153 results on '"P. Hovette"'
Search Results
2. What pulmonologists need to know about extrapulmonary tuberculosis
- Author
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Delphine Natali, Georges Cloatre, Christian Brosset, Pierre Verdalle, Alain Fauvy, Jean-Pierre Massart, Quy Vo Van, Nelly Gerard, Claudia C. Dobler, and Philippe Hovette
- Subjects
Diseases of the respiratory system ,RC705-779 - Abstract
Extrapulmonary tuberculosis (EPT) can affect all organs. Its diagnosis is often challenging, especially when the lung is not involved. Some EPT locations, such as when the central nervous system is involved, are a medical emergency, and some have implications for treatment options and length. This review describes clinical features of EPT, diagnostic tests and treatment regimens.
- Published
- 2020
- Full Text
- View/download PDF
3. Screening for comorbidities in COPD
- Author
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Delphine Natali, Georges Cloatre, Philippe Hovette, and Belinda Cochrane
- Subjects
Diseases of the respiratory system ,RC705-779 - Abstract
Due to growing recognition of comorbidities, COPD is no longer considered a disease affecting only the respiratory system. Its management now entails the early diagnosis and treatment of comorbidities. However, although many studies have examined the impact of comorbidities on the evolution of COPD and patients’ quality of life, very few have explored the means to systematically identify and manage them. The aims of this article are to summarise the state of current knowledge about comorbidities associated with COPD and to propose a possible screening protocol in the outpatient setting, emphasising the areas needing further research.
- Published
- 2020
- Full Text
- View/download PDF
4. In vitro susceptibility to quinine and microsatellite variations of the Plasmodium falciparum Na+/H+ exchanger (Pfnhe-1) gene: the absence of association in clinical isolates from the Republic of Congo
- Author
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Rogier Christophe, Amalvict Rémy, Baret Eric, Castello Jacky, Zettor Agnès, Hovette Philippe, Bogreau Hervé, Pelleau Stéphane, Briolant Sébastien, and Pradines Bruno
- Subjects
Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Quinine is still recommended as an effective therapy for severe cases of Plasmodium falciparum malaria, but the parasite has developed resistance to the drug in some cases. Investigations into the genetic basis for quinine resistance (QNR) suggest that QNR is complex and involves several genes, with either an additive or a pairwise effect. The results obtained when assessing one of these genes, the plasmodial Na+/H+ exchanger, Pfnhe-1, were found to depend upon the geographic origin of the parasite strain. Most of the associations identified have been made in Asian strains; in contrast, in African strains, the influence of Pfnhe on QNR is not apparent. However, a recent study carried out in Kenya did show a significant association between a Pfnhe polymorphism and QNR. As genetic differences may exist across the African continent, more field data are needed to determine if this association exists in other African regions. In the present study, association between Pfnhe and QNR is investigated in a series of isolates from central Africa. Methods The sequence analysis of the polymorphisms at the Pfnhe-1 ms4760 microsatellite and the evaluation of in vitro quinine susceptibility (by isotopic assay) were conducted in 74 P. falciparum isolates from the Republic of Congo. Results Polymorphisms in the number of DNNND or NHNDNHNNDDD repeats in the Pfnhe-1 ms4760 microsatellite were not associated with quinine susceptibility. Conclusions The polymorphism in the microsatellite ms4760 in Pfnhe-1 that cannot be used to monitor quinine response in the regions of the Republic of Congo, where the isolates came from. This finding suggests that there exists a genetic background associated with geographic area for the association that will prevent the use of Pfnhe as a molecular marker for QNR. The contribution of Pfnhe to the in vitro response to quinine remains to be assessed in other regions, including in countries with different levels of drug pressure.
- Published
- 2011
- Full Text
- View/download PDF
5. A 62-year-old man with stridor and dyspnoea.
- Author
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Natali, Delphine, Hoan Le, Cuong Nguyen Ngoc, Minh Tran Ngoc, Chi Tran Khanh, and Hovette, Philippe
- Published
- 2021
- Full Text
- View/download PDF
6. Screening for comorbidities in COPD.
- Author
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Natali, Delphine, Cloatre, Georges, Hovette, Philippe, and Cochrane, Belinda
- Published
- 2020
- Full Text
- View/download PDF
7. A 44-Year-Old Man With Acute Chest Pain
- Author
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Natali, Delphine, Van Tu, Do, Cloatre, Georges, Tison, Tristan, and Hovette, Philippe
- Abstract
A 44-year-old man consulted in April 2020 for a 1-week persistent left lateral chest pain, increased with deep breathing and change of position. He had left lower limb pain without redness or swelling 2 weeks before presentation. He did not complain of shortness of breath, cough, hemoptysis, syncope, fever, nor general status alteration.
- Published
- 2020
- Full Text
- View/download PDF
8. Prevalence of In Vitro Resistance to Eleven Standard or New Antimalarial Drugs among Plasmodium falciparum Isolates from Pointe-Noire, Republic of the Congo
- Author
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Bruno Pradines, Thierry Fusai, Julien Cren, Philippe Cheval, Rémy Amalvict, Jean Pierre Gardair, P. Hovette, Christophe Rogier, Alain Callec, Joel Mosnier, Eric Baret, and Henri Léonard Atanda
- Subjects
Microbiology (medical) ,Cycloguanil ,Adolescent ,medicine.medical_treatment ,Plasmodium falciparum ,Statistics as Topic ,Drug Resistance ,Dihydroartemisinin ,Amodiaquine ,Pharmacology ,Lumefantrine ,Antimalarials ,chemistry.chemical_compound ,Parasitic Sensitivity Tests ,Halofantrine ,parasitic diseases ,medicine ,Animals ,Humans ,Malaria, Falciparum ,Artemisinin ,Child ,Mefloquine ,business.industry ,Infant ,Congo ,chemistry ,Child, Preschool ,Parasitology ,business ,Atovaquone ,medicine.drug - Abstract
We determined the level of in vitro resistance of Plasmodium falciparum parasites to standard antimalarial drugs, such as chloroquine, quinine, amodiaquine, halofantrine, mefloquine, cycloguanil, and pyrimethamine, and to new compounds, such as dihydroartemisinin, doxycycline, atovaquone, and lumefantrine. The in vitro resistance to chloroquine reached 75.5%. Twenty-eight percent of the isolates were intermediate or had reduced susceptibility to quinine. Seventy-six percent and 96% of the tested isolates showed in vitro resistance or intermediate susceptibilities to cycloguanil and pyrimethamine, respectively. Only 2% of the parasites demonstrated in vitro resistance to monodesethylamodiaquine. No resistance was shown with halofantrine, lumefantrine, dihydroartemisinin, or atovaquone. Halofantrine, mefloquine, and lumefantrine demonstrated high correlation. No cross-resistance was identified between responses to monodesethyl-amodiaquine, dihydroartemisinin, atovaquone, and cycloguanil. Since the level of chloroquine resistance in vitro exceed an unacceptable upper limit, high rates of in vitro resistance to pyrimethamine and cycloguanil and diminution of the susceptibility to quinine, antimalarial drugs used in combination, such as amodiaquine, artemisinin derivatives, mefloquine, lumefantrine, or atovaquone, seem to be appropriate alternatives for the first line of treatment of acute, uncomplicated P. falciparum malaria.
