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1.
Ann Dermatol Venereol ; 149(4): 258-263, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35738946

RESUMO

BACKGROUND: Lentigo maligna (LM) can develop into lentigo maligna melanoma (LMM) with risk of metastatic dissemination. LMM may be underestimated on the basis of the initial biopsy. The invasion may affect both the therapeutic options and the prognosis. OBJECTIVES: To identify the clinical features associated with invasive forms of LM and factors associated with its recurrence. METHODS: A retrospective, single-centre study of consecutive LM and LMM histologically confirmed and treated by surgery between 2009 and 2014. RESULTS: In total, 175 patients with LM/LMM were surgically treated in our establishment. In men, lesions were more likely to be in the "peripheral zone" (41.8%), while in women they were seen more often in the "central zone" (P=0.001). In multivariate analysis, only the peripheral zone was found to be associated with a risk of invasion (P=0.008). The rate of recurrence was 9% and lesions were more likely to be primary LMM (P=0.0006) excised with clear margins. CONCLUSION: The treatment of choice in LM with non-clear margins must be re-excision, especially for lesions situated in the peripheral zone. Close follow-up is recommended due to risk of recurrence, even in the case of clear margins.


Assuntos
Sarda Melanótica de Hutchinson , Melanoma , Neoplasias Cutâneas , Masculino , Humanos , Feminino , Sarda Melanótica de Hutchinson/cirurgia , Estudos Retrospectivos , Melanoma/patologia , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Margens de Excisão
2.
Rev Med Interne ; 43(4): 225-232, 2022 Apr.
Artigo em Francês | MEDLINE | ID: mdl-35227526

RESUMO

Chronic Kidney Disease (CKD) is associated with a strong impact on phosphocalcic homeostasis, due to the chronic reduction in glomerular filtration rate (GFR) (phosphate excretion decrease), the inhibition of calcitriol synthesis and dietary restrictions. CKD-Mineral and Bone Disorders (CKD-MBD) must be monitored in CKD patients with biological work-up associated with bone markers and bone density dual X-ray absorptiometry. Adapted diet (phosphate restriction, normalization of calcium intake) and medications (vitamin D, phosphate binders, calcimimetics) help to correct CKD-MBD. Serum parathormone must be kept between 2 to 9 times the usual values, to limit renal osteodystrophy and avoid tertiary hyperparathyroidism. CKD patients are also at risk of artery calcifications, which can significantly increase the morbidity and mortality of the affection. Bisphosphonates may be used after correction of biological abnormalities, in patients with estimated GFR above 30ml/min/1,73m2. Even if transplantation aims to normalize kidney function, kidney transplant recipients remain at risk of CKD-MBD. Biology and bone density dual X-ray absorptiometry must be regularly assessed, especially in the few months following the transplantation. More studies are needed to know if treatments of CKD-MBD are well tolerated in severe CKD and if they are associated with a decrease of bone fracture and vascular calcifications.


Assuntos
Doenças Ósseas , Distúrbio Mineral e Ósseo na Doença Renal Crônica , Insuficiência Renal Crônica , Doenças Ósseas/diagnóstico , Doenças Ósseas/etiologia , Doenças Ósseas/terapia , Distúrbio Mineral e Ósseo na Doença Renal Crônica/diagnóstico , Distúrbio Mineral e Ósseo na Doença Renal Crônica/etiologia , Distúrbio Mineral e Ósseo na Doença Renal Crônica/terapia , Feminino , Humanos , Masculino , Minerais , Fosfatos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia
3.
Ann Dermatol Venereol ; 148(3): 172-176, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34176641

