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At least 415 records · Page 23Linked to original sources
PubMed2001

Clinical prediction of lower limb deep vein thrombosis in symptomatic hospitalized patients.

We evaluated two clinical scores for the prediction of deep venous thrombosis (DVT) in hospitalized patients (Wells' and Kahn's). We included 273 patients referred to the vascular exploration unit for the suspicion of DVT. A clinical questionnaire was tilled in by the practitioner and the scores were calculated from this form. 66 of the 273 patients had a DVT. When Wells' score was 3, a DVT was found by duplex echography in 51% patients; when the score was 0, a DVT was found in 9%. Kahn's score was not adapted to this population. We then developed a new simple score (cancer, palsy or plaster immobilization, warmth, superficial venous dilation, unilateral pitting edema, other diagnosis). A DVT was found in 76% patients with a score of 3 and in 11% in those with a score of 0. We therefore propose a 6-item score whose main advantages are simplicity and usefulness in routine practice.

Female↗
PubMed2002

[Lower limb occlusive arteriopathy: retrospective analysis of 73 patients with onset before the age of 50 years].

OBJECTIVES: Juvenile peripheral obstructive arterial diseases (POAD) have been poorly investigated but account for 1 to 7% of POAD. We analyzed retrospectively a cohort of patients with onset before the age of 50 years. PATIENTS AND METHODS: Seventy-three patients (60 males and 13 females) were divided into 4 groups (Buerger's disease: TAO, atheromatous PAOD, auto-immune POAD, arteriopathy of undetermined origin). RESULTS: The first symptoms occurred at 38 +/- 8 years of age. Fourteen patients (20%) had TAO, 51 (70%) atheromatous POAD, 4 (5%) POAD with systemic or autoimmune disease, and 4 (5%) undetermined POAD. Age of onset was earlier in TAO (35 +/- 8 vs 40 +/- 8 years, p=0.046), smoking greater in the atheroma group (33 +/- 16 vs 24 +/- 14 pack-years, p=0.033). Fifty-three POAD patients had dyslipidaemia and 26% hypertension. Regular cannabis intake was more frequent in the TAO group (21 vs 8%). At the time of medical care, Fontaine's stage was more frequently stage II in atheroma patients (57 vs 14%) and stage IV in TAO patients (86 vs 35%). TAO was diagnosed in 43% cannabis users and in 19% non users. CONCLUSION: The main etiology of juvenile POAD is atheroma, followed by TAO. Cannabis users account for at least 10% of these patients. They are characterized by lower tobacco intake, more distal lesions, more frequent involvement of the upper limbs. They present more frequently as TAO.

Adult↗
PubMedDate not supplied

[Lymphocytic infiltration in human gliomas].

A histological study of lymphocytic infiltration has been undertaken following removal at operation of one hundred human gliomas. This study has been completed with eight cases of tumour recurrence, six attempted autologous grafts, twenty one post-mortems and fourteen explorations of delayed hypersensitivity reactions. About half of the glioma specimens showed lymphocytic infiltration and no reaction was present in the other. Within this series of glioblastomas a correlation existed between the presence of infiltrating lymphocytes and the duration both of pre and post operative tumour evolution. The rejection of autologous grafts seemed to depend directly on the presence of lymphocytic infiltrations associated with the primary tumour. The retarded hypersensitivity reactions obtained after intradermic inoculations of cellular lyophilizates did not seem to be directly related either to the phenomenon of autologous graft rejection or to the presence of lymphocytic infiltrations. The results suggest that there is a complex system represented by two antigenic groups of transplantation type and sensitization type.

Age Factors↗
PubMed2002

[Cardiovascular involvement in systemic sclerosis].

