PubMed Health⌕ Search

Biomedical subjects

P Vautravers

Publications and source records attributed to P Vautravers.

At least 19 recordsLinked to original sources
PubMed2006

[Secondary screening for osteoporosis in patients admitted for hip fracture to a rehabilitation center. Results of a survey].

GOALS: To determine prevalence, risk factors and treatment of osteoporosis in patients with hip fracture observed in a rehabilitation ward. BACKGROUND: Hip fractures are associated with up to 20% excess mortality in the first year after fracture and cause functional disability in most survivors. Despite available risk indices and physician information, osteoporosis is still underdiagnosed and undertreated. METHOD: We obtained history, clinical and biological data, and bone density (BD) data in 41 patients admitted with hip fracture to a rehabilitation care centre. RESULTS: Only 3 patients had known osteoporosis. Although 50% had at least 1 clinical risk factor, all patients showed osteopenic BD scores and 68% had osteoporotic scores; only one was correctly treated. DISCUSSION: As with international studies, our study shows that osteoporosis is underdiagnosed. Risk assessment tools allow for routine screening and preventive measures incorporated into standard care practice. The prevention of osteoporotic fracture can be promoted in rehabilitation centres.

Age Factors↗
PubMed2006

[Spinal manipulations in sciatica].

Spinal manipulations have been shown to be efficient for common low back pain; they remain an option in the treatment of symptomatic lumbar disk herniation. From data in the literature, the author discusses the interest of spinal manipulations with a "thrust" at the level of disk herniation and concludes that this therapy, performed by an experienced physician and under conditions of strict application, could be an option in the treatment of subacute and chronique disc herniation.

Humans↗
PubMed2005

[Spinal manipulation: survey of French medical physicians who graduated with the national diploma of osteopathy from Strasbourg University].

INTRODUCTION: The use of spinal manipulation (SM) is widespread, particularly in English-speaking countries, where many studies are published showing its popularity. However, no study exists of the demography and activity of the French medical profession. Our objective was to investigate the use of SM by French doctors in their daily practice. MATERIALS AND METHODS: We questioned 234 doctors, general practitioners and specialists who obtained the Inter-Academy of Manual Medicine and Osteopathy Diploma from Strasbourg University between 1985 and 2002. RESULTS: We obtained a response from 140 physicians: 110 (79%) practiced SM in their daily practice. They considered the technique efficient and used it as a first intention. Approximately one quarter of cases resulted in adverse effects on the back. Most of the doctors (77%) continued their education during their career. CONCLUSION: This first assessment of the practice of physicians trained in a university in manual medicine allows for confirming the respect of good medical practice with regular actualization of knowledge and reasonable outpatient care.

Attitude of Health Personnel↗
PubMed2004

[Exertional compartment syndrome].

OBJECTIVES: To review the literature on chronic exertional compartment syndrome. METHODS: We searched the Medline database with use of the keys words compartment syndrome, exertional, chronic, pressure, and fasciotomy. RESULTS: Exertional compartment syndrome is characterized by pain on exertion, which recedes at rest, and by excessive increase in compartment intramuscular pressure. Intramuscular pressure measurement is the reference diagnostic tool, but it has not been standardized or evaluated. Pressure observed during the first 5 min after exertion stops is more often used in diagnosis. The first studies of noninvasive investigations (magnetic resonance imaging, thallium single-photon emission tomographic imaging, near infrared spectroscopy) revealed their inadequate diagnostic value. The pathophysiological features of exertional compartment syndrome remain unclear: increased muscle bulk, fascia thickness and stiffness, stimulation of fascial sensory stretch-receptors, poor venous return, micromuscular injuries, and small clinical myopathic abnormalities. Treatment includes decreased sport activity or fasciotomy with partial fasciectomy. Several authors have used endoscopically assisted fasciotomy, which retrospective studies have shown to be successful. Long-term outcome studies could investigate the persistence of exertional minor pain and recurrence of the compartment syndrome with this treatment. CONCLUSION: Further studies are required to understand the physiopathology, standardize the intramuscular pressure test and evaluate the pressure threshold values, evaluate noninvasive investigations and specify the long-term outcome of fasciotomy.

Chronic Disease↗
PubMed2003

[An unusual complication of coronarography: neuralgia of the internal saphenous].

Many causes of saphenous nerve lesions at the knee or leg level have been reported. Proximal nerve lesions, especially after varicose vein stripping, are uncommon. We report a case of saphenous nerve lesion following catheterization of the femoral artery complicated with arterial spasm. The patient experienced pain for 10 years and only transdermal electroneural stimulation provided sedation. To our knowledge, this is the first published case of such an unusual complication after coronarography, despite the frequency of this procedure. We suggest nerve ischemia could explain the definitive neuralgia.