- Published
- 2006
9. Severe imported malaria: Clinical presentation at the time of hospital admission and outcome in 42 cases diagnosed from 1996 to 2002
- Author
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Sékéné Badiaga, Claude Martin, Jean Claude Manelli, Jean Delmont, Philippe Brouqui, Jean Pierre Carpentier, Fabien Duigou, and P. Hovette
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Plasmodium falciparum ,World Health Organization ,law.invention ,Patient Admission ,law ,Surveys and Questionnaires ,medicine ,Animals ,Humans ,Aged ,Retrospective Studies ,Coma ,Travel ,Quinine ,business.industry ,Retrospective cohort study ,Emergency department ,Middle Aged ,Jaundice ,medicine.disease ,Health Surveys ,Intensive care unit ,Malaria ,Treatment Outcome ,Chemoprophylaxis ,Emergency Medicine ,Female ,Prostration ,France ,medicine.symptom ,business - Abstract
The objectives of this retrospective study were to describe initial clinical profiles and subsequent outcome of adult patients in France who were diagnosed with severe imported malaria, as defined by the World Health Organization (WHO). Forty-two patients diagnosed from 1996 to 2002 were included (median age: 30 years, men: 78%, non-immune persons: 74%, return from Africa: 100%, inappropriate antimalarial chemoprophylaxis: 95%). At the time of hospital admission, jaundice (62%), hyperparasitemia (56%), and prostration (52%) were the most frequent findings, followed by acute renal failure (31%). Other findings, as described by the WHO criteria, were less common. Twenty-three patients presented only with jaundice, hyperparasitemia, or prostration in isolation, or in combination. Of these 23, five non-immune persons subsequently developed coma, shock, acute respiratory distress syndrome or acute renal failure; this led to death in 2 of these cases. This suggests that non-immune persons with imported malaria who present with jaundice, hyperparasitemia, or prostration should be admitted to the intensive care unit for close monitoring.
- Published
- 2005
10. In vitro susceptibility to quinine and microsatellite variations of the Plasmodium falciparum Na+/H+ exchanger (Pfnhe-1) gene: the absence of association in clinical isolates from the Republic of Congo
- Author
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Bruno Pradines, Eric Baret, Agnès Zettor, Jacky Castello, Christophe Rogier, Hervé Bogreau, P. Hovette, Sébastien Briolant, Rémy Amalvict, and Stéphane Pelleau
- Subjects
Sodium-Hydrogen Exchangers ,lcsh:Arctic medicine. Tropical medicine ,Genotype ,lcsh:RC955-962 ,Molecular Sequence Data ,Plasmodium falciparum ,Drug Resistance ,Protozoan Proteins ,Drug resistance ,Biology ,lcsh:Infectious and parasitic diseases ,Antimalarials ,Inhibitory Concentration 50 ,chemistry.chemical_compound ,Parasitic Sensitivity Tests ,Molecular marker ,medicine ,Humans ,lcsh:RC109-216 ,Amino Acid Sequence ,Malaria, Falciparum ,Genetics ,Quinine ,Polymorphism, Genetic ,Research ,Chloroquine ,medicine.disease ,biology.organism_classification ,Infectious Diseases ,Congo ,Parasitology ,chemistry ,Insect Proteins ,Microsatellite ,Sequence Alignment ,Malaria ,Microsatellite Repeats ,medicine.drug - Abstract
Background Quinine is still recommended as an effective therapy for severe cases of Plasmodium falciparum malaria, but the parasite has developed resistance to the drug in some cases. Investigations into the genetic basis for quinine resistance (QNR) suggest that QNR is complex and involves several genes, with either an additive or a pairwise effect. The results obtained when assessing one of these genes, the plasmodial Na+/H+ exchanger, Pfnhe-1, were found to depend upon the geographic origin of the parasite strain. Most of the associations identified have been made in Asian strains; in contrast, in African strains, the influence of Pfnhe on QNR is not apparent. However, a recent study carried out in Kenya did show a significant association between a Pfnhe polymorphism and QNR. As genetic differences may exist across the African continent, more field data are needed to determine if this association exists in other African regions. In the present study, association between Pfnhe and QNR is investigated in a series of isolates from central Africa. Methods The sequence analysis of the polymorphisms at the Pfnhe-1 ms4760 microsatellite and the evaluation of in vitro quinine susceptibility (by isotopic assay) were conducted in 74 P. falciparum isolates from the Republic of Congo. Results Polymorphisms in the number of DNNND or NHNDNHNNDDD repeats in the Pfnhe-1 ms4760 microsatellite were not associated with quinine susceptibility. Conclusions The polymorphism in the microsatellite ms4760 in Pfnhe-1 that cannot be used to monitor quinine response in the regions of the Republic of Congo, where the isolates came from. This finding suggests that there exists a genetic background associated with geographic area for the association that will prevent the use of Pfnhe as a molecular marker for QNR. The contribution of Pfnhe to the in vitro response to quinine remains to be assessed in other regions, including in countries with different levels of drug pressure.
- Published
- 2011
11. Actualités et perspectives en thérapeutique anti-parasitaire
- Author
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J. C. Doury, P. Hovette, J.M. Debonne, J. E. Touze, and R. Laroche
- Subjects
business.industry ,Gastroenterology ,Internal Medicine ,Medicine ,business - Published
- 1992
12. L'infection par le virus de l'immunodéficience humaine (VIH1) en Afrique sub-Saharienne en 1992. Originalités ?
- Author
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J. E. Touze, J.M. Debonne, P. Hovette, and R. Laroche
- Subjects
Gastroenterology ,Internal Medicine - Published
- 1992
13. Localisations osseuses révélatrices de la maladie de hodgkin. À propos de 11 observations
- Author
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B. Delmarre, D. Jaubert, J.G. Fuzibet, D. Hauteville, H. Eghbali, A. Pesce, B. Hoerni, and P. Hovette
- Subjects
medicine.medical_specialty ,Axial skeleton ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Lymph node biopsy ,Magnetic resonance imaging ,Scintigraphy ,medicine.disease ,Metastasis ,Radiation therapy ,medicine.anatomical_structure ,Cytology ,Internal Medicine ,medicine ,Medical imaging ,Radiology ,business - Abstract
The authors report 11 cases of Hodgkin's disease in which the first sign was due to bone involvement. Such observations are rare and raise diagnosis delays (Means: 5, 6 months in this series). Modern medical imaging techniques (scintigraphy, CT scan, magnetic resonance imaging) are very useful to an earlier diagnosis which will be better confirmed by lymph node biopsy given the poor information yielded by osseous cytology and/or histology. The elective localisation in bones belonging to the axial skeleton seems to support the hypothesis of a contiguous osseous involvement from lymphoid organs in contact with bones. Evolution with chemotherapy and radiotherapy is very similar to that observed in patients without bone involvement.
