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Biomedical subjects

C Payan

Publications and source records attributed to C Payan.

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

Novel DNA assay for cytomegalovirus detection: comparison with conventional culture and pp65 antigenemia assay.

We compared conventional cytomegalovirus (CMV) isolation, rapid viral culture, a CMV pp65 antigenemia assay, and a novel CMV DNA hybrid capture system (HCS). A total of 309 blood samples from individuals in different risk groups were assessed by at least two of the methods mentioned above. Leukocytes were recovered either after centrifugation in Leucosep tubes containing 1.080 Ficoll for pp65 assay or after simple differential lysis steps for DNA detection. HCS was based on DNA hybridization with a CMV RNA probe and its capture by antibodies to DNA-RNA hybrids. The CMV pp65 lower matrix protein was detected by fluorescence with c10-c11 monoclonal antibody in formalin-fixed leukocytes. Concordant results were observed for 92.9, 78.3, and 82.7% of the patients when comparing (i) viral culture and the pp65 antigenemia assay, (ii) viral culture and HCS, and (iii) the pp65 antigenemia assay and HCS, respectively. Discordant results were observed between a positive HCS result and negative culture and/or pp65 results. These results were associated with relatively low DNA levels (< 20 pg/10(6) cells) and positive viruria. In conclusion, the pp65 antigenemia assay is a rapid and reliable method of detecting CMV and is preferable to culture, but the Murex HCS appears to be more sensitive for CMV detection.

Antigens, Viral↗
PubMed1995

Detection of seminal antibodies to human immunodeficiency virus in vaginal secretions after sexual intercourse: possible means of preventing the risk of human immunodeficiency virus transmission in a rape victim.

Detection of semen anti-human immunodeficiency virus (HIV) antibodies within the cervicovaginal secretions from a non-HIV-infected woman who has had a recent sexual intercourse with an HIV-infected man is theoretically possible since the seminal fluid from all HIV-infected men contains a high titer of IgG antibodies to HIV. We report the case of an HIV-seronegative African woman whose cervico-vaginal secretions contained IgG antibodies to HIV, including antibodies to HIV-env-encoded glycoproteins. This woman had also detectable prostatic specific antigens and acid phosphatase in her cervico-vaginal secretions, establishing the persistence of semen. In order to confirm whether anti-HIV antibodies in seminal fluid could be detected in vitro when mixed with cervico-vaginal secretions, 10(-1) to 10(-6) 10-fold dilutions of seminal fluid from HIV-1-seropositive donors were realized with a pool of HIV-negative cervico-vaginal secretions as diluent. Six commercial enzyme immunoassays or rapid tests were compared for semen anti-HIV detection in the secretions. At a 10(-1) dilution of the mixture, all assays were markedly positive for all tested semens and the greatest dilutions of seminal fluid showing positivity ranged from 10(-3) to 10(-5). The IgG immunocapture assay appeared to be the most sensitive test. The rapid tests permitted the detection of semen IgG antibodies to HIV at dilutions ranging from 10(-1) to 10(-3) suggesting their potential value in emergency situations.

Coitus↗
PubMed1995

Proinflammatory cytokine expression in cervicovaginal secretions of normal and HIV-infected women.

Proinflammatory cytokines may stimulate replication and spread of HIV. To evaluate to what extent the female genital tract represents a source of these cytokines, we determined TNF-alpha, IL-1 beta and IL-6 concentrations in paired serum and cervicovaginal washings from 45 HIV-negative and 50 HIV-positive women, and then we looked for the relevant mRNAs in cervicovaginal secretions by RT-PCR. Cytokines were detected by ELISA in cervicovaginal fluid from most healthy women. Cervicovaginal washing levels of TNF-alpha were increased above the control value +2 SD in 11/50 HIV-positive women, those of IL-1 beta in 13/50, and those of IL-6 in 14/50. The prevalences of TNF-alpha, IL-1 beta and IL-6 increase and their levels in cervicovaginal washings were significantly higher in the 20 patients at stage IV than in the 30 patients at earlier stages of the disease. In HIV-infected patients, serum and cervicovaginal washing levels correlated positively for TNF-alpha and IL-6, but not for IL-1 beta. Nine of 15 cytokine mRNAs determinations were positive in HIV-infected women versus 1 of 15 in controls (P < 0.01). These findings could be relevant to bidirectional heterosexual transmission of HIV.

Case-Control Studies↗
PubMed1995

Single-step reverse transcription-polymerase chain reaction for hepatitis C virus RNA with DNA enzyme immunoassay hybridization.

