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Biomedical subjects

P Meier

Publications and source records attributed to P Meier.

At least 19 recordsLinked to original sources
PubMed2006

[Lercanidipine, a third generation calcium antagonist. Which advantages?].

Lercanidipine is a new highly lipophylic dihydropyrdine derivative of the third generation with equal efficacy but an improved tolerability profile. Comparative therapeutic trials have shown that it is as effective as other dihydropyridines, in particular amlodipine, beta-blockers, and angiotensin-converting enzyme inhibitors. Lercanidipine is well tolerated, with most treatment-emergent events related to vasodilation. Lercanidipine produces less reflex tachycardia and peripheral oedema. Common adverse events included headache and flushing. Because of its efficacy and favorable safety profile, lercanidipine has the potential to improve blood pressure control in a wide range of patients, including those who have not responded to, or who have been unable to tolerate other antihypertensive agents.

Antihypertensive Agents↗
PubMed2006

Systematic in vivo RNAi analysis of putative components of the Drosophila cell death machinery.

Despite the identification of numerous key players of the cell death machinery, little is known about their physiological role. Using RNA interference (RNAi) in vivo, we have studied the requirement of all Drosophila caspases and caspase-adaptors in different paradigms of apoptosis. Of the seven caspases, Dronc, drICE, Strica and Decay are rate limiting for apoptosis. Surprisingly, Hid-mediated apoptosis requires a broader range of caspases than apoptosis initiated by loss of the caspase inhibitor DIAP1, suggesting that Hid causes apoptosis not only by antagonizing DIAP1 but also by activating DIAP1-independent caspase cascades. While Hid killing requires Strica, Decay, Dronc/Dark and drICE, apoptosis triggered by DIAP1 depletion merely relied upon Dronc/Dark and drICE. Furthermore, we found that overexpression of DIAP2 can rescue diap1-RNAi-mediated apoptosis, suggesting that DIAP2 regulates caspases directly. Consistently, we show that DIAP2 binds active drICE. Since DIAP2 associates with Hid, we propose a model whereby Hid co-ordinately targets both DIAP1 and DIAP2 to unleash drICE.

Animals↗
PubMed2006

[Leucocoria in childhood].

BACKGROUND: There are a number of conditions in infants and young children which produce a white reflex in the pupillary area, termed leucocoria. In cases of leucocoria, retinoblastoma has to be excluded without delay. METHODS: We analysed data from consecutive children who were presented to our hospital because of leucocoria between January 1999 and June 2005. The analysis was performed by methods of descriptive statistics. RESULTS: Leucocoria was found in 83 eyes of 58 children. Leucocoria was caused in most cases by congenital cataract (35 %), followed by malformations (18 %) (persistent hyperplastic primary vitreous, coloboma, disc anomaly, combined developmental abnormalities), hereditary vitreoretinal disorders (13 %), retinopathy of prematurity (12 %), trauma-associated diseases (8 %). Five children suffered from retinoblastoma (6 %). Following in frequency were inflammatory disorders (5 %) and Coats' disease (2 %). DISCUSSION: Several ocular conditions of childhood can clinically cause leucocoria. Knowledge of the clinical features that serve to differentiate retinoblastoma from simulating lesions may assist the clinician in arriving at the correct diagnosis.

Cataract↗
PubMed2005

[Do selective COX-2 inhibitors have adverse renal and cardiovascular effects?].

Selective cyclooxygenase-2-inhibitors (COX-2) were developed as an alternative to the non-steroidal anti-inflammatory drugs (NSAID) in order to reduce their known gastrointestinal and renal toxicity. Several recent studies have shown the complex mechanism of the cyclooxygenase-2. The inhibition of the COX-2 has effects on renal hemodynamics, renal salt and water retention and may increase the thromboembolic and therefore the cardiovascular risk. The renal toxicity of the COX-2 inhibitors is similar to that of traditional NSAID. Regarding these data, COX-2 inhibitors should be prescribed with much caution to high risk patients, that is, patients with renal failure and/or cardiovascular diseases.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2005

[Selective COX-2 inhibitors and cardiovascular risk].

Selective cyclooxygenase-2 (COX-2) inhibitors were initially developed to reduce the gastrointestinal toxicity of conventional NSAIDs. However, it became rapidly evident that selective COX-2 inhibitors may increase the risk of cardiovascular events. Today, the mechanisms for the potentially adverse cardiovascular effects of coxibs remain unknown, and it is increasingly clear that our understanding of the role of COX-2 in cardiovascular function is incomplete. Based on some available indirect evidence, and unless more clear-cut data become available, the longterm use of high doses of selective COX-2 inhibitors, in elderly patients or patients with a high cardiovascular risk should be limited whenever possible.

Cardiovascular Diseases↗
PubMed2005

[Fever of unknown origin with granulomatous hepatitis, uveitis and acute renal failure].

