequencing showed that the Sp alpha I/74 Kd peptide resulted from cleavage at lysine residue 42 of the Sp alpha I/80 Kd domain. Knowledge of the exon/intron organization of the human alpha Sp gene allowed us to amplify by the polymerase chain reaction the second exon of the alpha Sp gene in total cellular DNA of the HPP proposita. The amplified fragment was subcloned and sequenced. We found a G to A base substitution in the 22nd codon (CAT for CGT), which changes the normal arginine to a histidine. Hybridization of amplified DNAs with allele-specific oligonucleotides corresponding to the normal and mutant sequences confirmed the presence of the mutation in six other HE and HPP members of the family. The identification of this mutation at the DNA level confirmed the transmission of the same molecular defect in Sp through four generations but with different patterns of clinical expression.
We report the case of a type B lymphoma originating from the mediastinum, characterized principally by massive metastatic invasion of the right cardiac cavities in the form of a projecting mass well visualized at echography responsible of the presenting features of the illness. This lymphoma was, moreover, associated with an auto-immune haemolytic anaemia due to cold agglutinins.
Several compounds derived from benzamidines and nicotinic pyridinic amidines with a structure similar to that of procainamide, exhibit notable antiarrhythmic properties after injection into animals. The diffusion rate of these different compounds through a solid lipidic artificial membrane was studied with Dibbern's apparatus. A statistical relation was established between the diffusion rate and the principal pharmacological parameters obtained after intraperitoneal injection (toxicity and anthiarrhythmic activity). Essential structural elements seem to determine a better bioavailability than procainamide: character of the substitution (in para) of the benzenic cycle; length of the lateral chain.
The case of a young, male patient hospitalized for investigation of a cerebral vascular accident is reported. The investigations led to the diagnosis of disseminated lupus erythematosus associated with the presence of antiphospholipid antibodies (lupus circulating anticoagulant and anticardiolipin antibody). The authors discuss certain notions relating to antiphospholipid antibodies and the thromboembolic, particularly neurological, manifestations thereof.
Nitroglycerin pharmacodynamic efficiency is 3 to 4 times higher than isosorbide dinitrate efficiency. Authors put forward that this difference is at least partially pertained to the transmembrane diffusion potential of the molecules. Data of this first study on red cell membranes are in accordance with this hypothesis.
Nitroglycerin pharmacodynamic efficiency is 3 to 4 times higher than isosorbide dinitrate efficiency. Data of this study on physiological and artificial membranes point the greater nitroglycerin transmembrane diffusion, which is discussed as a possible relevant explanation.
We report the case of a patient who presented with cardiac and neurological signs of lithium toxicity as the result of an association with amitriptyline. These manifestations disappeared spontaneously as medication was stopped. We review the possible physiopathological mechanisms that could account for these adverse effects.
Forty patients with hypereosinophilic syndrome (HES), defined according to the criteria established by Chusid et al., were studied retrospectively in order to determine the prognostic factors in this heterogeneous disease. A myeloproliferative syndrome (MPS) was diagnosed 17 times when splenomegaly and/or a greater than 5 times the normal vitamin B12, level existed. Cutaneous-visceral involvement was almost always present (95%), but could appear after several years of evolution. Twenty-three patients had cardiac involvement, determined by clinical, radiological, electrocardiographic and echocardiographic examinations; 12 of these had endomyocardiac fibrosis. The overall survival rate was 80% at 5 years and 42% at 10 and 15 years. Among the factors evaluated that are capable of influencing this survival, 5 were found to impair the prognosis; presence of an MPS; non-response of the hypereosinophilia to corticoids; existence of a cardiopathy; being male; and an elevated maximum eosinophilia; the last two factors were significantly associated with the cardiopathy. Because hematological or cardiac anomalies are not always present at the time of the first examination, HES patients require very close surveillance.
Two cases of pulmonary cystic adenomatoid malformation are presented. The first case presented with bilateral pulmonary cystic involvement associated with oligoamnios and feto-placental anasarca. A peculiar feature of this case was the elevated level of alphafetoprotein in the amniotic fluid. In the second case, the pulmonary involvement was limited to one lobe. There was coexistent aplasia of the diaphragm. Premature rupture of the amniotic membranes necessitated a therapeutic abortion at 21 weeks of pregnancy. In connection with these two cases, a discussion based on the data in the literature.
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Over a period of 7 years a typical hemolytic uremic syndrome (HUS) developed in 3 brothers, at the age of 27, 31 and 35 years respectively. The patients did not share a common HLA haplotype. Two sisters, now 36 and 39 years old, did not develop HUS despite pregnancy and prolonged oral contraception. We investigated in the 3 patients (outside of the acute phase of the HUS) and in 12 other first degree relatives complement components (C3, C4, C1q, factor B), coagulation factors (i.e., antithrombin III, F VIII, protein C) prostacyclin regulating plasma factor and vitamin E levels: all results were normal. Renal failure was irreversible in the 3 patients, despite fresh plasma infusions in 2 of them. After a 7 to 32-month period on hemodialysis, the 3 patients were transplanted with a cadaver kidney. Twenty-one to 94 months later, they have a functioning graft and no recurrence of the HUS. We conclude that, in this family, HUS is not linked to HLA or female gender. No phenotypic marker of the disease was found. Evolution after dialysis and transplantation is excellent, with no short term recurrence of the HUS.
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The authors present a computer program designed for the practising cardiac surgeon who wishes to computerize patient data. The program is efficient, versatile and can be adapted to individual needs. It can be used with any IBM PC-compatible machine and requires little knowledge of computer science. More than 250 items on 30 000 patients can be stored and all this information analysed simultaneously. The program can chart a patient's profile and tabulate the information of the entire registry. It can generate lists of patients with their surgeons, cardiologists, diagnoses, operations and dates of intervention. It can also be used for mailing purposes.