RESUMO

BACKGROUND: Treatment of rhinophyma consists primarily of destructive procedures. There is currently no consensus regarding treatment. In this study, we propose an algorithm based on a cohort of 25 patients and a literature review. PATIENTS AND METHODS: This was a retrospective study conducted between January 2016 and December 2018. The cosmetic outcome was evaluated by 2 independent assessors based on pre- and postoperative photographs. Patients were ranked according to the severity (mild, moderate, severe) of their rhinophyma. The different surgical methods used were cold blade excision or rhinoshave, electrosurgery or monopolar diathermy knife (MDK), and carbon dioxide laser (CO2 laser), either alone or in combination with another technique. All patients were contacted after the procedure to evaluate their satisfaction and to investigate for adverse effects. RESULTS: Twenty-five patients were included retrospectively: 7 with mild rhinophyma (5 were treated by MDK, 1 by fractional CO2 laser, and 1 by cold-blade excision and TCA solution), 11 with moderate rhinophyma (2 were treated by MDK, 9 by continuous CO2 laser), and 7 with severe rhinophyma (2 were treated by MDK, 5 by MDK plus CO2 laser). Cosmetic outcomes were deemed good or excellent in 80% of cases, and 84% of patients were fully satisfied with the result. We observed 5 cases of hypertrophic scarring, 2 cases of hypopigmentation, 3 cases of notching of the nasal ala, and 7 cases of prolonged erythema, most of which were caused by the MDK technique. CONCLUSION: A wide range of treatment options are available for rhinophyma. We suggest the use of cold-blade excision and trichloroacetic acid or fractional carbon dioxide laser for mild rhinophyma, continuous and pulsed CO2 laser for moderate rhinophyma, and MDK for severe rhinophyma.


Assuntos
Eletrocoagulação/métodos , Lasers de Gás/uso terapêutico , Rinofima/cirurgia , Humanos , Terapia a Laser , Estudos Retrospectivos , Resultado do Tratamento
4.
J Eur Acad Dermatol Venereol ; 34 Suppl 2: 3-11, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32476176

RESUMO

BACKGROUND: Inflammation from skin conditions such as psoriasis, eczema-like atopic dermatitis (AD) and hand eczema (HE) and following dermatological procedures (post-acts) can result in intense itching and cutaneous pain. Dermo-cosmetics containing plant extracts have been shown to reduce or alleviate these symptoms. OBJECTIVES: Assessment of the tolerability and efficacy of a spray containing Rhealba\xAE Oat plantlets and Uncaria tomentosa extracts in adults and children with inflammatory skin diseases and after dermatological procedures. METHODS: Data from five open label studies were analysed (Study 1: adults with AD; Study 2: children with AD; Study 3: adults with psoriasis; Study 4: adults with HE; Study 5: adults who had undergone a dermatological procedure: laser, intense pulsed light, glycolic acid peeling, photodynamic therapy or cryotherapy procedure). In all studies, subjects could use the test product up to six times per day for symptom relief. Physical and functional signs of inflammation, treatment-emergent adverse events (TEAEs), soothing effect, changes in quality of life, cutaneous pain and cosmetic acceptability were compared pre- and postapplication. RESULTS: A total of 176 subjects were enrolled across the five studies. Overall, investigators judged the dermatological tolerance of the test product containing Rhealba\xAE Oat plantlets extract and Uncaria tomentosa as good to excellent. All studies showed significant improvements in physical signs, reduction in itching and feeling of pain (P < 0.05). The soothing effect was evident after the first application. TEAEs were mostly mild, transient and occurred within the first few days of treatment. The majority of subjects reported improved QoL across the studies. CONCLUSIONS: The dermo-cosmetic spray containing Rhealba\xAE Oat plantlets extract and U. tomentosa was well tolerated and efficacious in providing relief of symptoms associated with cutaneous pain from inflammatory skin diseases and following dermatological procedures; however, further studies are needed to rule out alternative explanations of symptom reduction such as natural history and response biases.


Assuntos
Avena/química , Unha-de-Gato/química , Dermatite/tratamento farmacológico , Dor/tratamento farmacológico , Extratos Vegetais/farmacologia , Doença Crônica , Dermatite/complicações , Humanos , Dor/etiologia , Extratos Vegetais/uso terapêutico
5.
J Fr Ophtalmol ; 43(6): 467-476, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32376037

RESUMO

PURPOSE: Fibrous dysplasia (FD) is a benign fibro-osseous developmental disorder of growing bone, sometimes involving the craniofacial skeleton (CFD). We wish to present a patient series with CFD of the orbital region and discuss treatment modalities. METHODS: Twelve patients were referred for orbital CFD in the Nantes University Hospital between 2000 and 2018 and studied according to the clinical parameters, radiological features, and modalities of treatment. RESULTS: The mean age was 25.6 years. Ten patients exhibited facial asymmetry with vertical globe dystopia (75%), proptosis (58%) and facial bump (50%). The disease was monostotic in 83% of patients, involving the frontal bone (25%), the sphenoidal bone (33%), the fronto-sphenoidal complex (25%), and the skull base (17%). Unilateral radiological proptosis was found in 7 patients, with a mean protrusion 3.9mm. The optic canal was involved in 75% of patients, with no functional impairment. Three patients were treated with bisphosphonate therapy to stop progression of the disease; 6 patients were given a bone remodelling procedure with good aesthetic outcomes. CONCLUSION: The orbit is a rare localization for FD causing aesthetic and functional disabilities. Medical and surgical treatment can be proposed as part of a multidisciplinary approach.


