PubMed Health⌕ Search

Biomedical subjects

P Chevallier

Publications and source records attributed to P Chevallier.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Cost of acute hepatitis A in adults in France].

OBJECTIVES: Seroprophylaxy against hepatitis A has been limited to subjects visiting endemic areas or in contact with acutely infected patients due to the short half-life and high cost of the non-specific immunoglobulins. Inactivated vaccines might offer a better solution, but the real cost factors remain unknown. We undertook this study to determine the cost of acute hepatitis A. METHODS: Serum samples from all the non-hospital medical laboratories in the Lyon (France) area were prospectively screened to identify 100 consecutive patients with acute hepatitis (positive for hepatitis A IgM antibodies). A questionnaire was addressed to these 100 subjects 1 year later requesting information on health care expenditures and work loss related to their episode of acute hepatitis A. Imprecise answers were completed by telephone interview. RESULTS: Answers were obtained from 92 subjects. Confirmation was obtained that the 8 other subjects had not died from their episode of acute hepatitis. Only two patients were hospitalized (for 2 and 4 days). Total mean cost (including medical expenditures and work loss was 11,789 French francs (range 1,524-62,117). Medical consultations and prescriptions comprised 20.0% of the total cost. The real mean cost of work loss (8,423 F) was greater than the cost calculated by the national health service (6,500 F). CONCLUSIONS: This evaluation of the real cost of hepatitis A in non-hospitalized patients should contribute to the definition of an adapted policy for the prevention of hepatitis A.

Acute Disease↗
PubMed1994

Hepatitis C: description of a highly sensitive method for clinical detection of viral RNA.

To improve the sensitivity of hepatitis C virus RNA (HCV RNA) detection in serum by 'nested' polymerase chain reaction (PCR), primers belonging to 5' non-coding (5'NC) regions were used to compare the classical phenol/chloroform technique by using the proteinase K and silica gel technique with guanidinium thiocyanate. The silica gel techniques was found to be more efficient and sensitive for the extraction and purification of viral RNA from serum samples. The silica gel technique also avoids contact with hazardous volatile chemicals like phenol and chloroform and provides a better protection for viral RNA. Furthermore, the RNA detection sensitivity was greatly improved by modifying the buffer for reverse transcription and PCR. Using silica gel extraction, and the modified buffer, viral RNA was detected in 699 sera from anti-HCV second generation ELISA positive patients. These sera were distributed in second generation RIBA confirmed, indeterminate and non confirmed groups with PCR positive rates of 71.4%, 45.7% and 15.8%, respectively. Two out of 227 ELISA negative patients showed the presence of HCV RNA in serum. An association between the presence of antibodies against a determined viral peptide and viremia was not detected.

Adult↗
PubMed1994

Inhibitory effects of the dopamine agonists quinagolide (CV 205-502) and bromocriptine on prolactin secretion and growth of SMtTW pituitary tumors in the rat.

The SMtTW tumor, a spontaneous PRL-secreting transplantable tumor, is the only available animal model sensitive to dopamine agonists. This model has been used to compare the long term in vivo effects of CV 205-502 (CV) and bromocriptine (BR) on PRL secretion and tumor growth. These two drugs were given for 2 months to female Wistar-Furth rats bearing either small or large tumors 4 and 6 months after the graft. Untreated grafted rats served as control. In all rats treated with 5 or 10 mg/kg.day BR or 0.3 mg/kg.day CV, a normalization of plasma PRL levels was observed whatever the pretreatment levels (plasma PRL or CV or BR-treated rats, < 15 ng/ml vs. 28253 ng/ml in control rats 8 months after graft). An inhibition of tumor growth was found for both small and large tumors, but the tumors never disappeared completely (mean tumor weights at autopsy, 440 and 660 mg in BR and CV groups vs. 5270 mg in control group 8 months after graft). Experiments performed with increasing doses of BR (0.15-5 mg/kg.day) or CV (0.03-0.6 mg/kg.day) indicated that CV is effective at doses 5-10 times lower than those of BR. A shrinkage under treatment and a regrowth after drug withdrawal were demonstrated for large tumors by in vivo ultrasonographic measurements of tumor size. Histological and ultrastructural effects were similar for the two drugs: decrease in hemorrhage, reduction of the cell size and secretory activity, increase in immunoreactive PRL cellular content, and inhibition of exocytosis. There was no difference in the PRL mRNA content of treated and untreated tumors, as assessed by in situ hybridization. In conclusion, CV and BR exhibit similar inhibitory effects on tumor growth and PRL secretion. These effects are rapidly and fully reversible after drug withdrawal. The present results give a complete account of the actions of the two dopamine agonists under conditions comparable to those used in the treatment of human prolactinomas.

