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Biomedical subjects

P Denis

Publications and source records attributed to P Denis.

At least 19 recordsLinked to original sources
PubMed2006

[Helicobacter pylori prevalence in Raynaud's disease].

PURPOSE: Recent studies have suggested that the prevalence of Helicobacter pylori may be more frequent in patients with primary Raynaud's phenomenon (PRP) compared to healthy subjects. These data prompted us to conduct this prospective study, in order to assess the prevalence of H. pylori infection in a large series of patients with PRP. METHODS: Forty consecutive patients with a definite diagnosis of PRP were included in the study. The findings in the PRP patients were compared with those of 80 age- and sex-matched healthy subjects. H. pylori infection was diagnosed using serology and urease breath test. RESULTS: The prevalence of H. pylori infection was as high as 12.5% in PRP patients using both serology and urease breath test, whereas it was found to be 16.7% and 18%, respectively, in healthy controls. CONCLUSION: As prevalence of H. pylori infection was similar in PRP patients compared to controls (P=0.53 and 0.43, respectively), our data underscore that H. pylori infection may not play a role in the genesis of PRP-related vascular complication onset. Interestingly, PRP patients exhibited more commonly digestive symptoms consistent with H. pylori infection compared to controls (P<0.05).

Adolescent↗
PubMed2006

Outcome of small-bowel motor impairment in systemic sclerosis--a prospective manometric 5-yr follow-up.

OBJECTIVE: To assess the 5-yr course of small-bowel motor disorders, using manometry in patients with systemic sclerosis (SSc), and to investigate for an association between small-bowel motor dysfunction outcome and other clinical manifestations of SSc. METHODS: Fasting and post-prandial motor activity of the small-bowel was systematically assessed in eight consecutive patients with SSc, using 24 h manometry: initially and at 5-yr follow-up. RESULTS: At 5-yr follow-up, the eight SSc patients (100%) exhibited deterioration of small-bowel motor activity on manometry as follows: (1) more severe abnormalities of migrating motor complex phase III during the fasting period; (2) decreased median duodenal and duodeno-jejunal index during the post-prandial period; and (3) more frequent alterations of small-bowel motor activity in response to octreotide infusion. Furthermore, an association could be found between the deterioration of small-bowel motor function and pitting scars' onset. CONCLUSION: Our study underscores the rapid deterioration of small-bowel motor impairment in SSc patients (100%). It also highlights the usefulness of small-bowel manometry in symptomatic SSc patients in objectively defining both the characteristics and degree of motor impairment, which may influence the choice of medical treatment in patients, particularly octreotide therapy.

Adult↗
PubMed2006

Genetic variability of encephalomyocarditis virus (EMCV) isolates.

In order to evaluate the variability of encephalomyocarditis virus (EMCV), field isolates originating from different European regions and inducing different clinical pictures in pigs have been molecularly characterised. The regions targeted were the poly(C) tract, a part of the 5'-UTR (360 nucleotides), the Leader gene (201 nucleotides), the complete capsid coding region (2502 nucleotides), the 2A gene (403 nucleotides), the end of the 3D polymerase gene (305 nucleotides) and the 3'-UTR (123 nucleotides). Analyses have also been performed on a virulent field isolate, which had been subjected to serial passages in vivo and in vitro resulting, in the case of the in vitro passaged virus, in attenuation, as demonstrated by animal experiments. The present study shows that different clinical pictures, such as acute fatal myocarditis or reproductive failure, may not only be caused by EMCV isolates which are genetically diverse but also by the same isolate. Thus no correlation could be demonstrated between genotype and clinical disease. However, the European isolate which showed the highest genetic divergence also gave rise to a more complex clinical picture. Despite EMCV having been isolated from cases of acute fatal myocarditis in pigs in certain areas of the world for many years, clinical disease, including a variety of clinical pictures and pathogenicity, has only been recognised in Europe since 1986 and thus it can be considered an emerging disease in this region. These findings, associated with the reported phenotype changes of the virus under environmental changes (passages), along with its wide distribution among vertebrate species (including higher primates), shows the validity of considering EMCV as a potential pathogen for recipients in xenotransplantation.

