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Biomedical subjects

P Philippe

Publications and source records attributed to P Philippe.

At least 19 recordsLinked to original sources
PubMed2006

Effect of daily versus twice weekly long-term iron supplementation on iron absorption and status in iron-deficient women: a stable isotope study.

OBJECTIVES: This work aims at studying the effect of daily versus twice weekly long-term Fe supplementation on Fe absorption and status in Fe-deficient women. DESIGN AND METHODS: The study design is a randomized controlled open study carried out in the Internal Medicine Department, CHU de Clermont-Ferrand, France. Twenty-four young women participated in this study and were randomized into two groups: Group 1 received 50 mg Fe daily, and group 2 received 50 mg Fe twice weekly for 3 months. On day 10 (D10) and on day 90 (D90) of Fe supplementation, blood samples were obtained, and women received orally about 5 mg of 57Fe, and blood was sampled at different times over 24 h. The 57Fe absorption was evaluated by calculating the areas under the curves (AUC). Fe and oxidative stress status were also assessed. RESULTS: 57Fe absorption was similar in both groups on D10 but was greatly decreased in Group 1 and remained high in Group 2 on D90. Fe status was more improved in Group 1 than in Group 2. Oxidative stress status remained statistically unchanged. CONCLUSIONS: Our study shows that daily Fe supplementation is able to correct an Fe deficiency much more than twice weekly Fe supplementation in young women.

Absorption↗
PubMed2006

[Measles, pertussis, rubella and mumps completeness of reporting. Literature review of estimates for industrialized countries].

BACKGROUND: Surveillance data for infectious diseases in industrialized countries have been providing useful epidemiological information for several years. However, surveillance is complex and notifications underestimate the true disease incidence. The goal of this paper is to determine the completeness of reporting of measles, pertussis, rubella and mumps through notification in industrialized countries. METHODS: A thorough literature review of papers published (in French or English) on surveillance data of measles, pertussis, rubella and mumps was undertaken with PUBMED. The review was limited to studies conducted in industrialized countries that quantitatively assessed the completeness of the reporting of these diseases. RESULTS: Fourteen studies published from the 1920s met the inclusion criteria. For measles, the studies suggest that 64-85% of symptomatic patients sought medical care, 13-57% of those were diagnosed with measles and 22-81% of the diagnosed cases were reported for a completeness of reporting ranging from 7% to 63% between 1920 and 1980 and 3% to 41% in recent years. For pertussis, it was estimated that 49-59% of symptomatic patients sought medical care, 12% of those were diagnosed and 19-47% of the diagnosed cases were reported for a completeness of reporting ranging from 5% to 25% between 1920 and 1980 and from 3% to 12% in recent years. Very few studies on rubella and mumps were found and none allowed the determination of the global completeness of reporting. CONCLUSION: Reporting has been found to be considerably incomplete. Continued efforts to improve the recognition and reporting of these diseases are needed.

Developed Countries↗
PubMed2005

[Non infectious endocarditis: retrospective study (6 cases)].

PURPOSE: If there is cardiac valve vegetation and the blood cultures are negatives we need to look for slow growing bacteria, fungi, Legionella pneumophilia, Bartonella henselae and quintana, Brucella melitensis and abortus, Coxiella burneti, Chlamydiae pneumoniae by serologic tests. The diagnosis of non- infectious endocarditis could be considered only if these results were negative. The main purpose of this study was to describe the clinical and echocardiographic signs of non-infectious endocarditis cases observed in two different wards. METHODS: This study was done retrospectively during a five-year period in a cardiology and an internal medicine wards. The selection criteria are: the proof of at least one cardiac valve vegetation, observed on echocardiography, negative blood cultures and negative serologic tests as described above. RESULTS: Six non-bacterial endocarditis were described. Four Libman-Sacks endocarditis, two associated with a primary antiphospholipid syndrome revealed by an acute ischemia of leg for one patient and by an eclampsia for another and the other two associated with a systemic lupus erythematous revealed by fever for one patient and by neurologic symptoms for the other. One fibroblastic endocarditis associated to an essential hypereosinophilia and one marastic endocarditis associated to a metastatic mucin-producing cancer. CONCLUSIONS: For these six cases, a complete physical examination, a CBC for hypereosinophylia, a dosage of antiphospholipid antibodies and a thoraco-abdominal CT-scan allowed the etiologic diagnosis of non infectious endocarditis. Libman Sacks endocarditis associated with an antiphospholipid syndrome is the main etiology for which a long-term anticoagulation treatment was not followed.

