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Biomedical subjects

C Pierre

Publications and source records attributed to C Pierre.

At least 55 records · Page 3Linked to original sources

Diagnosis of tuberculosis by DNA amplification in clinical practice evaluation.

Various polymerase chain reaction (PCR) assays have been devised for the rapid identification of mycobacteria in clinical specimens. To assess the value of such assays in routine laboratory work the results obtained by PCR were compared with those obtained by standard microbiological methods for 514 specimens collected for investigation of mycobacterial infection. Specimens were tested for the presence of Mycobacterium tuberculosis complex and atypical mycobacteria in two assays, one based on amplification of the 65 kDa gene and the other on the IS6110 insertion sequence. For the 489 samples that did not contain inhibitors of the amplification reaction PCR findings correlated well with bacteriological and/or clinical data in 476 (97.4%). 6 PCR results turned out to be false negatives, 3 to be false positives and 4 to be mis-identification of strains. Pre-treatment of samples with guanidium thiocyanate reduced the proportion of false-negative results and of samples that contained inhibitors. This study confirms the potential of DNA amplification for early diagnosis of mycobacterial infections.

DNA Probes↗

Use of a reamplification protocol improves sensitivity of detection of Mycobacterium tuberculosis in clinical samples by amplification of DNA.

We have compared the sensitivity and specificity of quantitative mycobacterial culture against results obtained by using the polymerase chain reaction for the detection of DNA from organisms of the Mycobacterium tuberculosis complex in 82 clinical specimens from patients suspected of having tuberculosis. Two amplification protocols were used, a standard amplification protocol, which amplifies a segment of the gene coding for the 65-kDa antigen, and a protocol in which the initial amplification products are reamplified with a second set of nested oligonucleotide primers. Although the standard amplification protocol gave positive results for 18 of 18 samples which grew greater than 100 CFU/ml and gave positive results in 4 of 35 specimens from patients with tuberculosis which were negative by culture, only 1 of 6 samples which grew less than 100 CFU/ml was positive. This lack of sensitivity could not be explained by the presence of inhibitors of Taq polymerase present in the original samples. In contrast, the reamplification protocol gave positive results for 24 of 24 samples which were positive by culture as well as for 13 of 35 samples from patients with tuberculosis which were negative by culture (overall sensitivity, 63%, P less than 0.02, compared with the standard amplification protocol and routine culture). Two of 23 samples from patients not diagnosed as having tuberculosis gave positive results when the standard amplification protocol was used, but no additional false-positive results were seen with the reamplification protocol (overall specificity, 91%). We conclude that the use of a reamplification protocol improves the sensitivity of detection of mycobacterial DNA in clinical samples without sacrificing specificity. The sensitivity of this approach appears to be superior to that of standard culture techniques.

Base Sequence↗

Retinopathy of prematurity. Review of 7 cases.

A retrospective review of children with ROP, stage 2 or more, diagnosed between 24 April 1985 and 31 December 1990, is presented. The 7 patients had been born prematurely. The gestational age at birth ranged from 24 to 31 weeks. Their birth weight was less than 1430 g. Spontaneous evolution and evolution following cryotherapy are described. The follow-up period ranged from 2.5 to 30 months.

Birth Weight↗

[Massive necrotizing adenitis complicating a disseminated herpes simplex virus 2 infection in chronic lymphoid leukemia].

We report a case of a 68 years old male patient treated for chronic lymphocytic leukaemia, presenting a right inguino-crural tender lymphadenopathy with periadenitis. The histologic changes associated with adenitis were large foci of necrosis with regular crown of epithelioid cells, without giant cell. The presence of Herpes simplex virus 2 was confirmed by immunohistochemistry and culture. Occurrence, physiopathology, clinical and histological aspects of Herpes simplex lymphadenitis in patients with haematologic disorders, are discussed.

Aged↗

[Retinitis in an infant infected with HIV].

A 7 month-old HIV-infected infant of African origin was admitted to the hospital. A routinely performed fundoscopy showed the presence of an unilateral left retinitis. Urine culture was positive for cytomegalovirus (CMV). Treatment with AZT (3.5 mg/kg/6 hr) was started concomitantly with monthly 350 mg/kg gammaglobulin intravenous administration. The retinitis resolved after 3 weeks and no recurrence was observed after 4 months of follow-up. The difficulties in establishing a diagnosis and in evaluating a response to treatment are briefly discussed.

