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Biomedical subjects

P Senet

Publications and source records attributed to P Senet.

At least 19 recordsLinked to original sources
PubMed2006

A Hirshfeld partitioning of polarizabilities of water clusters.

A new Hirshfeld partitioning of cluster polarizability into intrinsic polarizabilities and charge delocalization contributions is presented. For water clusters, density-functional theory calculations demonstrate that the total polarizability of a water molecule in a cluster depends upon the number and type of hydrogen bonds the molecule makes with its neighbors. The intrinsic contribution to the molecular polarizability is transferable between water molecules displaying the same H-bond scheme in clusters of different sizes, and geometries, while the charge delocalization contribution also depends on the cluster size. These results could be used to improve the existing force fields.

Journal Article↗
PubMed2006

[Correlation between the presence of type-2 anti-pemphigoid antibodies and dementia in elderly subjects with no clinical signs of pemphigoid].

BACKGROUND: Pemphigoid is a form of auto-immune bullous dermatosis characterised by the production of antibodies directed against components of hemidesmosomes in the basal membrane. The physiopathological process responsible for unmasking of these antigens is unknown. Pemphigoid is more common in elderly subjects and is most often seen in debilitated subjects. The prevalence of pemphigoid anti-pemphigoid antibodies (anti-PB) is not known in the elderly population presenting no dermatological signs evocative of the disease. We studied the prevalence of anti-PBAg2 antibodies in elderly subjects with no signs of pemphigoid as well as in the correlation between the presence of these antibodies and diagnosis of dementia. PATIENTS AND METHODS: Elderly subjects (aged over 69 years) with no signs of pemphigoid were recruited consecutively in dermatology and geriatrics departments (138 subjects). Details of concomitant medication were recorded for all subjects and clinical examination was performed with calculation of MMS (Mini Mental Score). The subjects were then divided into two groups based on MMS score. The first group comprised subjects without dementia (MMS > 24) while the second comprised subjects with dementia. Serum anti-PBAg2 antibodies were determined by ELISA and indirect immunofluorescence with confirmation by Western blot. Antinuclear antibodies, used as a control for non-specific immune response, were assayed in all serum samples. The prevalence of these antibodies was compared between the two groups. RESULTS: The two groups were comparable in terms of age, sex and presence of dermatological diseases (ulcers, bedsores, erysipelas). Each group comprised 69 subjects. The overall presence of anti-PBAg2 antibodies in subjects with no signs are suggestive of pemphigoid was 3.6%. Presence of anti-PBAg2 antibodies was associated with diagnosis of dementia (p=0.04; 0% and 7% in groups 1 and 2, respectively). No correlation was seen between the presence of anti-PBAg2 antibodies and concomitant medication or dermatological disease. The overall prevalence of antinuclear antibodies was 14.5% and the figure was similar between the two groups. DISCUSSION: The presence of anti-PBAg2 could be associated with the diagnosis of dementia in elderly subjects.

Aged↗
PubMed2006

Prospective aetiological study of diaper dermatitis in the elderly.

BACKGROUND: The different causes of diaper dermatitis (DD) in the elderly are not well known and the treatment is often empirical. OBJECTIVES: To determine the causes of DD in the elderly and to evaluate the efficacy of antifungal treatments in this indication. METHODS: Consecutive patients presenting with DD were included. Clinical evaluation, skin swabs for bacterial and mycological cultures, patch testing and skin biopsy were performed at inclusion. This was followed by 1 month of topical antifungal cream and, if needed, by oral fluconazole for the second month. RESULTS: Forty-six patients were included (mean age 85 years). Causes of DD were established for 38 patients: 24 had candidiasis (63%), six irritant dermatitis (16%), four eczema (11%) and four psoriasis (11%). After 2 months of treatment, 27 of 37 (73%) patients were cured and five of 37 were improved. CONCLUSIONS: Mycoses and irritant dermatitis are the main causes of DD in the elderly, and emollient skin care and topical antifungal treatment can be considered a first-line therapy for this indication.

Aged↗
PubMed2004

[Becaplermin gel (Regranex gel)].