A single reverse transcription-polymerase chain reaction (SRT-PCR) for HCV RNA detection, confirmed by hybridization of amplified products with biotinylated probes using DNA enzyme immunoassay (DEIA), was compared to nested-PCR (N-PCR) on 20 sera from patients with chronic (n = 18) or acute (n = 2) hepatitis. Results obtained by SRT-PCR confirmed by DEIA and by N-PCR identical. All but one of the patients with chronic hepatitis and positive HCV serology as well as the patients with acute hepatitis had detectable HCV RNA in serum; all patients with chronic hepatitis and indeterminate HCV serology and all controls (n = 5) were negative by the two PCR methods. Both SRT-PCR and N-PCR remained positive after 7 x 10(-2) and 5 x 10(-4) dilutions of two HCV RNA-positive sera. The threshold of detection for SRT-PCR was 15 RNA copies per assay, as assessed by testing serial dilutions of an in vitro synthesized 5'-NCR HCV RNA transcript. SRT-PCR confirmed by DEIA for HCV RNA appears to be as sensitive and specific as N-PCR. Furthermore, it is easier to perform, with less of contamination, is less time-consuming, requires fewer enzymes, and it permits semi-quantification of PCR products.

Acute Disease↗
PubMed1995

Human immunodeficiency virus type 1 p24 antigen in cervicovaginal secretions.

The failure to detect human immunodeficiency virus (HIV) antigen in cervicovaginal secretions (CVS) from HIV-infected women could be due in part to an in situ formation of immune complexes involving HIV antigens and cervicovaginal anti-HIV antibodies. CVS from 30 HIV-1-infected heterosexual women were assayed for p24 antigen detection by ELISA before and after acid disruption of immune complexes. Before acid treatment, free p24 antigen was detected in only 1 sample of CVS, whereas after acid dissociation, 4 (13.5%) of 30 samples had detectable and neutralizable p24 antigen. Adsorbent capacities of the CVS for recombinant p24 antigen, evaluated in an in vitro model, depended on both titer and avidity of cervicovaginal antibodies to HIV. In conclusion, local antibodies to HIV are able in vivo to bind HIV antigen within CVS and to participate in the immune exclusion of free virus particles or proteins.

Adolescent↗
PubMed1995

Evaluation of the alpha 2-adrenoceptor blocking properties of buspirone and ipsapirone in healthy subjects. Relationship with the plasma concentration of the common metabolite 1-(2-pyrimidinyl)-piperazine.

1. Because the 5-HT1A agonist anxiolytic azapirones have a common alpha 2-adrenoceptor antagonist metabolite, 1-(2-pyrimidinyl)-piperazine (1PP), we measured central and peripheral alpha 2-adrenoceptor dependent responses before and after intravenous administration of 0.15 mg clonidine when healthy subjects were taking buspirone (30 mg day-1 for 4 days and 10 mg on day 5), ipsapirone (15 mg day-1 for 4 days and 5 mg on day 5) or placebo. 2. Clonidine decreased blood pressure, heart rate, oral body temperature, salivary excretion, plasma noradrenaline, 3,4-dihydroxyphenylglycol (DHPG) concentrations, increased plasma growth hormone but did not modify plasma insulin and C-peptide concentrations. Treatments tended to modify only the effect of clonidine on growth hormone (P = 0.07). 3. The azapirones reduced clonidine induced prolongation of choice reaction time (P = 0.015) and tended to antagonise clonidine induced fall in critical flicker fusion frequency (P = 0.066). 4. Only buspirone reduced total reaction time and increased critical flicker fusion threshold measured 12 h after the evening dose and these effects were correlated with the residual plasma 1PP concentration which was higher on buspirone than on ipsapirone (2.76 micrograms l-1, 95% CI:1.3-4.22 vs 0.65 microgram l-1, 95% CI: 0.32-0.98, P = 0.006). 5. Mean AUC of the 1PP plasma concentrations after the last dose of treatments were 3.7 times greater with buspirone than with ipsapirone (P = 0.0011). The AUC ipsapirone/AUC 1PP ratio was 6.45 and the AUC buspirone/AUC 1PP ratio was 0.076.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Antagonists↗
PubMed1995

Transrectal and transurethral hyperthermia versus sham treatment in benign prostatic hyperplasia: a double-blind randomized multicentre clinical trial. The French BPH Hyperthermia.

