PubMed Health⌕ Search

Biomedical subjects

C Lefebvre

Publications and source records attributed to C Lefebvre.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Pleural effusion and severe edema of the lower limbs induced by bromocriptine].

High doses of bromocriptine used for treatment of Parkinson's disease may be associated with pleuropulmonary complications. Isolated pleural effusions are a rare manifestation as is lower limbs edema are an exceptionally one. We report the case of a 67-year-old man, treated since five years by a daily dose of 30 mg of bromocriptine for Parkinson's disease, who developed important leg's edema and a few months later an exsudative right pleural effusion. No etiologies were found. Bromocriptine was discontinued. The evolution was characterized by nearly complete resolution of pleural effusion and disparition of lower limbs edema.

Aged↗
PubMed1996

Monoamniotic twin pregnancies. Review of the literature, and a case report with vaginal delivery.

OBJECTIVE: To specify the process of the sometimes difficult diagnosis of monoamniotic twin pregnancies, as well as the best practise for delivery of this type of pregnancy. METHOD: Using their personal observation (a patient with a monoamniotic twin pregnancy, which presented a vaginal delivery at 35 weeks of gestation, two girls, in cephalic presentation, without particular problem, despite an entanglement of the cord and the existence of a knot), the authors established a review of the literature on this subject. RESULTS: Monoamniotic twin pregnancies represent a rare possibility. The prognosis is traditionally somber: 40-60% mortality, mainly due to pathologies of the cord. The review of the recent literature shows that most authors remain in favour of weekly ultrasound supervision from the 23rd week and of caesarean section in principle at 34 weeks (or from fetal pulmonary maturation). CONCLUSION: In the absence of funicular compression signs by colour-doppler, and under the cover of flawless obstetrical conditions, vaginal delivery can only be authorized for cases when both presentations are cephalic.

Adult↗
PubMed1996

Trabecular and cortical bone loss in systemic lupus erythematosus.

We measured lumbar spine, hip (total and sub-regions) and total body bone mineral densities (BMDs) by dual-energy X-ray absorptiometry (DXA) in 47 premenopausal female patients suffering from systemic lupus erythematosus (SLE). As compared to health controls, SLE patients had lower BMDs at all trabecular and cortical sites. Comparison of BMDs between patients ever and never treated with glucocorticoids indicated that patients who had ever received glucocorticoids had a significantly lower lumbar spine BMD compared to those who never did. Moreover, bone loss in patients ever treated with glucocorticoids was commensurate with their cumulated oral glucocorticoid intake. Interestingly, patients never treated with glucocorticoids had a lower hip BMD compared to controls, thereby suggesting that the disease per se might induce some bone loss. Taken together, SLE patients suffer from a significant trabecular and cortical bone loss indicative of an increased risk of future fracture.

Adult↗
PubMed1996

Case report: thoracic aorta thrombus with systemic embolization: a rare paraneoplastic antiphospholipid syndrome?

Antiphospholipid syndrome (APS) is characterized by venous and/or arterial thromboses in the presence of the lupus anticoagulant, anticardiolipin antibodies, or both. Antiphospholipid syndrome may occur as a primary disease or in patients with systemic lupus erythematosus or other autoimmune, infectious, or neoplastic disorders. This is a case of APS associated with chronic myelomonocytic leukemia and complicated by a large descending thoracic aorta thrombus responsible for lower limb and visceral emboli. The intraaortic clot was discovered by transesophageal echography (TEE). The association of APS with chronic leukemias has only rarely been described and, as far as can be ascertained, the location of a thrombus in the descending thoracic aorta has never been reported for this syndrome. This case illustrates the crucial role of TEE in the assessment of patients with systemic embolizations.

Aged↗
PubMed1996

Hepatic angiomyo(myelo)lipoma: difficulties in radiological diagnosis and interest of fine needle aspiration biopsy.

We report the case of a patient admitted for acute heart failure associated with severe dilated cardiomyopathy in whom a large hepatic tumor of the right lobe of the liver was incidentally discovered. A fine needle biopsy was performed that led to the diagnosis of angiomyo(myelo)-lipoma (AMML). The difficulties in radiological diagnosis of these very rare heterogeneous benign tumors of the liver and the interest of fine needle aspiration biopsy are discussed.

Angiomyolipoma↗
PubMed1996

Hepatic abscess likely related to Leptotrichia buccalis in an immunocompetent patient.

We present the case of a 64-year-old previously healthy man admitted for long evoluating fever. Buccal examination showed severe parodontitis. Blood cultures were positive for Leptotrichia buccalis and computed abdominal tomography discovered a hepatic abscess. So far, only exceptional cases of systemic diseases associated with Leptotrichia buccalis infections have been described in immunocompetent patients. Thus, in cases of severe parodontitis and long evoluating fever, attention must be paid to secondary anaerobic infections even in immunocompetent subjects.

Echocardiography, Transesophageal↗
PubMed1996

FISH detection of chromosome polymorphism and deletions in the spinal muscular atrophy (SMA) region of 5q13.

