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Biomedical subjects

M David

Publications and source records attributed to M David.

At least 37 records · Page 2Linked to original sources
PubMed1992

Treatment with bifonazole shampoo for seborrhea and seborrheic dermatitis: a randomized, double-blind study.

Forty-four patients with seborrhea and seborrheic dermatitis of the scalp were treated with either bifonazole shampoo (22 patients) or the vehicle shampoo (22 patients) in a randomized, double-blind vehicle-controlled study. The patients were instructed to wash their scalps 3 times weekly for 6 weeks and were examined every 3 weeks. Responses were evaluated by clinicians using a clinical grading of scaling, erythema and overall improvement, and also by the patients, who assessed pruritus and overall improvement, using a scale of 0 to 3. The improvement following the bifonazole shampoo was found to be significantly greater than that achieved with the vehicle shampoo in regard to the clinical evaluation of scaling (p = 0.01) as well as patient evaluation of pruritus (p = 0.008) and overall improvement (p = 0.03). No major adverse side effects were recorded.

Adolescent↗
PubMed1992

[Prevention of sexual ambiguity in children with 21-hydroxylase deficiency by treatment in utero].

In the classical form of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, female fetuses are virilized by the excessive production of adrenal androgens. Sexual ambiguity is a major complication. Prenatal treatment has been proposed with the aim of reducing the adrenal androgen overproduction and hence of preventing the in utero virilization of CAH affected females. As there is good placental transfer of natural or synthetic glucocorticoids, dexamethasone (Dex) in particular, efficient treatment can be administered to the fetus via the mother. In early protocols the mothers were given 0.5 mg of Dex either 8- or 12 hourly. Analysis of the results of a French multicentric study has shown that the first consideration is to start treatment as early as possible, and no later than the 7th week of gestation. Also, the daily dose should be adjusted to maternal size. A dose of 20-25 micrograms/kg body weight is suggested. As this condition has to be treated early it is not possible to make a prenatal diagnosis before instituting therapy, which is not necessary in 7 out of 8 fetuses. It is thus important to establish as soon as possible a reliable diagnosis of sex and CAH. The generalization of villus chorionic biopsies and the recent progress in molecular genetics--restriction length fragment polymorphism and polymerase chain reaction (PCR)--now permit a direct analysis of the DNA during the first trimester. In particular, the determination of point mutations using PCR amplification of specific alleles in the proband an the parents, simplifies the procedure and also increases the reliability of prenatal diagnosis. On the whole, prenatal treatment with an adequate protocol has been fully or partially successful in almost all cases. No teratogenic or major adverse effects in the mother or child have been reported.

Adrenal Hyperplasia, Congenital↗
PubMed1992

[Heart valvular and coronary manifestations of Takayasu disease. Apropos of a surgically-treated case].

Cardiac involvement in Takayasu's disease is well documented. This is often the result of severe hypertension. However, severe clinical manifestations of aortic regurgitation and coronary insufficiency are much less common. The authors report a case in which post-infarction angina and severe left ventricular failure led to a double valve replacement and an aorto-right coronary bypass graft procedure. The diagnosis of Takayasu's disease was suspected before surgery and was confirmed by histological examination.

Aortic Valve Insufficiency↗
PubMed1992

Immunomodulatory effects of AS101 on interleukin-2 production and T-lymphocyte function of lymphocytes treated with psoralens and ultraviolet A.