OBJECTIVE: To compare the safety and efficacy of hyperthermia for the treatment of benign prostatic hyperplasia (BPH), by either the transrectal or transurethral approach, relative to sham treatment. PATIENTS AND METHODS: Two hundred patients from seven urological departments were randomized and treated in a single centre. Principal inclusion criteria were a peak flow rate (PFR) < 15 mL/s and residual urine < 300 mL/s. Comparisons were made between transurethral hyperthermia (TUH) and transurethral sham (TUS) and between transrectal hyperthermia (TRH) and transrectal sham (TRS) 12 months after treatment. Outcome was assessed by improvements in the Madsen score and PFR, and the incidence of side-effects. RESULTS: After 12 months, 145 patients were evaluated; 12 patients withdrew during treatment, 43 withdrew during follow-up and two were lost to follow-up. Withdrawals were mainly due to side-effects during treatment (17% in the TRH and 1.5% in the TUH group) and to a lack of improvement during follow-up (14% in the TUH group, 19% in the TUS, 15% in the TRH and 10.5% in the TRS group received other treatments for BPH). Complications during treatment consisted mainly of local pain, urethral bleeding, urethral pain and acute retention, and were five times more frequent in the TRH than the TUH group (34% versus 6%). There was no improvement in PFR after TUH and TRH (response < 20%). Only TUH improved the Madsen score (TUH, +50% and TUS, +17%). CONCLUSION: Hyperthermia was not an effective treatment for BPH.

Aged↗
PubMed1995

Is there a relationship between antipsychotic blood levels and their clinical efficacy? An analysis of studies design and methodology.

There are now more than 50 studies concerning neuroleptic blood levels and clinical outcome relationships. Haloperidol, the most studied, is the only antipsychotic permitting some conclusions. A number of authors suggest that the striking lack of agreement between different studies results from heterogeneity of their quality. Here, we have used a scoring system for assessing the quality of those studies. According to this system, none (0/14) of the studies having a score < 0.60 was able to show a therapeutic window, as compared to 53% (10/19) of those having a score > or = 0.60 (p = 0.002, Fisher exact test). Also, the studies able to identify the presence of a therapeutic window during haloperidol treatment were those having sample size > 20 (p = 0.06) and those whose patients were treated with fixed doses (p = 0.02). The diagnosis of schizophrenia in the studies seems not to be an exclusive condition, as compared with those also including schizophreniform and schizoaffective disorders (p = 0.12). Our qualitative analysis of haloperidol blood level publications seem to indicate that an upper limit may exist for haloperidol efficacy; values above this limit seem not to provide any supplementary clinical improvement and may even reduce therapeutic effect.

Antipsychotic Agents↗
PubMed1995

Moclobemide versus clomipramine in nonmelancholic, nonpsychotic major depression. A Study group.

The efficacy and the safety of moclobemide (400-600 mg/day), a reversible and selective inhibitor of monoamine oxidase-A (RIMA) and of clomipramine (100-150 mg/day) were compared respectively in 98 and 93 nonmelancholic, nonpsychotic out-patients with a DSM-III major depressive episode over 6 weeks and up to 3 months, in a multi-center double-blind trial. No statistically significant difference between the treatments was found on the number of responders, at 6 weeks and 3 months, to the Hamilton Depression Rating Scale (HDRS), which was the main criterion for efficacy. The sample size was sufficient to detect a difference of approximatively 20% in response rates. Reduction of the total scores on HDRS and Covi anxiety scale was comparable for both treatments, but the reduction on the Retardation Depressive Scale (RDS) was significantly higher with moclobemide at the 1- and 2-week assessments. According to the RDS as well as the global impression of both patient and physician, a somewhat earlier onset of antidepressant action was evident in the moclobemide group. Tolerance was significantly better in the moclobemide group, mainly due to a lower frequency of weight gain, sedation and anticholinergic effects.

Adolescent↗
PubMed1995

Gender and age at onset in schizophrenia: impact of family history.

OBJECTIVE: The 1-year prevalence of schizophrenia was studied in a limited geographical area of Reunion Island (Indian Ocean) to assess the impact of family history of schizophrenia on the well-known association between gender and age at onset. METHOD: The population of schizophrenic patients meeting the DSM-III-R criteria for schizophrenia (N = 663) was identified and divided according to the presence of another schizophrenic patient among the first- and second-degree relatives. RESULTS: As previously reported, the median age at onset differed between the sexes: the males had an earlier onset (mean age = 27.8 years) than the females (31.5 years). Comparison of the ages at onset according to family history revealed that onset was later for female subjects with a negative family history than for the three other groups (i.e., males with or without a family history and females with a family history). No difference emerged in the comparison of the ages at onset of the males and females with a positive family history. CONCLUSIONS: Comparison of schizophrenic patients with familial versus sporadic disorder confirms the absence of a gender effect for age at onset in the subgroup with familial disorder. This approach also demonstrates the existence of a subgroup composed of affected females having late onset and no family history of schizophrenia.

