[History of the discovery of gold salts action in rheumatoid polyarthritis].
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Antirheumatic Agents↗
Biomedical subjects
F Forestier
Publications and source records attributed to F Forestier.
Absence of transplacental passage of fragmin (Kabi) during the second and the third trimesters of pregnancy.
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Blood Coagulation↗
Contribution of a new PCR assay to the prenatal diagnosis of congenital toxoplasmosis.
A polymerase chain reaction (PCR) assay has been developed for the detection of Toxoplasma gondii. The target sequence (88 bp) is part of a rDNA repetitive gene. A signal can be observed with only one parasite. It is directly and rapidly detected by electrophoresis and ethidium bromide staining. We report a prospective study of 80 documented cases of toxoplasmic seroconversions during pregnancy. The PCR assay of the amniotic fluids was compared with the current standard methods for diagnosis of fetal infection. Seventy specimens gave no PCR signal, and were negative according to prenatal tests and postnatal examinations. The presence of T. gondii was detected in ten specimens by PCR analysis. Four were confirmed by isolation of the parasite from the amniotic fluid; four by biological study of the fetal blood. For the remaining two, infection was diagnosed after birth. Together with ultrasonographic and biological data, this technique permits prenatal diagnosis within 1 day.
Amniotic Fluid↗
Effect of nanoparticle-bound ampicillin on the survival of Listeria monocytogenes in mouse peritoneal macrophages.
The efficacy of ampicillin bound to polyisohexylcyanoacrylate nanoparticles was studied in vitro in mouse peritoneal macrophages infected with Listeria monocytogenes. Nanoparticles containing ampicillin 1 mg/L were more effective after 30 h than free ampicillin at the same concentration, with viable counts of 3.68 and 5.43 log10 cfu/mL, respectively. The nanoparticles acted on the intracellular bacteria after a lag period of 6-9 h; this time was apparently required for the degradation of the polymer. At the doses used in these experiments, empty nanoparticles had neither an anti-listeria nor a cytotoxic effect.
Ampicillin↗
Electrophoretic and functional characteristics of the von Willebrand factor in human fetal plasma.
Although the haemostatic role of von Willebrand factor (vWF) in adults is well known, there is little information currently available about its possible contribution to in utero haemostasis. We have investigated the distribution of vWF multimers in 27 pure fetal platelet-poor plasma (FP) samples aged from 20 to greater than 36 weeks, by using electrophoresis in both low- and high-resolution agarose gels in the presence of sodium dodecyl sulphate. Our data confirm that most FP samples contain higher molecular weight (HMW) vWF multimers than those present in normal adult plasma, the proportion of these HMW forms being lower in FP samples aged greater than 36 weeks. However, we found that the multimeric unit and the protomeric form of vWF were similar in normal fetal and adult plasma. Functional assays of vWF were performed on three pooled FP samples. In all cases, fetal vWF was able to interact with factor VIII and to bind to GP Ib platelet receptor in the presence of ristocetin and to types I and III collagen. These results indicate that plasma vWF has already acquired in fetal life the functional activities required for its role in both coagulation and primary haemostasis.
Adult↗
Fetal and neonatal alloimmune thrombocytopenia: current trends in diagnosis and therapy.
Neonatal thrombocytopenia affects 20-40% of the infants in intensive care units. The frequency of neonatal alloimmune thrombocytopenia (NAIT) is estimated at 1/1500 to 1/5000 live births. The risk of morbidity is significant with 20% neurological sequelae and the death rate is estimated at 10% of affected infants. During recent years considerable efforts have been made to prevent fetal bleeding and to avoid birth trauma, which have significantly changed the natural history of NAIT.
Antigens, Human Platelet↗
Diagnosis of Toxoplasma infection in the pregnant woman and the unborn child: current problems.