Adolescent↗
PubMed2004

A continuous series of 96 laparoscopic inguinal hernia repairs in children by a new technique.

BACKGROUND: The aim of this study was evaluate a novel technique of laparoscopic hernia repair in children. METHODS: Eighty two consecutive patients aged >or=2 years old were operated on for hernia repair using a laparoscopic technique that reproduced every step of the conventional open procedure. Technical details and clinical results are reported. RESULTS: Ninety six sacs were divided in 82 patients (15 girls and 67 boys). Fourteen bilateral hernias that had been diagnosed before operation in nine cases and during laparoscopy in five cases were repaired. Nine controplateral dimples were left and not repaired. Mean operative time was 23 min in girls and 28 min in boys for unilateral hernias, and 30 min in girls and 40 min in boys for bilateral hernias. Sixty-seven of the children were followed up 6 months later. None of them suffered recurrences. No unsightly scars were observed at the port sites. Discomfort did not extend beyond 48 h after the operation, enabling a rapid return to normal activities. CONCLUSION: Dividing the sac and suturing the peritoneum is feasible and efficient by laparoscopy. Compared with the other techniques that have previously been reported, either without any dissection of the sac or any ligature, our technique seems to be advantageous. It is not time consuming and does not require any special laparoscopic skill.

Child↗
PubMed2004

[Gastroparesis on a gastric ulcer].

INTRODUCTION: Gastroparesis is the failure of the stomach to empty because of decreased gastric motility. It's a fairly frequent medical problem. Diabetes is the most common known cause. OBSERVATION: The first case report is that of an 82 year-old woman, in whom acute gastric distension occurred, evoking a gastric volvulus on the scan. Upper endoscopy revealed gastric ulcers. All symptoms disappeared with medical treatment. The second case report concerns a 37 year-old man who was admitted with signs of occlusion. CT scans revealed acute gastric distension. Emergency surgery revealed no gastric volvulus. Upper endoscopy revealed gastritis and numerous ulcers. The signs regressed with medical treatment. DISCUSSION: Our observations are original in their -pseudo-surgical discovery. Acute gastric distension is rare, but must be recognised because of the risk of perforation and rupture of the stomach walls. These case reports are also original in their aetiology. Gastric ulcers are rarely described in this situation. CONCLUSION; Gastroparesis is a frequent situation but potentially severe. A review of the principle signs, aetiology and treatment is made.

Acute Disease↗
PubMed2004

Haematopoetic stem cell transplantation for refractory autoimmune cytopenia.

This study describes the outcome of patients receiving haematopoietic stem cell transplantation (HSCT) to treat severe refractory autoimmune cytopenia. The registry of the European Group of Blood and Marrow Transplantation holds data on 36 patients receiving 38 transplants, the first transplant was autologous for 27 and allogeneic for nine patients. Patients had autoimmune haemolytic anaemia (autologous: 5; allogeneic: 2), Evans's syndrome (autologous: 2; allogeneic: 5); immune thrombocytopenia (autologous: 12), pure red cell aplasia (autologous: 4; allogeneic: 1), pure white cell aplasia (autologous: 1; allogeneic 1), or thrombotic thrombocytopenic purpura (autologous: 3). Patients had longstanding disease having failed multiple prior treatments. Among 26 evaluable patients mobilized for autologous HSCT, three died of treatment-related causes, one died of disease progression, seven were non-responders, six patients had transient responses and nine had continuous partial or complete remission. Of the seven evaluable patients receiving allogeneic HSCT, one died of treatment-related complications, one with transient response died of progressive disease and five had a continuous response. Autologous and allogeneic HSCT may induce a response in a subset of patients with autoimmune cytopenia of long duration albeit at the price of considerable toxicity.

Adolescent↗
PubMed2003

Granular medium under vertical tapping: change of compaction and convection dynamics around the liftoff threshold.

A granular medium submitted to vertical tapping reveals simultaneously compaction and convection. The two phenomena are directly coupled and their dynamics can be quantified by a characteristic compaction time and by an estimation of the convective downhill speed along the wall. A remarkable change of behavior is observed around the liftoff acceleration threshold of the whole packing, with a drastic slowing down of both dynamics below this threshold. Above it, a collective shock wave densifies the packing at each tap, whereas, below it, cumulative localized rearrangements will compact the entire system in the long time range.