The search for the SMA defect has culminated in the identification of two candidate 5q13.1 SMA genes, NAIP and SMN both of which are deleted in individuals with SMA. It was postulated that the intact and degenerate versions of NAIP are present in variable and frequently high copy numbers in this region while SMN was proposed to be present in only two copies. In order to assess the copy number of NAIP and SMN we have conducted interphase FISH analysis using NAIP and SMN gene-containing cosmid and plasmid probes. Our results confirm the variability in the number of NAIP signals in non-SMA chromosomes (2-6) and show that SMN is present on average twice per chromosome although in one chromosome 4-5 signals for the SMN-containing cosmid probe were detected. Our analysis reveals that one of four and three of six type I SMA chromosomes had a lower than normal number of NAIP and SMN signals, respectively. In two of six SMA type I chromosomes, complete loss of hybridization signal was observed on one chromosome 5 with our SMN cosmid probe possibly reflecting a large scale deletion. Large scale deletions were not detectable when metaphase chromosomes of an SMA type II and III patient were analyzed.

Chromosome Deletion↗
PubMed1996

[Contribution of Doppler color ultrasonography to the screening and surveillance of ovarian hyperstimulation syndrome].

Color and power Doppler producing ovarian vascular mapping allows to realize a new functional approach of ovarian hyperstimulation syndrome (OHS); local vascular factors (ovarian angiogenesis, increase in cappillary permeability) released by hCG injection (LH effect) have in fact an important part in this syndrome. Vaginal Doppler sonography allows: -before induction, to predict potential risk of hyperstimulation: polycystic ovaries, spontaneous stromal hypervascularization; -in monitoring of ovulation stimulation, to reduce risk of multiple pregnancy and to detect early hyperstimulation, decision of hCG injection depends on number of follicles able to be fertilized (> 15 mm) and luteinized (> 10 mm); -to assess severity of OHS and search complications: ascites, hydrothorax, ovarian torsion and deep venous thrombosis. So OHS prevention imposes a monitoring by Doppler sonography and estradiol assay of all cycles induced by gonadotropins.

Female↗
PubMed1995

Refined physical map of the spinal muscular atrophy gene (SMA) region at 5q13 based on YAC and cosmid contiguous arrays.

The gene for the autosomal recessive neurodegenerative disorder spinal muscular atrophy has been mapped to a region of 5q13 flanked proximally by CMS-1 and distally by D5S557. We present a 2-Mb yeast artificial chromosome (YAC) contig constructed from three libraries encompassing the D5S435/D5S629/CMS-1-SMA-D5S557/D5S112 interval. The D5S629/CMS-1-SMA-D5S557 interval is unusual insofar as chromosome 5-specific repetitive sequences are present and many of the simple tandem repeats (STR) are located at multiple loci that are unstable in our YAC clones. A long-range restriction map that demonstrates the SMA-containing interval to be 550 kb is presented. Moreover, a 210-kb cosmid array from both a YAC-specific and a chromosome 5-specific cosmid library encompassing the multilocus STRs CATT-1, CMS-1, D5F149, D5F150, and D5F153 has been assembled. We have recently reported strong linkage disequilibrium with Type I SMA for two of these STRs, indicating that the gene is located in close proximity to or within our cosmid clone array.

Base Sequence↗
PubMed1995

The gene for neuronal apoptosis inhibitory protein is partially deleted in individuals with spinal muscular atrophy.

The spinal muscular atrophies (SMAs), characterized by spinal cord motor neuron depletion, are among the most common autosomal recessive disorders. One model of SMA pathogenesis invokes an inappropriate persistence of normally occurring motor neuron apoptosis. Consistent with this hypothesis, the novel gene for neuronal apoptosis inhibitory protein (NAIP) has been mapped to the SMA region of chromosome 5q13.1 and is homologous with baculoviral apoptosis inhibitor proteins. The two first coding exons of this gene are deleted in approximately 67% of type I SMA chromosomes compared with 2% of non-SMA chromosomes. Furthermore, RT-PCR analysis reveals internally deleted and mutated forms of the NAIP transcript in type I SMA individuals and not in unaffected individuals. These findings suggest that mutations in the NAIP locus may lead to a failure of a normally occurring inhibition of motor neuron apoptosis resulting in or contributing to the SMA phenotype.

Amino Acid Sequence↗
PubMed1995

Gamma globulin administration in relapsing Clostridium difficile-induced pseudomembranous colitis with a defective antibody response to toxin A.

A 53-year-old woman suffered six episodes of Clostridium difficile-pseudomembranous colitis. The serological follow-up demonstrated the absence of a rise in IgG and IgA to toxin A. Human pooled gamma globulin was administered during the fifth relapse and raised IgG levels to toxin A. Normal stools reappeared a week later. The role of the antibodies to toxin A and gamma globulin in C. difficile colitis are discussed.

Bacterial Toxins↗
PubMed1995

[Pulmonary-renal syndrome: diagnostic and therapeutic strategy].

