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J Aubert

Publications and source records attributed to J Aubert.

At least 19 recordsLinked to original sources

HIV-1 sensitivity to zidovudine: a consensus culture technique validated by genotypic analysis of the reverse transcriptase.

In order to select and standardize a reliable assay for the analysis of sensitivity of HIV isolates to AZT, we have compared two culture methods. The first assay (Cell-Associated Isolate Sensitivity Assay: CAISA) quantified AZT-resistant HIV isolates by end-point dilution cultures of peripheral blood mononuclear cells (PBMCs) in the presence of various concentrations of AZT. In the second assay (Cell-Free Isolate Sensitivity Assay: CFISA), following a conventional isolation of HIV, dilutions of infected cell-free supernatants were cultivated with fresh normal donor PBMCs in the presence of increasing concentrations of AZT. Samples from 64 untreated and AZT-treated patients were studied by CAISA (41), CFISA (43) or both assays (20). The CFISA, which allows the determination of titration parameters with respect to various kinetics patterns of viral replication was selected, and some of the CFISA phenotypically characterized isolates were further studied by nucleotide sequence analysis of the reverse transcriptase gene. CFISA showed that isolates from untreated patients were susceptible to AZT while the frequency of resistance increased with the duration of therapy. Genotypic analysis of CFISA-resistant isolates exhibited mutations at crucial positions, particularly at residue 215. We consider CFISA as a consensus culture technique for longitudinal studies of isolates from patients receiving AZT or other analogs of nucleosides.

Cell-Free System

[Complications of prostatic biopsies. Analysis of a series of 4,764 biopsies].

A multicentre, retrospective series of 4,764 prostatic biopsies revealed 89 complications (1.86%). The commonest complications were infectious (including 10 cases of septicaemia) and antibiotic prophylaxis does not appear to be able to totally prevent them. Thirty three complications occurred after negative biopsies. Many minor complications are probably treated at home by the local doctor and would therefore not be reported to the urologist.

Biopsy

[Silica urinary calculi. Report of a case].

The authors report a case of anuria due to bilateral ureteric obstruction by silica stones in a patient taking magnesium trisilicate for many years. A review of the literature concerning silica stones is presented. The diagnosis should be suggested by the clinical history and confirmed by stone analysis. The treatment of silica stones is not specific, but must be associated with withdrawal of the drug responsible.

Humans

[Long-term tolerability of formoterol in chronic obstructive bronchopathies].

Formoterol aerosol, a long-acting new beta 2-mimetic was administered over a year at a dose of 12 micrograms twice daily, to 62 chronic obstructive bronchitics of mean age 66 +/- 6 years and of whom the basal VEMS was at 12,801 +/- 0.59. Clinical tolerance of the product was good with undesirable effects in 13 patients, the most frequent being shaking. No untoward effect was seen on systolic or diastolic arterial pressure, or the heart rate over successive visits at 1, 3, 6, 9 months and one year. Electrocardiographic surveillance found in only four patients electrical abnormalities that may be due to Formoterol, these were patients without previous cardiac problems but of advanced mean age. Functionally, a significant improvement of basal VEMS was noticed from the 6th month. The VEMS improved significantly after administration of 12 micrograms on successive visits, without tachyphylactic signs. Well tolerated, with functional benefits, Formoterol is a promising product amongst the long-acting beta 2-mimetics. Its usefulness and limitations in the basic treatment of these chronic bronchopathies remains to be defined.

Adrenergic beta-Agonists

[Prostatic cancer before the age of 50--report of 7 cases].

Based on a retrospective series of 7 cases, the authors study the particular features of prostatic cancer before the age of 50 years. These 7 patients all had an advanced tumour with, in 4 cases, documented metastases. A single patient had a well differentiated tumour, while the others had a moderately or poorly differentiated or undifferentiated tumour. All patients died rapidly, except one who is currently receiving treatment with an LHRH agonist, with a follow-up of 25 months. On the basis of this study, the authors distinguish between prostatic cancers clinically detectable before the age of 50 years, and those which remain occult, leading to a histological discussion between a benign disease and true early cancer. In the light of these findings, systematic screening for prostatic cancer before the age of 50 years does not appear to be justified.

Age Factors

[Burch's procedure. Value of association with fixation to the promontorium and colpoperineorrhaphy].

One hundred and ninety nine patients complaining of genuine stress incontinence not previously treated underwent Burch colposuspension. The operation has been either isolated (42.2%) or associated to a vaginal repair (36.2%) or associated to a vaginal repair and a sacral hysteropexy (21.6%). No serious operative complication occurred. The overall rate of postoperative complications was of 14% without significant difference between the surgical procedures. The overall clinical cure rate for stress incontinence was 90%. The rate of failure was significantly higher when the Burch operation was performed alone. The failures were revealed mostly in the six first months, confirming the stability of the results (20 months average follow-up). The present data confirms that Burch colposuspension is effective in stress urinary incontinence. The authors recommend a systematic association to a vaginal repair and, in case of bladder descent, to a sacral hysteropexy.

