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Biomedical subjects

D Lagauche

Publications and source records attributed to D Lagauche.

7 recordsLinked to original sources
PubMed2005

[Onset of Leber's hereditary optic neuropathy in association with borreliosis].

INTRODUCTION: The diagnosis of Lyme disease in the presence of an acute optical neuritis always raises a difficult diagnostic problem. We present a case of Lyme-associated Leber's hereditary optic neuropathy (LHON). OBSERVATION: A 17-year-old Eurasian young man presented with left-eye visual impairment for 1 month. This loss of vision acuity in the left eye is related to an optic neuropathy. Mitochondrial DNA testing showed a G to A substitution at position 11778 confirming a diagnosis of LHON. The family history disclosed a case of LHON in a maternal cousin. The mother's family is Asian. Besides, serum examination of anti-Borrelia antibodies was performed and was positive against Borrelia burgdorferi garinii. The patient history indicated that he had been possessing a dog and was living in an endemic area of Lyme disease. But he did not recall receiving a tick bite nor having any erythema chronicum migrans. Initial examination showed bilateral green-red axis colour vision defects which made us fear bilateralisation of the optic neuropathy, which occurred 2 months later (that is 3 months after the onset of symptoms on the left eye). An antibiotic treatment by ceftriaxone was administered for 4 weeks all in all; and a long term ubidecarenone therapy was established. At present, after a 1-year follow up, the eyes' conditions remains unchanged. CONCLUSION: To our knowledge, this would be the first case reporting such an association, in which we can discuss the fortuitous character or the role of the infectious factor in the developing of the mitochondrial pathology. This observation also raises the problem of the positive diagnosis of Lyme disease when tick bite and erythema are absent or underestimated.

Adolescent↗
PubMed2004

[Scurvy in intensive care despite vitamin supplementation].

INTRODUCTION: Scurvy can occur in hospitalized patients despite vitamin supplementation. OBSERVATION: A 63 Year-old patient who had spent several weeks in intensive care developed an unexplained anemia and ecchymoses. Despite daily administration of 130 mg/day of vitamin C since his admission, his ascorbic acid blood levels had collapsed. Administration of 1g/day relieved the symptoms within four weeks. DISCUSSION: Whether a deficiency had existed prior to admission or not, scurvy developed during the week of intensive care despite parenteral nutrition supplying a daily dose of 130 mg of vitamin C. Such deficiencies decompensated in surgical situations remain a reality in developed countries. CONCLUSION: In certain pathological contexts and in all the growing number of cases in elderly patients and many surgical indications, the need for vitamin C supplementation has to be defined. The needs at that particular time must be taken into account and the prior nutritional status.

Ascorbic Acid↗
PubMed2000

[Clinical evaluation of female urinary incontinence].

EXAMINATION: Clinical evaluation of stress and urge incontinence is always necessary before therapeutic decisions. Full bladder examination may reveal stress incontinence during cough when cervico-urethral hypermobility is suspected, and leak during Vasalva manoeuvre when incontinence is due to intrinsic sphincter deficiency. OBJECTIVE SCORES: Pad test objectives the quantitative importance of incontinence. Symptom scores allow intra and inter individual comparisons. Psychosocial implications are studied with specific quality of life scales. They allow better therapeutic strategies in the management of urge and stress urinary incontinence. Objective evaluation of the different treatments and medico-economic approach of incontinence are thus possible.

Diagnosis, Differential↗
PubMed2000

Instability of the coccyx in coccydynia.

Coccygectomy is a controversial operation. Some authors have reported good results, but others advise against the procedure. The criteria for selection are ill-defined. We describe a study to validate an objective criterion for patient selection, namely radiological instability of the coccyx as judged by intermittent subluxation or hypermobility seen on lateral dynamic radiographs when sitting. We enrolled prospectively 37 patients with chronic pain because of coccygeal instability unrelieved by conservative treatment who were not involved in litigation. The operation was performed by the same surgeon. Patients were followed up for a minimum of two years after coccygectomy, with independent assessment at two years. There were 23 excellent, 11 good and three poor results. The mean time to definitive improvement was four to eight months. Coccygectomy gave good results in this group of patients.

Adult↗