Prevention of congenital toxoplasmosis requires identification of non immune women at the beginning of pregnancy, instruction on how to avoid contamination and a serological follow-up of the women until the delivery. The latter is easily achieved by a repeated testing for specific IgG and IgM. Most of the interpretation difficulties arise from results suggestive of recent infection obtained on a first specimen. If no rise in IgG titer is demonstrated on a second serum sample, the use of additional tests studying other Ig-isotypes or acute-phase IgG antibodies can be helpful, mainly as a way to exclude the possibility of infection acquired during pregnancy. Congenital infection can be investigated by biological measurements on fetal blood and by ultrasound examination. Detection of specific IgM and IgA in fetal serum must be interpreted with care because of the existing risk of contamination with maternal blood. Demonstration of Toxoplasma gondii in fetal blood or amniotic fluid by mouse inoculation definitely proves the diagnosis; though less sensitive, tissue culture offers the advantage of a more rapid result. The very promising results obtained by the PCR-method applied to amniotic fluid samples give the hope that it can replace som of the existing confirmatory methods.
Animals↗
[Chronic Corynebacterium endophthalmitis. Apropos of 3 cases].
Only a few isolated cases of endophthalmitis have Corynebacterium been implicated as etiology. This diphtheroid, which has been considered for a long time as a nonpathogenic contaminant from the conjunctival flora, may produce systemic diseases usually in immuno-deficient patients. Keratitis and endophthalmitis cases have been reported in the literature. We report three cases of chronic endophthalmitis after extracapsular extraction with intraocular chamber posterior lens which are characterized by many subacute iridocyclitis and vitritis attacks treated by topical steroids. These endophthalmitis are characterized by decrease of visual acuity, hypopion, white plaque on posterior capsule and vitritis. In the first case, Corynebacterium has been isolated from the culture of vitreous and in the second and third cases from the culture of aqueous humor. These bacteria are often very slow growing, 8 to 14 days in the 3 cases. Colonies may not become visible on culture plates before one week or more. Corynebacterium grow well on ordinary media (blood and chocolate agar). The major difficulty is not to discard organism frequently considered contaminants. The treatment associated systemic antibiotherapy with steroids or not, central capsulotomy and vitrectomy with intraocular injection of antibiotic with or without steroids. Antibiotics sensitivities among diphteroids vary greatly. Quinolones, penicillins, vancomycin, cyclines and aminosides are often a good choice. However, individual sensitivities determined by the antibiogram must be used for an appropriate treatment.
Aged↗
[Bacterial endophthalmitis. Ophthalmological results of a national multicenter prospective survey].
Under the aegis of the GEEP (Groupement d'Etudes Epidémiologiques et Prophylactiques) a prospective multicentre study concerning bacterial endophthalmitis was carried out over a period of one year long with the contribution of 64 metropolitan ophthalmologic hospital departments. During this survey 143 cases of post surgical endophthalmitis were recorded: 111 of them were secondary to elective surgery, 32 developed after a perforating eye injury. Twenty-four cases of endophthalmitis developed in the absence of surgery were therefore called "medical" endophthalmitis. The frequency of endophthalmitis after elective surgery was 0.32%, and 2.8% after penetrating eye injury. Intraocular samples were obtained in 61.5% of the cases of post surgical endophthalmitis. 53 bacteria were isolated from 50 cases of endophthalmitis. The bacterial nature of the endophthalmitis was proved in 35% of these cases of post surgical endophthalmitis. Bacteria isolated from these cases of post surgical endophthalmitis were gram positive in 86.7%, and gram negative in 13.3% of cases. 20 bacteria were isolated from pseudophakic eyes: 10 of them were Staphylococcus epidermidis. The visual prognosis of endophthalmitis depends on the strain: visual acuity was more than 1/10 in 68% of cases of Staphylococcus endophthalmitis infection, but in only in 7% of cases of Streptococcus endophthalmitis infection. Intraocular injections of antibiotics both in the anterior chamber and in the vitreous, and vitrectomy increased the quality of the visual result. Three months after post surgical endophthalmitis, 35% of those eyes who received systemic and periocular antibiotic therapy, combined with intraocular antibiotics, with or without vitrectomy, recovered a visual acuity of 4/10 or more, instead of only 18% in the group without any intraocular therapy.
