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Biomedical subjects

C Mourey

Publications and source records attributed to C Mourey.

6 recordsLinked to original sources

TT virus infection in French hemodialysis patients: study of prevalence and risk factors.

The TT virus (TTV) is a recently discovered DNA virus which was first identified in patients with non-A to -G hepatitis following blood transfusion. In this study, we tested 150 attendees of two hemodialysis (HD) units of the public hospitals of Marseilles, France, for the presence of TTV genome by using a PCR-based methodology. The overall prevalence of TTV viremia was 28% (compared to 5.3% in blood donors from the same region). We demonstrated the existence of chronic infections and superinfections by strains belonging to different genotypes. The prevalence of infection was higher in patients originating from Africa, in patients with previous blood transfusion or organ transplantation, in patients with antibody to hepatitis B core antigen, and in those with diabetes mellitus. A high prevalence of TTV infection (50%) was also observed in a population of patients with diabetes mellitus but without renal disease. No significant relationship was found between TTV viremia and hepatitis C virus or GB virus C, transaminases, age, sex, and duration of HD treatment. The PCR amplification products (located in open reading frame 1 of the TTV genome) were sequenced. These genomic sequences were submitted to phylogenetic analysis by using the Jukes-Cantor algorithm for distance determination and the neighbor-joining method for tree building. In several instances, sequences from viruses isolated in a HD unit were grouped in the same phylogenetic cluster. These results together with the different distribution of cases in the two HD units suggest there is viral transmission within each.

Adult↗

[Beta-mimetics and Pourcelot's index].

In a series of 20 patients presenting a threat of premature delivery, the vascular resistance index of Pourcelot, in the umbilical artery, was measured before, and then 24 hours after starting a continuous Salbutamol perfusion. A moderate but significant decreased placental vascular resistances is noted under betamimetic treatment. Relaxation of the myometrium obtained with a tocolytic treatment could be implicated in this alteration of placental resistances.

Albuterol↗

[Human immunodeficiency virus (HIV), thrombopenia and pregnancy].

Three cases of thrombocytopenia in pregnant women are described. Two of these patients had an AIDS-like illness and the third one had AIDS. This HIV-associated change occurred in 8% of the complications of a consecutive series of 38 pregnant women who were positive for the HIV antibody test in the course of one year. A link with HIV was established after eliminating idiopathic pregnancy thrombocytopenic purpura and after eliminating every other viral cause for the thrombocytopenia. The normal myelogram speaks in favour of a peripheral origin for the platelet destruction. Treatment consisted in administering immunoglobulins intravenously in a continuous transfusion in doses of 0.04 g/kg per day. The method was effective in two cases. Three cesareans were carried out. In two cases the recovery was uncomplicated and in the third case the haemorrhagic syndrome developed immediately after delivery. This patient died 35 days after delivery. Fetal scalp blood or fetal cord blood could not be taken in any of these three cases. The newborn did not have thrombocytopenia at birth, but they did have anti-IVF antibodies and one of them developed and AIDS-like syndrome. The time interval has not been long enough to assess the further development in the two other cases. The survivors are being followed up with a threefold assessment of the blood picture, the immunological state and the virology. This is being done on the two surviving mothers and the three infants.

Acquired Immunodeficiency Syndrome↗

[Microsurgical treatment of lesions of the proximal segment of the oviduct. Isthmo-ostial reimplantation. Isthmo-ostial anastomosis and isthmo-uterine reimplantation].

The authors, who operated on 187 patients with 277 interstitial sections of the isthmus, describe their microsurgical techniques for isthmo-ostial anastomosis, for isthmo-ostial reimplantation and for isthmo-uterine reimplantation. Histological analysis of the lesions and the anatomical features of the proximal segment of the tube justify their method. Patency is re-established and the results are encouraging. All the same, these partial proximal lesions can be markedly improved with success by medical treatment before operation.

Fallopian Tube Diseases↗

[Positive HIV (human immunodeficiency virus) serology in the pregnant woman: current data on its management. Apropos of a continuous series of 56 cases].

56 cases of pregnant women with a positive HIV serology were reported in 20 months at the Maternity of the Nice Hospital Center. In 10 cases, there were clinical signs of the disease (9 ARC-Syndrome, one case of AIDS). The predisposing factor was most of the time drug addiction, 53 cases (94.5%) and one case occurred after a blood transfusion. In the majority of the cases (52%) the pregnancy was pursued because of the late term or the patient's decision. A therapeutic abortion was performed in 12 instances (25%) and an interruption before 12 weeks of amenorrhea in 15 cases. 24 women delivered. The obstetrical complications were frequent with especially a fetal death in utero, five premature deliveries and fifteen hypotrophies. A severe infectious complication (septicemia, pneumopathy secondary to Pneumocystis carinii) was observed in 9 cases, a marked thrombopenia causing profuse post-partum haemorrhages in one case. Finally, one woman died 35 days after delivery. The study of the consequences on the child is incomplete because of insufficient follow-up: all children were sero-positive at birth and among thirteen children aged between 12 to 20 months, there were one death, one AIDS syndrome, 4 ARC-syndrome, 4 sero-positive and 3 sero-negative. The notion of HIV sero-positivity in a pregnant woman presents serious problems for the obstetrician. Decompensation of the disease during the pregnancy is uncertain but it is now confirmed that the child is affected, and this is a well established fact. These important consequences lead to propose, at this time a therapeutic interruption of pregnancy when possible, depending on the term, and when accepted by the patient.

AIDS-Related Complex↗

[Epidemiologic aspects of extrauterine pregnancy and therapeutic approach. Apropos of 200 cases in a continuous series].

The study of 200 files has enabled to define a few epidemiological aspects of ectopic pregnancy: large frequency of this pregnancy with ectopic location, for 42 births, in an average, occurrence in young women, between 25 and 35 years, hypofertile, nulli or primiparous, importance of utero-adnexal infections and their sequelae, found in 50% of the cases, and linked to the increase of sexually transmissible diseases and the frequency of voluntary interruptions of pregnancy, importance also of histological lesions of the isthmo-interstitial segment of the tube. The different therapeutic approaches are presented: the authors explain the reasons for a deliberately conservative therapy (in 82% of the cases) without compromising the maternal prognosis: absence of anatomical abnormality justifying the excision of the tube, or, often bilateral anatomical lesions requiring a subsequent radiological work-up, and a secondary treatment. Finally, desire of another pregnancy in a population which is infertile, most of the time, and of which the mean age is 28 years.

Adolescent↗