Adolescent↗
PubMed1994

Effect of a single dose (10 mg) of zolpidem on visual and spectral analysis of sleep in young poor sleepers.

Four non-consecutive nights of sleep were recorded in eight young volunteers complaining of chronic poor sleep. The subjects received a placebo or a 10 mg zolpidem dose prior to bedtime according to a Latin square double-blind design. All-night spectral analyses of the Cz-Pz lead were associated to the standard polysomnography. According to the visual scoring performed with the Rechtschaffen and Kales criteria, zolpidem significantly increased the stage 4 amount and reduced waking. Compared to placebo no difference in sleep stages was observed when the scoring was based on the power in the 0.7 to 4-Hz band. In zolpidem nights power was significantly reduced in the 4 to 8-Hz band during NREM (stages 2, 3 and 4) and was increased in the 2 to 4-Hz band during REM sleep. A significant reduction of fast activities over 12 Hz was observed during the first 3 h of sleep. Concerning slow wave activity, the only change noted was a significant slowing of its build-up rate at the beginning of cycle 1.

Adult↗
PubMed1994

[Free dissociated and precipitated p24 antigenemia of HIV-1 in subjects of the black race].

P24/HIV-1 antigen in the sera from 41 HIV-1-infected Black individuals, living in the Central African Republic (n = 17) and in France (n = 24), and in 21 HIV-1-infected Caucasians patients, matched on the stages of the disease, has been detected and quantified by ELISA, without and with acid pretreatment of the sera by HC1 or by glycine, and after ultracentrifugation of serum. Free p24 antigenemia was detected less frequently in Black patients (9.7%), than in Caucasian controls (33%) (p < 0.05). Decomplexed p24 antigenemia was detected in 34% of patients after dissociation of circulating immune complexes (CIC) by HC1 (p < 0.01) and in 44% of patients after dissociation of CIC by glycine (p < 0.001). However, the mean concentration of decomplexed p24 antigenemia of positive sera was higher after pretreatment by HC1 (88 pg/ml) than by glycine (52 pg/ml), suggesting that a strong acid is more convenient than a weak one to disrupt the CIC in Black individuals. After ultracentrifugation of the serum, the detection of p24 antigen was not significantly increased. Acid dissociation of CIC is a usefull method to increase the sensitivity of detection of circulating p24 antigen in HIV-1-infected Black individuals.

AIDS Serodiagnosis↗
PubMed1993

Coxiella burnetii infection among subjects infected with HIV type 1 in the Central African Republic.

Sixty-six sera from HIV-1-seropositive adult African subjects and 49 sera from HIV-seronegative age and sex matched healthy African controls living in Bangui, Central African Republic, were screened for Coxiella burnetii antibody by an indirect immunofluorescent antibody test. 16.7% of HIV-infected patients and 16.3% of the HIV-negative controls had positive IgG titres, with no significant difference between the two groups. Two of the seven HIV-infected patients seropositive for Coxiella burnetii for whom clinical data was available had a medical history compatible with symptomatic Q fever. These findings indicate that there is a high degree of exposure to Coxiella burnetii infection in Bangui. In individuals co-infected with HIV and Coxiella burnetii, cellular immunosuppression could favour symptomatic Q fever. Physicians should be aware of the possibility of symptomatic Coxiella burnetii infection among HIV-infected people, particularly in endemic regions for both infections such as in sub-saharan Africa.

AIDS-Related Opportunistic Infections↗
PubMed1993

Automated percutaneous lumbar discectomy versus chemonucleolysis in the treatment of sciatica. A randomized multicenter trial.

A randomized clinical trial was conducted to compare the results of automated percutaneous discectomy with those of chemonucleolysis in 141 patients with sciatica caused by a disk herniation; 69 underwent automated percutaneous discectomy and 72 were subjected to chemonucleolysis. The principle outcome was the overall assessment of the patient 6 months after treatment. Treatment was considered to be successful by 61% of the patients in the chemonucleolysis group compared with 44% in the automated percutaneous discectomy group. At 1-year follow-up, overall success rates were 66% in the chemonucleolysis group and 37% in the automated percutaneous group. Within 6 months of treatment, 7% of the patients in the chemonucleolysis group and 33% in the discectomy group underwent subsequent open surgery. The complication rates of both treatment groups were low, with the exception of a high rate of low-back pain in the chemonucleolysis group (42%). The results of this trial confirm previous controlled studies on chemonucleolysis and suggest that controlled studies should be carried out before automated percutaneous discectomy can be considered a useful intervention.

