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J L Lesbordes

Publications and source records attributed to J L Lesbordes.

At least 19 recordsLinked to original sources
PubMed1997

Neurocysticercosis: a major aetiological factor of late-onset epilepsy in Madagascar.

To assess the impact of cysticercosis on public health in Madagascar, we compared patients > 15 years with late-onset epilepsy to non-epileptic controls in a matched case-control study. The association between epilepsy and cysticercosis was studied by enzyme-linked immunoelectrotransfer blot (EITB) assay for antibodies specific to Taenia solium. The EITB assay was performed on 104 pairs of sera specimens and on 95 pairs of cerebrospinal fluid (CSF) specimens. Depending on whether we consider the results obtained from sera or from CSF, we obtain for the population attributable risk percent of cysticercosis in late-onset epilepsy two slightly different estimates: 22.3% and 17.6%. Therefore cysticercosis is a major aetiological factor of late-onset epilepsy in Madagascar. In the control group, the frequency of positive results, especially in CSF specimens (7.4%), confirms the existence of asymptomatic cases of neurocysticercosis.

Adolescent↗
PubMed1995

Serial transmission of spongiocytic hepatitis to woodchucks (possible association with a specific delta strain).

BACKGROUND/AIMS: Outbreaks of severe hepatitis have been reported from Africa and South America. Description of the cases has shown the histological hallmark to be the presence of ballooning hepatocytes with fat drops surrounding the nucleus (spongiocytes or morula cells). METHODS: Experimental reproduction of this syndrome for the verification of a possible role of a specific HDV strain was performed by the inoculation of serum and liver extracts from African patients (Bangui-Central African Republic), who died with this syndrome, into American woodchuck carriers of WHV (WC 231,144), the results of which were then compared with animals inoculated with a reference wild HDV strain (WC 300,173,154), and those which received material from a European fulminant HDV case (WC 88,93). RESULTS: Following the initial inoculation, the animals receiving African inocula had a delayed anti-HDV seroconversion, high mortality and showed the presence of spongiocytes, while the other animals had a classical evolution of HDV superinfection in woodchucks. Furthermore, the African inocula caused less inhibition of WHV replication, as well as a predominant cytoplasmic expression of HDAg, in contrast to the animals which received the other inocula. The second passage experiments gave similar results. CONCLUSIONS: We conclude that this peculiar form of HDV fulminant hepatitis can be experimentally reproduced and might be specifically related to a more pathogenic strain.

Animals↗
PubMed1995

[Extra-pulmonary tuberculosis in Antananarivo. Principal localizations and biological diagnosis].

We describe the state of extrapulmonary tuberculosis in the capital of Antananarivo, a city of high endemicity for tuberculosis but very low endemicity for HIV infection. The Laboratory of Mycobacteria in the Institut Pasteur of Madagascar had examined from August 94 to April 95, 543 pathological samples issued from 295 patients clinically suspected of extrapulmonary tuberculosis (64% male and 36% female). The diagnosis of tuberculosis was confirmed for 47.7% of the patients (141/295), using either the culture technique or the histopathological method: 93% of them had an unique localization whereas 7% had a double localization. The most frequent form encountered was the pleural localization (77.8%), followed by the lymphadenopathic form (8,4%) and the abdominal form (6.9%). The confirmation rate on biopsies was 67% by histopathological method compared to 55% by the culture. On the fluid samples, the confirmation rate was 20.9% using the culture. The agreement between histology and culture was 70.3%. Of the 138 strains identified, 135 were M. tuberculosis, 1 M. bovis and 2 environmental mycobacteria.

Adolescent↗
PubMed1995

[Pericardial tuberculosis in Madagascar. 23 cases].