Assuntos
Doenças do Desenvolvimento Ósseo , Órbita/patologia , Doenças Orbitárias , Adolescente , Adulto , Idoso , Doenças do Desenvolvimento Ósseo/diagnóstico , Doenças do Desenvolvimento Ósseo/tratamento farmacológico , Doenças do Desenvolvimento Ósseo/patologia , Criança , Estudos de Coortes , Exoftalmia/tratamento farmacológico , Exoftalmia/etiologia , Exoftalmia/cirurgia , Face/cirurgia , Assimetria Facial/tratamento farmacológico , Assimetria Facial/etiologia , Assimetria Facial/cirurgia , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Órbita/efeitos dos fármacos , Órbita/cirurgia , Doenças Orbitárias/complicações , Doenças Orbitárias/tratamento farmacológico , Doenças Orbitárias/cirurgia , Estudos Retrospectivos , Adulto Jovem
6.
Clin Cosmet Investig Dermatol ; 11: 579-589, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30519069

RESUMO

Background: The frequency of dermatological acts is increasing. These procedures often cause injuries and traumatic alterations in specific skin layers, slowing down wound healing. Patients and methods: An open observational study lasting 1 month was conducted on 2,363 patients who had undergone various dermatological procedures. This study was conducted in eight European countries and an Asian country during which the tolerance and efficacy of a cosmetic cream based on Rhealba oat plantlets' extract, l-ALA-l-GLU dipeptide, and hyaluronic acid were assessed on patients' wounds. Results: Efficacy was observed 5' after the first application, which leads to an immediate relief, confirmed by the overall efficacy judged by the doctors as good or very good in 96.8% of the cases. In Germany, the efficacy of the same cream was assessed on children suffering from first- or second-degree burns. In this dermatopediatric case, the aim was to support the regeneration process and prevent scarring by using a topical cream rather than a silicon bandage or corticosteroids. A positive effect on skin regeneration and prevention of scaring could already be observed after 4 weeks of application without any undesired complication. Conclusion: This clinical focus complements the previous meta-analysis by demonstrating that the tested cream containing Rhealba oat plantlets' extracts, l-ALA-l-GLU dipeptide, and hyaluronic acid could also be used with a great efficacy in children after thermal burns to prevent scaring.

7.
Br J Surg ; 105(3): 223-229, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29405278

RESUMO

BACKGROUND: Normocalcaemic primary hyperparathyroidism (NcPHPT) is a new clinical entity being diagnosed increasingly among patients with mild primary hyperparathyroidism (PHPT). The aim of this study was to evaluate quality of life and non-specific symptoms before and after parathyroidectomy in patients with NcPHPT compared with those with hypercalcaemic mild PHPT (Hc-m-PHPT). METHODS: This was a prospective multicentre study of patients with mild PHPT from four university hospitals. Patients were evaluated before operation, and 3, 6 and 12 months after surgery for quality of life using the SF-36-v2® questionnaire, as well as for 25 non-specific symptoms. RESULTS: Before operation, the only statistically significant difference between the NcPHPT and Hc-m-PHPT groups was in the mean(s.d.) blood calcium level (2·54 versus 2·73 mmol; P < 0·001). At 1 year after surgery, the blood calcium level had improved significantly in both groups, with no significant difference between them. Quality of life improved significantly in each group compared with its preoperative score, with regard to the physical component summary (P = 0·040 and P = 0·016 respectively), whereas the mental component summary improved significantly in the Hc-m-PHPT group only (P = 0·043). Only two non-specific symptoms improved significantly in the NcPHPT group compared with nine in the Hc-m-PHPT group. CONCLUSION: Parathyroidectomy mildly improves quality of life and some non-specific symptoms in patients with NcPHPT.


