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P M Preux

Publications and source records attributed to P M Preux.

At least 19 recordsLinked to original sources
PubMed2006

[Dépistage de l'épilepsie en zones tropicales: validation d'un questionnaire en Mauritanie].

Prevalence of epilepsy in developing countries is considered to be 2 to 5 times superior to the industrialized countries. In tropical areas, the diagnosis of epilepsy is still reliant on the clinic and requires a precise semiological description. A good epidemiological and clinical research requires standardized and validated screening tools. The objective of this work was to evaluate the validity of the screening module of the investigation questionnaire on epilepsy in tropical areas, in Nouakchott, Mauritania. All the patients included in the study were examined at first by a neurologist, then directed towards an investigator who asked the 5 screening items of the investigation questionnaire. Any person answering "yes" at least one question was regarded as "suspected of epilepsy" by the investigator. Secondly the neurologist re-examined the subjects and confirmed the diagnosis. The sensitivity and the specificity of the module of screening were calculated. On the whole, 236 patients were included in the study 131 had answered "yes" at least one of the questions of the module of screening and was regarded as "suspected" of epilepsy (55.5%) by the questionnaire. The diagnosis of epilepsy was made for 82 subjects by the neurologist. The sensitivity of the module of screening of the epilepsy was 95.1% (CI 95%: 87.3-98.4) and specificity was 65.6% (CI 95%: 57.5-72.9). The screening module of the investigation questionnaire of epilepsy in tropical zones, made up only by 5 questions, has diagnosis qualities acceptable and comparable with those reported in the literature. The use of this tool integrated in a more general questionnaire of investigation of the. epilepsy proves to be an essential instrument in conducting epidemiologic studies in epileptology' in tropical zones.

Adolescent↗
PubMed2005

Docetaxel and concurrent radiotherapy after two cycles of induction chemotherapy with cisplatin and vinorelbine in patients with locally advanced non-small-cell lung cancer. A phase II trial conducted by the Groupe Francais de Pneumo-Cancerologie (GFPC).

CONTEXT: The most satisfactory treatment for patients with locally advanced non-small-cell lung cancer (NSCLC) is combination chemotherapy-radiotherapy (CT-RT). The optimal treatment modalities remain to be determined. OBJECTIVE: We conducted a multicenter phase II trial of the docetaxel-radiotherapy combination after induction chemotherapy with cisplatin-vinorelbine. The main endpoint was the objective response rate. PATIENTS AND METHODS: Patient with inoperable stage locally advanced NSCLC received induction chemotherapy consisting of two cycles of cisplatin 100 mg/m2 on D1 and vinorelbine 25 mg/m2 on D1, D8, D15 and D22. Patients with responses or stable disease then received concurrent RT-CT consisting of 25 mg/m2/week docetaxel and single-fraction radiotherapy (66 grays (Gy) in 33 fractions) over 6.5 weeks. RESULTS: Fifty-six patients were enrolled from 1 July 2000 to 31 December 2001. Sixteen patients left the trial after induction chemotherapy, eight for progression, five for toxicity, and two for intercurrent events. One patient underwent surgery after induction chemotherapy. In total, 40 of the 56 patients received RT-CT. Twelve (30%) of these 40 patients experienced grade III or IV pulmonary or esophageal toxicity. In the intention-to-treat analysis, the objective response rate was 46.4% (95% CI 33.0-60.2). The median time to progression was 6.2 months [1.1-26.0]. The median survival time was 13 months [0.3-44.9 months]. Nine patients progressed during RT-CT, six with brain metastases. CONCLUSION: Weekly docetaxel with concurrent radiotherapy, following chemotherapy is acceptable. The tumor response rate is moderate. Further trials are required to determine the risk-benefit relationship of this treatment schedule, and the possible benefit of adding other cytotoxic drugs.

Adult↗
PubMed2005

[Cognitive disorders in an Andean community located in a cysticercosis endemic zone of Ecuador].