The pulmonary-renal syndrome is defined by the association of alveolar hemorrhage and rapidly progressive glomerulonephritis. Goodpasture syndrome and necrotizing vasculitides are the most frequent causes. New serologic markers are currently more rapidly available (anti-glomerular basement membrane--anti-GBM--and antineutrophil cytoplasmic antibodies -ANCA), allowing clinicians to identify and distinguish these 2 entities, and to hasten the initiation of a pulse therapy, now well standardized, which improves the outcome of patients. However, these 2 serologic markers have limitations so that clinical assessment and renal biopsy remains essential in the diagnosis of pulmonary-renal syndrome. The authors propose an algorithmic approach for those confronted with such a condition.

Anti-Glomerular Basement Membrane Disease↗
PubMed1995

Serum interleukin 10 titers in systemic lupus erythematosus reflect disease activity.

We investigated whether serum titers of interleukin 10 (IL-10), a cytokine known to shift lymphocyte responses towards humoral immunity, reflect disease activity in systemic lupus erythematosus (SLE). Sera from 72 SLE patients, 25 RA patients and 30 healthy controls were tested for IL-10 by ELISA. Low titers of IL-10 were detected in the serum of 37.5% of SLE patients and in 24% of RA patients but in only 3% of healthy controls. Interestingly, serum IL-10 titers in SLE patients were positively correlated with the SLE Disease Activity Index (SLEDAI) and with anti-DNA antibody titers, but negatively with complement fraction C3 levels. These results indicate that serum IL-10 values reflect SLE disease activity and suggest that overexpression of IL-10 might play a pathogenic role in severe lupus disease.

Adolescent↗
PubMed1995

[Unusual manifestation of Horton's disease: apropos of 2 case reports].

Giant-cell arteritis is a polysymptomatic disease of the elderly. We report 2 patients, with positive temporal artery biopsy for giant-cell arteritis and unusual ocular manifestations. The first patient present an unilateral, acute ischaemic ocular and orbital syndrome partially cortico-resistant. The second one present a right Horner syndrome appeared several months after an important malaise, weights loss and pharyngeal and maxillary pain which had been successfully treated with antibiotics and non steroid anti-inflammatory drugs. We discuss the diagnostic and therapeutic management of giant-cell arteritis in our patients, with a review of the literature.

Aged↗
PubMed1994

Identifying relevant studies for systematic reviews.

OBJECTIVE: To examine the sensitivity and precision of Medline searching for randomised clinical trials. DESIGN: Comparison of results of Medline searches to a "gold standard" of known randomised clinical trials in ophthalmology published in 1988; systematic review (meta-analysis) of results of similar, but separate, studies from many fields of medicine. POPULATIONS: Randomised clinical trials published in 1988 in journals indexed in Medline, and those not indexed in Medline and identified by hand search, comprised the gold standard. Gold standards for the other studies combined in the meta-analysis were based on: randomised clinical trials published in any journal, whether indexed in Medline or not; those published in any journal indexed in Medline; or those published in a selected group of journals indexed in Medline. MAIN OUTCOME MEASURE: Sensitivity (proportion of the total number of known randomised clinical trials identified by the search) and precision (proportion of publications retrieved by Medline that were actually randomised clinical trials) were calculated for each study and combined to obtain weighted means. Searches producing the "best" sensitivity were used for sensitivity and precision estimates when multiple searches were performed. RESULTS: The sensitivity of searching for ophthalmology randomised clinical trials published in 1988 was 82%, when the gold standard was for any journal, 87% for any journal indexed in Medline, and 88% for selected journals indexed in Medline. Weighted means for sensitivity across all studies were 51%, 77%, and 63%, respectively. The weighted mean for precision was 8% (median 32.5%). Most searchers seemed not to use freetext subject terms and truncation of those terms. CONCLUSION: Although the indexing terms available for searching Medline for randomised clinical trials have improved, sensitivity still remains unsatisfactory. A mechanism is needed to "'register" known trials, preferably by retrospective tagging of Medline entries, and incorporating trials published before 1966 and in journals not indexed by Medline into the system.

Abstracting and Indexing↗
PubMed1994

Motor memory and the preselection effect in Huntington's and Parkinson's disease.

Patients with Huntington's disease (HD) and Parkinson's disease (PD) show different patterns of preserved and impaired memory performance. This study investigates explicit memory for movements in HD and PD with a linear positioning apparatus using Dick et al.'s procedure (J. Gerontol. 43, 127-135, 1988). In the first experiment, 12 HD patients were compared to 12 matched-controls. HD patients were more impaired than the controls by the delay between criterion and recall movements, whether the delay was filled or unfilled. Switching the limb between criterion and recall movements did not lead to more effects in HD patients and in controls. In the second experiment, 12 non-demented PD patients were compared to matched-controls. PD patients were more impaired than controls when the recall movement was executed with the contralateral hand, but were not more affected by the delay. In both experiments, HD and PD patients, as well as the controls, recalled self-generated preselected movements better than imposed movements. These results suggest the existence of distinct forms of motor memory impairment in some subcortical neurodegenerative diseases.

Adult↗