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Biomedical subjects

G Blanchard

Publications and source records attributed to G Blanchard.

At least 19 recordsLinked to original sources

[Methicillin resistant Staphylococcus aureus bacteremia seven years of survey in a French hospital].

In our French general hospital with 1000 hospitalization beds, a specific isolation for multiresistant bacteria colonized or infected patients was set up since 1998. To assess the impact of these recommendations, the rate of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia was calculated for each year since 1998. From 1998 to 2004, 493 cases of Staphylococcus aureus (SA) bacteremia occurred in our hospital: 319 strains were susceptible to methicillin and 174 were MRSA. During the 7 years period of our study, we observed a significant tendency for reduction in the number of bacteremia with MRSA strains (p=0.016). The significant decrease of the MRSA bacteremia between 1998 and 2004 was obtained through the cooperation between staff members, bacteriologists and hospital nosocomial infection committee members.

Bacteremia↗

Plasma lipids, lipoprotein composition and profile during induction and treatment of hepatic lipidosis in cats and the metabolic effect of one daily meal in healthy cats.

Anorexia in obese cats may result in feline hepatic lipidosis (FHL). This study was designed to determine plasma lipids and lipoprotein profiles in queens at different stages during experimental induction of FHL (lean, obese, FHL), and after 10 weeks of treatment. Results were compared with those obtained from lean queens of same age fed the same diet but at a maintenance level, once a day. Hepatic lipidosis led to an increase in plasma triacylglycerol (TG), very low density lipoprotein (VLDL) and low density lipoprotein (LDL), and an enrichment of LDL with TG and of high density lipoprotein (HDL) with cholesterol, suggesting that VLDL secretion is enhanced, VLDL and LDL catabolism is lowered, and lipoprotein exchanges are impaired in FHL. This study also showed that cholesterolaemia is increased in cats fed at a dietary rhythm of one meal per day compared to ad libitum feeding.

Animal Feed↗

Carbohydrate production in relation to microphytobenthic biofilm development: an integrated approach in a tidal mesocosm.

Experiments were performed to evaluate short-term changes in sediment extracellular carbohydrates for a multispecific assemblage of benthic diatoms in relation to physiological status, endogenous migratory rhythms, and environmental conditions. For this purpose, a mesocosm was used, which simulated both tidal and dark: light alternating cycles under controlled conditions. Scanning electronic microscopy in combination with picture analyses indicated that natural diatom migration patterns were reproduced in the mesocosm. Two EPS fractions were operationally separated in colloidal carbohydrate measurements: alcohol-soluble EPS (termed "soluble EPS") and alcohol-insoluble EPS (termed "bound EPS"). Microphytobenthic biomass followed a logistic-type curve and converged toward a maximal value termed the "biotic capacity of the local environment." Both EPS fractions showed oscillations with production during photosynthetic periods and sharp decreases during night immersion periods. Productions of both EPS fractions increased with Chl a production during light periods suggesting a light dependence in relation to migratory patterns. The decreases in both EPS fractions, which occurred during night immersion periods suggest that carbohydrate hydrolysis and/or washaway affected both EPS fractions similarly in benthic environments. Our results confirm the theory according to which the two distinct fractions are under different metabolic controls. No change in soluble EPS release was obtained during the transition from logarithmic to stationary phase. On the other hand, a metabolism modification of microalgae, probably related to ammonium depletion, occurred when cells entered the stationary phase, since there was a high enhancement in bound EPS production. Mesocosm results can serve as a system of reference useful to characterize biofilm development in field investigations and to revisit the effective implication of each EPS fraction in sediment stability.

Biofilms↗

Virologic and immunologic parameters that predict clinical response of AIDS-associated Kaposi's sarcoma to highly active antiretroviral therapy.