- Published
- 1992
14. Multinormal In Vitro Distribution Model Suitable for the Distribution of Plasmodium falciparum Chemosusceptibility to Doxycycline▿
- Author
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Christophe Rogier, Thierry Fusai, Maryvonne Kombila, Cheikh Sokhna, Jacky Castello, Jean Pierre Gardair, Jean-Louis Koeck, P. Hovette, Philippe Parola, Modeste Mabika Mamfoumbi, Fabrice Simon, André Spiegel, Adama Tall, Sébastien Briolant, Bruno Pradines, Jean Delmont, Philippe Minodier, Meïli Baragatti, and Jean-François Trape
- Subjects
Plasmodium falciparum ,Drug Resistance ,Microbiology ,Apicomplexa ,Antimalarials ,parasitic diseases ,medicine ,Distribution (pharmacology) ,Animals ,Humans ,Pharmacology (medical) ,Distribution model ,Malaria, Falciparum ,Antibacterial agent ,Pharmacology ,Doxycycline ,Models, Statistical ,biology ,Bayes Theorem ,biology.organism_classification ,In vitro ,Anti-Bacterial Agents ,Infectious Diseases ,Susceptibility ,Africa ,Geometric mean ,Algorithms ,medicine.drug - Abstract
The distribution and range of 50% inhibitory concentrations (IC 50 s) of doxycycline were determined for 747 isolates obtained between 1997 and 2006 from patients living in Senegal, Republic of the Congo, and Gabon and patients hospitalized in France for imported malaria. The statistical analysis was designed to answer the specific question of whether Plasmodium falciparum has different phenotypes of susceptibility to doxycycline. A triple normal distribution was fitted to the data using a Bayesian mixture modeling approach. The IC 50 geometric mean ranged from 6.2 μM to 11.1 μM according to the geographical origin, with a mean of 9.3 μM for all 747 parasites. The values for all 747 isolates were classified into three components: component A, with an IC 50 mean of 4.9 μM (±2.1 μM [standard deviation]); component B, with an IC 50 mean of 7.7 μM (±1.2 μM); and component C, with an IC 50 mean of 17.9 μM (±1.4 μM). According to the origin of the P. falciparum isolates, the triple normal distribution was found in each subgroup. However, the proportion of isolates predicted to belong to component B was most important in isolates from Gabon and Congo and in isolates imported from Africa (from 46 to 56%). In Senegal, 55% of the P. falciparum isolates were predicted to be classified as component C. The cutoff of reduced susceptibility to doxycycline in vitro was estimated to be 35 μM.
- Published
- 2008
15. [Listeria disease. The first 2 cases reported at the Principal Hospital of Dakar]
- Author
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K M, Ba-Fall, B, Wade, P, Hovette, P, Colbachini, P S, Mbaye, and J M, Debonne
- Subjects
Male ,Humans ,Listeriosis ,Middle Aged ,Hospitals ,Senegal ,Aged - Abstract
Infection disease due to Listeria monocytogenes, which is a ubiquitous positive Gram bacillus to the essentially alimentary transmission, listeriosis happens on patients presenting an immunodeficiency. The authors report the two first cases of listeriosis diagnosed at Hopital Principal de Dakar. The first case was observed on a 73 years old man, hospitalised for a feverish coma scored at 9 using Glasgow scale, with neither meningitis syndrome, nor sign of neurological localisation. The analysis of the RLC reveals a hypercytosis at 126 GB/mm3, with prevailing neutrophile polynuclears, a hyperproteinorachia at 3.2 g/l. The culture of the RLC was sterile but the blood culture showed the presence of L. monocytogenes. The other paraclinical tests has revealed a glycaemia at 2.45 g/l, an imporant hepatic cytolisis with ASAT at 13 N and ALAT at 20 N. The patient was also presenting a cerebromeningitis and hepatic listeriosis on a diabetic field. The second case was observed on a 58 years old patient admitted for headaches, fever and an important degradation of the general state with an emaciation of 17 kg in 5 months. The physical screening revealed a bad general state, a fever at 38 degrees 2 and was without other particularity. The analysis of the RLC showed a hyperproteinorachia at 1.35 g/l with neither hypercytosis nor germ at the culture. Haemoculture isolated Listeria monocytogenes. HIV serology was positive. CD4 were counted to 61/mm3. and the viral charge was at 110.000 copies / mm3. The patient was presenting a Listeria monocytogenes at meningo-encephalitis on HIV-1 field. stade B of the CDC classification. This ubiquitous anthropozoonosis should be searched through early haemocultures before antibiotherapy. in case of long lasting fever, endocarditis, meningo-encephalitis, localised infections on children. pregnant women, diabetic persons, and people infected with HIV and some others presenting immunity troubles.
- Published
- 2005
16. [Infective etiology of diarrhea in adults with HIV infection in Dakar: a case-control study on 594 patients]
- Author
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A, Gassama, B, Thiaw, N M, Dia, F, Fall, P, Camara, P, Hovette, J L, Perret, A, Gueye-Ndiaye, S, Mboup, P S, Sow, and A, Aidara-Kane
- Subjects
Adult ,Diarrhea ,Male ,Case-Control Studies ,Surveys and Questionnaires ,Prevalence ,Humans ,Female ,HIV Infections ,Senegal - Abstract
A survey was conducted in Dakar, Senegal from May 1997 to May 1999, to identify major types and prevalences of bacteria, parasites, fungi and Rotaviruses associated with diarrhea in relation to human immunodeficiency virus serostatus with the aim to provide guidance to physicians for case management. Etiologic agents were identified in a case-control study: cases were HIV-infected patients with diarrhea (HIV+ D+) and HIV seronegative patients with diarrhea (HIV- D+); controls were HIV-infected patients without diarrhea (HIV+ D-) and seronegative controls without diarrhea (HIV- D-). Strict enteric pathogens were identified by conventional methods. Different E. coli pathotypes were characterized by PCR. Opportunistic parasites such as Cryptosporidium and Microsporidium were identified by the Kinyoun method and trichromic stain of Weber respectively. Rotaviruses were identified with a commercial latex agglutination kit. Antimicrobial susceptibility testing was carried out by the disk diffusion method. A total of 594 patients were examined (158 HIV+D+, 121 HIV- D+, 160 HIV+ D- and 155 HIV- D-). In immunocompetent adults the main causes of diarrhea were: Shigella sp. (12.4%), Entamoeba histolytica (10.7%), Salmonella enterica (6,6%) and Giardia lamblia (4.9%). In the immunocompromised host the more frequent pathogens were: enteroaggregative E.coli (19,6%), Microsporidium(9.4%), Cryptosporidium sp.(8.2%), Rotavirus (8.2%), Shigella sp. (7.6%), Candida albicans (7.6%), Entamoeba histolytica (5,1%), Salmonella enterica (4.4%), Isospora belli (4.4%) and Blastocystis hominis (2,5%). Isolated enteropathogenic strains displayed high resistance to most antibiotics used in Senegal for treating diarrhea (tetracycline, cotrimoxazole); they were susceptible to quinolons and cephalosporins III .