Journal Article↗
PubMed2003

[POEMS syndrome: imaging of skeletal manifestations, a study of 8 cases].

PURPOSE: To describe the imaging features of POEMS, and to compare our experience of 8 cases to a review of literature. MATERIALS AND METHODS: This retrospective study included 8 patients (6 men, 2 women) with POEMS. Plain radiographs (8 patients), CT (6), MR (2) were performed. RESULTS: Topographic localizations of POEMS were pelvis (7 cases), spine (5), femur (1), humerus (1), rib cage (1). Focal bone lesions, multiple (5 cases) or solitary (3 cases), were sclerotic in 4 cases, mixed lytic-sclerotic (lytic center and sclerotic rim) in 3 cases and one patient had an osteolytic lesion with sclerotic margins associated with many osteosclerotic lesions. Profilerative osseous changes were seen in 4 cases (pelvis, spine, tibia). MR imaging was performed in 2 patients: in one patient MR imaging revealed areas of low signal intensity on spin echo T1- and T2-weighted images in vertebral bodies, the other showed a lesion of low signal intensity on spin echo T1-weighted and high signal intensity on T2-weighted images in the ilium and adjacent soft tissue. CONCLUSION: The imaging features commonly observed in POEMS syndrome are sclerotic and mixed lytic-sclerotic lesions, particularly in the pelvis and spine. Proliferative new bone formation is detected in 50%. MR imaging correlates with ostesclerotic or mixed lytic-sclerotic appearance.

Adult↗
PubMed2002

A case-control study of temporomandibular disorders: symptomatic disc displacement.

This case-control study was designed to investigate the risk factors for disc displacement (DD) without myofascial pain (MFP). The study population included 59 cases with DD without MFP, selected in two hospital dental clinics, and 100 concurrent controls selected in one of these clinics. The association with DD was evaluated for bruxism, head-neck trauma, orthodontic treatment, and sociodemographic characteristics by using unconditional logistic regression. In the multivariate analysis, excluding psychological factors, an association was found between DD and clenching-grinding (OR=3.57; 95% CI: 1.27-9.98). This association persisted when anxiety (OR=3.07; 95% CI: 1.08-8.70) or depression (OR=4.02; 95% CI: 1.43-11.31) was included in the model. A positive association was noted between orthodontic treatment and DD (OR=3.10; 95% CI: 1.06-9.65). The effect between orthodontic treatment and DD remained and increased with the inclusion of anxiety (OR=3.65; 95% CI: 1.15-11.61) or depression (OR=3.20; 95% CI: 1.06-9.65). A high level of anxiety (OR=2.40; 95% CI: 1.01-5.73), was positively related to DD. We concluded that clenching combined with grinding, and orthodontic treatment are factors related to DD. The interpretation of these associations, however, requires caution because of the inclusion of prevalent cases.

Adolescent↗
PubMed2002

Heterogeneity of temporomandibular disorders: cluster and case-control analyses.

Cluster analysis has been applied to the classification of temporomandibular disorders (TMD). The factors most often used in these classification systems are psychological and psychosocial. The aim of this study is to classify individuals diagnosed with TMD, by using cluster analysis based on their clinical condition and the global severity of the disease. In this study, one investigator selected the patients at the dental clinics located at the Jewish General and Montreal General hospitals, Montreal, Canada, from September 1994 to December 1997. The study population included 162 outpatients. The results of this study indicated the existence of four TMD subgroups: three TMD pain groups with localized or generalized disorder related to different levels of interferences in their life and a non-pain, but disabled group. External validation of the cluster solution support the replication of the four groups and allow for further interpretation of the patients' profiles. Clenching-grinding and depression were related to the groups presenting generalized TMD. Orthodontic treatment and female sex, however, were the factors associated with a more localized condition. This classification system may provide a better understanding of the TMD subgroups and clues for the treatment and prognosis of TMD patients.

Adolescent↗
PubMed2001

Numerical model for granular compaction under vertical tapping.

A simple numerical model is used to simulate the effect of vertical taps on a packing of monodisperse hard spheres. Our results are in good agreement with an experimental work done in Chicago and with other previous models, especially concerning the dynamics of the compaction, the influence of the excitation strength on the compaction efficiency, and some aging effects. The principal asset of the model is that it allows a local analysis of the packings. Vertical and transverse density profiles are used, as well as size and volume distributions of the pores. An interesting result concerns the appearance of a vertical gradient in the density profiles during compaction. Furthermore, the volume distribution of the pores suggests that the smallest pores, ranging in size between tetrahedral and octahedral sites, are not strongly affected by the tapping process, in contrast to the largest pores which are more sensitive to the compaction of the packing.