Heart involvement is frequent in systemic sclerosis. Cardiomyopathy is the main localization but its diagnosis is often late. Cardiac echography or radionuclide imaging show early involvement of the myocardium while showing alterations of diastolic function of the left ventricle or perfusion defects. The pathogenesis of this cardiomyopathy is supposed to be related to myocardial ischemia in relation with vasospasm, or with organic lesions of small arteries or coronary microcirculation. Pericarditis rarely is of clinical significance. Pulmonary hypertension concerns patients with proximal and advanced systemic sclerosis or limited forms such as CREST. It can be efficiently diagnosed by doppler echography but its therapy is difficult and its prognosis is poor. Epoprostenol in continuous venous infusion seems to be efficient but the accessibility to this therapy is difficult. While the involvement of middle-sized arteries of the hands is common, systemic sclerosis seems to be associated to an increased frequency of large-sized arteries disease.

CREST Syndrome↗
PubMed1975

[Trial of experimental induction of cerebral metastasis in the rabbit carrying a VX2 tumor].

Numerous factors remain unknown as far as the mechanism of induction of cerebral metastases is concerned. Where as of cancer give metastases more readily than others, especially cerebral metastases, the neoplastic embolus can be either eliminated or remain in place in a state of quiescence. What is the role played by the blood brain barrier from a pathophysiological point of view? Is there a mechanism which prevents central nervous system metastases? What is the importance of individual variation? We attempted to induce cerebral metastases in VX2 carcinoma carrying rabbits to look for an approach to these problems and to create an experimental model of cerebral metastase. The VX2 carcinoma is easily transplantable and its biological characteristics are well known. The VX2 tumor is implanted in the thigh of the rabbits and is used in the experimentation starting two weeks following the take of the graft; the tumor is surgically resected and a solution containing approximatively 50,000 tumor cells for 0,1 ml is prepared. This solution is inoculated via the carotid artery to the same rabbit or to another rabbit of the same breed either or intrathecal way into the brain. Death occurred 6 to 20 days later and was followed by a complete pathological survey. The results were the following: --The inoculation via the carotid artery, even with very highly concentrated solution was never followed by any recognizable brain metastasis. --The inoculation intrathecaly produced only extraparenchymatous metastases where as the direct intracerebral inoculation was followed by the occurence of intracerebral metastases.

Animals↗
PubMed2003

Early response to chemotherapy in hypopharyngeal cancer: assessment with (11)C-methionine PET, correlation with morphologic response, and clinical outcome.

UNLABELLED: Neoadjuvant chemotherapy in hypopharyngeal cancer globally improves survival, but some patients do not respond to chemotherapy and adjuvant therapy is delayed. Prediction of response to chemotherapy may allow physicians to optimize planned treatment. The aim of this study was to compare treatment response assessed early with (11)C-methionine PET and morphologic response assessed after treatment completion with MRI. METHODS: Thirteen patients with previously untreated squamous cell carcinoma of the hypopharynx, T3 or T4, were included. All patients received 3 courses of chemotherapy comprising cisplatin and 5-fluorouracil. (11)C-Methionine PET was performed before and after the first course of chemotherapy. PET estimation of response was expressed in relative variation of mean standardized uptake value (SUVmean), maximal standardized uptake value (SUVmax), volume of (11)C-methionine tumor uptake, and total tumor uptake. Posttreatment response was assessed with MRI, which was performed before the first course and after treatment completion, and expressed in relative variation of tumor volume. Patients were considered responders if their tumor volume was reduced by more than 50%. RESULTS: The relative decrease in all PET parameters correlated significantly with the relative decrease in MRI volume. The larger area under the receiver operating characteristic curve was obtained for SUVmean (0.883), but that area was close to the area of SUVmax (0.857). For methodologic considerations, SUVmax was more reproducible. The optimal threshold of response for SUVmax was -25%, leading to a mean of 83% (range, 36%-93%) sensitivity and 86% (range, 42%-100%) specificity. Using this threshold, survival at 2 y was improved for responders (83%), compared with nonresponders (57%), but the difference was not statistically significant. CONCLUSION: (11)C-Methionine PET provides early useful information about changes in tumor metabolism induced by chemotherapy in hypopharynx cancer. (11)C-Methionine PET measurements correlate with end-of-treatment response evaluated with MRI and may thus be helpful to physicians in treatment planning by avoiding unnecessary chemotherapy courses for nonresponding patients.