Becaplermine gel (Regranex) is an hydrogel which contains 100 microg of Platelet Derived Growth Factor-BB (rhPDGF-BB) per gram. Regranex is presented in 15-gram multidose tubes. It has been approved as adjuvant treatment for neuropathic diabetic ulcerations of less than 5 cm2, extending into the subcutaneous tIssue, in the absence of ischemia, in conjunction with a standardised program of appropriate wound care, (control of infection, sharp debridement, provision of a moist environment and avoidance of pressure on the wound). PDGF-BB promotes cutaneous wound healing by increasing proliferation and migration of dermal fibroblasts and extracellular matrix deposition. PDGF also promotes chemotaxis of neutrophils, monocytes and smooth muscle cells in wounds. Topical application of rhPDGF-BB speeds wound healing and promotes granulation tIssue formation, synthesis of extracellular matrix and the inflammatory phase of the wound healing process in healthy and healing-impaired animal models. In clinical trials in humans, accelarated healing has been demonstrated in patients with lower extremity diabetic neuropathic ulcers and decubitus sores by increasing granulation tIssue formation and epithelialization. Local toxicity studies in humans were negative (repeated becaplermin gel application under occlusion to intact or abraded skin, dermal sensitization tests). Pharmacokinetic studies in humans have shown that systemic absorption after topical applications was minimal. In trials, systemic and local tolerance were excellent. Reported adverse effects were similar in incidence and in nature in all groups. The 0.01% Regranex gel is safe and easy to use, with single daily application. It is currently the only commercially available topical growth factor for use in cutaneous wound healing.

Becaplermin↗
PubMed2002

Urgotul: a novel non-adherent lipidocolloid dressing.

Urgotul belongs to a new class of non-adherent dressings: the lipidocolloid dressings. It is composed of an open weave polyester mesh impregnated with hydrocolloid polymers dispersed within petrolatum. The first clinical trial data are presented. Efficacy and safety were evaluated in a multicentre non-comparative trial involving 92 patients treated to healing or up to 4 weeks. Adult outpatients with acute wounds (n = 34), leg ulcers (n = 24), other chronic wounds (n = 14) or with second-degree burns (n = 20) were included. Results showed 32.4% (n = 11) of the acute wounds, 12.5% (n = 3) of the leg ulcers and 14.3% (n = 2) of the other chronic wounds completely healed before 4 weeks. Surface areas decreased on average by 76.4%, 63.5% and 44.2% at study endpoint respectively. For burns, 19 patients healed (95%) within 5-19 days. A total of 771 dressing changes were performed during the course of the study. Dressing application was considered as easy or very easy in 90% or more of the changes and there was no difficulty in removing the dressing in about 95% of the cases. Safety was good with five reports of a transitory local adverse event, probably dressing-related, being observed, two patients (2.2%) prematurely stopped treatment because of moderate periwound erythema. Urgotul is a highly promising new dressing which is currently undergoing further comparative clinical evaluation.

Adult↗
PubMed2002

Evaluation of the stability and efficacy of rhGM-CSF as a topical agent in a gel formulation.

OBJECTIVE: It has been reported that recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF), applied as a solution or an emulsion, improves wound healing. In order to confirm these data, the wound-healing efficacy of this growth factor was studied in a murine model. METHOD: In this double-blind randomised study, murine excisional wounds were treated with either sterilised rhGM-CSF gel (10 micrograms/cm2) or a sterilised placebo gel (control group). rhGM-CSF was applied at dosages of 10 micrograms/cm2/day to wounds until complete closure occurred. RESULTS: rhGM-CSF stability in gel formulation was excellent during the first week but decreased thereafter. Full wound healing occurred within 9.7 days (mean time) in the intervention group compared with 10 days in the control group. This difference was not statistically significant. Histological evaluation of the healed wounds indicated that there was a similar percentage of neutrophils in the cellular infiltrate in both groups. CONCLUSION: rhGM-CSF sterile gel had an excellent safety profile and was easy to use, but did not significantly accelerate the healing rate in this model.

Administration, Topical↗
PubMed2002

[Nutritional status assessment of patients with leg ulcers].

INTRODUCTION: Nutritional deficiencies may delay the wound healing process. The aim of this study was to evaluate the prevalence of protein malnutrition in patients presenting with a leg ulcers and to determine which clinical data can predict malnutrition on population. PATIENTS AND METHODS: This prospective survey included community patients, hospitalized in rehabilitation care unit for treatment of a leg ulcer unhealed for at least 3 months. Clinical, anthropometric and biological data were collected on admission. RESULTS: Sixty-six patients, mean age 72.9 +/- 16.3 years, were included. Fifty-three p. 100 presented wound surfaces over 30 cm(2); 59 p. 100 of the ulcers had lasted for more than one year; 62 p. 100 of the ulcers were venous. 48.5 p. 100 of the patients exhibited protein malnutrition defined by biological criteria, associated with an inflammatory syndrome in 66 p. 100. Anemia and an inflammatory syndrome were present in respectively 59 and 58 p. 100 of the patients. Neither anthropometric measurements nor nutritional intake or wound characteristics significantly differenced between patients with malnutrition or not. Hypoalbuminemia was significantly more frequent and severe in patients aged over 70. DISCUSSION: Protein malnutrition prevalence is very high in patients with leg ulcers, particularly in the elderly. Since nutritional interview or clinical data failed to predict protein malnutrition, systematic biological assessment is justified in all patients with leg ulcers.