3' Untranslated Regions↗
PubMed2006

[Optic disc pit complicated by serous macular detachment: a case report].

INTRODUCTION: Optic disc pit is a rare congenital anomaly that, in 60% of cases, can be complicated by serous macular detachment. CASE REPORT: We report the case of a 56-year-old patient who presented with serous macular detachment caused by optic disc pit and responsible for a deterioration of visual acuity. Intravitreal injection of 0.3 cc of C3F8 and peripapillary photocoagulation was unsuccessful. Vitrectomy, peripapillary photocoagulation, and intravitreal injection of C3F8 helped reduce the serous detachment and improved visual acuity. CONCLUSION: Optic coherence tomography has become necessary in the management of this pathology whose mechanism is uncertain and treatment unconventional.

Humans↗
PubMed2006

[Perforating ocular injuries in children: a retrospective study of 57 cases].

PURPOSE: The purpose of this study was to investigate the current causes and outcomes of open eye injuries in children. PATIENTS AND METHODS: We reviewed the hospital records of 57 patients under 14 years of age who were treated for open globe injuries at Edouard Herriot Hospital, Lyon, France, between January 1999 and December 2003. RESULTS: This review includes 57 patients: 41 males and 16 females. The mean age at admission was 6.8 +/- 3.5 years. The injury involved the right eye in 27 cases and the left eye in 30 cases. Sharp or pointed objects accounted for the majority of injuries. The most common location for a perforating ocular injury to occur was at home. Wounds involved the cornea in 41 cases. There was iris hernia in 21 cases, hyphema in 15 cases, vitreous prolapse in 14 cases, lens damage in 12 cases, and shallow anterior chamber in 11 cases. The most frequent complication was traumatic cataract. Secondary lens removal was performed in 15 cases. Visual acuity was 0.5 or better in 27 of the 57 eyes, with a mean follow-up period of 12 months. CONCLUSIONS: Perforating ocular injuries are a frequent cause of unilateral visual loss. The highest proportion of injuries occurred at home and sharp objects were the most frequent causative agents. More adequate adult supervision and educational measures are necessary in order to reduce the prevalence of these accidents.

Adolescent↗
PubMed2006

[Consequences of glaucoma on circadian and central visual systems].

Glaucoma is a chronic optic neuropathy leading to a degeneration of retinal ganglion cells. There is accumulating evidence that glaucomatous damage extends from retinal ganglion cells to vision centers in the brain. Degenerative changes are observed in magnocellular, parvocellular, and koniocellular pathways in the lateral geniculate nucleus, and these changes are related to intraocular pressure and the severity of optic nerve damage. In addition, recent studies show that there are also changes in the visual cortex in relation to varying degrees of retinal ganglion cell loss. In a rat model of glaucoma, we have recently demonstrated a reduction of retinal projections of retinal ganglion cells, not only on the visual system but also on the suprachiasmatic nucleus. Human studies suggest that the ganglion cell degeneration caused by glaucoma could lead to a lesion of the retinohypothalamic tract, which permits the synchronization of circadian rhythms.

Brain Diseases↗
PubMed2006

[Prevalence and description of treatment with intraocular pressure-lowering topical medications in continental France].

PURPOSE: The first objective of the present study was to estimate the prevalence of patients treated for glaucoma or ocular hypertension (OHT) with an IOP (intraocular pressure) -lowering topical medication. Subjects were 40 years old and living in continental France. The second objective was to describe the type of therapy, compliance, and the quality of life of the subjects treated. METHODS: This study was a telephone survey conducted in a general population on a representative sample of 5726 subjects in 2004. Subjects treated for glaucoma or OHT were defined as those declaring use of eye drops for more than 1 month and mentioning one of the 52 registered IOP-lowering topical medications and/or stating that they were taking eye drops for glaucoma or OHT. Quality of life was measured using the GlauQOL-17 questionnaire. RESULTS: 237 subjects (4.1%) corresponded to this definition. The prevalence increased with age, from 0.7% in subjects aged 40-44 years to 10.6% in those aged 80 years or more. The age-standardized prevalence was higher in the Paris area (5.3%), the Mediterranean (4.5%), and the Southwest (4.7%), and lower in rural areas (3.2%), and in subjects with less than high school education (2.9%). Beta-blockers (49.5%) and prostaglandins (37.4%) were the most frequent treatments, followed by carbonic anhydrase inhibitors (15.3%), sympathomimetics (5.7%), and myotics (1.3%). Compliance was not total in 39% of the patients (22% of those treated with once-a-day dosage). DISCUSSION: The results of the present study are in line with French health authority data and with the results of the French "Glaucoma and intraocular high pressure, one day" study results. Moreover, the lower prevalence in regions with low medical density, low socioeconomic level, and rural areas, suggest that glaucoma or OHT might be underdiagnosed. CONCLUSION: On the basis of this first nationwide study, it can be estimated that the prevalence of subjects treated with IOP-lowering topical medications is about 1.2 million in France. The number of daily doses appears to influence compliance.