This study tested the immunomodulatory effects of AS101, a synthetic organotellurium compound, on interleukin (IL-2) production and functional activity of normal human lymphocytes. Normal human lymphocytes were treated in vitro with 8-methoxypsoralen alone, ultraviolet A (UVA) and psoralen plus UVA (PUVA) as well as with a combination of AS101 + phytohaemagglutinin (PHA)+phorbol myristate acetate (PMA) and the above-mentioned treatments. Following treatment IL-2 production, free IL-2 receptor (IL-2R), the ability of lymphocytes to induce a local graft-versus-host reaction (GVHR) and the ability of separated CD4 cells to induce help were tested. 8-Methoxypsoralen alone did not significantly affect either cell proliferation or IL-2 production or functional activity. However, UVA and PUVA had a high inhibitory effect on cell proliferation, IL-2 production, IL-2R release and the functional activity of T- and T-helper lymphocytes. In the present study, the addition of AS101 and PMA serve to restore the impaired IL-2 production, T- and T-helper lymphocyte functional activity, but not the IL-2R release. AS101 alone without PMA was also effective in restoring GVHR and helper activity of CD4 lymphocytes, without affecting cell proliferation.

Adjuvants, Immunologic↗
PubMed1992

[Post-traumatic aortic valve insufficiencies].

Aortic regurgitation due to closed chest trauma is rare. It is related either to a valve lesion itself (ruptured cusp) or to trauma of the ascending aorta (subadventitial rupture with prolapse of the underlying aortic valve cusp). Four cases are described, 2 men and 2 women aged 30 to 66 years, after severe injuries in road traffic accidents: three patients had rupture of the aorta and the other had isolated rupture of the non-coronary aortic valve cusp. This pathology is unique due to the pathogenic mechanism associated with multiple thoracic injuries (right costal flap, sternal fracture, pulmonary contusion ...). The polytraumatic context explains the diagnostic difficulties and the secondary importance of the valve problem. Late surgery of these lesions was conservative in 3 cases: valve replacement was necessary in 1 case. If the haemodynamic tolerance of the aortic regurgitation is good, surgery should be deferred until the polytraumatic emergency has been dealt with. Good surgical results, often with conservative procedures, encourage earl operation after the acute polytraumatic period.

Adult↗
PubMed1992

[Familial Mediterranean fever and electroencephalographic changes. A clinical case].

The Authors describe the case of a non-Hebrew Italian girl suffering from short-lasting fever episodes, associated with abdominal colic, since the age of 3. The occurrence of acute arthrosynovitis during the last episode, at 12 years of age, clinically confirms the diagnosis of familial mediterranean fever, as previously supposed. The increase in urinary coproporphyrins, with normal values of delta-aminolevulinic acid and porphobilinogen poses the problem of the differential diagnosis between hereditary coproporphyria and secondary coproporphinuria. The importance of this case lies in the presence of electroencephalographic alteration since the first years of life, suggesting a temporal epilepsy for which the patient was at length submitted to anti-epileptic treatment. Electroencephalographic alterations, of different type and uneasy interpretation, are described in the literature with a frequency which does not seem accidental. Renal biopsy does not show amyloid, nor the RMN reveals cerebral abnormalities. The anti-epileptic therapy being withdrawn, the patient was treated with daily administrations of colchicine (1 mg/die); 18 months after, she is disease free.

Biochemical Phenomena↗
PubMed1992

[Eduard Arnold Martin (1809-1875)--founder of the Berlin Gynecologic Society. A contribution to the history of the Berlin Society of Obstetrics and Gynecology. II].

In 1844 the society of obstetrics in Berlin was founded by Carl Mayer (1795-1868). In 1873 this society splits in the society of obstetrics and the society of gynaecology. The present paper demonstrate the biography of Eduard Arnold Martin (1809-1875), the founder of the gynaecological society in Berlin (1873) and also his importance in the creation of an modern gynaecology.

Berlin↗
PubMed1992

Immunologic abnormalities associated with primary anetoderma.