A 56 months retrospective study, from October 1990 to May 1995, at the Centre Hospitalier de Soavinandriana in Antananarivo pointed out 29 tuberculous pericarditis among the 97 pericardial effusions discovered by the echocardiography of 5600 patients. The sex-ratio was 0,81 and the mean age 38,6 years old (+/- 14,3). Hospitalization was justified by dyspnea (18 cases), thoracic pain (18 cases), lower limbs edema (6 cases) and ascitis (3 cases). Moreover, electrocardiography showed microvoltage in 18 cases and thoracic radiography showed one heart enlargement. Even if for 15 cases a pleural effusion was associated, only 2 patients had a pulmonary image suggestive of tuberculosis. Tuberculous pericarditis has been proved by the following examinations: pericardium puncture (21 cases), pericardium and pleural biopsy (respectively 11 and 13 cases), ganglionic biopsy and search of alcohol-acid-fast bacilli in sputum: 1 case. Histologic proof has been obtained 8 times out of 9 pericardial biopsies and 6 times out of 7 pleural biopsies. Bacteriological proof has been obtained 11 times by pathological samples cultivation: twice from fresh caseous material taken from the pericardium, once from 13 pleural fluids, 5 times from 6 pericardial biopsies, 3 times from 3 pleural biopsies. The patients have been put under antituberculous treatment associated with prednisone. 20 patients have been declared cured at the end of the treatment, 5 were dead and 4 were lost out of sight. Tuberculous pericarditis has become rare in developed countries but it is still challenging in Madagascar. In spite of the antituberculous treatment associated with corticoids, prognosis is severe (evolution towards pericardial constriction death.

Adult↗
PubMed1993

Discovery of a novel point mutation changing the HDAg expression of a hepatitis delta virus isolate from Central African Republic.

None of the mutations so far discovered in several hepatitis delta virus (HDV) isolates appears to determine important changes in HDV specific protein (HDAg) expression, except for a putative mutation at nucleotide 1012 converting an amber stop codon (TAG) to a codon for tryptophan (TGG). Here we present the characterization of an HDV obtained from the liver of a woodchuck inoculated with sera from fulminant HDV patients in Central African Republic (CAR). By restriction enzyme analysis and sequencing of HDAg-coding region cDNA clones, we found that this HDV isolate bears a novel mutation (T to A) at nucleotide 1013 which converts the amber stop codon (TAG) to a codon for lysine (AAG). Comparison of these nucleotide sequences with those available from American, Japanese, Taiwanese, French, Italian and Nauru isolates showed a variability of 1.7 to 21.5% and 1.9 to 28.7% at the nucleic acid and amino acid levels, respectively. The HDAg-encoding sequence of the CAR isolate is closely related to that of the Italian HDV isolate. The in vitro expression of this HDV isolate resulted in a unique HDAg species (28K) which was identical with that characterized in vivo.

Amino Acid Sequence↗
PubMed1991

[Idiopathic chylopericardium. Apropos of a new case. Review of the literature].

The authors report a new case of primary chylopericardium in an asymptomatic 26 year old male. In view of the negativity of the complementary etiological investigations a surgical subxiphoid window was performed and this confirmed the diagnosis. After failure of isolated evacuatory drainage, the patient was cured by pericardectomy. The anatomo-clinical, biochemical and diagnostic features of this condition are described based on a review of the other cases of primary chylopericardium reported in the literature. Surgical pericardectomy seems to be the only effective long term treatment.

Adult↗
PubMed1990

[The treatment of imported Plasmodium falciparum malaria with halofantrine. Apropos of 59 case reports (corrected and republished article orginally printed in Med Trop (Mars) 1990 Jan-Mar;50(1):113-7)].

59 cases of Plasmodium falciparum malaria fever occurring in non-immune Caucasian subjects having got a correct chemoprophylaxis by chloroquine were treated by halofantrine (HALFAN). They were given 1500 mg divided in 3 doses of 500 mg every 6 hours from D1 to D8. All them were back from a malarial highly endemic zone with chloroquine resistance. Analysis of the main biological and clinical efficiency parameters displayed very satisfactory results: disappearances of fever (mean 22 H) and parasitemia (mean 36 H) are short. After two months of monitoring, no malaria recrudescence was noted. With an efficacy of 10 p.c. associated to a noticeable clinical and biological tolerance Halofantrine is a first-class treatment of chloroquine resistant malaria fever.