Aminoquinolines↗
PubMed1994

[Diagnostic value of exercise test in the evaluation of sustained ventricular arrhythmia].

The authors undertook a prospective study comparing exercise testing and programmed ventricular stimulation in order to assess the diagnostic value and risks of exercise stress testing in patients with sustained ventricular arrhythmias. Fifty-five consecutive patients (47 men and 8 women) with an average age of 47 +/- 15 years were included. The initial condition requiring investigation was sustained ventricular tachycardia (47 cases) and ventricular fibrillation (8 cases). The patients had ischaemic heart disease (N = 18), dilated cardiomyopathy (N = 9), valvular heart disease (N = 4) and congenital heart disease (N = 3). Six patients presented with arrhythmogenic right ventricular dysplasia and 15 patients had apparently normal hearts. Four episodes of sustained ventricular tachycardia (7.3%) and 10 non-sustained ventricular tachycardia (18.2%) were induced by exercise testing. One poorly tolerated episode of ventricular tachycardia required cardioversion. No signs of myocardial ischaemia were observed in association with the induced ventricular tachycardia Patients with ventricular tachycardia induced by exercise were significantly younger (39.5 +/- 12.5 vs 49.5 +/- 15.4 years; p = 0.04) and attained a lower predicted maximal heart rate (82.2 +/- 14.6 vs 91.4 +/- 14.4%; p = 0.04), but the underlying pathologies were the same, as were the initial arrhythmias and the level of exercise attained. With respect to the clinical circumstances of induction of the initial ventricular arrhythmia, patients with ventricular tachycardia induced by exercise had an increased tendency to arrhythmias during effort or stress (7/14 vs 8/41; p = 0.06). Programmed ventricular stimulation induced more ventricular tachycardias than exercise testing (36/55 vs 14/55; p < 0.0001). The results of exercise testing were not correlated to those of programmed stimulation (p = 0.38).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[HBV-DNA assay by hybridization in solution. Value of low levels measured with the Abbott-Genostics device].

Quantitation of HBV-DNA is the most precise test for measuring viral replication. A commercial liquid phase hybridation test (Abbott) is now commonly used for diagnosis and monitoring of chronic hepatitis B. Interpretation of weak positive results obtained with this test are often difficult. Fifty-four sera with a concentration lower than 12 pg/ml with the Abbott HBV-DNA assay were tested with another commercial hybridation assay (Digene-Murex) and with an in-house PCR test. PCR is positive in 24 sera among the 35 HBs antigen positive sera, but is always negative in HBs Antigene negative sera. All the HBe Antigen positive sera were positive with the PCR test. A positive result was obtained with the Digene test in only 14 sera, 13 of them were confirmed by PCR. Ten sera among the remaining 11 PCR positive sera had a low HBV-DNA concentration but under the Digene cut-off level (10 pg/ml). The sensitivity could be greatly enforced with a lower cut-off level without any lack of specificity. The PCR test remains very helpful for sera with low concentration of HBV-DNA.

DNA, Viral↗
PubMed1994

[Early postoperative complications of rigid uretero-renoscopy: screening for iatrogenic vesico-ureteral reflux. 30 cases].