A 46-year-old man was referred to our hospital because of fever of unknown origin (FUO). Two months before admission, he noted fever, weight loss, and asthenia. Physical examination revealed only mechanical pains of the right shoulder. In the past, patient's father had a tuberculosis. At the age of 29 years, Brucella granulomatous hepatitis and B hepatitis were diagnosed. The past three years, he developed two episodes of uveitis which resolved with local treatment. The hepatic biopsy revealed only a non specific granulomatous hepatitis. Few days after admission, the patient developed acute renal failure without proteinuria or hematuria. The renal biopsy confirmed the presence of noncaseating granulomas. In the context of the patient, we diagnosed a sarcoidosis. All the symptoms resolved with the initiation of prednisone treatment. The FUO differential diagnosis, and the different aspects of renal sarcoidosis are discussed.

Biopsy, Needle↗
PubMed2005

Dysregulation of IL-2/IL-2R system alters proliferation of early activated CD4+ T cell subset in patients with end-stage renal failure.

BACKGROUND/AIM: Although CD4+ T cells are preactivated in patients with end-stage renal failure (ESRF), these patients present an impairment of T cell immune response, which is partly responsible for the higher incidence of infection in this population. The aim of the present study was to analyze the mechanisms underlying the altered function of activated CD4+ T cells in patients with ESRF. METHODS: Thirty patients undergoing chronic hemodialysis (HD) and 20 patients with ESRF were compared with 15 sex- and age-matched controls. CD4+ T cell early activation (CD69, CD25), interleukin-2 (IL-2)/IL-2 receptor (IL-2R) system, and proliferation capacity of CD69+/CD4+ T cells were assessed ex vivo after blood draw sampling, in culture conditions and after phytohemagglutinin (PHA) stimulation. RESULTS: Although the CD4+ T cell count was lower in chronic HD patients than in predialysis patients and controls (p = 0.007), CD4+ T cells showed a pre-activation state as demonstrated by higher percentage of CD69+/CD4+ T cells and CD25+/CD4+ T cells in chronic HD patients compared with the other groups ex vivo. Furthermore, CD69+/CD4+ T cells from chronic HD patients spontaneously released more IL-2 (22 +/- 6 pg/ml) than those from pre-dialysis patients (12 +/- 4 pg/ml, p = 0.005) and controls (5 +/- 3 pg/ml, p = 0.001). However, after PHA stimulation, CD69+/CD4+ T cells from chronic HD patients expressed lower cell surface CD25 density, and were unable to show further activation. Indeed, these cells produced less IL-2 and released more soluble IL-2R, and correlatively with IL-2 production, they showed lower proliferation capacity compared with predialysis patients (p = 0.001) and controls (p < 0.001). They also displayed decreased responsiveness to exogenous human recombinant IL-2. The restoration of the PHA stimulation index of CD69+/CD4+ T cells from chronic HD patients in the presence of normal human serum as well as the decreased stimulation index of CD69+/CD4+ T cells from control subjects incubated with HD serum, strongly suggest that uremic toxins and mediators induced by HD affect the IL-2/IL-2R pathway. CONCLUSION: These findings demonstrate the presence, in chronic HD patients, and to lesser extent, in predialysis patients, of abnormally high proportion of spontaneously preactivated CD4+ T cells whose proliferation and further activation are blunted due to dysregulation of the IL-2/IL-2R system.

Antigens, CD↗
PubMed2004

Vacuum-assisted conservative treatment for the management and salvage of exposed prosthetic hemodialysis access.

Recurrent puncture of dialysis grafts can cause erosion and ulcer formation in the skin over the prosthetic material. Contamination of the wound can lead to infection of the graft, and the necessity to remove it. We describe four cases where agressive treatment with debridement, intravenous antibiotics and negative pressure therapy allowed prosthesis salvage without discontinuation of hemodialysis.

Aged↗
PubMed2004

[Eye globe reconstruction after severe injury of the posterior segment].

Severe injuries of the posterior eye segment mostly occur during perforation or rupture of the globe. The first treatment includes primary surgical repair of the ocular wound and prophylactic scleral buckling in case of involvement of the posterior segment. Thereafter, a vitrectomy should be performed to remove vitreous hemorrhage and intraocular foreign bodies and to achieve a stable attachment of the retina. Therefore, temporary perfluorocarbon and permanent silicone oil tamponade are used. A predictor of poor visual outcome is the presence of retinal and choroidal injury. In our patients, the most important prognostic factor was the initial visual acuity after the injury. Vitrectomy can significantly reduce the incidence of enucleation. Currently, better visual outcome is achieved by advances in surgical techniques.

Eye Injuries, Penetrating↗
PubMed2003

A duck hepatitis B virus strain with a knockout mutation in the putative X ORF shows similar infectivity and in vivo growth characteristics to wild-type virus.