- Published
- 2005
17. [Extensive bone marrow necrosis as presenting manifestation of sickle cell disease in Africa]
- Author
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F, Simon, E, Carloz, B, Chaudier, P, Kraemer, P, Colbacchini, and P, Hovette
- Subjects
Male ,Necrosis ,Adolescent ,Bone Marrow ,Homozygote ,Humans ,Anemia, Sickle Cell ,Senegal - Abstract
Extensive bone marrow necrosis is a rare but severe complication of sickle cell disease. A formerly healthy man was admitted for bone pain, fever, and jaundice with severe aregenerative anemia. Bone marrow aspiration and biopsy showed extensive bone marrow necrosis while hemoglobin electrophoresis demonstrated homozygotic sickle cell disease. Despite early onset of septic arthritis of the right shoulder, outcome after blood transfusion and nonspecific treatment was favorable. Six months later, hemoglobin level remained stable up to 97 g/L. This first African case report illustrates typical features and good prognosis of extensive bone marrow necrosis in sickle cell disease. Extensive bone marrow necrosis is a highly unusual presenting manifestation of sickle cell in an adult.
- Published
- 2004
18. [Absidia corymbifera skin necrosis in a Senegalese diabetic]
- Author
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F, Simon, P, Camara, and P, Hovette
- Subjects
Male ,Necrosis ,Humans ,Mucormycosis ,Absidia ,Middle Aged ,Skin Diseases - Published
- 2004
19. [Concurrent mycetoma and chromomycosis: case report from Senegal]
- Author
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T, Passeron, P, Barberet, P, Colbachini, P, Hovette, and J P, Lacour
- Subjects
Foot Diseases ,Male ,Chromoblastomycosis ,Mycetoma ,Humans ,Osteolysis ,Tomography, X-Ray Computed ,Aged - Abstract
A 68-year-old cattle farmer from northern Senegal sought medical attention for tumefaction that had been progressing on the right foot and leg for 20 years. Physical examination of the right extremity revealed very firm tumefaction involving the foot and whole leg associated with numerous nodules. Bone radiographs and CT-scan of the foot and leg disclosed extensive osteolytic involvement. A specimen of squamous tissue from the top of nodules showed the presence of fumagoid cells characteristic of chromomycosis. Histologic examination after skin biopsy demonstrated fungal myocetoma. Due to the extent of involvement surgical and antifungal treatment was proposed but the patient refused to undergo surgery. Only one previous case of concurrent chromomycosis and mycetoma has been described. However the previous case involved actinomycetoma. The rarity of this combination of diseases despite their common contamination mode is due to different geographical distribution with mycetoma being found in the Sahelian region and chromomycosis in the humid equatorial region.
- Published
- 2004
20. [Malaria in military personnel: the case of the Ivory Coast in 2002-2003]
- Author
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R, Migliani, R, Josse, P, Hovette, A, Keundjian, F, Pages, J-B, Meynard, L, Ollivier, K, Sbai Idrissi, K, Tifratene, E, Orlandi, C, Rogier, and J-P, Boutin
- Subjects
Adult ,Health Knowledge, Attitudes, Practice ,Insect Bites and Stings ,Disease Outbreaks ,Malaria ,Antimalarials ,Cote d'Ivoire ,Military Personnel ,Case-Control Studies ,Health Care Surveys ,Animals ,Humans ,Patient Compliance ,France - Abstract
French troops were sent to the Ivory Coast on September 22, 2002 within the framework of Operation Unicorn in response to the political unrest. From September 22 to October 20, a total of 37 cases of malaria were reported, i.e., 35.7 cases per 1000 man-months. As of October 11, the central headquarters of the Armed Services Health Corps decided to use doxycycline as the exclusive agent for drug prophylaxis in military personnel on duty in the Ivory Coast and to enhance vector control measures. The incidence of malaria decreased to 2 cases per 1000 man-months at the sixth month. A recrudescence of malaria to 15 cases per 1000 man-months was observed with the rainy season in April. During this period one person presenting severe malaria with coma required emergency evacuation to France. In May 2003, several studies were undertaken to determine the factors that caused this recrudescence. These studies included surveys to evaluate awareness concerning malaria and monitor compliance with drug prophylaxis and tolerance of doxycycline, a case-control study to identify factors related to malarious episodes and an entomological study. Awareness of malaria was high with 75% of the 477 respondents stating that malaria could be transmitted by single mosquito bite. The case-control study showed a correlation between occurrence of malarious bouts and non-compliance with drug prophylaxis (p10(-5)). The odds-ratio was 3.05 (95% confidence interval, 1.52-6.14) for subjects claiming zero to one incident of non-compliance per week and 7.51 (IC95%, 3.24-17.40) for those claiming more than one incident of non-compliance per week. Tolerance of doxycyline was good since 72% of respondents reported no adverse effects. The main vector was Anopheles gambiae. The number of bites per man per night ranged from 25 to 2 and the number of infected bites ranged from 2 to 3 per week. Treatment was initiated promptly using quinine at a total dose of 25 mg/kg in 3 daily doses for 7 days by the intravenous then oral route. This experience shows that malaria remains a major concern for military forces, that standardization of preventive measures in emergency situations is needed, and that enhanced vector control, verification of compliance with drug prophylaxis and prompt treatment based on the presence of a physician in each emergency outpost is crucial. These recommendation must be applied to all French military personnel in the Ivory Coast.
- Published
- 2003
21. [Epidemiologic surveillance of cutaneous leishmaniasis in Guiana. Summary of military data collected over 10 years]
- Author
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E, Lightburn, J B, Meynard, J J, Morand, E, Garnotel, P, Kraemer, P, Hovette, S, Banzet, H, Dampierre, J, Lepage, B, Carme, R, Pradinaud, M, Morillon, J P, Dedet, C, Chouc, and J P, Boutin
- Subjects
Climate ,Incidence ,Insect Bites and Stings ,Leishmaniasis, Cutaneous ,Insect Control ,French Guiana ,Insect Vectors ,Epidemiologic Studies ,Military Personnel ,Risk Factors ,Population Surveillance ,Zoonoses ,Animals ,Humans ,Psychodidae - Abstract
This report describes the results of epidemiological surveillance of cutaneous leishmaniasis in French military personnel in French Guiana. Data was collected regarding microscopic diagnosis, clinical manifestations, and lesion location as well as compliance with vector control measures. Year-to-year variations in the incidence in the general population have been attributed to changes in climatic conditions. Monitoring incidence and density curves, correlation of findings with local epidemiological data, and analysis of the most recent epidemic in 1998/99 (326 cases, attack rate 3.2% men years) highlight the importance of behavioral factors. The proportion of total cases involving military personnel varied widely from 20 to 85%. Investigation consistently showed that failure to apply elementary protective measures against sandfly bites was the most determinant factor in this proportion. Strict compliance with these measures appears to reduce the risk of infection considerably.