The purpose of the work was to assess the predictive value of biologic factors on the efficacy of highly active antiretroviral therapy alone or combined with chemotherapy on AIDS-associated Kaposi's sarcoma. Twenty-six AIDS-Kaposi's sarcoma patients who started therapy with protease inhibitors were investigated. No baseline chemotherapy was associated with less severe initial clinical status. Median follow-up was 652 d. The main outcome measures were as follows: best Kaposi's sarcoma clinical response; Kaposi's-sarcoma-associated herpesviral load in peripheral blood mononuclear cells using real-time quantitative polymerase chain reaction (non-detectable if less than 100 copies per microg); human immunodeficiency viral charge in plasma (non-detectable if less than 200 copies per ml); and CD4 lymphocyte count. Time to undetectable Kaposi's-sarcoma-associated herpesviral load, time to undetectable human immunodeficiency viral charge, and time to CD4 >or= 150 per microl were also recorded over time, from 2 mo measurements. Patients were staged according to the AIDS Clinical Trials Group-based tumor, immune, systemic staging system criteria. At baseline, Kaposi's sarcoma was progressive for 25 (96%) of the 26 enrolled patients. Complete or partial response to highly active antiretroviral therapy alone or combined with chemotherapy was achieved in 22 patients (85%). Median time to clinical response was estimated at 251 d. Clinical response was faster in patients without chemotherapy at baseline (p = 0.003) as well as in patients not previously treated with reverse transcriptase inhibitors (p = 0.0012). Using univariable analyses, predictive factors of clinical response were undetectable Kaposi's-sarcoma-associated herpesviremia (p = 0.013), undetectable human immunodeficiency viremia (p = 0.03), and relative variation of CD4 lymphocytes (p = 0.004). Using multivariable analysis, undetectable Kaposi's-sarcoma-associated herpesviremia (p = 0.009) and relative variation of CD4 (p = 0.005) were independently selected as having a predictive value for clinical response. Occurrence of nondetection of either Kaposi's-sarcoma-associated herpesvirus or human immunodeficiency virus was not associated with baseline CD4 value. Kaposi's-sarcoma-associated herpesvirus quantitative viral charge is an independent predictive factor of the efficacy of highly active antiretroviral therapy on AIDS-Kaposi's sarcoma. Our results support immune reconstitution as a mechanism of response of Kaposi's sarcoma to highly active antiretroviral therapy.

Acquired Immunodeficiency Syndrome↗

Cholesterol, bile acid, and lipoprotein metabolism in two strains of hamster, one resistant, the other sensitive (LPN) to sucrose-induced cholelithiasis.

A comprehensive study of cholesterol, bile acid, and lipoprotein metabolism was undertaken in two strains of hamster that differed markedly in their response to a sucrose-rich/low fat diet. Under basal conditions, hamsters from the LPN strain differed from Janvier hamsters by a lower cholesterolemia, a higher postprandial insulinemia, a more active cholesterogenesis in both liver [3- to 4-fold higher 3-hydroxy 3-methylglutaryl coenzyme A reductase (HMG-CoAR) activity and mRNA] and small intestine, and a lower hepatic acyl-coenzyme A:cholesterol acyltransferase activity. Cholesterol saturation indices in the gallbladder bile were similar for both strains, but the lipid concentration was 2-fold higher in LPN than in Janvier hamsters. LPN hamsters had a lower capacity to transform cholesterol into bile acids, shown by the smaller fraction of endogenous cholesterol converted into bile acids prior to fecal excretion (0.34 vs. 0.77). In LPN hamsters, the activities of cholesterol 7alpha-hydroxylase (C7OHase) and sterol 27-hydroxylase (S27OHase), the two rate-limiting enzymes of bile acid synthesis, were disproportionably lower (by 2-fold) to that of HMG-CoAR. When fed a sucrose-rich diet, plasma lipids increased, dietary cholesterol absorption improved, hepatic activities of HMG-CoA reductase, C7Ohase, and S27OHase were reduced, and intestinal S27OHase was inhibited in both strains. Despite a similar increase in the biliary hydrophobicity index due to the bile acid enrichment in chenodeoxycholic acid and derivatives, only LPN hamsters had an increased lithogenic index and developed cholesterol gallstones (75% incidence), whereas Janvier hamsters formed pigment gallstones (79% incidence). These studies indicate that LPN hamsters have a genetic predisposition to sucrose-induced cholesterol gallstone formation related to differences in cholesterol and bile acid metabolism.

Animals↗

Clinical and biological impact of antiretroviral therapy with protease inhibitors on HIV-related Kaposi's sarcoma.

