PubMed Health⌕ Search

Biomedical subjects

P Brasseur

Publications and source records attributed to P Brasseur.

At least 19 recordsLinked to original sources
PubMed2006

The silent sinus syndrome.

Silent sinus syndrome is a rare clinical entity typically characterized by spontaneous and progressive enophthalmos and hypoglobus caused by an alteration of the normal orbital architecture and function from maxillary collapse in the setting of the chronic maxillary sinus hypoventilation. The authors report an unusual case revealed by mild dental pain, present the imaging (before, during and after the development of the disease), discuss the different theories related to pathogenesis and comment the treatment.

Animals↗
PubMed2006

[Malignant peripheral nerve sheath tumor in the posterior mediastinum].

We report the case of a 52-year-old male patient who developed a malignant peripheral nerve sheath tumor (MPNST) localized in the posterior mediastinum. The diagnosis of this rare tumor is difficult because the clinical presentation of the benign or malignant types is often similar, i.e. elective pain and bone erosions. Similarly, radiological procedures do not always allow distinction between the two types. MNR and CT-scan are the first line procedures: they localize and characterize the lesions, and CT-scan can also be a guide for biopsies. Histological diagnosis is required, but diagnosis can be compromised by the heterogeneous nature of the tumor. Surgical treatment should be undertaken whenever possible. Survival was unusually long in our patient, more than 5 years after discovery of the MPNST. This type of sarcoma is often very aggressive with frequent development of local recurrences and metastases.

Diagnosis, Differential↗
PubMed2006

Plasmodium falciparum in vitro susceptibility to antimalarial drugs in Casamance (southwestern Senegal) during the first 5 years of routine use of artesunate-amodiaquine.

We have monitored the in vitro sensitivities of Plasmodium falciparum isolates predeployment and during the deployment of artesunate plus amodiaquine treatment in Mlomp, Casamance (southwestern Senegal) during 2000 to 2004. Parasites remained susceptible to both drugs. Chloroquine resistance levels were high but stable. Quinine continues to be effective.

Amodiaquine↗
PubMed2006

[Treatment of pediatric malaria in Africa: act at issue].

Artemisinin-based combination therapies (ACT) have been proposed as alternatives to currently used antimalarials and are poised large-scale deployment in Africa. These combinations are particularly attractive for managing malaria in children. Expected benefits of ACT include enhanced efficacy, rapid action, stabilized antimalarial resistance growth and lower malaria transmission. This article discusses what can be reasonably expected of ACT in an African setting with emphasis on patient comfort.

Antimalarials↗
PubMed2005

Economic evaluation of a policy change from single-agent treatment for suspected malaria to artesunate-amodiaquine for microscopically confirmed uncomplicated falciparum malaria in the Oussouye District of south-western Senegal.

Senegal is changing policy for case management of uncomplicated falciparum malaria, which hitherto is diagnosed clinically and treated with chloroquine or intramuscular quinine. The WHO recommends artemisinin-based combinations for treating falciparum malaria, preferably based on a parasitological diagnosis. There are no economic projections if such a policy were introduced in Senegal. We have conducted a preliminary economic assessment of such a policy change. The study took place in the chloroquine-resistant district of Oussouye in south-western Senegal. We reviewed clinic registers of the district health posts (n=5) from 1996 to 2001, and piloted artesunate combined with amodiaquine (at 4 and 10 mg/kg/day x 3 days respectively) (AS--AQ) for treating slide-proven falciparum malaria during two rainy seasons (2000 and 2001) at one health centre. These data were used to calculate current direct patient costs (clinic visit, diagnosis, drugs) of malaria treatment and project future costs for the district. The robustness of the model was tested by allowing for different drug failure rates and costs of diagnosis. During 1996--2001, the mean number of primary treatments per year was 7654 for a mean, direct cost of 17,452 US dollars to the community. Clinical diagnosis resulted in over-treatment: 56% and 66% in the wet and dry seasons respectively. Current policy leads to substantial drug wastage and excess direct costs for the community. The direct costs of implementing AS-AQ for slide-proven malaria would be 8,150 US dollars (53% less expensive). Studies examining the public health effect and economics of deploying AS--AQ on a wider scale are underway in Senegal.

Adolescent↗
PubMed2005

[In vitro evaluation of the sensitivity of Plasmodium falciparum to chloroquine using the deli-microtest in region of Dakar, Senegal].