- Published
- 2003
22. [Image ... of Borrelia]
- Author
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P, Hovette, P, Kraemer, and B, Chaudier
- Subjects
Adult ,Diagnosis, Differential ,Plasmodium ,Borrelia ,Animals ,Humans ,Female ,Borrelia Infections ,Prognosis ,Physical Examination ,Malaria - Published
- 2003
23. [Mechanism of action of antimalarials. Value of combined atovaquone/proguanil]
- Author
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J E, Touze, L, Fourcade, B, Pradines, P, Hovette, P, Paule, and Ph, Heno
- Subjects
DNA Replication ,Organelles ,Plasmodium falciparum ,Drug Resistance, Microbial ,DNA, Protozoan ,Mitochondria ,Antimalarials ,Proguanil ,Animals ,Humans ,Drug Therapy, Combination ,Malaria, Falciparum ,Atovaquone ,Naphthoquinones - Abstract
Determining the mode of action of different antimalarial drugs at the cellular level is essential to optimizing their use and to understanding the mechanisms underlying plasmodial resistance. The main targets for antimalarial drugs in Plasmodium falciparum have been the food vacuole and mitochondrial system. A new target is recently discovered organelle named the apicoplast. The apicoplast is the site of a number of metabolic pathways crucial to the survival of the parasite. It may also be involved in DNA replication and transcription. Antimalarial drugs are classified into three groups according to site of action, i.e., drugs that act on the food vacuole, drugs that block metabolic synthesis and oxidative processes, and drugs that interfere with membrane processes. Knowledge of these sites of action has enabled identification of new drugs with the most promising potential for development. Current antimalarial strategies prioritize combination therapies such as atovaquone/proguanil or artemether/lumefantrine and prolonged treatments to limit the risk of inducing drug resistant Plasmodium.
- Published
- 2002
24. [Does emergency tropical medicine exist? The physician's point of view]
- Author
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P, Hovette, K, Bâ, P, Kraemer, B, Chaudier, L, Bahrouch, and L, Fourcade
- Subjects
Adult ,Male ,Acquired Immunodeficiency Syndrome ,Emergency Medical Services ,Age Factors ,Middle Aged ,Severity of Illness Index ,Health Services Accessibility ,Diagnosis, Differential ,Immunocompromised Host ,Tropical Medicine ,HIV-1 ,Humans ,Pericarditis ,Tuberculosis ,Female ,Malaria, Falciparum ,Physician's Role - Abstract
The existence of tropical medical emergencies is a recurrent issue that joins the debate over the definition of tropical medicine. Is it medicine practiced in warmer climates, medicine practiced with poor diagnostic and therapeutic facilities or medicine involving only tropical diseases? Presentation of a few case reports provides a better response to this question than a long speech. The first case involves a 57-year-old man presenting a complicated attack of Plasmodium falciparum malaria and severe respiratory distress. The second case involves a pregnant AIDS patient presenting multifocal miliary tuberculosis associated with renal abscess and bacteremia. The third case involves a 34-year-old soldier hospitalized for right hilar pneumonia in whom work-up demonstrated co-infection by HIV 1 and 2, thick drop tests revealed uncomplicated Plasmodium falciparum malaria, and cytobacterial examination of sputum samples identified Salmonella enteritidis and acid-alcohol resistant germs. The fourth case involves a 60-year man hospitalized for febrile collapse in whom work-up revealed amebic pericarditis. These four case reports illustrate the main features of tropical medical emergencies: adult patients (frequently young), associated deficiencies or immunocompromise (HIV infection/AIDS), severe or complicated tropical disease, severe advanced stage disease because of inability to pay for care, multiple pathology, poor diagnostic/therapeutic facilities, and high mortality.
- Published
- 2002
25. [Pulmonary strongyloidiasis complicated by E. coli meningitis in a HIV-1 and HTLV-1 positive patient]
- Author
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P, Hovette, J F, Tuan, P, Camara, Y, Lejean, N, Lô, and P, Colbacchini
- Subjects
Lung Diseases ,Male ,Immunocompromised Host ,Ivermectin ,Meningitis, Escherichia coli ,Antinematodal Agents ,HIV-1 ,Strongyloidiasis ,Humans ,HIV Infections ,Middle Aged ,Prognosis ,HTLV-I Infections - Abstract
Disseminated strongyloidiasis occurs in immunodepressed patients, notably those infected by retroviruses.A pulmonary strongyloidiasis, complicated by an Escherichia coli meningitis, occurred in a patient exhibiting seropositivity HIV1 for the past year. The status of cell immunity, with 354 lymphocytes T CD4+/mm3, could not explain this severe complication. This led to the diagnosis of an HTLV1 infection. The strongyloidiasis was treated with two cycles of ivermectine, which cured the patient.In HIV-infected patients exhibiting severe strongyloidiasis, research for an HTLV co-infection is recommended.
- Published
- 2002
26. [Predictive factors of mortality in severe shigellosis]
- Author
-
A, de Widerspach-Thor, L, d'Alteroche, A, Rault, J F, Thuan, T, Masseron, and P, Hovette
- Subjects
Adult ,Male ,Adolescent ,Child, Preschool ,Humans ,Infant ,Female ,Child ,Severity of Illness Index ,Dysentery, Bacillary - Published
- 2002
27. [The plague]
- Author
-
P, Hovette, B, Chaudier, and P, Kraemer
- Subjects
Diagnosis, Differential ,Male ,Plague ,Fever ,Streptomycin ,Humans ,Child ,Drug Administration Schedule ,Anti-Bacterial Agents - Published
- 2002
28. [Salmonella enteritidis splenic abscess complicating a Plasmodium falciparum malaria attack]
- Author
-
P, Hovette, P, Camara, T, Passeron, J F, Tuan, K, Ba, G, Barberet, and F, Moncade
- Subjects
Adolescent ,Salmonella enteritidis ,Salmonella Infections ,Humans ,Female ,Malaria, Falciparum ,Abscess ,Splenic Diseases - Abstract
Salmonella splenic abscesses are rare and usually occur on pre-existing lesions.A Moorish 16 year-old woman from Senegal presented with a S. enteritidis abscess without any factor other than an attack of P. falciparum malaria. Treatment associated quinine salts, antibiotherapy and splenectomy.P. falciparum malaria attacks not only induce humoral and then cellular immunodepression but are also at the origin of infarction or splenic hematoma that may enhance bacterial infection and the development of abscesses. Splenectomy or percutaneous drainage associated with antibiotherapy is the usual treatment for splenic abscesses. Prognosis remains severe (13 to 16% mortality).