Adult↗
PubMed1993

Surgical management of brain-stem tumors in children: results and statistical analysis of 75 cases.

A study was made of 75 children treated between 1970 and 1990, with partial, subtotal, or total removal of three intrinsic and 72 exophytic or surface brain-stem tumors. In all cases, the goal of surgery was to remove as much tumor as possible. Extent of removal was defined according to data obtained from postoperative computerized tomography or magnetic resonance imaging, and was considered partial when only a small amount of tumor was removed, subtotal when a few cubic millimeters of tumor was left, and total when no residual tumor was seen on postoperative radiological investigations. An ultrasonic aspirator was used for the 43 most recent operations. Among tumor removals without the aspirator, 24 (75%) were partial, eight (25%) subtotal, and none total; with the use of the aspirator, the number of partial removals decreased to 44.5% while that of subtotal and total removals increased to 32% and 23.5%, respectively. There were 69 gliomas (92%) and 47 benign tumors (62.6%). Forty-nine patients were irradiated postoperatively, and 14 of the 23 patients whose benign tumors were removed totally or subtotally did not undergo irradiation. This study showed that: 1) the overall prognosis of patients with malignant tumors was poor and was not improved by surgery; 2) the survival rate of those with benign tumors was significantly (p < 0.01) lower after partial removal than after total or subtotal removal (52% and 94%, respectively, at 5 years); 3) comparison of means and proportions (Student's and chi-squared tests) between benign and malignant tumors showed a significant difference relating to patient age (p < 0.03), peritumoral hypodensity (p < 0.001), and preoperative duration of symptoms (p < 0.001); 4) stepwise logistic regression analysis confirmed that two of these three variables were related to malignancy: namely, patient age at surgery (p < 0.03) and presence of peritumoral hypodensity (p < 0.001); and 5) routine postoperative irradiation was contraindicated after total or subtotal removal of benign tumors.

Adolescent↗
PubMed1993

[Alternative strategy for the diagnosis of HIV infection in sub-saharan Africa. Value of the sequential combination of the ELISA test and a 2nd generation rapid test].

The "conventional" algorithm for HIV testing based on the confirmation of all positive anti-HIV screening reactions by Western blot requires sufficient laboratory facilities and is expensive, that limits its use in developing countries, such as in subsaharian Africa. The apparition of second and third generation screening ELISA which are very sensitive and specific, as well as the development of rapid tests which are simple, visually read, and sufficiently sensitive and specific, has permitted the design of "alternative" strategy for HIV testing utilizing the association of 2 ELISA and/or rapid tests, in order to limit the use of a confirmatory assay. Alternative strategies are less expensive, yield generally very high sensitivity and specificity, and have proved to be valuable for African countries. In this study, 5 alternative strategies, using different associations of two second generation screening tests, one classical ELISA (Genelavia mixt) and one rapid test (Test PACK HIV-1/HIV-2 AB) have been retrospectively evaluated in the field in Bangui, Central African Republic, with a panel of 130 sera (prevalence of HIV infection: 42.7%). The strategy using two sequential screening tests (Test Pack HIV-1/HIV-2 AB following by Genelavia mixt) with the confirmation of discordant results by Western blot permitted to diagnose HIV-1 infection in Bangui with a sensitivity, a specificity and a positive predictive value of 100%, and to reduce the cost of more than 50% in comparison with the conventional strategy. Such an alternative strategy could be useful for the individual notification of HIV serology in Bangui.

Adult↗
PubMed1993

[Diagnostic criteria in bulimia: reassessment and proposals based on a series of 539 cases].

Bulimia nervosa is a recently identified psychiatric disorder. Several clinical definitions have been successively proposed, some of which contradictory. In a multicenter study (INSERM clinical research network), 539 consecutive outpatients with bulimic behaviors were evaluated in 18 treatment centers and classified according to several diagnostic reference systems. We tested the validity of diagnostic criteria proposed by the American Psychiatric Association for DSM-IV classification. Our data support inclusion of both purging and nonpurging subtypes for the diagnosis of bulimia nervosa. The newly defined syndrome "Binge Eating Disorder" should be retained, but its diagnostic criteria modified.

Adolescent↗