Adult↗
PubMed2006

[Practical measures. Advantages of fixed combination treatments].

Even if glaucoma treatment often begins with monotherapy, combined treatments are in fact frequent. However, they are associated with poorer compliance, which may lead to lower efficacy, notably if the delay between two eyedrops is too short. The main advantages of fixed combinations are better therapeutic compliance and a lesser effect of dilution of the first eyedrops by the second. Nevertheless, it is impossible to change the dosing interval of one or the other of the components and adverse side effects cannot be controlled. The fixed combinations available today or in the near future are based for the most part on the combination of timolol and a prostaglandin. Their efficacy is comparable to the efficacy of each of the components or of nonfixed combinations, but it is not strictly equivalent. This difference (on the order of 1 mmHg) could be explained by unsuitable frequency or poor timing of the instillation.

Drug Therapy, Combination↗
PubMed2006

Oesophageal mucosal involvement in patients with systemic sclerosis receiving proton pump inhibitor therapy.

AIM: To assess the prevalence of oesophagitis, Barrett's oesophagus (BE) and other oesophageal mucosal abnormalities in patients with systemic sclerosis (SSc) without prior selection on digestive clinical presentation. We also investigated the association between oesophageal endoscopic and manometric data with clinical manifestations of SSc. METHODS: Oesophageal endoscopy and manometry were performed in 133 consecutive patients with SSc, receiving proton pump inhibitor (PPI) therapy since SSc diagnosis. RESULTS: Endoscopy revealed oesophagitis in 43 patients (32.3%), BE in 9 patients (6.8%), candidiasis in 7 patients (5.3%) and hyperplastic polyp arising in ectopic gastric mucosa in 1 patient. Patients with severe oesophageal motor impairment further exhibited a higher prevalence of interstitial lung disease (ILD) when compared with those without. CONCLUSION: Our study underlines the high frequency of oesophageal mucosal abnormalities in unselected SSc patients receiving long-term PPI therapy. A relationship between oesophagitis/BE and severe manometric motor disturbances was established; these patients may require a higher regimen of PPI. Finally, our series indicates a correlation between severe oesophageal motor disturbances and evidence for ILD in patients, suggesting that gastro-oesophageal reflux may be one of the contributing factors of ILD in SSc; this subgroup of patients may require close monitoring of lung parameters.

Adult↗
PubMed2005

Coats' disease and bilateral cataract in a child with Turner syndrome: a case report.

PURPOSE: To report the first case in which Coats' disease was observed with infantile cataract in a girl with Turner syndrome (TS). MATERIALS AND METHODS: We examined a 4-year-old female infant with TS who was referred with a diagnosis of leukocoria in the left eye. RESULTS AND DISCUSSION: Examination under anaesthesia revealed a bilateral punctate cataract and left eye fundus showed vascular retinal abnormalities typical of Coats' disease. Cryotherapy was performed on the telangiectatic vessels and the child was followed up for a period of 12 months. Despite cryotherapy resulting in regression of the peripheral exudates, an exudative maculopathy persisted with poor visual outcome. We suggest that Coats' disease should be considered as a rare ocular manifestation in TS.

Cataract↗
PubMed2005

Simultaneous recordings of oesophageal acid exposure with conventional pH monitoring and a wireless system (Bravo).