- Published
- 2002
29. [Value of Quantitative Buffy Coat (QBC) in borreliasis-malaria co-infection]
- Author
-
P, Hovette, C, Aubron, J D, Perrier-Gros-Claude, R, Schieman, M C, N'Dir, and P, Camara
- Subjects
Leukocytes ,Humans ,Centrifugation ,Borrelia Infections ,Sensitivity and Specificity ,Malaria - Published
- 2001
30. [Cerebromeningeal listeriosis associated with a cytolytic hepatitis. First case report in Senegal]
- Author
-
P, Camara, R, Petrognani, C, Aubron, P, Colbachini, C, Ferret, and P, Hovette
- Subjects
Male ,Fatal Outcome ,Risk Factors ,Meningitis, Listeria ,Humans ,Ampicillin ,Penicillins ,Senegal ,Aged ,Hepatitis - Abstract
Hepatitis due to Listeria monocytogenes is uncommon in adults. This report describes the first case observed in Senegal. The patient was a 73-year old man presenting listeria-related hepatitis presumably secondary to low-grade meningeal encephalitis. Treatment using ampicillin was unsuccessful and the patient died four days after hospitalization. The authors note that the incidence of adult listeriosis has risen constantly for the past twenty years in relation with alcohol abuse, cirrhosis, diabetes, kidney insufficiency, cancer, AIDS, and organ transplantation. However no predisposing factors were observed in the present case.
- Published
- 2001
31. [Symptomatic subcutaneous iliac empyema in lumbar Pott's disease]
- Author
-
P, Hovette, F, Simon, C, Aubron, M C, N'Dir, P, Camara, and G, Barberet
- Subjects
Adult ,Lumbar Vertebrae ,Empyema, Tuberculous ,Humans ,Psoas Abscess ,Female ,Tuberculosis, Spinal ,Muscle, Skeletal ,Tomography, X-Ray Computed ,Abscess - Published
- 2001
32. [Borreliosis-malaria co-infection: 'one course can hide another!']
- Author
-
P, Hovette, J D, Perrier-Gros-Claude, P, Camara, A, Spiegel, K, Ba, and B, Wade
- Subjects
Diagnosis, Differential ,Male ,Adolescent ,Humans ,Comorbidity ,Borrelia Infections ,Malaria - Published
- 2000
33. [Frequency of pulmonary manifestations associated with visceral leishmaniasis]
- Author
-
P, Hovette, A, Rault, B, Graffin, and T, Masseron
- Subjects
Adult ,Lung Diseases ,Male ,Humans ,Leishmaniasis, Visceral ,Female ,Child - Published
- 1999
34. [Evolution of Shigella antibiotic resistance in Djibouti]
- Author
-
T, Masseron and P, Hovette
- Subjects
Feces ,Population Surveillance ,Djibouti ,Humans ,Drug Resistance, Microbial ,Shigella ,Serotyping ,Dysentery, Bacillary - Published
- 1999
35. [Pleuropulmonary manifestations of salmonellosis]
- Author
-
P, Hovette, P, Camara, R, Petrognani, and C, Donzel
- Subjects
Adult ,Emphysema ,Lung Diseases ,Pleural Effusion ,Salmonella Infections ,Humans ,Pleural Diseases ,Typhoid Fever ,Bronchitis ,Pleurisy - Abstract
Salmonella infections are widespread particularly in tropical zones. Each year, 12.5 million cases of typhoid fever are reported with an incidence of 540 cases for every 100,000 inhabitants in developing countries versus 0.2 cases in industrialized countries. Pleuropulmonary manifestations constitute the most common extra-intestinal manifestation of salmonella infection. Counts are usually carried out in the digestive tract. Respiratory tract manifestations result from blood-borne diffusion from mesenteric lymph nodes, but gastroenteritis goes unnoticed in 2 of 3 cases. Predisposing factors are frequent including cancer, previous graft placement and immunosuppressant therapy, sickle cell disease, alcohol abuse, and pre-existing pulmonary disease. Clinical manifestations are usually acute but subacute forms cannot be ruled out. Cough is a common symptom observed in 25% of patients with typhoid fever. Pneumonia is uncommon overall (1%) but occurs in 50% of patients with pleural effusion, empyema, lung abscess, or bronchopleural fistula. A few cases of adult respiratory distress syndrome have been described in the literature. Recognition is important since these manifestations may signal previously unsuspected underlying pulmonary disease. Treatment requires appropriate antimicrobial therapy and close surveillance to prevent recurrence or complications.
- Published
- 1999
36. [Prevalence of cerebro-meningeal cryptococcosis associated with AIDS in Dakar]
- Author
-
P, Hovette, P, Camara, G, Raphenon, T O, Soko, and P R, Burgel
- Subjects
Adult ,Male ,AIDS-Related Opportunistic Infections ,Adolescent ,Humans ,Meningitis, Cryptococcal ,Senegal - Published
- 1999
37. [Pulmonary manifestations associated with malaria]
- Author
-
P, Hovette, P, Camara, P R, Burgel, P S, Mbaye, M, Sane, and F, Klotz
- Subjects
Adult ,Lung Diseases ,Male ,Respiratory Distress Syndrome, Newborn ,Travel ,Quinine ,Infant, Newborn ,Oxygen Inhalation Therapy ,Chloroquine ,Pulmonary Edema ,Phenanthrenes ,Quinidine ,Anti-Bacterial Agents ,Mefloquine ,Antimalarials ,Pregnancy ,Pregnancy Complications, Parasitic ,Humans ,Female ,Malaria, Falciparum ,Bronchitis ,Child ,Pleurisy - Abstract
Pulmonary manifestations are frequently observed in children, pregnant women and travellers with malaria. The pathophysiology of these pulmonary manifestations is poorly understood but would appear to be secondary to an interaction between the parasitized red cells and the pulmonary capillary endothelium. Bronchitis and pneumonia do not directly compromise outcome but, left unrecognized, the delay in diagnosis and treatment may be fatal. Acute respiratory distress in children is the first cause of overmortality, coming before neurological involvement. The acute respiratory distress caused by severe malaria has no specific characteristics. Iatrogenic complications and pulmonary superinfections must be differentiated. The prevention of pulmonary manifestations associated with malaria can easily be accomplished by limiting water intake and carefully monitoring urinary output and weight. Treatment is the same as for acute flare-ups in combination with symptomatic respiratory treatment when required.