Assuntos
Hiperparatireoidismo Primário/cirurgia , Paratireoidectomia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Resultado do Tratamento
8.
Placenta ; 36(1): 18-26, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25468543

RESUMO

INTRODUCTION: Human term placenta has attracted increasing attention as an alternative source of stem cells for regenerative medicine since it is accessible without ethical objections. The amniotic membrane (AM) contains at least two stem cell types from different embryological origins: ectodermal amniotic epithelial stem cells, and mesodermal mesenchymal stromal cells. Among the second group we studied the characteristics of amniotic mesenchymal cells (AMC) versus the ones enriched for the commonly used surface marker c-Kit (amniotic progenitor/stem cells-ASC), a stem cell factor receptor with crucial functions in a variety of biological systems and presents in early progenitors of different origin, as been already demonstrated in the enriched chorionic stem cells. METHODS: After isolation, cells from the amniotic membranes (amniotic cells-AC) were selected for c-Kit (ASC) and compared these cells with c-Kit unselected (AMC), evaluating the expression of other stem cell markers (Oct-4, Tra-1-81, SSEA-4), CD271 and Slug. RESULTS: Immunofluorescence analysis showed that ASC cells exhibited greater stem cell marker expression and included more CD271 and Slug positive cells. This was consistent with the interpretation that c-Kit enriched AC show greater stemness capacity compared to c-Kit unselected AMC. DISCUSSION: AMC and ASC can both differentiate into various cell types including adipogenic, osteogenic, chondrogenic, neurogenic and hepatic lineages, but the enrichment in c-Kit improved stemness and differentiation potential of ASC.


Assuntos
Âmnio/citologia , Diferenciação Celular/fisiologia , Células-Tronco Mesenquimais/citologia , Proteínas Proto-Oncogênicas c-kit/metabolismo , Células-Tronco/citologia , Âmnio/metabolismo , Células Epiteliais/citologia , Células Epiteliais/metabolismo , Feminino , Humanos , Células-Tronco Mesenquimais/metabolismo , Fator 3 de Transcrição de Octâmero/metabolismo , Placenta/citologia , Placenta/metabolismo , Gravidez , Células-Tronco/metabolismo
9.
Placenta ; 34(7): 526-35, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23643069

RESUMO

OBJECTIVE: Human term placenta (HTP) has attracted increasing attention as an alternative source of stem cells for regenerative medicine since the amniochorionic membrane harbors stem cells populations that are easily accessible, abundantly available without ethical objections. In the chorionic side of HTP we found a progenitor perivascular "niche" in which rare cells co-express Oct-4 and c-Kit. We investigated the stem cell characteristics and differentiation potential of a chorionic derived population enriched in c-Kit(+) cells and compared this to the unenriched population. STUDY DESIGN: Cells, isolated from the chorion of HTP, were expanded and enriched in c-Kit(+) cells (Chorionic Stem Cells-CSC). Histological staining, immunofluorescence, Western blot and flow cytometry were used to verify the stem cells characteristics of the populations and to compare the differentiation capability towards mesodermal and neural lineages in vitro. RESULTS: The expression of the pluripotent marker Oct-4 was greater in the CSCs compared to the unselected cells (Chorionic Cell-CC) but both Oct-4 and c-Kit expression decreased during passages. After differentiation, CSC displayed stronger chondrogenic and osteogenic potential and a greater adipogenic forming capacity compared to unselected ones. CSC differentiated better into immature oligodendrocytes while CC showed a neuronal progenitor differentiation potential. Moreover, both populations were able to differentiate in hepatogenic lineage. CONCLUSION: CSC display improved Oct-4 expression and a high differentiation potential into mesodermal lineages and oligodendrocytes.


Assuntos
Diferenciação Celular , Córion/citologia , Células-Tronco Embrionárias/metabolismo , Fator 3 de Transcrição de Octâmero/biossíntese , Proteínas Proto-Oncogênicas c-kit/biossíntese , Adulto , Linhagem da Célula , Córion/metabolismo , Células-Tronco Embrionárias/citologia , Feminino , Humanos , Mesoderma/citologia , Sistema Nervoso/embriologia , Placenta/citologia , Gravidez
10.
Rev Laryngol Otol Rhinol (Bord) ; 134(4-5): 203-6, 2013.
Artigo em Francês | MEDLINE | ID: mdl-25252575

RESUMO

A solid understanding of anatomy, basic surgical principles, and tissue movement is essential when undertaking the reconstruction of facial cutaneous surgical defects. Aesthetic facial reconstruction requires understanding ability to use the tissue adjacent to the defect to create a reconstruction that preserves the function of the area and the cosmetic facial units and subunits. The closure of non interrupted white upper lip defects by using a combined advancement and rotation flap is preferred for defects not overtaking 2.5 cm in diameter.