Journal Article↗
PubMed2001

Sacrococcygeal teratoma: results of a retrospective multicentric study in Belgium and Luxembourg.

Eighteen patients, operated upon for sacrococcygeal teratoma in 7 different centres in Belgium and Luxembourg between 1992 and 1996, were reviewed. From an epidemiological point of view, this series compares very well to others. Although excellent results were obtained, with all patients surviving, some imperfection in diagnosis, timing of delivery and of operation, and in operative technique was observed. Therefore, it is stated that for optimal treatment of sacrococcygeal teratoma to be achieved, these cases should be treated in just a very few centres of neonatal surgery.

Adult↗
PubMed2000

[Iron and inflammation].

Iron is essential for life. Inflammatory disorders cause iron metabolism disturbances resulting in very low concentration of free iron. Iron binding proteins synthesis have a central role in the decreasing iron reutilization for erythropoiesis, and in the increasing iron storage. Inflammatory disorders also induce inhibition of the erythroid progenitors. Synthesis and action of erythropoietin are also disturbed. All these changes are mediated by the activated cytokine cascade (TNF alpha, IL1, IL6...) that is able to induce anaemia of inflammation those clinical and biological characteristics are well defined. Soluble transferrin receptor concentration can help to identify iron deficiency when inflammation is associated. Management of anaemia of inflammation requires prior to treat the cause of inflammation when it is possible, even if human recombinant erythropoietin has been demonstrated to be effective.

Anemia, Hemolytic↗
PubMed2000

Anterior mandibular osteotomy for tumor extirpation: a critical evaluation.

BACKGROUND: Anterior mandibular osteotomy gives excellent access to the oropharynx for oncologic resections. Although rigid internal fixation has improved results in stability and bone healing, side effects and complications of the surgical procedure must be considered. METHODS: Between 1991 and 1997, 64 patients underwent a transmandibular approach for benign or malignant tumors of the head and neck. Sixty-one of them were included in a 6-month follow-up study. Final results and major and minor complications were recorded. RESULTS: Three (5%) cases of non-union and infection of the osteotomy site required plate removal, curettage, and reosteosynthesis. Occlusal disturbances and local periodontal disease occurred in 2 (3%) patients. Thirty-two (52%) patients complained of sensitivity disturbances, 18 (30%) of temporomandibular joint pain, and 44 (72%) of a limitation in opening the mouth. Six patients (10%) had a cosmetic complaint. CONCLUSION: Dental condition and periodontal care in the vicinity of the osteotomy are important factors in reducing the risk of major complications. Trismus, limitation of joint motion, and pain cannot be directly related to the technique; they depend on the extent of tumor resection and postoperative radiotherapy.

Adolescent↗
PubMed2000

[Diagnosis of iron deficiency: evaluation of the "soluble transferrin receptor/transferrin" ratio].

OBJECTIVE: This study was aimed at determining the diagnostic value of conventional laboratory tests regarding the iron status and serum transferrin receptor in hospitalized patients. METHODS: Patients who had to undergo bone marrow aspirate examination were included in this 8-month prospective study. Iron deficiency was defined as the absence of stainable iron on bone marrow examination. Patients with stainable iron were included in the control group. The higher value of diagnostic efficacy determined the cut-off value for each parameter of the iron status. RESULTS: Twenty-one patients (17 females, four males) (mean age: 52 years) with iron deficiency and 33 control subjects (20 females, 13 males) (mean age: 60 years) were included in the study. The ratio serum transferrin receptor/serum ferritin had the best diagnostic efficiency (78%) with a sensitivity of 81% and a specificity of 97%. Serum ferritin alone with a cut-off value of 60 micrograms/L had the same specificity (97%) but a lower sensitivity (76%). The diagnostic value of all other analyzed tests was below 66% (transferrin alone, mean corpuscular volume, transferrin saturation, iron, serum transferrin receptor alone, red cell distribution width). CONCLUSION: Among in-patients, ferritin remains the first intention test to diagnose iron deficiency, but the cut-off value should be increased (60 micrograms/L in this study). The ratio "serum transferrin receptor to serum ferritin" provides the highest specificity with a higher cost and should be used only in doubtful cases.

Anemia, Iron-Deficiency↗