- Published
- 1999
38. [Pulmonary manifestations of schistosomiasis]
- Author
-
F, Klotz, P, Hovette, P S, Mbaye, F, Fall, M, Thiam, and G, Cloatre
- Subjects
Diagnosis, Differential ,Schistosomiasis haematobia ,Schistosomicides ,Pulmonary Heart Disease ,Adrenal Cortex Hormones ,Lung Diseases, Parasitic ,Hypertension, Pulmonary ,Schistosomiasis japonica ,Humans ,Schistosomiasis ,Schistosomiasis mansoni - Abstract
Bilharziosis or schistosomiasis is the third leading endemic parasitic disease in the world, following malaria and ambiasis. More than 300 million individuals are infested. Schistomosomes are blood flukes which live in the perivisceral veins. Clinical signs result from ova migrations. Transmitted by urine and feces, the parasite cycle requires intermediary host, usually fresh water snails. Bilharsiosis is endemic in tropical zones where it is a major public health problem closely correlated with the socio-economic conditions. Liver, intestinal or urinary complications, depending on the species, lead to underestimated morbidity and mortality. Pulmonary lesions are attributed to 3 species: S. haematobium, S. mansoni and S. japonicum. Although the lung is mandatory step in the parasite cycle, pulmonary manifestations are limited. They can be acute or chronic depending on the phase of the cycle, but are the most frequent extradigestive localization for S. mansoni. Morbidity due to chronic manifestations is particularly severe and should be prevented whenever possible.
- Published
- 1999
39. [Pulmonic plague]
- Author
-
P, Hovette, P R, Burgel, P, Camara, M, Sane, G, Auregan, and F, Klotz
- Subjects
Diagnosis, Differential ,Plague ,Anti-Infective Agents ,Child, Preschool ,Pneumonia, Bacterial ,Streptomycin ,Humans ,Infant ,Anti-Bacterial Agents ,Cephalosporins ,Fluoroquinolones - Abstract
One hundred years after Yersin discovered Yersinia pestis during the plague epidemic in Hong Kong in 1894, human plague still has not been eliminated. The epidemic in 1994 in India, a country where no cases had been observed since 1996, raised great concern. Plague is an epizootic bacterial infection caused by a Gram negative coccobacillus, Y. pestis, transmitted by the bite of infected fleas. Bubonic plague is the most common form. Other clinical presentations include asymptomatic plague, abortive plague, pharyngeal plague, septicemic plague, meningeal plague, and primary or secondary pneumonic plague which is observed in 5 to 20% of cases. Plague is a highly communicable disease between humans despite antibiotic therapy which has reduced mortality by 80%. The prognosis depends on early diagnosis. Streptomycin and cyclines are the gold standard treatment.
- Published
- 1999
40. [Pulmonary parasitoses. General aspects]
- Author
-
P, L'Her, F, Vaylet, and P, Hovette
- Subjects
Anthelmintics ,Antiparasitic Agents ,Lung Diseases, Parasitic ,Antinematodal Agents ,Antiprotozoal Agents ,Helminthiasis ,Leishmaniasis, Cutaneous ,Anisakiasis ,Filariasis ,Diagnosis, Differential ,Larva Migrans, Visceral ,Strongyloidiasis ,Humans ,Chagas Disease ,Radiography, Thoracic ,Dirofilariasis ,Pulmonary Eosinophilia ,Nematode Infections ,Tomography, X-Ray Computed ,Leishmaniasis - Abstract
Parasite diseases of the lung comprise a wide group of nosological entities. The main parasite diseases of the lung (malaria, ambiasis, bilharziosis, distomatosis, hydatidiasis) as well as the eosinophilic lung will be discussed in specific articles in the journal. Other parasite diseases of the lung are discussed here after studying the general aspects of pulmonary parasite diseases.
- Published
- 1999
41. [Pleuropulmonary manifestations of amebiasis]
- Author
-
P S, Mbaye, N, Koffi, P, Camara, P R, Burgel, P, Hovette, and F, Klotz
- Subjects
Male ,Entamoebiasis ,Lung Diseases, Parasitic ,Amebiasis ,Pleural Diseases ,Prognosis ,Diagnosis, Differential ,Liver Abscess, Amebic ,Humans ,Female ,Radiography, Thoracic ,Amebicides ,Lung Abscess ,Pulmonary Embolism - Abstract
Amibiasis is the third leading cause of death due to parasitic infections in the world. Amibiasis is endemic in the warm regions of the world with deficient hygiene and socio-economic situations. Entamoeba histolytica is the causal agent of invasive amibiasis, unlike Entamoeba dispar which is not a pathogen for humans. Amibian colitis and amibian abscess of the liver are the most frequent intestinal and extra-intestinal manifestations. Pleuropulmonary complications almost always occur in patients with a liver abscess, the intrathoracic contamination via transphrenic dissemination predominating. Respiratory signs are inaugural in 80% of the cases. Pleuropulmonary ambiasis designates the localization of the amibian infestation, but the clinical expression may vary: pneumonia, lung abscess, pleurisy, hepatobronchial fistulization and more infrequently pulmonary embolism. The preferential localization is the right hemithorax related to abscess in the right lobe of the liver. Left lobe abscesses lead to left-sided pleuropulmonary complications with the risk of rupture into the pericardium. Chocolate-colored pus from a pleural or abscess puncture or vomitus strongly suggests the diagnosis, which is confirmed by highly-positive serology. Metronidazole is the treatment of choice, providing cure without sequellae. In Africa, mortality and morbidity due to ambiasis are high. In Abidjan, 92% of cured patients have sequella, and mortality reaches 15%, the consequence of late diagnosis.
- Published
- 1999
42. [Antibiotic resistance of strains of Neisseria gonorrhoeae isolated in Dijibouti from 1995 to 1997]
- Author
-
T, Masseron and P, Hovette
- Subjects
Species Specificity ,Djibouti ,Drug Resistance, Microbial ,Neisseria gonorrhoeae - Published
- 1999
43. [Intracranial subdural hematoma during spinal anesthesia]
- Author
-
R, Petrognani, P, Hovette, G, Barberet, C, Badiane, P, Camara, P, Burgel, and X, Theobald
- Subjects
Adult ,Hematoma, Subdural ,Humans ,Female ,Tomography, X-Ray Computed ,Anesthesia, Spinal ,Senegal - Abstract
Spinal anesthesia (SA) is frequently used in tropical zones. Intracranial subdural hematoma is an uncommon complication of SA. The purpose of this report was to describe a case of intracranial subdural hematoma observed during SA performed for cesarean section in a 22-year-old women in Senegal. After one month of persistent intense headache, diagnosis was confirmed by computerized tomography. The hematoma was successfully treated by drainage under general anesthesia. Intracranial subdural hematoma has been attributed to cerebrospinal fluid hypotension due to leakage through the dural puncture site. Diagnosis, which may be difficult in Africa, should be suspected in patients with persistent headaches after SA. Confirmation requires computerized tomography of the brain. Prevention of this complication depends on the use of fine beveled-tipped puncture needle which are rarely available in the African setting.