Adolescent↗
Changes in alpha 1-acid glycoprotein serum concentrations and glycoforms in the developing human fetus.
alpha 1-Acid glycoprotein concentrations and reactivity to concanavalin A were measured in maternal and fetal serum and amniotic fluid obtained from 24 women undergoing diagnostic cordocentesis at 20 to 33 wk gestation and in 30 additional fetal sera (19 to 34 weeks gestation). Maternal alpha 1-acid glycoprotein serum levels were five to ten times higher than fetal and amniotic levels. Fetal alpha 1-acid glycoprotein levels were found to increase with advancing gestational age. Using crossed immunoaffino electrophoresis with concanavalin A, alpha 1-acid glycoprotein patterns were identical in maternal serum and amniotic fluid but totally different in fetal serum. The fetal concanavalin A pattern changed progressively during fetal life towards that of the newborn. These data confirm earlier assumptions of fetal synthesis of alpha 1-acid glycoprotein and provide normal reference values for alpha 1-acid glycoprotein in fetal serum. In addition, the specific fetal concanavalin A pattern indicates that the alpha 1-acid glycoprotein glycosylation process during fetal life differs from that in post-natal life.
Amniotic Fluid↗
Epidemiology of infective endophthalmitis in France. The French Collaborative Study Group on Endophthalmitis.
Data from retrospective studies of endophthalmitis vary widely with respect to incidence and to the pathogens implicated. To see whether we could provide more accurate data, we have done a prospective multicentre national survey of endophthalmitis over one year in France. Records of 36,241 operations and 1148 cases of ocular trauma from 64 centres specialising in eye surgery were analysed. There were 167 cases of endophthalmitis; incidence of postoperative endophthalmitis was 0.31 per 100 operations, and the risk after penetrating ocular trauma was 2.8%. In contrast with most previous studies, Staphylococcus epidermidis was the most frequently isolated organism, with gram-negative organisms accounting for only a small proportion of cases. Patients infected with streptococci had the least favourable outcome. The survey confirms data from retrospective studies showing that the incidence of postoperative or post-injury endophthalmitis is low. The low frequency means that large numbers of patients would be required for a trial of antibiotic efficacy, but such a trial is worthwhile because there are now antibiotics with good ocular bioavailability that are effective against most of the bacteria that cause endophthalmitis.
Adolescent↗
[Infectious fetal diseases. Prevention, prenatal diagnosis, practical measures].
Many congenital infections can produce foetal diseases and are sometimes responsible for major disablements. The most frequent infectious foetal diseases are toxoplasmosis, rubella and chickenpox. Diseases caused by parvovirus or cytomegalovirus are exceptional. Foetal blood sampling has considerably simplified the prenatal diagnosis and made it accessible to more medical centres; it has also widened the therapeutic possibilities and above all, it has considerably reduced the number of therapeutic abortions. It may well be that the development of molecular biology, which has the great advantage of permitting an earlier diagnosis, will in the near future make it possible not only to detect numerous monogenic diseases before birth, but also to diagnose some foetal infections. We might then hope that a much earlier treatment in utero will also be more effective.
Chickenpox↗
Fetal toxoplasmosis: ultrasonographic signs.
Eighty-nine cases of proven Toxoplasma gondii fetal infection were studied in order to describe the morphological lesions which could be demonstrated on ultrasound examination; these were present in 32 of the infected cases. Cerebral ventricular dilatation was the most common sign and was generally bilateral and symmetrical. Its evolution was always very rapid over a period of a few days. Other signs observed included intracranial and intrahepatic densities, increased thickness and hyperdensity of the placenta, ascites and rarely pericardial and pleural effusions. Thirteen fetuses demonstrated two or more ultrasound features. Intrauterine growth retardation and microcephaly were not observed. Ultrasonographic assessment of the fetus injected with Toxoplasma gondii is important. It improves the reliability of prenatal diagnosis and is of important prognostic value in cases with severe brain lesions, but is of little value in detecting brain necrosis without ventricular dilatation.
Journal Article↗
Developmental hematopoiesis in normal human fetal blood.