Adult↗
PubMed2001

The use of tetracyclines for the treatment of sarcoidosis.

BACKGROUND: To evaluate the safety and efficacy of minocycline in the treatment of sarcoidosis, a nonrandomized, open study was performed in patients with cutaneous sarcoidosis. OBSERVATIONS: Twelve patients with cutaneous sarcoidosis were treated with minocycline, 200 mg/d, for a median duration of 12 months. Three patients had extracutaneous lesions at the time of the study. The median follow-up was 26 months. A clinical response was observed in 10 patients, consisting of complete responses in 8 patients and partial responses in 2 patients. A progression of skin lesions was observed in 1 patient, and lesions remained stable in another patient. Adverse effects were minimal, except in 1 patient, who developed hypersensitivity syndrome. A slight hyperpigmentation occurred in 2 patients at the site of previous lesions, which completely disappeared after minocycline use was discontinued. A relapse of skin symptoms occurred after minocycline withdrawal in 3 patients, who further received doxycycline, 200 mg/d, allowing a complete remission of lesions. CONCLUSIONS: These results support that minocycline and doxycycline may be beneficial for the treatment of cutaneous sarcoidosis. Randomized controlled studies are warranted for the evaluation of the true efficacy of tetracyclines in these patients.

Adolescent↗
PubMed1999

[Decubitus sores in geriatric medicine. Local and general treatment of pressure sores in the aged].

LOCAL CARE: Local antiseptics and antibiotics must be avoided to preserve the local bacterial ecosystem of the wound. If surgical debridement is not possible, hypercolloid, alginate or hydrogel dressings should be applied to achieve natural autolytic cleansing. The budding and epithelization phases are also treated either with oily or humid dressings or more modern hypercellular, hydrocolloid and polyurethane film dressings. Other treatments under evaluation include physical means (negative pressure, electrical stimulation) or use of recombinant growth factors. GENERAL TREATMENT: Surgical repair with flaps or grafts is not usually indicated in fragile elderly patients. Special attention must be given to all associated diseases (diabetes, heart failure, etc.) as well as protein-calorie nutrition. The objective is 35 cal/kg/d including 1.25-1.5 g protein/kg/d. TREATMENT OF COMPLICATIONS: Wound infection should be suspected in case of an inflammatory induration around the wound, fever, or delayed healing. Systemic antibiotics are indicated as for cellulitis. The wound is generally colonized by germs found on local bacteriological samples. Osteitis should be suspected if the wound is in contact with bone. In case of biopsy proven osteitis with positive culture, prolonged oral antibiotics are indicated. Tendon retractions should benefit from rehabilitation exercises and surgery in case of medical failure. Antalgesics may be required, either continuously or when making the dressings.

Aged↗
PubMed1999

[Prevention of decubitus scars in the elderly].

IDENTIFYING RISK: Groups of elderly patients at risk of pressure sores must be carefully identified for effective prevention. Recommended risk scales are insufficiently used in everyday practice. Preventive measures must be rapidly implemented in order to reduce or eliminate factors contributing to the development of pressure sores. Risk factors include, among others, prolonged or heavy pressure, friction, shearing force, malnutrition, and bowel incontinence. POSITION: The position of patients with severe sensorial disorders should be changed every 2 or 3 hours. Bed rest should be interrupted as soon as possible, using a cushioned chair. Reclining in the strictly lateral position (with pressure on the trochanter) must be avoided. A 30 degrees dorsal inclination in the lateral position is preferable. The reclining-sitting position with a greater than 30 degrees inclination should be avoided as it increases the shearing forces applied to the sacrum. The ventral position is inappropriate for the elderly. PREVENTION AIDS: Mattresses, mattress covers, cushions and various other aids have been developed specifically for the prevention of pressure sores but the evaluation and choice of material requires careful assessment using pressure sensors. GENERAL MEASURES: Instruments designed to facilitate position changing help reduce the risk of friction. The general practice of massage, widely used in France, is not based on confirmed arguments of efficacy. On the contrary, certain studies would show that such methods can have unfavorable effects. Prevention of undernutrition and renutrition cannot be overlooked. Maintaining the patient in a dry environment (particularly in case of incontinence) and use of emollients to prevent skin drying are recommended. Written prevention protocols for education of patients, family, and health care personnel are indispensable.

Aged↗