Mini mental state tests (MMS) were administered to 227 adults over the age of 40 years living in an Ecuadorian urban Andean community known to be an endemic zone for Taenia solium taeniasis and cysticercosis. The overall prevalence of cognitive impairment was 8.4% (19/227). The prevalence of cognitive impairment was 23.5% (8 cases) in adults over 75 years (n=34). The Hachinski ischemic score for vascular dementia was abnormal in 4 of the 19 adults (21%) exhibiting cognitive impairment. This survey highlighted a high prevalence of dementia in comparison with industrialised countries. Parasitic encephalopathy that was present in one out of five persons in this Andean community could play a part in early damage of cognitive function.

Aged↗
PubMed2005

[Japanese encephalitis].

Japanese encephalitis is an arboviral disease due to a flavivirus transmitted by a mosquito of the genus Culex. It is a major public health problem in Southeast Asia where it is endemo-epidemic. The socio-economic impact of Japanese encephalitis is great since most cases occur in children and young adults and lead to death in 25 to 30 % and neurological sequelae in survivors. The tendency of Japanese encephalitis to spread geographically and the existence of imported cases are particularly important issues. The clinical features are the same as other viral encephalitis. Suspicion of imported Japanese encephalitis depends on awareness of the epidemiological setting (return from endemic areas). Diagnosis must be confirmed by serology using ELISA capture method to detect anti-viral antibodies in blood and cerebrospinal fluid. Unlike herpes encephalitis, there is currently no specific treatment for Japanese encephalitis. Only preventive measures can be effective against infection. At the present time the most widely used vaccine is Biken's lyophilized vaccine produced from a reference strain (Nakayama strain), but its high cost prevents mass vaccination in endemic areas. Recent progress in molecular biology has raised hope for the discovery of a genetically engineered vaccine to improve overall protection against Japanese encephalitis.

Encephalitis, Japanese↗
PubMed2004

Evaluation of the microbial safety of a new 1.5 l enteral feeding diet reservoir system.

BACKGROUND & AIMS: Microbial safety is essential during enteral nutrition (EN) as it can be the origin of gastrointestinal symptoms, but can also lead to systemic infections. The use of large-volume diet reservoirs could limit the risk of contamination and reduce nursing time, due to fewer repeated manipulations. The aim of the study was to evaluate in vivo the microbial safety of a new 1.5l enteral feeding diet reservoir system. METHODS: After validation of the study settings under standard laboratory conditions, 86 EN lines with sealed fittings were connected to 1.5l diet reservoirs under hospital/patient conditions. Microbial identification and quantification at different sampling times and points were performed. RESULTS AND CONCLUSIONS: No microbial contamination was observed in the diet reservoirs and in the nutrition lines above the drip chamber, demonstrating the microbial safety of this system. Retrograde contamination of the distal nutrition line end at completion of EN was observed and may be affected by the cumulative time of use of the tube. The contaminating microbial species were essentially bacteria of normal oral and digestive flora.

Bacteria↗
PubMed2004

Psychosocial issues in people with epilepsy in Togo and Benin (West Africa) I. Anxiety and depression measured using Goldberg's scale.

PURPOSE: This study in Togo and Benin, West Africa, was aimed at measuring depression and anxiety among people with epilepsy (PWE). METHODS: This cross-sectional study of 281 adult PWE in Togo and 215 in Benin matched with the same number of controls without epilepsy used Goldberg's anxiety and depression scale. The statistical tests used for comparisons were chi(2) tests, Fisher's exact test, analysis of variance, and Fisher's PLSD test when necessary. RESULTS: PWE in Togo and Benin had significantly higher (P<0.0001) average depression scores (4.4+/-2.1, 4.7+/-2.7) than controls (0.5+/-0.9, 1.4+/-2.4). They also had significantly higher (P<0.0001) average anxiety scores (5.3+/-2.0, 6.2+/-2.1) than controls (2.5+/-1.6, 1.6+/-2.0). In consideration of the thresholds of the scale, the prevalence of possible major anxiety and depression among PWE was also very high compared with controls (P<0.0001). High anxiety and depression scores were, in general, positively correlated with a higher frequency of seizures and lack of treatment. CONCLUSION: Results confirmed the existence of anxiety and depression among PWE in Togo and Benin.