Assuntos
Lábio/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Complicações Pós-Operatórias/cirurgia , Retalhos Cirúrgicos , Feminino , Humanos , Lábio/patologia , Masculino , Mucosa Bucal/patologia , Mucosa Bucal/cirurgia , Rotação , Pele/patologia , Cicatrização
11.
J Antimicrob Chemother ; 67(9): 2222-30, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22589455

RESUMO

OBJECTIVES: The aim of this study was to assess 25-hydroxyvitamin D (vitamin D) status in an HIV-infected adult population and to define HIV- and antiretroviral-related factors associated with vitamin D deficiency. METHODS: Using data from a prospective cohort of HIV-infected adult patients followed in five French centres (Dat'AIDS cohort), we evaluated the prevalence of vitamin D deficiency/insufficiency (<30 ng/mL). A multiple linear regression model was used to examine risk factors for vitamin D deficiency (≤10 ng/mL). RESULTS: Vitamin D deficiency/insufficiency was observed in 86.7% of the 2994 patients, including 55.6% with vitamin D insufficiency and 31.1% with vitamin D deficiency. In multivariate analysis, factors associated with vitamin D deficiency were current smoking [adjusted OR (aOR) 1.55], estimated glomerular filtration rate ≥90 mL/min/1.73 m(2) (aOR 1.51), vitamin D measurement not performed in summer (aOR 0.27), CD4 <350 cells/mm(3) (aOR 1.37 for CD4 200 to <350 and 1.62 for CD4 <200 cells/mm(3)) and antiretroviral therapy (aOR 2.61). Gender, body mass index, age, coinfection and previous AIDS were not associated factors. In the antiretroviral-treated population (n = 2660), besides the same factors found in the whole population, efavirenz was the only drug to be significantly associated with deficiency, with an aOR of 1.89 (95% CI 1.45-2.47). CONCLUSIONS: Vitamin D deficiency is frequent in this HIV-infected population. Patients on antiretroviral therapy are at higher risk of vitamin D deficiency than antiretroviral-naive patients, with an increased risk in patients receiving efavirenz. No effect of the other antiretrovirals, including the latest (etravirine, darunavir, raltegravir), was found.


Assuntos
Antirretrovirais/administração & dosagem , Antirretrovirais/efeitos adversos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Deficiência de Vitamina D/induzido quimicamente , Deficiência de Vitamina D/epidemiologia , Adulto , Alcinos , Benzoxazinas/administração & dosagem , Benzoxazinas/efeitos adversos , Estudos de Coortes , Estudos Transversais , Ciclopropanos , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
12.
Ann Fr Anesth Reanim ; 31(5): 478-80, 2012 May.
Artigo em Francês | MEDLINE | ID: mdl-22465649
13.
Ann Dermatol Venereol ; 137(12): 789-93, 2010 Dec.
Artigo em Francês | MEDLINE | ID: mdl-21134581

RESUMO

BACKGROUND: in this report of three new cases of superficial acral fibromyxoma (SAF), we discuss the clinicopathological features of this acral fibrous tumour as well as the differential diagnoses for hard nodules affecting the extremities. PATIENTS AND METHODS: these three lesions involved the standard presentation of a large solitary flesh coloured nodule causing deformation of a toenail or a fingernail. Biopsy showed the presence within a fibromyxoid tumour of proliferating fusiform cells having no atypical features and expressing CD 34 diffusely, and in more focal and less consistent fashion, epithelial membrane antigen (EMA) and CD 99. FISH testing for translocation t(17; 22) proved negative. DISCUSSION: this fairly common acral fibrous tumour is poorly known and in certain cases histology results may suggest myxoid dermatofibrosarcoma, which carries a completely different prognosis.


Assuntos
Fibroma/diagnóstico , Dedos , Doenças da Unha/diagnóstico , Neoplasias Cutâneas/diagnóstico , Dedos do Pé , Adulto , Idoso , Biomarcadores Tumorais/análise , Biópsia , Procedimentos Cirúrgicos Dermatológicos , Feminino , Fibroma/patologia , Fibroma/cirurgia , Dedos/patologia , Dedos/cirurgia , Humanos , Masculino , Doenças da Unha/patologia , Doenças da Unha/cirurgia , Pele/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Dedos do Pé/patologia , Dedos do Pé/cirurgia
14.
Curr Pharm Des ; 16(27): 3037-44, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20722614