Cytomegalovirus Infections↗

Biointegration of massive bone allografts: imaging and histological studies in cat.

A study was carried out in a cat model to compare three imaging methods (X-ray, bone scintigraphy (BS) and magnetic resonance imaging (MRI] in order to assess the healing of bone allografts. X-ray remains the first technique to proceed, for morphological information and control of devices. BS is very sensitive although unspecific and difficult to quantify in exploration of bone reconstruction. It may be a useful complement of X-ray methods in some pathological circumstances (stress fracture, infection, non union). MRI is a very sensitive exploration of the bone marrow, but not of the cortical bone. In its present state it is of little value in bone graft imaging because of its low specificity and because of metallic artefacts (material, micro particles).

Animals↗

Predictability of surgery on non-accommodative esotropia.

The aim of the present retrospective study is to determine those clinical parameters which could be helpful on the predictability of postoperative outcome on non-accommodative esotropia. We could conclude that our results are similar to those previously described in the literature, although we could not find any new guidelines, which could predict the postoperative alignment.

Age Factors↗

[Pyoderma gangrenosum and IgA gammopathy. Association with atrophic gastritis].

Pyoderma gangrenosum (PG) is a rare condition remarkable for its association with particular diseases, notably haemopathies and gastrointestinal diseases. As regards haemopathies, the associations most frequently encountered are with myeloid malignancies and monoclonal dysglobulinaemia. The association of PG with mainly inflammatory digestive tract diseases is also classical. The lack of publications concerning gastric atrophy and the dual haematological and gastric pathology which characterizes our case have prompted us to report it. A 60-year-old woman without significant history was admitted for PG on both knees, following vesiculo-bullous lesions. Laboratory examinations detected a normochromic anaemia tending to be macrocytic, a marked inflammatory syndrome and a monoclonal lambda light chain IgA peak at protein immunoelectrophoresis. Bone marrow biopsy, skeletal radiography and a search for Bence-Jones proteinuria were normal or negative. Colonoscopy showed no abnormality, but fibroscopy of the upper digestive tract revealed a severe gastric atrophy en plaques. Serum vitamin B12 level was moderately low, but there was no other sign of pernicious anaemia. After one month treatment with systemic corticosteroids, healing was obtained under replacement vitamin therapy. PG recurred a few months later; serum vitamin B12 level was normal, and the lesions healed after systemic corticosteroid treatment. In non-myelomatous dysglobulinaemia IgA is frequently found and there is no light chain predominance. PG often precedes dysglobulinaemia. Evolution towards a true myeloma seems to be exceptional. In a recent publication, 17 cases of association between PG and myeloma were mentioned, the IgA type being most common. Protein electrophoresis is indispensable in patients with PG. Five cases of congenital hypogammaglobulinaemia have been recorded, including three with IgA deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Agammaglobulinemia↗

[Richter's syndrome with testicular localization].

Based on a case showing testicular localisation of sarcomatous degeneration in the context of the progression of chronic lymphoid leukemia (Richter's syndrome), the authors discuss the classification of intrascrotal lymphomatous conditions.

Aged↗

Tolerance of once-daily dosing of netilmicin and teicoplanin, alone or in combination, in healthy volunteers.

The purposes of this study were to test the pharmacokinetics and renal and otologic tolerances of a once-daily regimen of netilmicin and teicoplanin administered intramuscularly, alone or in combination (4.5 and 6 mg/kg, respectively), for 7 days in 30 healthy male volunteers. Teicoplanin induced only a mild increase in enzymuria. Nephrotoxicity was moderate and reversible with netilmicin; there was increased enzymuria and alteration in diluting ability, without significant changes in urinary beta 2-microglobulin levels, concentrating ability, and glomerular filtration rate. Ototoxicity was not detected in any of the subjects. Our results suggest that (1) teicoplanin and netilmicin given once daily induced only slight, reversible tubular damage, without any sign of ototoxicity; (2) their combination was not more toxic; and (3) clinical studies can be envisaged to evaluate the efficacy and tolerance of once-daily regimens in long-term treatment.

Acetylglucosaminidase↗