Adult↗
PubMed2004

Psychosocial issues in people with epilepsy in Togo and Benin (West Africa) II: quality of life measured using the QOLIE-31 scale.

PURPOSE: This study in Togo and Benin, West Africa, was aimed at measuring health-related quality of life (HRQOL) of people with epilepsy (PWE). METHODS: It was a cross-sectional study among 281 adult PWE in Togo and 215 in Benin matched with the same number of controls without epilepsy, using the Quality Of Life in Epilepsy Scale-31 (QOLIE-31). RESULTS: In Togo and Benin, controls had significantly better HRQOL (80.3+/-7.4, 72.2+/-12.7) than PWE (49.5+/-14.4, 52.1+/-33.4) according to the QOLIE-31 Overall score (P<0.0001). HRQOL was, in general, negatively correlated with a higher frequency of seizures and lack of treatment. CONCLUSION: Results call for specific management of epilepsy in PWE in Togo and Benin to improve their HRQOL.

Adult↗
PubMed2004

Epilepsy and traditional medicine in Bobo-Dioulasso (Burkina Faso).

OBJECTIVES: To contribute to a better knowledge of how epilepsy is perceived by traditional healers in Burkina Faso; what means they use to treat it, and how they think about modern treatment. MATERIAL AND METHODS: Individual interviews with 65 traditional healers chosen at random from members of the Reelwende Association. RESULTS: All traditional practitioners were of male gender. Most of them were above 50 years of age, and 75% had more than 10 years' experience. Epilepsy was considered to be contagious by 44% of the traditional practitioners, and hereditary according to 40% of them. Roughly, 15% of the healers think that the problem is localized in the head of a person and 7.8% think that they have worms in their head. Thirty-one per cent of them diagnose epilepsy if there is a combination of 'convulsions, sudden fall, dribbling and amnesia'. Another 15% require a combination of 'convulsions, amnesia and dribbling', the remaining 54% make the diagnosis based on one symptom or various combinations of two symptoms of 'grand mal' (generalized tonic clonic) seizures and most claim they have a treatment for it. For a quarter of them, therapeutic-means include concoctions of herbs or roots, baths and infusions. During the fit, 31% of the traditional practitioners think that nothing should be performed. According to 75% of them, traditional and modern treatments are complementary. CONCLUSION: Notwithstanding important differences in culture and religions (Muslim, Christian and Original), there is great similarity between the knowledge and beliefs about epilepsy reported from other parts of Africa and those presented by our study-group, suggesting an ancient origin of the concepts. Further study is needed to find out how other facets of epilepsy (e.g. complex partial seizures, absences) are perceived and how these are being treated. Ways need to be found to raise awareness about epilepsy without interfering with religious and cultural beliefs.

Adult↗
PubMed2003

Epidemiology of venous insufficiency in an occupational population.

AIM: A cross sectional study of the prevalence and risk factors of chronic venous insufficiency (CVI) in a South European occupational population was performed. METHODS: Over a 7-month period a questionnaire (CVI symptoms, general data and life style habits) was administrated to 1604 consecutive females (73.3%) and 586 consecutive males (26.7%). An oriented clinical examination was then performed. Subjects were classified into 4 groups: asymptomatic, light, moderate and severe CVI. Univariate and multivariate analysis were used. RESULTS: Mean age 38.8+/-11.6 years (range 15-65). The prevalence of CVI all classes confounded was 51.4% (62.3% in women and 21.8% in men); the prevalence of moderate and severe CVI was 10.4% (12.1% in female and 6.3% in male). Age (Odds Ratio (OR): 1.93, 95% confidence interval (CI): 1.55-3.53), female sex (OR: 2.34, 95% CI: 1.62-2.30), obesity (kg/m(2)) (OR:1.11, 95% CI: 1.07-1.15) and familial history of CVI (OR: 2.80, 95% CI: 2.02-3.89) were risks factors of moderate and severe CVI. The comparison extended to the whole group of CVI added other risk factors: history of leg injury, pregnancy; a sitting posture at work. Unexpectedly smoking had a protective effect but only in the female group for the last one. CONCLUSION: CVI is an important medical problem concern in this population. Some of the risk factors like obesity and standing position at work may benefit from preventive measures.