Adolescent↗
PubMed1990

[malnutrition and human immunodeficiency virus (HIV) in Bagui (Central Africa). Study and 2-year follow-up of a cohort of 175 malnourished children and 101 mothers].

In Bangui (Central African Republic) a survey started in 1986 for 2 years. 175 undernourished children and the mothers were surveyed. In this target group, a high seroprevalence to HIV was determined (12 p.c. of the undernourished children and 25 p.c. for the mothers.) It was also possible to put into light the predictive signs of HIV1 infection in the undernourished people, to follow them up clinically and to determine the sociocultural profile of the undernourished child's mother. In fact, unmarried woman, incidentally prostitute. This is a group at risk that has to be privileged within the control of HIV infection.

Adolescent↗
PubMed1988

[Rift Valley Fever and phleboviroses in the Central African Republic].

During 1984 and 1985, six Rift Valley Fever virus strains (RVF) were isolated in Central African Republic, among them five from human samples. Three strains were isolated in 1985 at the end of the rainy season, from sera of patients dead with severe jaundice with haemorrhagic syndrome, what could evoke a little outbreak. At this occasion, these RVF strains and the other strains of phleboviruses previously isolated in CAR, were antigenically compared by Immuno-fluorescent assay (IFA) and Complement Fixation Test (CF), using mice immuno ascitic fluids prepared against each strain. A lot of cross reactions were noted between the different strains, but all the RVF strains seem to have the same antigenic outline.

Animals↗
PubMed1987

[Role of delta viruses in fulminating hepatitis in Central Africa].

The delta virus (DV) was shown to be the predominant but not exclusive aetiology in 124 cases of fulminating hepatitis (FH) in the Central African Republic. The condition occurs in an endemo-epidemic form in young adults with no apparent risk factors. The mortality is high (88 p. 100) and the clinical features well established. After a short prodromic period, the patients develop severe jaundice, hepatic encephalopathy, and, in over 1/3 of cases, severe haemorrhage. Biologically, the main changes are related to hepatic cytolysis and insufficiency. Histology shows appearances of spongiocytic (steatosic) hepatitis in 81 p. 100 of cases. HBS antigen is found in 90 p. 100 of cases and DV markers are present in 53 p. 100 of these. The HBS Ag also occurs in 60 to 90 p. 100 of the close relatives of the patients and anti-DV antibodies occur in 40 to 90 p. 100 of these subjects. To the authors' knowledge, this is the first published series to demonstrate FH associated with DV in the African continent.

Adolescent↗
PubMed1980

[Long-term administration of calcium-heparin in thromboembolism (author's transl)].

The profound importance of thrombosis in natural history of venous and arterial thromboembolism justifies long-term use of heparin, the best antithrombotic agent. Through the study of 88 cases concerning patients treated by subcutaneous calcium-heparin for a time from 3 months to 6 years, in several indications of venous and arterial thromboembolism, we can bring the following results: - The treatment is easily accepted when patients are inquired and trained. The doses must be adapted according to clotting assays, which do no more restrain patients than during oral anticoagulant treatment. - The frequency of hemorrhagic complications is the same than during antivitamine K treatments. - Thrombosis occur rarely during heparin therapy, but with high frequency during oral anticoagulant treatments. - Osteoporosis is a real but acceptable risk (10 p. cent) of long-term heparin prescription. - The true limit of treatment is the frequency (34 p. cent) of cutaneous hypersensibility reactions with high blood eosinophilia rate. Always mild, this reaction is related to the subcutaneous administration, and heparin is likely not the single impeached substance. These undesirable effects bind us to their thorough study, in order to obtain better tolerated drugs.

Adult↗