This study was carried out between 2000 and 2001 in the peri-urban Pikine area located 15 km from Dakar, Senegal. The purpose was to evaluate the in vitro sensitivity of Plasmodium falciparum isolates to chloroquine, which was the recommended first-line drug for uncomplicated malaria treatment in Senegal. Testing was carried out using the double-site enzyme-linked lactate dehydrogenase imnunosorbent (DELI) microtest. The DELI-microtest is an ELISA method using 2 monoclonal antibodies against 2 antigenic sites of the specific P. falciparum lactate dehydrogenase (LDH) enzyme. The level of LDH is proportional to the extent of parasite growth. P. falciparum isolates were cultured in 96-well plates in RPMI 1640 medium supplemented with hypoxanthine and albumax, in the presence of chloroquine sulphate concentrations ranging from 5.6 nM/L to 2870.8 nM/L. Plates were incubated in a candle-jar for 48 hours at 37 degrees C and frozen at -20 degrees C. The DELI-microtest was performed using the supernatant of hemolysed cultures. The amount of pLDH released was evaluated based on optical density. The chloroquine sensitivity of the isolate was estimated based on IC50 with a cut-off of <100 nM/L. Geometric mean IC50 values were 41 nM/L (range: 4.8 nM/L to 1435 nM/L) and 135 nM/L (range: 8.63 nM/L to 2153 nM/L) in 2000 and 2001 respectively. This study demonstrated a dramatic increase in the in vitro resistance of P. falciparum to chloroquine from 30% in 2000 to 59.6% in 2001. These findings suggest that regular surveillance of in vitro drug resistance is important to predict in vivo drug resistance and allow timely changes in public health recommendations.

Animals↗
PubMed2004

Kinetics of spleen and Peyer's patch lymphocyte populations during gut parasite clearing in Cryptosporidium parvum infected suckling mice.

Data from experimental and human cryptosporidiosis have established a major role of specific immunity in the control of Cryptosporidium parvum infection. In this work, alterations in spleen and Peyer's patch (Pp) lymphocytes were investigated in the course of a spontaneously resolutive gut cryptosporidiosis in four-day-old suckling NMRI mice infected with either 4 x 10(5) or 30 viable oocysts. Oocysts from entire small intestines, and spleen and Pp lymphocytes were examined using flow cytometry from day 7 to day 27 post-infection. Compared to uninfected animals, a 3-5 fold increase in the numbers of spleen TCR alphabeta+, CD4+, CD8+, TCR gammadelta+ and CD45R/B220+ lymphocytes was observed on day 17 post-infection in heavily infected animals. In Pp, more than ten-fold increases were observed, except for TCR gammadelta+ lymphocytes. At termination of infection, i.e. on days 21-23 after ingestion of 4 x 105 oocysts, T and B lymphocytes decreased rapidly in both organs, and remained lower than in uninfected animals on days 19-23 post-infection. In mice infected with 30 oocysts, similar alterations were observed in Pp, but not in spleen. Data suggest that in normally developing mice, clearance of gut C. parvum infection is associated with an initial increase in systemic and local lymphocyte numbers, followed by their decrease to below control levels during the recovery phase.

Animals↗
PubMed2004

[Tuberculous sacroiliitis: report of a case].

Our case concerns a 32-year old Cameroonian male presenting with tuberculous sacroiliitis. Diagnosis was made on the basis of a positive abscess needle aspirate. Tuberculous sacroiliitis is rare and generally an isolated phenomenon. Its insidious presentation leads to delayed diagnosis. The affection is often overlooked due to lack of awareness of the clinicians, the usually good condition of the patient and minimal signs of sacroiliac joint infection. Haematological data are frequently non contributory. High risk groups include developing countries immigrants, immunodepressed patients and low socioeconomic status. Accurate diagnosis is based on percutaneous synovial fluid or abscess aspirate bacteriology. CT-scan and NMR are the most helpful radiological examinations.

Adult↗
PubMed2004

[Gallstone ileus. Abdominal CT usefulness].

The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.

Aged↗
PubMed2003

Pulmonary nodular lesions in a 70-year-old man.

Bronchiolitis obliterans organizing pneumonia (BOOP) is an uncommon but increasingly recognized clinicopathologic syndrome. This report illustrates a proteiform clinical presentation of BOOP in a 70-year-old patient with cough, low-grade fever, weight loss, and hemoptysis. Chest radiograph and computed tomography (CT scan) showed nodular lesions. A video-assisted thoracoscopic procedure for biopsy of the largest nodule was performed at the end of an extensive work-up. A diagnosis of BOOP was established and, because of persistent symptomatology, corticosteroid therapy was initiated. This observation illustrates that the clinical and radiological findings of BOOP are non-specific and can sometimes mimic primary and/or secondary pulmonary malignancies.

