Biomedical subjects

P Bernet-Bernady

Publications and source records attributed to P Bernet-Bernady.

7 recordsLinked to original sources

PubMed2000

[Case study of 199 patients with multiple sclerosis: the use of EDMUS program].

European Database Multiple Sclerosis (EDMUS) is a standardized tool which allows the collection of clinical, biological, radiological and therapeutic data on multiple sclerosis (MS). A descriptive analysis of 199 patients was done using EDMUS (version 2.2). Most data agreed with previous published results, except a low 0.4 sex ratio. At the beginning of MS, 42 p. 100 of MS patients developed pyramidal and sensory involvements and 14 p. 100 retrobulbar optic neuritis. Optic neuritis was the most frequent initial symptom of relapsing-remitting MS (25.9 p. 100) but not in the chronic progressive form (5.5 p, 100; p < 0.01). Surprisingly, relapsing-remitting form occurred more frequently whereas the secondary progressive form was diagnosed less. The concordances between the three disability scales, EGS (EDMUS Grading Scale), EDSS (Expanded Disability Status Score) and AI (Hauser Ambulation Index) were correct. In clinical practice, EDMUS is user-friendly and rapid. The lack of radiological data and the necessary quantification of only one disability scale, EGS may be too restrictive. The analysis of most of clinical data is possible by using integrated selection within the software, but sometimes needs more complex procedures.

Databases as Topic↗

PubMed2000

[Interest of a computerized ALS database in the diagnosis and follow-up of patients with ALS].

The aim of the study is to present a computerized database of the Neurology department of Limoges University Hospital and the main results obtained from data of 340 patients suffering from amyotrophic lateral sclerosis (ALS), diagnosed between 1984 and 1997. It is a user friendly and can be accessed by all neurologists at any level of computer knowledge. This database is modular (6 modules) and flexible according to need. The software used, Access 7, is an open relation database, which allows export of data to statistical or other compatible software. One of the reasons, which led to the elaboration of this database was to develop a means of collecting data in an analyzable manner for therapeutic trials. During these trials, a great number of data can be collected during each clinic visit for the evaluation of the degree of impairment, disability, and handicap. We present part of the data from the patients followed, some of whom were treated with riluzole, the current reference molecule for ALS.

Aged↗

PubMed1999

Onchocerciasis and epilepsy: a matched case-control study in the Central African Republic.

The occurrence of epileptic seizures during onchocercal infestation has been suspected. Epidemiologic studies are necessary to confirm the relation between onchocerciasis and epilepsy. A matched case-control study was conducted in dispensaries of three northwestern towns of the Central African Republic. Each epileptic case was matched against two nonepileptic controls on the six criteria of sex, age (+/-5 years), residence, treatment with ivermectin, date of last ivermectin dose, and the number of ivermectin doses. Onchocerciasis was defined as at least one microfilaria observed in iliac crest skin snip biopsy. A total of 561 subjects (187 cases and 374 controls) were included in the study. Of the epileptics, 39.6% had onchocerciasis, as did 35.8% of the controls. The mean dermal microfilarial load was 26 microfilariae per mg of skin (standard deviation, 42) in the epileptics and 24 microfilariae per mg of skin (standard deviation, 48) in the controls. This matched case-control study found some relation (odds ratio = 1.21, 95% confidence interval 0.81-1.80), although it was nonstatistically significant.

Adolescent↗

PubMed1999

[Cerebral miliary granulomatosis with Histoplasma capsulatum in an HIV seronegative patient].

A 51 year old patient who worked in Africa for eight years, presented twelve years later a progressive ataxia associated with headaches. Neuroimaging studies done after a partial complex seizure demonstrated multiple supra and sub-tentorial cortical ring enhancing lesions. Histoplasma capsulatum histoplasmosis was found on histological examination of brain biopsy and confirmed by isolation of the fungus. Medical treatment with intravenous amphotericin B followed by oral itraconazole (400 mg per day) improved both clinical and radiological status. This observation of cerebral histoplasmosis is rather unusual for a seronegative HIV patient in a non endemic area.

Amphotericin B↗

PubMed1998

[Lead intoxication and amyotrophic lateral sclerosis].

A seventy-six-year-old patient developed a bulbar form of amyotrophic lateral sclerosis, after chronic lead intoxication from drinking water. Treatment with 2,3 dimercaptosuccinic acid was administered for six months and had no effect on clinical course. We discuss the imputability of lead as a possible etiological factor.

Aged↗

PubMed1997

[Epilepsy and its impact in northwest region of the Central African Republic].

In African countries, epilepsy is an important public health problem with major medical, socio-cultural, and economic implications. This study was carried out to evaluate attitudes towards epilepsy in the Central African Republic. A total of 187 epileptic patients were included. Only 20.9% of the study population were married. School attendance never exceeded the elementary level. Epilepsy was active in 98.4% of patients who continued to present attacks despite extensive treatment which was either poorly complied with or inadequate. Attitudes towards epilepsy remain rooted in belief in supernatural phenomenon and evil spirits with use of traditional therapies involving abstinence from certain foods and use of laxative agents to drive out evil forces. Epileptics are excluded from their families and not allowed to attend school but, in our study, they were not prevented from the work place since 70% held jobs. In this study, 54% of epileptics believed that the disease was contagious, 55.6% that it was incurable, and 20.9% that it was due occult or supernatural causes. While precise quantification is impossible, our experience based on interviews with patients and frequent observation of burn wounds suggests that moral and physical suffering is immense among epileptics in the Central African Republic. Epilepsy in Black Africa is a major public health problem requiring serious attention from government officials, health care specialists, and the families of patients. Better information to promote awareness of the non-contagious nature of the disease, greater support for families of patients, and improvement in treatment compliance are essential.

Adolescent↗

PubMed1996

Survival prediction in sporadic amyotrophic lateral sclerosis. Age and clinical form at onset are independent risk factors.

Amyotrophic lateral sclerosis is a progressive neurological disease of unknown etiology and fatal outcome. Patient management can be aided by careful assessment of prognostic factors. A prospective study of 158 patients was carried out to examine the prognostic significance of age and clinical form at onset. The overall 5-year survival rate was 14.7%. The higher the age was at first symptoms, the worse the prognosis. The bulbar and common forms had a worse prognosis than the pseudo-polyneuritic forms. After adjustment for age, the clinical form at onset remained a prognostic factor. In a multivariate analysis using the Cox model, these two factors remained independent despite the later onset of the bulbar forms. In view of the discrepancies between the different published studies, the evaluation of the survival of an individual patient is of doubtful value.

Age of Onset↗