From April to September 1992, systematic screening for iatrogenic vesicoureteric reflux was performed in a series of 30 patients treated by rigid ureterorenoscopy. Most of these endoscopies were performed for renal stones using a Wolff Multiscope (7.5/12 F) without prior dilatation of the urinary tract. The study protocol was essentially based on pre- and postoperative retrograde and voiding cystography. The site and tone of the ureteric orifice and the compliance of the intramural ureter were also evaluated and the operating time was determined. Out of 33 ureteric endoscopies, only one case of type I pelvic vesicoureteric reflux was demonstrated following an operation with no particular technical problems. This rare and benign deferred complication draws attention to the potential consequences of rigid ureterorenoscopy on the vesicoureteric antireflux device.

Adult↗
PubMed1993

The (8-thiotheophyllinate) (triphenylphosphine) gold (I), (tTAuP): a new gold complex as an anticancer agent.

In continuous Friend leukemia cell exposure to tTAuP, the IC50 was 0.2 microM whereas in cells exposed 15 or 60 min to tTAuP followed by 72 h in drug-free medium the IC50 was 2.2 and 1.3 microM respectively. A combination of tTAuP and cisplatin (CDDP) is shown to be more active than either agent alone. Intracellular accumulation studies analysed by SXRF have shown that to achieve a cytotoxic effect, large concentrations of gold are necessary to accumulate in both the nuclear and cytoplasmic fraction. However, at cytostatic doses (1 microM), tTAuP has no effect on the cell cycle but does affect DNA synthesis. At a higher dose, greater than that necessary to induce cytotoxicity, it produces DNA damage, as observed by alkaline elution method. When cells were exposed to toxic doses of tTAuP (10 microM) in the presence of albumin, cytotoxicity was significantly reduced. Similar results were obtained when cells were co-treated with L-cysteine, dithiothreitol or reduced gluthatione. Reduced cytotoxic effect can be related to the interaction with free thiol groups. According to these data it is concluded that tTAuP is highly effective in vitro; whether it is active in vivo remains to be determined.

Antineoplastic Agents↗
PubMed1993

[Diagnosis of ectopic ureteral openings in the seminal tract. Value of modern imaging].

We recently observed 3 cases of ectopic ureteric orifice in the seminal tract in patients between the ages of 16 and 42 years. The first case was discovered incidentally, but the other two presented with scrotal symptoms. Intravenous urography, ultrasonography and computed tomography contributed to the diagnosis, but magnetic resonance imaging was the most conclusive, avoiding the need for deferentography in one case. These 3 recent cases allow an evaluation of the respective value of these various imaging modalities.

Adolescent↗
PubMed1993

[Ballistic (Lithoclast) and hydro-electric (Riwolith) endo-ureteral lithotripsy. Report of 60 cases].

25 hydroelectric endoureteric lithotripsies (Group 1, Riwolith) and 35 ballistic endoureteric lithotripsies (Group 2, Lithoclast) were analysed. 60 stones were treated, including 18 pelvic stones (Group 1 : 10, Group 2 : 8), 39 iliolumbar stones (Group 1 : 14, Group 2 : 25), and 3 stones of the ureteropelvic junction (Group 1 : 1, Group 2 : 2). The mean maximal diameter was 9.9 mm (Group 1 : 8.2, Group 2 : 11). Complementary Dormia extraction was performed in 24 cases (Group 1 : 8, Group 2 : 16), 55 double J stents were implanted (Group 1 : 24, Group 2 : 31) and 23 immediate ECL sessions were performed (Group 1 : 8, Group 2 : 15). Overall, 57 good results were recorded, but 3 complete failures of fragmentation and 2 severe ureteric lesions were attributed to hydroelectric lithotripsy. The Lithoclast, much less traumatic, had a greater stone fragmentation potential, but its efficacy on very mobile stones is limited due to its more intense stone propulsion effect.

Adult↗
PubMed1992

Concanavalin-A-bound and -unbound prolactin in normal and hyperprolactinaemic rats.