Journal Article↗
PubMed2003

[Fournier's gangrene: emergency diagnosis].

We present one case of Fournier's gangrene in a 56-year alcoholic patient. The source of infection was an anal fistula. Prompt diagnosis was based on CT and ultrasonography of the pelvis. An orchidectomy was performed because of testicular involvement. Fournier's gangrene is an emergency that requires early recognition to ensure therapeutic success. Treatment involves aggressive surgical debridement, broad spectrum antibiotic therapy and haemodynamic stabilization. Hyperbaric oxygen therapy may be helpful.

Emergencies↗
PubMed2003

[Pulmonary and hepatic arteriovenous malformations in a case of Rendu-Osler disease].

The authors report one case of Rendu-Osler disease in a 59-year-old woman presenting with pulmonary and hepatic arteriovenous malformations. She suffered from high-output heart failure due to a left-to-right intrahepatic shunt. Diagnosis and treatment by coil embolization of pulmonary and hepatic fistulas were performed by radiological techniques. Pulmonary shunting can produce severe neurologic complications. The disease is hereditary and progressive. Follow-up of treated patients and family screening are recommended.

Angiography↗
PubMed2003

[Subcutaneous emphysema in a borderline patient].

This report concerns a 31-year-old woman. It is an intricate case including bilateral self-induced pneumoparotitis, cervical and facial subcutaneous emphysema and limited pneumomediastinum. Besides, this borderline patient simulated asthma attacks. The clinical picture was characteristic of Munchausen's syndrome with multiple hospitalisations in various hospitals, automutilations and intentional production of physical symptoms. The diagnosis and the treatment are discussed.

Adult↗
PubMed2002

Amodiaquine-artesunate versus amodiaquine for uncomplicated Plasmodium falciparum malaria in African children: a randomised, multicentre trial.

BACKGROUND: Increasing drug resistance limits the choice of efficacious chemotherapy against Plasmodium falciparum malaria in Africa. Amodiaquine still retains efficacy against P falciparum in many African countries. We assessed the safety, treatment efficacy, and effect on gametocyte carriage of adding artesunate to amodiaquine in three randomised trials in Kenya, Sénégal, and Gabon. METHODS: We enrolled 941 children (400 in Kenya, 321 in Sénégal, and 220 in Gabon) who were 10 years or older and who had uncomplicated P falciparum malaria. Patients were randomly assigned amodiaquine (10 mg/kg per day for 3 days) plus artesunate (4 mg/kg per day for 3 days) or amodiaquine (as above) and placebo (for 3 days). The primary endpoints were parasitological cure rates at days 14 and 28. Analysis was by intention to treat and by an evaluability method. FINDINGS: Both regimens were well tolerated. Six patients in the amodiaquine-artesunate group and five in the amodiaquine group developed early, drug-induced vomiting, necessitating alternative treatment. By intention-to-treat analysis, the day-14 cure rates for amodiaquine-artesunate versus amodiaquine were: 175/192 (91%) versus 140/188 (74%) in Kenya (D=16.7% [95% CI 9.3-24.1], p<0.0001), 148/160 (93%) versus 147/157 (94%) in Sénégal (-1.1% [-6.7 to 4.5], p=0.7), and 92/94 (98%) versus 86/96 (90%) in Gabon (8.3% [1.5-15.1], p=0.02). The corresponding rates for day 28 were: 123/180 (68%) versus 75/183 (41%) in Kenya (27.3% [17.5-37.2], p<0.0001), 130/159 (82%) versus 123/156 (79%) in Sénégal (2.9% [-5.9 to 11.7], p=0.5), and 80/94 (85%) versus 70/98 (71%) in Gabon (13.7% [2.2-25.2], p=0.02). Similar rates were obtained by evaluability analysis. INTERPRETATION: The combination of artesunate and amodiaquine improved treatment efficacy in Gabon and Kenya, and was equivalent in Sénégal. Amodiaquine-artesunate is a potential combination for use in Africa. Further investigations to assess the potential effect on the evolution of drug resistance, disease transmission, and safety of amodiaquine-artesunate are warranted.

Amodiaquine↗