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Biomedical subjects

P Métais

Publications and source records attributed to P Métais.

At least 19 recordsLinked to original sources
PubMed2003

[Delirious states in elderly persons. Clinical characteristics].

EXTENSIVE HETEROGENEITY: The nosology of delusional disorders in the elderly is still debatable. The nosology varies greatly from that of the younger adults. It is heterogeneous because of the age at onset of the symptomatology, etiology and behavioural consequences (agitation, aggressiveness) of the delusion. TWO DISTINCT CONTEXTS: We can distinguish between the long term, old, psychoses and the delusions having occurred later in life (after the age of 60). The outcome of the former is still unknown; but often progresses towards the reduction in symptomatology. In the latter, various etiologies are observed with, primarily, delusions associated with dementia, followed by thymus delusions, schizophrenic or non-schizophrenic psychoses, delusions related to cerebral-vascular disorders or sensorial dysafferentation. It is important to underline the fact that any de novo delusion occurring after the age of 65 must evoke an underlying deterioration. ENHANCING FACTORS: In addition to a genetic predisposition suspected in certain cases, vulnerability factors are usually found in the context of age: somatic comorbidity, loneliness, sensory deficiencies, cognitive impairment, polymedication, and addict attitude. FROM A DIAGNOSTIC POINT OF VIEW: The differential diagnosis is essentially made with mental confusion. The evaluation calls upon scales, either specific to the psychosis and similar to those used in adults (SANSS, PANSS, PDI), or global and intended for psychological dementia and behavioural disorders (NPI).

Adult↗
PubMed2003

[Delirious states in elderly persons. Therapeutic modalities].

THE MAJOR THERAPEUTIC TRENDS: The treatment of psychosis in late life depends on the etiology of the delusion but also on its behavioral consequences (agitation, aggressiveness). We distinguish between the treatment of long term old psychosis and delusions occurring late in life (after the age of 60). FOR THE OLD PSYCHOSES: The reduction in the symptomatology often permits a reduction in the doses and the relay to atypical neuroleptics with improved tolerance. FOR DELUSIONS OCCURRING LATE IN LIFE: The treatment will be adjusted to the etiology of the delusion: delirious states associated with dementia, thymus delusion, schizophrenic or non-schizophrenic psychosis, delusion related to cerebral-vascular disorders or to sensorial dysafferentation. One should note that emotional and delusional disorders are often concomitant in the elderly. THE TWO TREATMENT AXES: The first therapeutic element is non-pharmacological: reassurance or even brief psychotherapy, family counseling and prevention of enhancing, notably environmental, factors. The pharmacological element preferably includes atypical anti-psychotics, antidepressants in some cases together with anti-epileptics in cases of concomitant rebellious aggressiveness. In cases of dementia with cholinergic deficiency (Alzheimer, Lewy body dementia, mixed dementia) cholinesterase inhibitors have demonstrated their efficacy on the hallucinations. Advice for a pertinent strategy of action should be provided.

Age of Onset↗
PubMed1998

HIV-1-resistance phenotype conferred by combination of two separate inherited mutations of CCR5 gene.

BACKGROUND: Despite multiple exposures to HIV-1, some individuals remain uninfected, and their peripheral-blood mononuclear cells (PBMC) are resistant to in-vitro infection by primary HIV-1 isolates. Such resistance has been associated with a homozygous 32-base-pair deletion (delta 32) in the C-C chemokine receptor gene CCR5. We examined other mutations of the CCR5 gene that could be associated with resistance to HIV-1 infection. METHODS: We assessed the susceptibility of PBMC to in-vitro infection by HIV-1 isolates that use the CCR5 as the major coreceptor for viral entry in 18 men who had frequent unprotected sexual intercourse with a seropositive partner. We also did genotypic analysis of CCR5 alleles. One of the 18 exposed but uninfected men (who we refer to as ExU2) showed total resistance to in-vitro infection by CCR5-dependent viruses, and was found to carry a CCR5 delta 32 allele and a single point mutation (T-->A) at position 303 on the other allele. To find out whether the CCR5 mutation was restricted to ExU2's family or existed in the general population, we did genetic analyses of the CCR5 genotype in ExU2's father and sister and also in 209 healthy blood donors who were not exposed to HIV-1. FINDINGS: The m303 mutation found in ExU2 introduced a premature stop codon and prevented the expression of a functional coreceptor. The family studies revealed that the m303 mutant allele was inherited as a single mendelian trait. Genotype analysis showed that three of the 209 healthy blood donors were heterozygous for the mutant allele. INTERPRETATION: We characterise a new CCR5 gene mutation, present in the general population, that prevents expression of functional coreceptors from the abnormal allele and confers resistance to HIV-1 infection when associated to the delta 32 CCR5 mutant gene.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Dilution assessment of cervicovaginal secretions collected by vaginal washing to evaluate mucosal shedding of free human immunodeficiency virus.