OBJECTIVE: To evaluate the clinical and biological impact of protease inhibitors on HIV-associated Kaposi's sarcoma. DESIGN AND SETTING: A cohort of 10 patients included prospectively from April 1996 to June 1997 were studied in one institutional centre after initiation of protease inhibitors. PATIENTS AND METHODS: All patients but one (stable disease) had progressive Kaposi's sarcoma. Three out of 10 patients had stopped specific chemotherapy for Kaposi's sarcoma for more than 4 weeks, three were still under chemotherapy, and four had never received specific treatment of Kaposi's sarcoma. Plasma HIV viral load, human herpesvirus (HHV)-8 viraemia in peripheral blood mononuclear cells (PBMC), and CD4 cell count were sequentially assessed from the beginning of therapy. For six patients, a semiquantitative evaluation of HHV-8 viral load in the Kaposi's sarcoma lesions was performed during treatment using polymerase chain reaction. RESULTS: After initiation of HIV triple therapy with protease inhibitors, we observed six complete responses, two partial responses, and two patients with progressive disease. All patients had undetectable plasma HIV viral load within 2 months of treatment. Undetectable HHV-8 viraemia in PBMC occurred in seven out of eight patients with partial or complete response and in none of the progressive patients. A decrease or negation of HHV-8 viral load in Kaposi's sarcoma lesions was observed in two complete responders. CONCLUSION: Our results suggest that antiviral therapy with protease inhibitors are clinically efficient in HIV-associated Kaposi's sarcoma and that there exists a correlation between clinical response and negation of HHV-8 viraemia.

AIDS-Related Opportunistic Infections↗

[In vivo drug sensitivity of Plasmodium falciparum in the Tabou region of Ivory Coast].

Malaria caused by Plasmodium falciparum is one of the major health problems in West-Africa, mainly affecting young children. This situation is further complicated by the emergence and rapid progression of resistance to chloroquine, the recommended first line treatment. In order to document the level of resistance of P. falciparum to chloroquine, pyrimethamine/sulfadoxine (Fansidar) and quinine, we performed a survey in Tabou district, Côre d'Ivoire, from June to August 1995. This area has been hosting some 100,000 Liberian refugees since September 1994. Children aged 1 to 15 years old attending the dispensary with a complain of fever or suspected malaria, were included into the study, diagnosed and followed for 7 days according to the WHO Standard Field (in vivo) Tests. Overall proportion of P. falciparum resistant to chloroquine reached 45.1% and was made of 34.3% type II and 10.8% type III resistance. Being less than 5 years of age and having received a lower dose of drug were 2 factors associated with the risk of resistance to chloroquine. Levels of R II resistance to pyrimethamine/sulfadoxine and quinine (3-day treatment) were respectively 5.4% and 4.2%. No R III resistance was found in neither pyrimethaminelsulfadoxine or quinine treatment groups. These results challenge the current chloroquine-based first line malaria treatment in Côre d'Ivoire. Alternative based on pyrimethamine/sulfadoxine could be considered, especially in high risk populations during transient situation (refugees). However, elaborating new treatment policy must take into consideration cost, side-effects, compliance and acceptability. Further studies are needed to evaluate the cost-benefit of alternative strategies.

Adolescent↗

Detailed deletion mapping of chromosome 6q in borderline epithelial ovarian tumors.

We have used PCR amplification of tandem repeats and Southern blot analysis to study the pattern of allelic loss at chromosome 6q in borderline ovarian tumors and compared that with invasive ovarian carcinomas. DNA from 46 borderline ovarian tissues, 20 invasive ovarian tumor tissues, together with corresponding uninvolved (control) tissues was used. The invasive tumors demonstrated the highest percentage of loss of heterozygosity (13 of 45 informative cases, 29%) at the 6q25-27 locus site. In contrast, the borderline ovarian tumors showed only an 11% frequency of loss of heterozygosity (3 of 26). Our results display a sharp contrast in the pattern of loss of heterozygosity between invasive and borderline ovarian tumors and suggest that allelic loss at chromosome 6q may not be involved in the development of borderline ovarian tumors.

Alleles↗

[The thoracic outlet: true syndromes, disputed syndrome (TOS, thoracic outlet syndrome). Current status 1991].

