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Christophe Strady

Publications and source records attributed to Christophe Strady.

7 recordsLinked to original sources
PubMed2006

[Tuberculosis during treatment by TNFalpha-inhibitors].

The clinical forms of tuberculosis that occur during anti-TNFalpha treatment are frequently extrapulmonary or even disseminated and life-threatening. The paradoxical reactions that can occur under appropriate treatment after stopping TNFalpha inhibitors raise the question of an immune restoration phenomenon. Adverse drug reaction reporting and epidemiologic studies, despite their methodological limitations, appear to show an excess risk of tuberculosis. Experimental studies reinforce these data. The French drug agency (Afssaps) has issued guidelines for the prevention and management of tuberculosis occurring under anti-TNFalpha treatment. Analogous guidelines in Spain led to a reduction in the incidence of these cases.

Adverse Drug Reaction Reporting Systems↗
PubMed2005

High seroprevalence of herpes simplex virus type 2 infection in French human immunodeficiency virus type 1-infected outpatients.

Using commercially available herpes simplex virus (HSV) type-specific serological diagnostic tests, HSV type 2 (HSV-2) antibody prevalence was assessed in two parallel prospective studies including 534 human immunodeficiency virus type 1 (HIV-1)-infected outpatients living in two areas of northern France. In the first cohort of 434 subjects, 223 (51%) individuals demonstrated a positive HSV-2 serological status while 66 (66%) of 100 subjects in the second cohort were seropositive for HSV-2 (51 versus 66%; P = 0.08). Among the 223 HSV-2-seropositive subjects identified in the first study cohort, only 22 (10%) had suffered from recurrent anogenital lesions during the past 12 months while 154 (69%) had no clinical history of herpesvirus infection. Our findings demonstrate high proportions of subclinical and undiagnosed HSV-2 infection in HIV-1-infected individuals and suggest that HSV type-specific serological testing in the French HIV-1-infected subpopulation could be an efficient strategy to diagnose clinically asymptomatic HSV-2 infections.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Osteonecrosis in six HIV-infected patients receiving highly active antiretroviral therapy.

OBJECTIVE: To report 6 cases of osteonecrosis in HIV-infected patients treated with highly active antiretroviral therapy (HAART) and compare the observed risk factors with those of published cases. CASE SUMMARIES: Osteonecrosis was diagnosed between 1999 and 2002 in 6 of 417 HIV-infected patients in our department of infectious diseases. At the time of diagnosis, mean patient age was 42 years, and 5 patients had developed AIDS. Mean CD4+ lymphocyte count was 563.5 cells/mm(3) and viral load was undetectable (<50 copies/mL) in 5 patients. The patients' mean body mass index was 22.5 kg/m(2). Four had lipodystrophy. All were receiving HAART, including a protease inhibitor in 4 patients; the remaining 2 patients had a history of protease inhibitor treatment. Median time from the first antiretroviral therapy to osteonecrosis diagnosis was 46.5 months. Established risk factors were the use of corticosteroids in 2 patients and dyslipidemia in all patients. All of the patients developed pain and functional impotence of the hip or ankle joints. Osteonecrosis of the hip was bilateral in 4 cases. Three patients required surgical intervention, all of whom had favorable outcomes. DISCUSSION: HIV-infected patients are at a higher risk for the development of osteonecrosis and are more likely to be exposed to predisposing factors to its development. The HAART implication as a predisposing factor remains controversial. CONCLUSIONS: The pathogenesis of osteonecrosis in HIV-infected individuals may be multifactorial; the reasonable approach for clinicians consists of treating concomitant predisposing conditions that might further cause osteonecrosis.

Adult↗
PubMed2002

[Community-acquired bacterial infections].

CORTICOSTEROIDS IN BACTERIAL MENINGITIS: A randomised multicentre study on meningitis in adults versus a placebo showed significant benefits of corticoids in terms of reduction in mortality and neurological complications. These results were essentially observed in pneumococcal infections. THE INTEREST IN MONITORING BLOOD CULTURES: Several works on Staphylococcus aureus bacteremia have confirmed the necessity of monitoring hemocultures, 48-72 hours following initiation of treatment. The persistence of bacteremia strongly suggests the poor prognosis and endocardial grafting should be envisaged. CARDIOVASCULAR RISK: Persisting Salmonella enterica bacteremia in an adult aged over 50 must lead to search for a cardiovascular infection, notably mycotic aneurism, in view of the risk of rupture and the necessity of early surgery. This type of infection is observed in 10 to 23% of cases. BACTERIAL ENDOCARDITIS: The size of the vegetations > 2 cm and the neurological complications of embolic nature are clearly identified as predictive factors of death in endocarditis of drug addicts. Early surgery in the case of voluminous vegetations, including in the right endocardium, is therefore discussed. URINARY INFECTIONS: A randomised study against a placebo in asymptomatic urinary infections of diabetic women showed no significant benefits of the antibiotherapy on reducing morbidity.

Adrenal Cortex Hormones↗
PubMed2002

[Diagnostic value of clinical signs in giant cell arteritis: analysis of 415 temporal artery biopsy findings].

AIM OF THE STUDY: The American College of Rheumatology (ACR) has proposed a list of criteria for diagnosis of giant cell arteritis in order to guide clinical research by differentiating it from other vasculitis. The aim of this retrospective investigation, based on the findings of 415 temporal artery biopsies was to assess the diagnostic value of these criteria in the daily clinical setting. METHODS: The demographic, clinical and biological characteristics of patients with positive (confirmed cases of giant cell arteritis) or negative (controls) histopathological temporal artery biopsy findings were analyzed using downward step-by-step logistic regression analysis. This analysis enabled investigators to list signs with inherent diagnostic value. Based their odds-ratio, these factors were used to determine a clinical score for giant cell arteritis. RESULTS: A score of over 7 - out of a maximum score of 32 - enables the diagnosis for giant cell arteritis with the best possible compromise between a sensitivity of 75.7% and a specificity of 72.2%. ACR criteria had a sensitivity of 97.5% and a specificity of 78.9% when used in our patient group. CONCLUSION: Our study results are original in that the control group was composed of patients in whom the diagnosis of giant cell arteritis had been suggested but refuted by the absence of histopathological findings on the temporal artery biopsy. This pragmatic attitude in selecting the control group may explain the difference observed with the ACR criteria in terms of sensitivity and specificity. Further research is needed to develop a diagnostic method for giant cell arteritis without resorting to temporal artery biopsy.

Aged↗