Adult↗
PubMed2000

[Spinal manipulation in the treatment of common low back pain].

Although the best designed studies have shown promising results, the efficacy of spinal manipulations has not as yet been proved. The mode of action may involve mechanical changes in the disk and facet joints, but neurological mechanisms probably play the key role. Complications of cervical spinal manipulations are rare. To protect patients, French legislation requires that spinal manipulations should only be performed by licensed physicians, who are capable of establishing the accurate diagnosis before undertaking manipulations.

Cervical Vertebrae↗
PubMed2000

Cervical spine manipulation and the precautionary principle.

Cervical manipulations can cause severe neurologic complications, which are both exceedingly rare and generally unpredictable. To meet the requirements of the principles of prevention and precaution, we believe the number of cervical manipulations should be reduced. To this end, we suggest that five recommendations developed by consensus be followed: unwanted effects, however minor, of previous manipulation should be looked for routinely and taken as absolute contraindications to further manipulation; a thorough physical examination, including a neurological evaluation, should be performed prior to manipulation; all known contraindications and indications should be followed; manipulation should be performed only by physicians experienced in this technique; and special caution should be exercised when performing first-line cervical manipulation.

Cervical Vertebrae↗
PubMed1998

Characterisation of xenobiotic-metabolising enzyme expression in human bronchial mucosa and peripheral lung tissues.

The human respiratory epithelium is in direct contact with chemical carcinogens and toxins in inhaled air. Therefore, the activities of xenobiotic-metabolising enzymes in this epithelium could modulate respiratory toxicity and carcinogenesis. We determined the expression of several xenobiotic-metabolising enzymes, including phase I and phase II enzymes, in human bronchial mucosa and peripheral lung tissues. Reverse transcription-polymerase chain reaction (RT-PCR) analysis of phase I enzymes showed CYP1A1 and CYP2C (CYP2C8 and CYP2C18) mRNA expression in all of the 14 bronchial mucosa specimens. CYP2A6 and CYP2B6 mRNAs were found in 85% of the samples, whereas 50 and 90% of the tissues displayed CYP2E1 and CYP3A5 expression, respectively. However, CYP1A2, CYP2D6 and CYP3A4 mRNAs were not detected in all samples analysed. Normal human bronchial epithelial cells (NHBE cells) cultured in serum-free conditions showed reduced P450 expression in comparison with the bronchial mucosal samples. Similar to the bronchial mucosa, the peripheral lung tissues expressed CYP1A1, CYP2A6, CYP2B6, CYP2C (CYP2C8 and CYP2C18), CYP2E1 and CYP3A5 mRNAs, but did not show detectable levels of CYP2D6. Additional P450s, such as CYP1A2 and CYP3A4, were detected. The expression of CYP1A1, CYP1A2, CYP2B6, CYP2E1 and CYP3A4/5 in peripheral lung tissues was confirmed at the protein level, whereas CYP2A6 protein was undetectable. The use of specific primers for the detection of the phase II isoenzymes belonging to the glutathione S-transferase mu (GST mu) and N-acetyl transferase (NAT) families showed that GSTM1 was expressed in 40% of the bronchial mucosa and 25% of the peripheral lung tissues, whereas GSTM3 and NAT1 mRNAs were found in all bronchial and lung samples. Finally, NAT2 expression was detected in all peripheral lung tissues, but was not detected in the bronchus. In conclusion, these results describing the diversity of the xenobiotic-metabolising enzymes expressed in the bronchus and lung tissues indicate that the human respiratory system could significantly and specifically contribute to the activation and metabolism of several environmental procarcinogens.

Adolescent↗
PubMed1998

Management and cost of care for low back pain in primary care settings in France.

We conducted a prospective observational study during the winter of 1994-1995 in a representative national sample of 2,406 patients aged 18 to 65 years seen in primary care settings for acute low back pain of less than 48 hours' duration. The following data were collected: demographic, social and clinical characteristics at inclusion; treatments prescribed throughout the episode, functional impairment and restriction of usual activities. These data were used to evaluate direct costs (health costs) and indirect costs (sickness payments). The sex ratio was predominantly male (60.4%), 80% of patients were economically active, mean age was 43 +/- 11.7 years, and most patients (76%) had a history of low back pain. Management consisted primarily of rest (bedrest, 32%; rest at home, 61%) and pharmacotherapy (mainly analgesics, nonsteroidal antiinflammatory drugs and muscle relaxants; mean number of drugs per patient, 3.2). Imaging studies were obtained in 34% of cases and physical therapy was prescribed in 30%. Referral and hospitalization rates were 5.4% and 0.8%, respectively. Among economically active patients, 82% were put on sick leave, for a mean duration of 8.4 +/- 4 days and 18.6% were reported as having work-related low back pain. The mean cost of outpatient care for the episode of low back pain was 1,021 French francs (FF), most of which was contributed by physical therapy (41.6%), physicians' fees (23.9%) and investigations (16%). Mean sickness payments were 821 FF per patient in the economically active subgroup and 523 FF per patient in the overall study population.