BACKGROUND AND DESIGN: Primary anetoderma is a rare cutaneous elastolytic disorder, the etiopathogenesis of which has not yet been established. Six patients with primary anetoderma were studied in an attempt to assess the role of the immunologic system in the elastolytic process. The investigation included the medical history, physical examination, routine blood tests, specific tests for collagen diseases, prothrombin time, activated partial thromboplastin time, thyroxine, indirect immunofluorescence test, and skin biopsies for histopathologic study and direct immunofluorescence. RESULTS: Two of the patients presented with autoimmune disorders: the first had Graves' disease, lupus anticoagulant, and autoimmune hemolysis, and the second had systemic scleroderma. There were positive direct immunofluorescence findings in most of the patients. Furthermore, all of them were found to have serologic immunologic abnormalities, of which the most common was a positive antinuclear factor. CONCLUSIONS: These findings indicate that there is an immunologic involvement in primary anetoderma.

Adult↗
PubMed1992

The association between unexplained second-trimester maternal serum hCG elevation and pregnancy complications.

OBJECTIVE: We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 16-20 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. METHODS: The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.5 multiples of the median (MOM). The exclusion criteria were fetal anomalies, an abnormal karyotype, and a maternal serum alpha-fetoprotein (MSAFP) level greater than 2.5 MOM. A group of randomly selected women with normal hCG and MSAFP levels served as controls. RESULTS: Of the 6011 women screened, 284 (4.7%) had an unexplained elevated hCG level. Patients with elevated levels of hCG had a significantly higher risk for hypertension (odds ratio 4.4; 95% confidence interval [CI] 1.9-10) and fetal growth restriction (odds ratio 2.8; 95% CI 1-7). Women with hCG levels greater than 4 MOM also had an increased risk of preterm delivery (odds ratio 3.3; 95% CI 1.3-8.2). CONCLUSION: Pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies and managed accordingly.

Chorionic Gonadotropin↗
PubMed1991

Circumscribed scleroderma induced by postlumpectomy radiation therapy.

A 57-year-old woman who had undergone a lumpectomy for infiltrating duct cell carcinoma of the right breast was found to have morphea after receiving radiation therapy. The morphea occurred at the site of the irradiated field. It is suggested that the irradiation served as a provoking factor and that the morphea might be an isomorphic response to the trauma of the irradiation.

Breast Neoplasms↗
PubMed1991

Lupus anticoagulants, anticardiolipin antibodies, and fetal loss. A case-control study.

BACKGROUND: Lupus anticoagulants and anticardiolipin antibodies are antiphospholipid antibodies that have been associated with fetal loss, but they have not been shown unequivocally to be a risk factor for this event. METHODS: To estimate the risk of fetal loss in association with these antibodies, we conducted a hospital-based case-control study of 331 women with spontaneous abortion or fetal death (case patients) and 993 controls. The subjects were included in the study only if they reported that they had had no previous spontaneous fetal loss. Each control was a pregnant woman who, in the same period of pregnancy as a case patient, had not had a fetal loss. Lupus anticoagulants were identified in blood samples through a series of coagulation tests, and IgG anticardiolipins by an enzyme-linked immunosorbent assay. Each subject was interviewed in person to obtain information on potential confounding variables, such as sociodemographic characteristics and medical conditions. RESULTS: Lupus anticoagulants were found in blood from 17 case patients (5.1 percent) and 38 controls (3.8 percent). The crude odds ratio for the association between lupus anticoagulants and fetal loss was 1.36 (95 percent confidence interval, 0.75 to 2.43); the odds ratio adjusted for confounders was 1.42 (95 percent confidence interval, 0.72 to 2.80). An IgG anticardiolipin level of 5 units or more was found in 4 case patients (1.2 percent) and 15 controls (1.5 percent). The crude and adjusted odds ratios for fetal loss were 0.80 (95 percent confidence interval, 0.26 to 2.41) and 1.28 (95 percent confidence interval, 0.38 to 4.21), respectively. CONCLUSIONS: There is not apparent justification for considering lupus anticoagulants or IgG anticardiolipins to be risk factors for fetal loss among women who present with spontaneous abortion or fetal death and have had no previous spontaneous fetal loss.

Abortion, Spontaneous↗
PubMed1991

Analysis of risk factors for surgical wound infections following vascular surgery.