Using an easy and safe procedure for fetal blood sampling in utero, we studied 3,415 fetuses for prenatal diagnosis. Retrospectively, 2,860 normal blood samples, performed from the 18th week of gestation to the end of pregnancy, were selected. Differentials were evaluated in 732 cases. Burst-forming unit erythroid (BFU-E) and erythropoietin (Epo) were measured in 27 and 163 cases, respectively. Total nucleated cell and platelet counts did not change from the 18th to the 30th week of gestation. The lymphocytes represented the main population and the decrease of normoblastic cells made up for the increase in neutrophils. The increase of red blood cells and hemoglobin was substantial during the studied period. At mid trimester threefold more BFU-E were obtained than at birth. Epo levels remained stable throughout the pregnancy and no correlation was found between Epo and gestational age. These normal values of fetal erythropoiesis will improve our knowledge of physiology and provide a better insight into developmental hematopoiesis.
Adult↗
Failure of fetal karyotyping and diagnosis of complete Di George syndrome.
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Abortion, Therapeutic↗
Prenatal diagnosis of fetal cytomegalovirus infection.
Twelve fetuses were evaluated with a combination of ultrasonography, amniocentesis, and blood sampling for possible cytomegalovirus infection. In seven the mother had a documented primary cytomegalovirus infection. All seven women had normal ultrasonographic findings and one fetus was found to be infected. In the other five cases fetal cytomegalovirus infection was diagnosed in association with abnormal ultrasonographic findings. There was no history of maternal infection in the latter group. All positive and negative diagnoses were confirmed and none of the six infected fetuses survived. In this series, the most reliable parameters of infection were the isolation of the virus from amniotic fluid and elevations of total immunoglobulin M and gamma-glutamyl transpeptidase in fetal blood. In the majority of infected fetuses cytomegalovirus-specific immunoglobulin M was not detected in blood. Prenatal diagnosis of fetal cytomegalovirus infection is possible with a combination of amniocentesis and fetal blood sampling.
Amniocentesis↗
Serum insulin-like growth factors and insulin-like growth factor binding proteins in the human fetus. Relationships with growth in normal subjects and in subjects with intrauterine growth retardation.
IGF-I, IGF-II, and their binding proteins (BP) were studied in sera obtained by direct puncture of umbilical cords in utero between 20 and 37 wk of gestation in 103 normal fetuses and in 16 fetuses with intrauterine growth retardation, as well as in the cord blood of 37 normal newborns of 38- to 42-wk pregnancies. In normal fetuses, IGF-I levels were approximately 50 ng/mL and IGF-II levels approximately 350 ng/mL up to the 33rd wk of pregnancy. Thereafter, both increased to reach values two to three times higher at term. Correlations were found between fetal placental lactogen levels and those of IGF-I and IGF-II, which is consistent with the hypothesis that placental lactogen is involved in the regulation of IGF synthesis in the fetus. With weight (either measured at birth or deduced from echographical data) as index of fetal size, IGF-I levels were significantly (p less than 0.001) higher in fetuses with weights above the mean for gestational age than in fetuses with weights below the mean, whereas IGF-II levels were similar in the two groups. Similarly, IGF-I (but not IGF-II) levels in fetuses with intrauterine growth retardation were significantly lower than those in normal fetuses of the same age (p less than 0.01). These findings suggest that, during the latter months of intrauterine life, IGF-I (but not IGF-II) is involved in the control of fetal size. Total fetal BP concentrations were approximately 1/3 those of adults. The fetal electrophoretic profile obtained by Western-ligand blotting bore a strong resemblance to that of subjects with growth hormone deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)
Body Constitution↗
[Prenatal diagnosis from fetal blood].
Fetal blood sampling under ultrasound guidance allows prenatal diagnosis of hemoglobin and coagulation disorders but also infectious fetal diseases (i.e. toxoplasmosis, rubella, cytomegalovirus). In utero, therapeutic possibilities have considerably reduced the number of therapeutic abortions.
Blood Coagulation Disorders↗