- Published
- 1999
44. Un cas de méningite à virus Toscana du Fyrom (former Yugoslav Republic of Macedonia)
- Author
-
J.P. Durand, B. Chaudier, P. Kraemer, and P. Hovette
- Subjects
Political science ,Gastroenterology ,Internal Medicine ,Humanities ,Virus - Published
- 2003
45. Spleen rupture in a patient with dengue fever
- Author
-
P, Imbert, D, Sordet, P, Hovette, and J E, Touze
- Subjects
Adult ,Dengue ,Male ,Hematoma ,Rupture, Spontaneous ,Splenectomy ,Humans ,Splenic Rupture - Abstract
A case of rupture of the spleen is described secondary to dengue 1 fever in an adult patient. This exceptional complication occurred during an outbreak of dengue in French Polynesia. After failure of conservative management, splenectomy was performed. Examination of the surgical specimen confirmed softening and enlargement organ with the formation of a subcapsular hematoma.
- Published
- 1993
46. [Value and limits of tomodensitometry applied to the diagnosis of sacroiliitis in young adults: study of 200 cases]
- Author
-
P, Jeandel, P Y, Chouc, J F, Briant, D, Prigent, G, Barberet, G, Dran, B, Dechamp, H, De Baillou, P, Hovette, and R, Laroche
- Subjects
Adult ,Male ,Arthritis ,Humans ,Female ,Sacroiliac Joint ,Prospective Studies ,Diagnostic Errors ,Tomography, X-Ray Computed - Abstract
Diagnosis of sacroiliitis may be difficult to establish in patients under 25 years of age since growth is not yet completed and joint damage is often still minor. A prospective study of 200 subjects with a median age of 22 years was carried out to compare the value of CT scan and conventional radiology. The study population included 32 healthy subjects and 168 consecutive patients with presumptive spondylarthropathy including 36 with bilateral sacroiliitis and 8 with unilateral sacroiliitis. Conventional roentgenograms and CT scans were performed in every patient. Blind reading of roentgenograms and CT scans was carried out by two pairs of observers with differing experience. CT scan provided no additional information when reading was done by experienced observers: rates of mistaken and doubtful results were similar with both investigations (10%); specificity of both tests was comparable (90%) but sensitivity was significantly greater for CT scan (91.2%) than for conventional roentgenograms (71.6%), reflecting improved detection of roentgenographically occult sacroiliitis. Less experienced observers obtained better results with CT scans, illustrating the ease of interpretation of CT scan images. Analysis of false-positive CT scans revealed that normal variations and, above all, features due to as yet uncompleted growth were the main sources of mistakes. These mistakes cancelled the advantage of increased sensitivity of CT scan studies and explained why CT scan failed to improve diagnosis.
- Published
- 1992
47. [Severe Plasmodium falciparum malaria attacks during chemoprophylaxis with chloroquine and proguanil]
- Author
-
P, Hovette, G, Blasco, J E, Touze, and R, Laroche
- Subjects
Proguanil ,Humans ,Chloroquine ,Drug Resistance, Microbial ,Drug Therapy, Combination ,Cameroon ,France ,Malaria, Falciparum - Published
- 1992
48. [Falciparum malaria in French residents in Yaounde]
- Author
-
G, Blasco, P, Hovette, P, Thibaut, G, de Quincenet, J M, Debonne, J E, Touze, and R, Laroche
- Subjects
Adult ,Adolescent ,Infant ,Emigration and Immigration ,Middle Aged ,Antimalarials ,Child, Preschool ,Humans ,Cameroon ,France ,Seasons ,Malaria, Falciparum ,Child ,Aged - Abstract
In South Cameroon, malaria is a disquieting problem. It represented 2.6% of consultants and concerned each year 10% among French residents. We have included 310 cases of Falciparum malaria between January 1, 1990 and December 31, 1990. There were 207 adults and 103 children with a mean age of 26 years. The duration of the stay was over one year in 137 cases and lower than 1 year in 183 patients. The chemoprophylaxis was correct in 194 patients according to the dose and duration. Forty-nine patients followed a combination of chloroquine and proguanil. Malaria attack was observed in 272 patients. Among them, there were 95 children. A severe malaria occurred in 38 cases. Mean parasitemia was of 0.24% (range: 0.002-7.5%). Therapy regimen was quinine: 36 cases, halofantrine: 266 cases, amodiaquine: 7 cases and association MFP (Fansimef) in 12 patients. The study shows the importance of malaria in an endemic area among expatriates despite the observance of chemoprophylactics regimens including proguanil.
- Published
- 1992
49. [Bone localizations disclosing Hodgkin's disease. Apropos of 11 cases]
- Author
-
D, Jaubert, H, Eghbali, J G, Fuzibet, A, Pesce, P, Hovette, B, Delmarre, D, Hauteville, and B, Hoerni
- Subjects
Adult ,Male ,Adolescent ,Humans ,Pain ,Bone Neoplasms ,Female ,Bone Diseases ,Middle Aged ,Combined Modality Therapy ,Hodgkin Disease ,Aged - Abstract
The authors report 11 cases of Hodgkin's disease in which the first sign was due to bone involvement. Such observations are rare and raise diagnosis delays (Means: 5, 6 months in this series). Modern medical imaging techniques (scintigraphy, CT scan, magnetic resonance imaging) are very useful to an earlier diagnosis which will be better confirmed by lymph node biopsy given the poor information yielded by osseous cytology and/or histology. The elective localisation in bones belonging to the axial skeleton seems to support the hypothesis of a contiguous osseous involvement from lymphoïd organs in contact with bones. Evolution with chemotherapy and radiotherapy is very similar to that observed in patients without bone involvement.
- Published
- 1992
50. [Healthy and pseudo-healthy carriers of hepatitis B virus. A comparative clinical, biological and pathological approach]
- Author
-
J M, Debonne, F, Klotz, D, Parzy, P, Hovette, G, Martet, and P, Aubry
- Subjects
Adult ,Hepatitis B Surface Antigens ,Liver Function Tests ,Biopsy ,Carrier State ,Humans ,Middle Aged ,Hepatitis B ,Prognosis ,Transaminases ,Retrospective Studies - Abstract
From a series of 100 patients hospitalized for chronic hepatitis B infections (HBV), 51 chronic carriers of the HBs antigen without elevated aminotransferases or circulating HBV DNA were studied retrospectively. They had no unusual epidemiological or clinical features compared to the other patients, but were distinguished by their normal liver function tests, except for 5 cases of isolated hypergammaglobulinemia. Hepatic biopsies performed on 28 patients showed minor lesions or normal tissue in 61% of the cases and persistent chronic hepatitis (PCH) in 39% of them. No clinical or biological abnormality was significantly associated with PCH, which was attributed to a delta hepatitis (HDV) superinfection in only one case. There were no cases of active chronic hepatitis or cirrhosis. The significance of the histological lesions in the absence of HBV replication or other symptoms of hepatocyte aggression was not elucidated; their longterm prognosis is not known even if no other difference, identifiable by usual methods, seems to exist between these "pseudo-healthy" carriers and real healthy carriers of HBV.
- Published
- 1992
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