OBJECTIVES: Oesophageal pH monitoring is a useful test for the diagnosis of gastro-oesophageal reflux disease (GORD) but has some limitations related to the nasopharyngeal electrode. Recently, a telemetric catheter free system (CFS) (Bravo; Medtronic) was developed. The aim of this study was to determine the concordance of data between the conventional pH measurement system (CPHMS) and the CFS Bravo. METHODS: Forty patients with symptoms suggestive of GORD underwent 24 hour oesophageal pH monitoring using the CPHMS with a nasopharyngeal electrode and the Bravo CFS simultaneously. The sensitive tips of both electrodes were positioned at the same level under fluoroscopy. In addition to automatic analysis, each reflux episode was checked visually and characterised. RESULTS: There was a significant correlation (r = 0.87, p < 0.0001) between the 24 hour oesophageal acid exposures recorded by the CPHMS and the CFS. Twenty four hour oesophageal acid exposure was significantly lower with the CFS than with the CPHMS (2.4 (0.4-8.7) v 3.6 (0.7-8.6); p < 0.0001). Consequently, with the CFS, the cut off level for the diagnosis of GORD, as calculated from the regression equation, was 2.9% (for the 4.2% cut off determined in controls with the CPHMS). After this adjustment, concordance of the diagnosis of GORD was 88% (kappa 0.760). Diagnosis of GORD was established in more patients with the CFS 48 hour results than with the 24 hour results. CONCLUSIONS: Despite strong correlations between oesophageal acid exposure recorded with the two devices, the Bravo CFS significantly under recorded acid exposure compared with the CPHMS. Provided some correcting factors are used, the Bravo CFS can improve the sensitivity of pHmetry for the diagnosis of GORD by allowing more prolonged recordings.

Adult↗
PubMed2005

[Assessment of anorectal disorders with paraplegia].

INTRODUCTION: Functional anorectal disorders in paraplegia are frequent; few studies evaluate the effect of these disorders on quality of life. OBJECTIVE: Assessment of the functional anorectal disorders in a homogeneous group of patients with total paraplegia in terms of quality of life. METHODS: During a global follow-up consultation, patients answered questions on a systematic questionnaire about anorectal disorders and a specific quality-of-life autoquestionnaire about functional digestive disorders: Functional Digestive Disorders Quality of Life (FDDQL) questionnaire; score 0 to 100 (100 corresponding to no effect on quality of life). RESULTS: Twenty-three patients with a mean age of 44.3 years who had been paraplegic for 10 years participated. Two had a colostomy because of bedsores. Fourteen underwent daily rectal examination, 10 with an evacuation aim; the time given to defecation was, on average, 36 minutes. One patient had clinical constipation. Twelve had had one or more episodes of incontinence. The mean global FDDQL score was 69.7. This score was not related to incontinence; only the "comfort" domain among the 8 domains was related to incontinence. DISCUSSION: Anorectal disorders are frequent in paraplegia; the duration and the methods of defecation represent a great worry to patients. More than half of the patients already had faecal incontinence; the effect of even occasional incontinence on quality of life is significant. Since the FDDQL scale is not specific to patients with paraplegia, its interest should be checked on a greater number of patients. For certain patients, it is important not to dismiss more complex surgical treatment methods.

Adult↗
PubMed2005

[Conjunctival tumors in children. A histopathologic study of 42 cases].

PURPOSE: The aim of this study was to describe the clinicopathological characteristics of 42 conjunctival tumors surgically removed in children. PATIENTS AND METHODS: Records of all conjunctival tumors surgically removed in children during the 11-year period 1990-2001 were collected from the records of the Department of Ophthalmology, Edouard Herriot Hospital, Lyon. In all cases, the tumor was resected with no additional treatment. Sections of all cases were reviewed by the same pathologist. RESULTS: A total of 42 cases (40 patients) were included in the study. The mean age of the subjects at the time of surgical excision was 10 years, with a range of 1-17 years; 45% were male. The most frequent indication for tumor removal was suspected growth. The clinical diagnosis was accurate in 91% of cases. The tumor was localized at the limbus in 57% of cases. Most tumors were pigmented nevi, accounting for 83% of the lesions. The histopathological diagnoses in decreasing order of frequency were: nevi (35), angioma (2), dermolipoma (2), dermoid (1), papilloma (1), and squamous cell carcinoma (1). In one case, the histological study revealed squamous cell carcinoma in a child suffering from xeroderma pigmentosum. CONCLUSIONS: This retrospective study suggests that malignancy of pigmented conjunctival lesions is extremely rare in children. Although squamous cell carcinoma is rare in children, surgical excision and histological study are necessary when a conjunctival lesion is associated with xeroderma pigmentosum or immunodeficiency.