Adolescent↗
PubMed2003

[Polyradiculoneuritis and Campylobacter jejuni: clinical and physiopathological aspects].

Several explanations have been proposed to explain the relationship between axonal forms of acute auto-immune inflammatory polyradiculoneuritis and Campylobacter jejuni. The major hypothesis involving molecular imitation is based on the existence of common antigenic determinants (epitopes) in the lipopolysaccharides of the infectious agent and gangliosides, i.e. glycosphingolipides on the surface of the nervous system cells, especially peripheral nervous system cells. The purpose of this literature review is to improve understanding of the rather complex physiopathological mechanisms underlying Guillain-Barre syndrome.

Antigens, Bacterial↗
PubMed2003

[Comparison of sociocultural attitudes towards epilepsy in Limousin (France), in Togo and in Benin (Africa)].

Sociocultural attitudes continue to have a negative impact on management of epilepsy in many African countries and in a few advanced countries. The purpose of this study was to compare attitudes toward epilepsy in France and two African nations: Togo and Benin. A total of 305 epileptic patients over 18 years of age were interviewed using the same quantitative questionnaire about their beliefs, knowledge attitudes and practices regarding their disease. There were 77 patients from the Limousin region in France, 129 from the rural canton of Nadoba in Togo and 99 from the coastal province in Benin. The frequency of epileptic seizure during the last two years prior to the study was lower in France than in Togo and Benin. The number of people who believed in supernatural causes of epilepsy was higher in Togo and Benin whereas the number of people attributing the disease to social causes (e.g. death and stress) was higher in France. Few epileptic patients in France thought that the disease was contagious whereas many patients in both Togo and Benin still believed that the disease was contagious and that some foods were forbidden. More patients in France than in Togo and Benin were aware of the relationship of epilepsy with alcohol, drug abuse and cerebral injury. Epileptic patients in France were more likely to consult a physician and use medical drugs for the treatment of epilepsy than their counterparts in Togo and Benin. Epileptic patients in Togo often complained of social exclusion. Although sometimes contradictory, these findings support the idea that sociocultural attitudes should be taken into account in the management of the disease.

Adult↗
PubMed2003

[Clinical and biological surveillance after the cessation of Hymenoptera venom desensitization].

107 patients have discontinued Hymenoptera venom immunotherapy between 1988 and 2000. 31 have been seen again with intradermal tests with IgEs, and 81 responded to a questionnaire. Intradermal reactions and IgEs decrease together significantly during immunotherapy and then persist at low level during three years. Beyond, the number of patients is insufficient. 32 patients were stung by the same Hymenoptera and not had any systemic reaction. However, five have beta blockers, three have IEC and half of the patients don't take precautions to avoid Hymenoptera.

Adolescent↗
PubMed2002

Blood-cerebrospinal fluid barrier and intrathecal immunoglobulins compared to field diagnosis of central nervous system involvement in sleeping sickness.

Diagnosis of central nervous system (CNS) involvement in sleeping sickness is crucial in order to give an appropriate treatment regimen. Neurological symptoms occur late, therefore field diagnosis is based on white blood cell count, total protein concentration and presence of trypanosomes in cerebrospinal fluid (CSF). More sensitive and specific parameters are now available. Blood-CSF barrier (B-CSFB) dysfunction, intrathecal total and specific immunoglobulin synthesis were evaluated in 95 patients with and without obvious meningoencephalitis, and compared to field criteria.B-CSFB dysfunction is a rather late event in the course of CNS involvement and correlates with the presence of trypanosomes, neurological signs and intrathecal polyspecific and specific immune response. IgM intrathecal response and particularly IgM antibody index are early markers of CNS invasion. We showed that 29% of patients with CSF abnormalities but without trypanosome detection in the field had no neuro-immunological response. In contrast, patients with normal CSF according to field diagnosis showed an intrathecal immune response in 31% of the cases.Field diagnosis can therefore fail to determine neurological involvement but can also provide false positive results. Improved criteria including B-CSFB dysfunction and IgM detection are needed in order to provide an adapted treatment regimen.

Albumins↗