Low prevalence of HTLV-1 antibodies in the serum of patients with tropical spastic paraplegia from the Ivory Coast.
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Biomedical subjects
Publications and source records attributed to M Verdier.
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Screening for human immunodeficiency viruses types 1 and 2 (HIV-1 and HIV-2) antibodies was carried out in the serum of 1,245 leprous patients and 5,731 controls selected in nine different centers from the Congo, Ivory Coast, Senegal, and Yemen Arab Republic. In Yemen, all sera were negative. In the Congo, the seropositivity among patients and controls was, respectively, 3.8 and 5.2%; in Senegal, it was 1.3 and 0.6%; and in the Ivory Coast 4.8 and 3.9%. Differences were not statistically significant, even considering lepromatous or tuberculoid forms (3.6% and 3.7%, respectively). HIV-2 antibodies were only detected in subjects from the Ivory Coast and Senegal. Using appropriate criteria for seropositivity (confirmation by Western blot, reactivity to HIV envelope glycoproteins) and a large selection of patients (several countries with several centers), it appears that leprosy (and specially the lepromatous form) is not a factor for HIV infection.
A large cross-sectional serologic survey for human T cell leukemia virus type 1 (HTLV-1) antibody was conducted in 3,177 Ivory Coast residents to evaluate the prevalence of HTLV-1 and to determine possible risk factors and correlates of HTLV-1 infection. Of the 3,177 serum samples, 110 (3.5%) were positive for antibody to HTLV-1 by indirect immunofluorescence assay and Western blot. The prevalence of HTLV-1 antibody in the general adult population was 1.8% and increased significantly with age. No difference between males (1.5%) and females (2%) was found. The highest prevalences were observed in female prostitutes (7.4%), patients with neurologic syndromes (5.8%), and lepers (13.7%). The high prevalence of HTLV-1 infection in prostitutes suggests that heterosexual contact is involved in the transmission of HTLV-1 and that prostitutes could play an important role in the spread of the virus in Africa. The high prevalence of HTLV-1 in patients with neurologic syndromes confirms the association between HTLV-1 and some type of neuropathies, as has been observed in the West Indies and Japan. The high prevalence observed in lepers deserves further investigation to find the cause of the association. Twenty-five individuals, including prostitutes, were coinfected with HTLV-1 and human immunodeficiency virus (HIV). Prospective studies are necessary to evaluate the exact role of HTLV-1 alone or in combination with HIV in inducing specific diseases.
Chlamydial serum antibodies were screened in more than 1,000 persons by immunofluorescence test. C. trachomatis antibodies (greater than or equal to 1/16 for males, greater than or equal to 1/64 for females) were found more frequently in risk group (prostitutes: 64.7%, prisoners: 64.0%) than in control groups (pregnant women: 18.8%, children: 6.6%). The presence of antibodies to C. trachomatis was correlated with presence of T. pallidum and HIV antibodies.
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Leiomyoma of the kidney is a rare tumor, for which little investigational imaging data is available, and which is poorly characterized by histological methods. We are here concerned with one case that benefitted from an extensive radiological workup, and we provide a comparison with other cases mentioned in the literature.
Loratadine is a long-acting H1 antagonist devoid of anticholinergic and sedative effects. A double-blind, placebo-controlled, parallel-group study was performed in 69 patients to compare efficacy and safety of loratadine and mequitazine. Patients allergic to grass pollens were randomly assigned to one of the three treatment groups and followed up to 2 weeks during the peak of the pollen season. Symptoms of allergic rhinitis were evaluated at baseline and after 3, 7, and 14 days of treatment by the physician with patients rating their response daily on diary cards. Both loratadine and mequitazine induced a significant relief of nasal symptoms when these were compared to placebo. Loratadine was found to be significantly superior to placebo after 3 days of treatment, whereas a significant improvement was only observed after 7 days in patients treated with mequitazine. For nonnasal symptoms, none of the two anti-H1 antagonist induced a significant improvement, and this lack of effect may be related to low symptoms at baseline. Loratadine did not induce more side effects than placebo. Loratadine can be considered to be an effective and safe anti H1 histamine with a rapid onset of action.