A 10 mM concentration of lithium does not interfere with reverse transcription (RT) or PCR. Sampling of cervicovaginal fluid by vaginal washing, with lithium (10 mM) in the washing buffer as a marker of dilution, may be utilized to accurately determine in HIV-infected women, by quantitative RT-PCR, the genital shedding of acellular HIV RNA at the level of the mucosa itself.

Cervix Mucus↗
PubMed1990

Variations in apolipoproteins serum amyloid A, A-I, A-II, and C-III in severely head-injured patients.

In five severely head-injured patients we determined the plasma concentrations of apolipoproteins serum amyloid A, A-I, A-II, C-III, and B, prealbumin and C-reactive protein on day 1, 5, 10 and 15 after head injury where possible. A dramatic increase in apolipoprotein serum amyloid A up to a mean plasma level of 0.764 g/l was accompanied by a considerable decrease in apolipoprotein A-I, apolipoprotein A-II and apolipoprotein C-III concentrations. The variations observed by immunological methods were confirmed by two-dimensional gel electrophoresis performed on plasma and different lipoprotein fractions. In addition to its association with high density lipoproteins, apolipoprotein serum amyloid A was also found with lipoproteins of low and very low density. Two-dimensional electrophoresis also showed the presence of several different serum amyloid A-peptides not seen in plasmas from healthy subjects. We propose that apolipoprotein serum amyloid A may be responsible for the decrease of the main HDL apolipoproteins in head-injured patients.

Apolipoprotein A-I↗
PubMed1989

Two-dimensional electrophoresis of plasma proteins and high density lipoproteins during inflammation.

Plasma protein and lipoprotein fractions of five patients were analyzed on day 1, 5, and 15 after severe head injury by combining three types of two-dimensional electrophoresis (2-DE) to obtain information on lipoprotein and apolipoprotein composition. On analysis under nondenaturing conditions in both dimensions on day 5, the samples show modifications of isoelectric point (pI) and molecular weight (Mr) properties of the high density lipoprotein (HDL) fraction in addition to an increase in inflammatory proteins and a return to a normal pattern on day 15. In the second type of 2-DE the samples were analyzed employing isoelectric focusing without denaturant in the first dimension, followed by sodium dodecyl sulfate (SDS) in the second dimension in order to study the protein composition of lipoprotein fractions. On day 5, a decrease of the apolipoproteins apo A-I, apo A-II, and apo C were noted, with simultaneous appearance of an unidentified protein with Mr 12,000 and pI 6.0. In the third type of 2-DE, employing urea and Nonidet P-40 in the first and SDS in the second dimension, the plasma polypeptide composition was studied. The presence of an unidentified polypeptide could be confirmed on day 5, tending to disappear thereafter. This Mr 12,000 component consists of two major spots at pI 5.7 and 6.0 and four minor ones between pI 6.0 and 8.0. These properties suggest that this protein corresponds to serum amyloid A apolipoprotein.

Apolipoprotein A-I↗
PubMed1989

[Quantitative analysis of apolipoproteins and lipoprotein particles in patients with head injuries].

By head-injured patients, apo A-I and apo A-II concentrations were more decreased in HDL3 than in HDL2. Then, the plasmatic concentrations of the main lipoprotein particles present in HDL fraction were modified. For example, a significant decrease of Lp A-I: A-II particles was observed and this variation was similar to that of total apo A-I (r = 0.78). On the other hand, the concentration of Lp A-I particles was slightly modified, apo C-III concentration was markedly decreased whereas apo E concentration was significantly increased (p less than 0.05); in plasma samples obtained 10 days after a severe head injury, apo E reached three times the normal value.

Adolescent↗
PubMed1986

[Value of the assay of C-reactive protein in osteoarticular infection].

The C-reactive protein is specifically increased in the acute phase of inflammation. Its level in the serum is measured by the use of immunonephelometry and is obtainable after 2.5 hours. It normally ranges between 3 and 22 mg/litre. The authors have measured the C-reactive protein after 50 surgical procedures in septic cases. They have compared its levels with other biological tests such as the sedimentation rate and the leucocyte count. The variations in C-reactive protein occurred very early and were very extensive, the increase ranging between 200 and 1500 per cent after the surgical procedure. In cases without septic complications the level returned to normal within seven days, while the sedimentation rate only became normal after three months. In cases with septic complications, the rise of C-reactive protein appeared before clinical signs. Therefore, such an increase should lead to a search for a persistent infective focus or the presence of an osteitis. However, this biological test cannot differentiate between an acute infective and a severe inflammatory process.