Hepadnaviruses including human hepatitis B virus (HBV) and duck hepatitis B virus (DHBV) express X proteins, HBx and DHBx, respectively. Both HBx and DHBx are transcriptional activators and modulate cellular signaling in in vitro assays. To test whether the DHBx protein plays a role in virus infection, we compared the in vivo infectivity and growth characteristics of a DHBV3 strain with a stop codon in the X-like ORF (DHBV3-X-K.O.) to those of the wild-type DHBV3 strain. Here we report that the two strains showed no significant difference in (i). their ability to induce infection that resulted in stable viraemia measured by serum surface antigen (DHBsAg) and DHBV DNA, and detection of viral proteins and replicative DNA intermediates in the liver; (ii). the rate of spread of infection in liver and extrahepatic sites after low-dose virus inoculation; and (iii). the ability to produce transient or persistent infection under balanced age/dose conditions designed to detect small differences between the strains. Thus, none of the infection parameters assayed were detectably affected by the X-ORF knockout mutation, raising the question whether DHBx expression plays a physiological role during in vivo infection with wild-type DHBV.

Animals↗
PubMed2003

[Retroperitoneal fibrosis, an unrecognized inflammatory disease. Clinical observations and review of the literature].

Retroperitoneal fibrosis (RF) is a rare disease, typically with an insidious clinical course. The peak incidence is seen in patients 40 to 60 years of age and mostly in man. The characteristic finding in this disease is a periaortic fibrous mass that often surrounds the ureters. Although usually regarded as an obstructive uropathy, there has been growing recognition of the condition as a generalized disease. It may have a wide variety of manifestations including mediastinitis, thyroiditis and sclerosing cholangitis. The most common mode of presentation remains abdominal or flank pain with uremia, anemia and a high sedimentation rate. Although ultrasound and renal scintigraphy may contribute to the general evaluation of patients with RF, CT-scanner is the preferred imaging method. The multiplanar imaging capability of magnetic resonance may facilitate assessment of disease extent. The pathogenesis of the disease remains unknown. Steroids and, more recently tamoxifen, appear to be effective in the treatment of the RF. In most instances, RF does not lead to long-term morbidity or affect survival. The three cases of RF reported herein illustrate the varied mode of presentation and the response to the treatment.

Aged↗
PubMed2002

[Evolution of interventional cardiology in France during the last decade (1991-2000)].

The annual inquiry by the "Angiography and Interventional Cardiology Group" of the French Society of Cardiology has allowed the evolution of interventional cardiology in France between 1991 and 2000 to be monitored. The results of the 2000 inquiry have been analysed in particular. The number of coronarography centres has increased by 27% in 10 years, growing from 173 in 1991 to stabilise at 220, and the number of centres performing percutaneous coronary angioplasty grew from 128 to 175 (+27%) at the same time. The number of coronarographies increased by 79% (131,636 to 236,111), and angioplasties increased by 197% (30,885 to 91,901). In the year 2000, angiographic procedures represented 39% of coronarographies, against 23% in 1991. Endoprosthesis implantation constitutes the principal revolution of this decade, the number of procedures growing from 393 to 77,388 between 1991 and 2000, some 84.2% of angioplasties, and a total number of endoprostheses of 107,869 (1.39 stents per procedure). The other revascularisation techniques remain anecdotal, representing only 1.9% of procedures. In 2000, at the 135 centres supplying detailed information, direct stenting represented 38.5% of procedures, and the indications for restenosis were 9.9%. The number of interventions performed in the public or private sector is almost identical for each category, only morphological or functional explorations remain the privilege of the public sector in the university setting. The activity of the University Hospitals Centres has noticeably and regularly decreased since 1991, falling from 39.2% to 28.7% of coronarographies and from 41.8% to 31.1% of angioplasties in 2000.

Angioplasty↗
PubMed2001

Long-term use of a left ventricular assist device for end-stage heart failure.

BACKGROUND: Implantable left ventricular assist devices have benefited patients with end-stage heart failure as a bridge to cardiac transplantation, but their long-term use for the purpose of enhancing survival and the quality of life has not been evaluated. METHODS: We randomly assigned 129 patients with end-stage heart failure who were ineligible for cardiac transplantation to receive a left ventricular assist device (68 patients) or optimal medical management (61). All patients had symptoms of New York Heart Association class IV heart failure. RESULTS: Kaplan-Meier survival analysis showed a reduction of 48 percent in the risk of death from any cause in the group that received left ventricular assist devices as compared with the medical-therapy group (relative risk, 0.52; 95 percent confidence interval, 0.34 to 0.78; P=0.001). The rates of survival at one year were 52 percent in the device group and 25 percent in the medical-therapy group (P=0.002), and the rates at two years were 23 percent and 8 percent (P=0.09), respectively. The frequency of serious adverse events in the device group was 2.35 (95 percent confidence interval, 1.86 to 2.95) times that in the medical-therapy group, with a predominance of infection, bleeding, and malfunction of the device. The quality of life was significantly improved at one year in the device group. CONCLUSIONS: The use of a left ventricular assist device in patients with advanced heart failure resulted in a clinically meaningful survival benefit and an improved quality of life. A left ventricular assist device is an acceptable alternative therapy in selected patients who are not candidates for cardiac transplantation.

Activities of Daily Living↗