There are 5 syndromes involving the thoracic outlet. The first four, although not well known, especially the first two, are authentic; they are: 1) arterial, due to a well formed cervical rib or to an incompletely formed first rib; 2) neurological, related to the fibrous band associated with a rudimentary cervical rib or a giant transverse process of C7; 3) venous, namely "effort thrombosis"; 4) late post-traumatic, secondary to a fracture of the clavicle. The study of these four syndromes prepares the reader to that of the controversial fifth syndrome, which is entirely subjective, made only of symptoms. The fifth syndrome, by very far the most frequent in the literature, called "scalenus anticus syndrome" in the past, now called "thoracic outlet syndrome" or "TOS" by North-American authors, has two varieties, one where hypotonic shoulder muscles, mostly in women, respond well to specific and simple exercises, and one where there is an accident in the background, a whiplash type of injury in most cases. Despite the fact that TOS is made only of symptoms, "diagnosing" it has led to scores of operations, scalenotomy in the past, now mostly resection of the first rib, sometimes scalenectomy. Huge surgical statistics, that deal mostly with resection of the first rib, have not proven the authenticity of this second variety of the 5th syndrome. Surgeons report only early surgical results, and the results claimed are invariably impressive. Never is there a statistic about return to work after surgery. First rib resection can be dangerous and it can be complicated by tardy permanent brachial plexopathy. One very recent European study proves the discrepancy between the early appreciation of the results by the surgeon and the late appreciation by independent observers.

Cervical Rib Syndrome↗

Atenolol and short umbilical cords.

Umbilical cord length may be a function of fetal movement. Agents that cause decreased fetal movement may cause short umbilical cords. This investigation examined the effect of the beta-blocker atenolol on umbilical cord length in rabbits. Fetuses of rabbits treated with atenolol had significantly shorter cords than control animals (p less than or equal to 0.0005). Since short cords are associated with problems in labor, low Apgar scores, and abruption, we recommend careful surveillance of mothers and fetuses who are given beta-blocking agents in the first 30 weeks of pregnancy.

Animals↗

Primary hypertension in a colony of dogs.

A 5-year-old female Siberian husky that was diagnosed as an essential hypertensive was bred several times over a 5-year period, producing a colony of 39 offspring. Thirty of the 39 animals were subjected to biweekly systemic arterial blood pressure determinations with femoral arterial puncture and were placed into two hypertensive and two normotensive groups based on mean blood pressure: Group 1 (mean blood pressure, 128 +/- 12 mm Hg), Group 2 (mean blood pressure, 121 +/- 3 mm Hg), Group 3 (mean blood pressure, 114 +/- 8 mm Hg), and Group 4 (mean blood pressure, 101 +/- 9 mm Hg). Groups 1, 2, and 3 had mean blood pressures significantly higher than that of Group 4 (p less than 0.05). Ten dogs (representatives from Groups 1, 2, and 3) were subjected to more detailed clinical testing including angiography, echocardiography, ophthalmic examination, plasma catecholamine and renin activity measurements, plasma lead and cadmium determinations, cerebrospinal fluid examination, renal profile, and serum chemistry and hematological analysis. Five unrelated normotensive Siberian huskies were compared with colony dogs by using echocardiography. Groups 1 and 2 showed a clear but statistically insignificant upward trend in left ventricular wall thickness indexed against body weights when compared with that in Group 3 and in the unrelated five normal Siberian dogs. Thus, the only specific difference from group to group in the colony at the termination of this study was the difference in mean blood pressure. Based on these data, it is possible and likely that aging will reveal changes secondary to chronic primary hypertension. The pathogenesis of this hereditary disorder remains unknown.

Animals↗

Canine essential hypertension: probable mode of inheritance.

Essential hypertension (EH) in dogs is a relatively recently reported phenomenon. In this colony the canine disorder follows family lines and has a probable polygenic mode of inheritance, although the specific mode of inheritance has not been defined since an autosomal dominant trait has not clearly been ruled out. Direct intra-arterial femoral punctures are used to monitor blood pressure elevations, which tend to increase with advancing age. As in man, there are dogs with blood pressures intermediate between affected and normal dogs.

Animals↗

A microcomputer system for the practising cardiac surgeon.

The authors present a computer program designed for the practising cardiac surgeon who wishes to computerize patient data. The program is efficient, versatile and can be adapted to individual needs. It can be used with any IBM PC-compatible machine and requires little knowledge of computer science. More than 250 items on 30 000 patients can be stored and all this information analysed simultaneously. The program can chart a patient's profile and tabulate the information of the entire registry. It can generate lists of patients with their surgeons, cardiologists, diagnoses, operations and dates of intervention. It can also be used for mailing purposes.

Cardiac Surgical Procedures↗