The efficacies of nine enzyme-linked immunosorbent assays (EIA) for antibody to human immunodeficiency virus type 1 (HIV-1) and one EIA for antibody to HIV-2 in detecting antibody to HIV-2 were studied. The competitive EIAs for antibody to HIV-1 were less sensitive than the indirect EIAs. The overall prevalence of positive results was between 28 and 51% with the competitive EIAs and between 70 and 93% with the indirect EIAs. Most of the EIAs were less sensitive in detecting antibody to HIV-2 in sera from people with acquired immunodeficiency syndrome-like diseases than in sera from symptomless individuals. The results indicate that there is a high degree of cross-reactivity between HIV-1 and HIV-2 by EIA, indicating that serotype specificity must be determined by Western blot (immunoblot) with both sets of viral antigens. The results are relevant for discussing public health strategies, especially the screening of blood donors; competitive EIAs for antibody to HIV-1 are not sensitive enough to be used in areas where HIV-2 is prevalent (West Africa).
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The authors report the case of a 28 year old man with Stage III E Hodgkin's disease presenting with massive upper oesophageal involvement with cervical and mediastinal lymphadenopathy. The diagnosis was confirmed by lymph node and endoscopic biopsies (mixed cellularity). A complete remission was obtained by chemotherapy (ABVD) followed by extended radiotherapy. Then other cases have been previously reported. Upper oesophageal involvement with mediastinal lymphadenopathy often occurring in young patients raises the differential diagnosis of a carcinoma. The efficacy of chemotherapy of first intention is underlined.
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Marked prognostic differences exist between the two cutaneous lesions: squamous cell epithelioma and keratoacanthoma. The former may affect the vital prognosis while the latter usually heals spontaneously. Early diagnosis is therefore of the utmost importance, but clinico-pathologic discordances can exist when a first intention partial biopsy does not provide histologic data essential for diagnosis, or as a result of misleading clinical forms. Wide excision of these lesions is therefore an immediate necessity.
The authors report the case of an IgA secreting multiple myeloma which, after a rapid initial remission, relapsed with skin, thyroid, testis and lung metastases without bone recurrence. A review of the medical literature on this subject underlines the poorly differentiated microscopic appearance and the low secretion of paraprotein of these extraosseous plasmacytic tumours which have a poor prognosis due to their increased malignancy.
Oriental Sore is the dry cutaneous form of leishmaniasis, a parasitic infection common to man and to certain vertebrates and transmitted by insects: the phlebotomes. This benign tropical disease exists in South East France where it remains very rare, human contamination always being accidental. The lesions, single or multiple, affect the skin only. On the face, the differential diagnosis arises with other much commoner cutaneous lesions (impetigo, etc.). They consist, after 2 to 4 months of incubation, of a rounded erythematous papule, neither pruritic nor painful, which becomes secondarily excavated to produce a crusted ulcer. This lesion, typical at this stage, then persists for many months before an unsightly scar develops. Treatment is local: surgical excision offering the possibility of histological examination and hence a diagnosis. Plastic surgery may be used to correct scars in advanced forms.
Anterior open-bites may be skeletal, alveolar or mixed. The infra-alveolae is always due to a postural or functional muscular cause and the clinical examination plays an important part in the diagnosis. Delaire's cephalometric analysis can define the type of infra-alveolae. In view of their aetiology, the infra-alveolae require functional re-education, although glossectomy and multiple bands therapy may also be useful.
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Suppurated maxillary sinusitis are frequent diseases. Diameatic puncture allows bacteriological investigations. Our results are positive in two thirds of cases. The bacterial flora is very varied, whose identification and antibiograms involve efficient treatment with daily washing and in situ antibiotherapy.
The treatment of maxillo-mandibular dysmorphies, which involves both surgery and orthodontics, depends on a precise diagnosis and tactical strategies based on simulations of treatment using teleradiography, telephotography and impressions. These measures are essential in order to obtain a stable, good quality result in terms of occlusion and the dental, pariodontal and skeletal aspects.