Although surgical wound infections (SWI) following implantation of prosthetic devices can be catastrophic and often require removal of the prosthesis, few studies have identified risk factors for these infections. We conducted a prospective multicenter study to identify risk factors for SWI. Of 561 vascular surgery patients enrolled in the study, 23 (4.1%) developed SWI. Multivariate analysis using logistic regression analyses identified surgery on lower extremities, delayed surgery, diabetes mellitus, past history of vascular surgery, and short antimicrobial prophylaxis (three doses of cefamandole) as independent risk factors for SWI. Consequences of SWI were serious; two (9%) died, 11 (48%) required reoperation, and five (22%) had their prosthesis removed. A risk index was developed using the independent risk factors for SWI identified by logistic regression analyses. When no risk factors were present, no SWI was observed (0 of 100), and the rate of SWI increased from 2.5% when one risk factor was present to 53.8% (7 of 13) when greater than or equal to 4 risk factors were present.

Cefamandole↗
PubMed1991

Citrate synthase from Mycobacterium smegmatis. Cloning, sequence determination and expression in Escherichia coli.

A Mycobacterium smegmatis PstI library was constructed by cloning these fragments downstream from the lac promoter of the expression vector pHG171. Three identically sized clones were isolated by complementation of an Escherichia coli strain (chi 2338) deficient in citrate synthase. One insert (pBL265) was used in hybridization experiments with DNA from E. coli and M. smegmatis and it was demonstrated that the clones were indeed from M. smegmatis. The transcription of the M. smegmatis citrate synthase gene in E. coli relied upon the lac promoter. In translation experiments performed in vitro pBL265 gave rise to a novel protein of about 42 kDa. This band was not seen in 'opposite-orientation' subclones. Various subclones in which the 5'-end was shortened nevertheless complement E. coli chi 2338 and produce the 42 kDa protein. This demonstrates that the M. smegmatis citrate synthase gene uses its own ribosome-binding site in E. coli. The relevant 1.8 kb of the 2.8 kb insert was sequenced. A consensus E. coli ribosome-binding site was found centred precisely 10 bp upstream of the methionine codon. Other interesting features revealed by the sequence are discussed. Citrate synthase activity was assayed in vitro and the mycobacterial enzyme was found to be similar to those of the Gram-positive bacteria.

Amino Acid Sequence↗
PubMed1991

Human vascular graft failure and frequency of infection.

Among 212 vascular prostheses collected in a vascular explant retrieval program, 50 exhibited one or more criteria of graft infection i.e., (a) clinical evidence of graft infection, (b) positive bacteriological analyses of the graft, and (c) presence at the blood-prosthetic interface of characterized microorganisms. Whereas each of these criteria was noted respectively in 25, 26, and 20 cases, there was no complete overlapping among the three criteria, but their combination led us to consider 50 cases of infected vascular grafts among the 212 collected. These results, and the occurrence in two cases among six investigations for viral infection, suggest that extensive bacteriological investigations of vascular explants should be included in an implant retrieval program, and that infection may represent a high risk in graft failure.

Aneurysm↗
PubMed1991

Esophageal involvement in pemphigus vulgaris: a clinical, histologic, and immunopathologic study.

Eleven newly diagnosed patients and one patient with pemphigus vulgaris who relapsed underwent endoscopy of the upper gastrointestinal tract. Three patients had blisters or erosions and two had longitudinal lines of erythema in the esophageal mucosa. In four patients histopathologic examination showed findings of pemphigus vulgaris but direct immunofluorescence was positive in all patients. This study demonstrates that the immunopathologic disturbance in pemphigus vulgaris involves the entire length of the esophagus, although only some patients have clinical or histologic involvement. To the best of our knowledge this is the first histopathologic and direct immunofluorescence study of esophageal involvement in patients with untreated pemphigus vulgaris.

Adult↗