Adolescent↗
PubMed2005

[Opacification of a hydrophilic acrylic intraocular lens].

PURPOSE: To report pathological and histochemical analysis of an explanted opacified hydrophilic acrylic intraocular lens. PATIENTS: and method: A hydrophilic acrylic intraocular lens--Orion IFP3D6--was explanted 2 years after routine phacoemulsification because of its opacification associated with significant visual impairment (20/40). The intraocular lens was examined by gross and light microscopy. Full-thickness cut sections of the lens were stained with 1% alizarin red (a special stain for calcium). RESULTS: Microscopic analyses revealed the presence of granules of various sizes distributed in a line parallel to the anterior and posterior curvatures of the lens. The granules stained positively for alizarin red. CONCLUSION: Such opacification has been described with the SC60B-OUV, MDR Inc., which is also a one-piece foldable-design intraocular lens (28% hydrophilic material). The opacification of the intraocular lens occurred over various periods after surgery. Forty percent of these lenses have been explanted. Microscopic and histochemical evaluation of these intraocular lenses revealed the same type of granulation deposits within the lenses. The origin and mechanism of the opacification are still not fully understood.

Female↗
PubMed2005

[Relation between ocular manifestations and organ involvement in ten patients with Fabry disease].

PURPOSE: To describe ocular manifestations in Fabry disease and compare them to other organ involvement in this disease. PATIENTS AND METHODS: Ten patients were included in a clinical trial, all of whom had specialized investigations in ophthalmology, cardiology, nephrology and dermatology. RESULTS: All the patients presented with ocular damage, some of which were rather characteristic of this disease, such as cornea verticillata and spoke-like cataract. However, such anomalies were not responsible for any visual acuity changes in most patients. Some patients had renal or cardiovascular damage at early stages of the disease. We therefore tried to establish a correlation between the severity of such involvement and ocular damage. CONCLUSION: Many ocular manifestations are frequently observed that should suggest a diagnosis of Fabry disease. However, there is no clear relationship between the presentation of the systemic cardiac and renal manifestations of the disease and the presence of ocular abnormalities.

Adult↗
PubMed2005

[Prospective study of contrast sensitivity and visual effects after LASIK].

PURPOSE: To evaluate changes in visual effects (contrast sensitivity, halos, and glare) following laser in situ keratomilleusis (LASIK). PATIENTS AND METHODS: In this prospective study, 72 eyes had LASIK to correct myopia. Contrast sensitivity was tested preoperatively, as well as 6 and 12 months postoperatively. The spatial frequencies tested were 3, 6, 12, and 18 cycles per degree (c/d). There were two groups: group 1 for myopia between -6 D (n=30) and -7.5 D and group 2 for myopia between -7.5 D and -10 D (n=25). There were 17 cases with loss of sight. For each visit, pupil diameter, halos, and glare were measured. RESULTS: Contrast sensitivity was better in group 1 than in group 2 (p<0.05) (for spatial frequencies of 3, 12, 18, c/d). In group 1, contrast sensitivity decreased 6 months postoperatively for all spatial frequencies (p<0.05); 12 months after surgery the changes were not significant. In group 2, changes were not significant. For halos and glare, pre- and postoperative percentages were not different. There was no correlation with pupil diameter. CONCLUSIONS: After LASIK to correct myopia, there may be a persistent decrease in contrast sensitivity. Changes are only significant at 6 months postoperatively. Patients should be informed preoperatively of this possible decrease in functional vision.

Adult↗