Activities of Daily Living↗
PubMed1998

[Polyneuropathy and neuromyopathy in intensive care. 4 new cases].

Neuromuscular complications acquired in the intensive care unit form a new clinical entity. Three neuromuscular deficits are described: so-called critical illness polyneuropathy where neuromyopathic changes are associated with corticosteroid and/or neuromuscular blocking agents, and catabolic myopathy. We report four new cases: three of them concerning polyneuropathy and one neuromyopathic change.

Adrenal Cortex Hormones↗
PubMed1997

Aflatoxin B1-induced DNA adduct formation and p53 mutations in CYP450-expressing human liver cell lines.

Epidemiological evidence has been supporting a relationship between dietary aflatoxin B1 (AFB1) exposure, development of human primary hepatocellular carcinoma (HCC) and mutations in the p53 tumor suppressor gene. However, the correlation between the observed p53 mutations, the AFB1 DNA adducts and their activation pathways has not been elucidated. Development of relevant cellular in vitro models, taking into account species and tissue specificity, could significantly contribute to the knowledge of cytotoxicity and genotoxicity mechanisms of chemical procarcinogens, such as AFB1, in humans. For this purpose a non-tumorigenic SV40-immortalized human liver epithelial cell line (THLE cells) which retained most of the phase II enzymes, but had markedly reduced phase I activities was used for stable expression of the human CYP1A2, CYP2A6, CYP2B6 and CYP3A4 cDNA. The four genetically engineered cell lines (T5-1A2, T5-2A6, T5-2B6 and T5-3A4) produced high levels of the specific CYP450 proteins and showed comparable or higher catalytic activities related to the CYP450 expression when compared to human hepatocytes. The T5-1A2, T5-2A6, T5-2B6 and T5-3A4 cell lines exhibited a very high sensitivity to the cytotoxic effects of AFB1 and were approximately 125-, 2-, 2- and 15-fold, respectively, more sensitive than the control T5-neo cells, transfected with an expressing vector which does not contain CYP450 cDNA. In the CYP450-expressing cells, nanomolar doses of AFB1-induced DNA adduct formation including AFB1-N7-guanine, -pyrimidyl and -diol adducts. In addition, the T5-1A2 cells showed AFM1-DNA adducts. At similar levels of total DNA adducts, both the T5-1A2 and T5-3A4 cells showed, at codon 249 of the p53 gene, AGG to AGT transversions at a relative frequency of 15x10(-6). In contrast, only the T5-3A4 cells showed CCC to ACC transversion at codon 250 at a high frequency, whereas the second most frequent mutations found in the T5-1A2 cells were C to T transitions at the first and second position of the codon 250. No significant AFB1-induced p53 mutations could be detected in the T5-2A6 cells. Therefore, the differential expression of specific CYP450 genes in human hepatocytes can modulate the cytotoxicity, DNA adduct levels and frequency of p53 mutations produced by AFB1.

Adult↗
PubMed1995

Identification of several isoforms of T-kininogen expressed in the liver of aging rats.

We have previously shown that senescent Sprague-Dawley rats have significantly increased levels of kininogen (KG) mRNA and protein, when compared with younger counterparts. In the rat, five different isoforms of kininogen have been identified: high-molecular-weight K-kininogen, low-molecular-weight K-kininogen, and T1 alpha, T1 beta, and T2 kininogens. Several of these isoforms have been shown to differ in their biological properties. It was therefore considered relevant to establish which of these isoforms are expressed in the liver of old rats. To this end, we have isolated and sequenced nine independent cDNA clones from a library constructed using liver mRNA from healthy senescent rats. Predicted protein sequences indicate the presence of T-kininogens only. The relative lack of induction of K-kininogens during aging was further confirmed by RNA hybridization experiments. The nucleotide sequences reveal a microheterogeneity of silent polymorphisms, suggesting the presence and expression of several different alleles of the genes. From our data we conclude that (i) Several isoforms of T-KG are expressed in the liver of senescent Sprague-Dawley rats and (ii) T1 kininogens appear to be the most highly represented T-KG mRNA species in old rat livers.

Aging↗