Aged↗
PubMed2003

[Malnutrition in the elderly].

Malnutrition is highly prevalent in the elderly populations: 4% in the community and near by 50% in the hospital or the long-term care facilities. Insufficient dietary intake results from loneliness, ignorance, impaired functional capacities and iatrogenic conditions. In case of acute injury or infection, stress reaction activates cytokine-induced metabolic events that impair nutritional status. There is a physiological anorexia with aging, but aging alone is not responsible for malnutrition. Diseases, psychological conditions and environmental factors are taken in account to treat malnutrition. Ethical considerations are necessary before tube-feeding decisions in a malnourished aged patient.

Aged↗
PubMed1976

[Chromatographic analysis of urinary amino acids in Paget's disease. I : Biochemical study. Isolation and amino acid composition of a urinary peptide specific to this bone disease].

The authors demonstrated in the urine of patients presenting Paget's bone disease a peptide rich in hydroxyproline. The level of this compound expressed as "norleucine equivalent" was determined by chromatographic analysis of the urinary amino acids. There was a very good correlation between the total hydroxyproline level and the quantity of this peptide in the urine. The authors isolated this peptide and determined that it contained 3 hydroxyprolines for every 2 glutamines. This peptide thus seems to indicate an anomaly in the chain of synthesis; a disorder of the collagen metabolism would produce in these patients large quantities of these molecules that are excreted via the kidney. At the present stage of the author's studies this urinary peptide appears to be "specific" to Pagets disease.

Amino Acids↗
PubMed2003

Anti-endothelial cell autoantibodies and soluble markers of endothelial cell dysfunction in systemic lupus erythematosus.

OBJECTIVE: To determine if anti-endothelial cell antibodies (AECA) and plasma markers of endothelial cell function are related to disease severity in systemic lupus erythematosus (SLE). METHODS: We measured AECA by human umbilical vein endothelial cell binding, endothelial markers von Willebrand factor, soluble thrombomodulin, and soluble E-selectin by ELISA, and disease severity by SLEDAI and SLICC/ACR in 35 patients with SLE. RESULTS: Despite high levels of IgG AECA (p = 0.001) and von Willebrand factor (p = 0.0007) compared to 21 healthy controls, we found a positive correlation only between IgG AECA and the SLEDAI index (r = 0.393, p = 0.021). CONCLUSION: IgG AECA seem to be related to disease activity in SLE, possibly in a pathogenic role. Conversely, plasma markers of endothelial cell damage seem to be an epiphenomenon and may simply be related to excess inflammation.

Adult↗
PubMed1992

Group-specific component is not only a vitamin-D-binding protein.

The vitamin-D-binding protein (DBP), also called group-specific component, is well known for two main reasons: its genetic polymorphism, and its binding affinities for actin and vitamin D compounds. In recent years, additional binding affinities have been described for this puzzling molecule, without any significant biological explanations being given for these observations. The molecular genetic data for DBP are analyzed in order to show that the affinities for vitamin D are supported by the genetic variability. The molecular evolution of the protein shows that the ancestral gene was present long before the development of related genes, such as those for albumin and alpha-fetoprotein. Other affinities for actin, C5a-desArg and for a B lymphocyte mitogen are also discussed. DBP is mainly present in the circulating blood as an apoprotein. The cytoplasmic presence of DBP has not been confirmed, and the major question today is to understand the biological role of this protein. In the last part of the review, the discussion focuses on relating the different binding affinities of DBP to its biological activities. Avenues for future research are also outlined: these include DBP metabolism, the differentiation of macrophages, and the activity of DBP during embryonic development.

Amino Acid Sequence↗