Adult

Carcinoma of the penis in lichen sclerosus atrophicus. A case report.

Three cases of glans penis epidermoid carcinoma after lichen sclerosus et atrophicus (LSA) or balanitis xerotica obliterans are discussed. Relationships between both diseases are analyzed but remain unclear. Balanitis xerotica obliterans causes foreskin and urethral meatus stenosis that requires circumcision. Glans penis carcinoma can be observed many years later even after circumcision. The knowledge of LSA is important to do circumcision at the beginning of the disease with a long-term follow-up of these patients to realize a glans penis biopsy if necessary. Most cases of LSA are not recognized, and the frequency is higher than reported.

Balanitis

[Cancers of the prostate and cyproterone acetate. Value of blood testosterone and PSA levels for treatment surveillance].

On the basis of a retrospective series of 74 patients with adenocarcinoma of the prostate, the authors study the survival of these patients according to the clinical stage of the lesion when treated with cyproterone acetate. Biologically speaking, the authors have studied the evolution of the blood testosterone level, as well as of PSA and PAPs. Their conclusion is that the PSA is an excellent indicator of the efficacy of the cyproterone acetate treatment. Its fast decrease proves treatment efficacy, while a new rise indicates the resumption of evolution of the neoplastic process and must lead to change the therapeutic approach.

Adenocarcinoma

[Hepatitis after treatment with cyproterone acetate. Apropos of a case].

Regarding a case of little-differentiated adenocarcinoma of prostate in a 79-year old male patient undergoing antiandrogenic corticosteroid therapy (cyproterone acetate), the authors describe a rare complication related to treatment with the drug. Cytolytic icterus, without cholestasis, occurred eleven weeks after starting the treatment without metastasis of the primary cancerous lesion, and regressed when administration of the antiandrogenic agent was interrupted. This description is compatible with toxic hepatitis. This is a rare complication, which should be differentiated from stasis icterus consecutive to treatment with progestogens. Its diagnosis precludes also primary or drug-induced secondary tumors or degenerative hepatic lesions. A knowledge of this complication by the urologist is important, so the latter might not conclude too hastily to metastatic extension of primary cancer of prostate. Withdrawal of the patient from antiandrogenic therapy is mandatory, and management should incorporate complete biological investigation of liver function, CT scans and, depending upon the case, liver biopsy as the only means of studying this exceptionally rare complication.

Adenocarcinoma

[Effect of the chemical nature of urinary calculi on the results of extracorporeal shockwave lithotripsy].

137 patients were treated by ESWL with a Sonolith 2000 lithotriptor using ultrasonography localization. 132 patients were eligible for review. Calculi were caliceal in 85 cases, pelvic in 51 cases, in the upper ureter in 1 case; 26 stones were treated by the "push and bang" technique with ureteric stent. Fragmentation rate was 83.9% and stone free rate at 3 months was 68.5%. Failure cases were reviewed: non fragmentation (16.1%) and insufficient fragmentation (15.6%): 14 calculi were analysed by infra red spectrophotometry and correlated with radiodensity on pre ESWL plain X-ray. Hardness and friability criteria were described. Calculi with different radiographic appearances respond differently to shock wave fragmentation. Some stone compositions such as calcium oxalate monohydrate pure or mixed with apatite and calcified uric acid are difficult to break by ESWL. These calculi represented almost 30% of the series. Another treatment should be proposed to improve the results of ESWL.

Adolescent

[Wegener's granulomatosis with urethral-penile location. Apropos of a case].

The authors report a case of Wegener granulomatosis presenting as a necrotizing urethral tumor in a 44 year-old man. Involvement of the urethra by Wegener granulomatosis in unusual which explains the delay in diagnosis particularly when the urethral localization is isolated. The prognosis is severe despite urinary diversion and appropriate therapy. Five cases from the literature are reviewed. Prednisone and cyclophosphamide therapy for Wegener granulomatosis now gives dramatic results, but an urethral localization could occur in the subsequent course of the disease with the same severe prognosis.

Adult

[Cystinic lithiasis. Current aspects of the urologic treatment].

On the basis of a series of 9 patients (12 renal units) gathered over 19 years, the authors analyze the current possibilities of treatment of cystine lithiasis. They first describe the characteristics of this litiasis, which is rare but serious, being naturally prone to recurrence because it is caused by a genetic defect. The development of extracorporeal lithotripsy raised great hopes for the treatment of this lithiasis, but it was soon realized that cystine strones were hard to break. However, even the mere fragmentation of the stones improves the dissolving action of the various drugs proposed to modify the pH of urine. The authors consider that open surgery by means of posterior vertical lumbar section still is indicated for larger stones, and percutaneous nephrolithotomy seems to be a very useful technique, either exclusively or as a complement of extracorporeal lithotrity.

Adult