Concanavalin-A (Con-A)-bound and -unbound forms of prolactin were studied in female Wistar-Furth rats, both normal and with hyperprolactinaemia induced by treatment with oestrogen or a prolactinoma graft. In normal rats, Con-A-bound prolactin was the major circulating form (more than 50%) and a minor pituitary component (less than 10%), essentially as 25 kDa prolactin. In oestrogen-treated rats, plasma prolactin levels were 100-fold higher and pituitary weight was fivefold higher than in the controls, but total pituitary prolactin content was unmodified. Under oestrogen, Con-A-bound prolactin represented about one-third of the total hormone levels in the plasma and less than 10% in the pituitary. In the pituitary, bound prolactin was found essentially as 25 kDa and unbound prolactin as 22, 30 and 40-45 kDa. A similar increase in plasma prolactin levels was induced 6 months after the graft of a prolactinoma. Pituitary weights and total pituitary prolactin contents were slightly decreased. Plasma and pituitary Con-A-bound prolactin levels were similar to those observed in oestrogen-treated rats. On the other hand, unbound prolactin was only present as a 22 kDa monomer. In the tumour, Con-A-bound prolactin (essentially as 25 kDa prolactin) represented one-third of the total hormone level and unbound prolactin was composed of the 22 and 45 kDa forms, this latter form being partially transformed into 22 kDa by heating.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Cancer of the testis after Hodgkin's disease. Apropos of 2 cases].

We report about two cases of cancer of the testis occurring 2 and 7 years after Hodgkin's disease treated with combined chemotherapy and radiation therapy. From an etiopathogenic point of view, this association may, of course, be accidental, but it may also have an iatrogenic origin or be caused by contiguous carcinogenesis, or even by an immune deficiency. In addition to orchidectomy, the therapeutic history of these patients requires an adaptation of the treatment of their tumors of the testes.

Adult↗
PubMed1992

New strategies for the prevention and treatment of allergic rhinitis in children.

Allergic rhinitis (AR) is a very common disease in children, often underdiagnosed and with underestimated complications. Its prevalence has increased during the last years, due to changes in environmental factors. The therapeutic strategy will include prevention by identification and eviction of the main allergens, associated to pharmacological therapy. Among antirhinitic drugs, the new generation of non-sedative specific antihistamines represent the main choice. We report our own experience with astemizole, one of these new antihistamines which confirms that astemizole is an effective and safe drug for the management of AR in children.

Allergens↗
PubMed1991

Natural and experimental infection of wild mallard ducks with duck hepatitis B virus.

Wild duck populations were investigated over a 4 year period for duck hepatitis B virus (DHBV) infection and liver disease. It appeared that DHBV is endemic in wild migratory mallards from France and the U.S.A., although neither hepatocellular carcinoma nor viral DNA integration could be detected in liver samples examined. The follow up of natural infection indicated that wild mallards developed significantly higher serum titres to DHBV DNA than Pekin ducks. The results of experimental transmission demonstrated that such differences in viraemia were not related to the breed of ducks but to the virus isolate, since the wild mallard-isolated DHBV (DHBV WM) induced significantly higher viraemia in both mallard and Pekin ducklings compared to the domestic Pekin DHBV (DHBVP) isolate. The naturally infected mallard and Pekin ducks had only minor histological lesions of the liver compared with experimentally infected birds. There was no correlation between the intensity of viraemia and the severity of liver lesions, suggesting that as for mammalian hepadnaviruses the hepatic injury in DHBV-infected ducks is probably immunologically mediated.

Animals↗
PubMed1991

[Tuberculosis and acute respiratory insufficiency. Apropos of 2 cases].

We report two cases of death from acute respiratory insufficiency of tuberculous origin. There were rare clinical presentations in which the clinical and radiological aspects were particularly atypical, suggesting a diagnosis of an acute respiratory distress syndrome. Bacteriological confirmation is necessary but it is worth considering this aetiology with each case of unexplained respiratory distress because the mortality is high and the prognosis is related to how early drug therapy is given.

Humans↗