Arthritis, Infectious↗
PubMed1986

[Assay of free plasma lipids after femoral and tibial fractures and centromedullary nailing].

Development of fat embolism is frequent following bone trauma involving the long bones of the legs. Determination of embolic free lipids in the plasma is based on microfiltration of lipid droplets (diameter greater than 5 micron) and nephelometric measurements after dissolution and specific precipitation. Free lipid levels in normal subjects are less than 5 mg/l. This value may rise to 37 mg/l after fracture of the leg bones and always increases after centromedullary pinning, reaching its maximum value three to nine hours after the operation. There is generally a rapid return to normal levels but sometimes this occurs slowly, particularly in patients presenting symptoms of fat embolism.

Adult↗
PubMed1986

[Urinary lipase: properties and value of its determination].

Lipase activity was detected by nephelometry in urine specimens from 23 patients. Urinary lipase and plasma activities present different sensitivities to changes in ionic strength and copper ion concentration. Experiments with mixtures of urine specimens with and without lipasic activity showed that there is no lipase inhibitor in urine. Urinary lipase is generally seen in patients presenting signs of renal impairment (increase in uremia and creatinemia) and hematuria. The highest urinary lipase levels in such patients are usually seen when blood lipase is increased. High urinary lipase in the absence of hepatic aliments could, therefore, be indicative of renal disorder.

Acute Disease↗
PubMed1984

Differentiating two forms of plasma lipase by use of media with different ionic strengths.

Three different techniques of lipase (EC 3.1.1.3) determination (titrimetry, nephelometry, and enzyme immunoassay) were used to investigate an interesting effect of ionic strength on enzyme activity. Both activation in the presence of NaCl (140 mmol/L) and strong immunoinhibition were observed for lipase from plasma of subjects with acute pancreatitis. Another type of lipase, not associated with pancreatitis and only weakly immunoinhibited, showed maximum activity in the presence of 80 mmol/L NaCl. The pancreatitis-type lipase was activated by 140 mmol/L NaCl solution only if colipase and sodium deoxycholate were also present, which suggests that these components are cofactors in the activating effect and confirms the specificity of this property. These findings can be exploited to improve the diagnosis of acute pancreatitis.

Acute Disease↗
PubMed1983

Prognostic value of combined data on enzymes and inflammation markers in plasma in cases of severe head injury.

We measured certain enzyme activities (aldolase, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase) and inflammation markers (alpha 1-antitrypsin, C-reactive protein, fibrinogen, and leukocytes) each day for four days in plasma of patients with severe head injury. The univariate prognostic efficiency of each biochemical parameter was assessed 24, 48, 72, and 96 h after trauma. By stepwise multivariate analysis applied every day, we found that (a) four variables, two enzymes (lactate dehydrogenase and aspartate aminotransferase) and two inflammation markers (C-reactive protein and leukocytes), sufficed to reliably predict the patient's outcome and (b) data recorded at 72 h best discriminated between survivors and nonsurvivors. A risk index based on the four selected variables and validated on a large control sample allowed the correct allocation of, respectively, 90% of survivors and 88% of nonsurvivors at 72 h. We discuss why results obtained at 72 h are more predictive than those obtained at any other of the times considered.

Adolescent↗
PubMed1983

[Plasma variations in severe head injuries: prognosis and post-traumatic surveillance. I. Enzymes].

Variations of four enzymatic activities (aldolase, aspartate aminotransferase, creatine kinase and lactate dehydrogenase) were followed in human plasma for four days after head injury. Univariate analysis showed that each plasma enzyme activity significantly differed as early as 72 h after head injury according to the clinical evolution (survival or death). Multivariate analysis performed with these four tests allowed us to correctly divide, in terms of survival or death, 75 to 91% of unselected patients (n = 280). Combining these four tests increased discriminant power in severe head injury. Most of the patients who were misclassified according to their biochemical data received phenobarbital for treatment. Valuable prognostic information may thus be obtained by daily determinations of four enzymatic activities.

Adolescent↗
PubMed1981

[Value of C-reactive protein determination in cranial traumatology].

Serum C reactive protein can be assayed precisely and specifically by immunonephelometry. This protein was determined daily for four days in 102 patients suffering of a skull trauma. Skull trauma without any complication (n=43) did not lead to a significant increase of C reactive protein level, in contrast to skull trauma complicated by an intracranial haematoma (n=32), in patients with profound coma (n=17) and in cases leading to a fatal issue (n=10). C reactive protein concentrations in uncomplicated skull trauma were found to be significantly different from those of the three series of complicated situations. C reactive protein patterns were correlated with the evolution of the trauma. It is therefore recommended that C reactive protein concentrations in serum should be determined daily during four days following the accident.

Brain Injuries↗