RESUMO

Since their development 30 years ago, bisphosphonates are now one of the standard therapy in the management of osteoporosis. Improvements in terms of anti-resorptive potency have leaded to new molecules available either orally or intravenously, from weekly to yearly administration. Overall tolerance of bisphosphonates is good with regards to the risk of mandibular necrosis, not comparable with those observed in cancer treatment, and with no causal link yet established in osteoporotic patients. Compliance remains poor and should be improved by a better education of the patients about their treatment. Other treatments like teriparatide, raloxifene or strontium ranelate are now also available and give more therapeutic options but also more questions on the best molecule to choose for each patient. There is currently no valid basis for distinguishing in a formal and objective manner the different new-generation bisphosphonates, in terms of efficacy against either vertebral, peripheral or hip fractures. In a same way, comparison between bisphosphonates and the other treatments available for osteoporosis is hard in absence of proper randomised controlled study. This review gives an overview of the recent data on the efficacity and tolerance of bisphosphonates in the different forms of osteoporosis and compares them to the other treatments currently available.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Difosfonatos/uso terapêutico , Osteoporose/tratamento farmacológico , Conservadores da Densidade Óssea/efeitos adversos , Conservadores da Densidade Óssea/economia , Difosfonatos/efeitos adversos , Difosfonatos/economia , Difosfonatos/farmacologia , Custos de Medicamentos , Monitoramento de Medicamentos , Feminino , França , Humanos , Masculino , Adesão à Medicação , Compostos Organometálicos/efeitos adversos , Compostos Organometálicos/economia , Compostos Organometálicos/uso terapêutico , Osteoporose/economia , Osteoporose Pós-Menopausa/tratamento farmacológico , Osteoporose Pós-Menopausa/economia , Cloridrato de Raloxifeno/efeitos adversos , Cloridrato de Raloxifeno/economia , Cloridrato de Raloxifeno/uso terapêutico , Moduladores Seletivos de Receptor Estrogênico/efeitos adversos , Moduladores Seletivos de Receptor Estrogênico/economia , Moduladores Seletivos de Receptor Estrogênico/uso terapêutico , Teriparatida/efeitos adversos , Teriparatida/economia , Teriparatida/uso terapêutico , Tiofenos/efeitos adversos , Tiofenos/economia , Tiofenos/uso terapêutico
15.
Ann Dermatol Venereol ; 136(6-7): 536-9, 2009.
Artigo em Francês | MEDLINE | ID: mdl-19560617

RESUMO

BACKGROUND: Although urachal remnants are very rare, dermatologists must be aware of them in order to ensure suitable treatment by urologists. Lack of appropriate treatment exposes patients to the risks of recurrent infectious complications or degeneration to vesical adenocarcinoma. CASE REPORT: A 32-year-old man consulted for mild and recurring umbilical weeping for approximately 1 year. He had previously undergone unsuccessful treatment, comprising application of liquid nitrogen and of silver nitrate to an umbilical lesion measuring several millimetres regarded as pyogenic granuloma. The diagnosis of urachal sinus was suspected clinically (umbilical weeping or inflammation) and confirmed by urological scan. DISCUSSION: A defect involving partial or total obliteration of the urachal canal after the fifth month of gestation can result in four types of benign abnormalities. Patent urachus (50%) is diagnosed during the neonatal period, while in adults, the most frequent form is a urachal cyst (30%), with sinuses (15%) and the diverticula (5%) being very rare. The urachus and its implantation base on the bladder must be removed surgically. Laparoscopic surgery offers a valuable alternative to open-surgery and probably leads to less morbidity and shorter convalescence in active young subjects.


Assuntos
Líquidos Corporais/metabolismo , Umbigo , Úraco/anormalidades , Adulto , Humanos , Masculino , Úraco/cirurgia
16.
Phys Rev E Stat Nonlin Soft Matter Phys ; 78(4 Pt 2): 046312, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18999531

RESUMO

Recent experimental studies on the instability of capillary jets have revealed the suitability of a linear spatiotemporal instability analysis to ascertain the parametrical conditions for specific flow regimes such as steady jetting or dripping. In this work, an extensive analytical, numerical, and experimental description of confined capillary jets is provided, leading to an integrated picture both in terms of data and interpretation. We propose an extended, accurate analytic model in the low Reynolds number limit, and introduce a numerical scheme to predict the system response when the liquid inertia is not negligible. Theoretical predictions show remarkable accuracy when compared with the extensive experimental mapping.

17.
Prog Urol ; 18(10): 634-41, 2008 Nov.
Artigo em Francês | MEDLINE | ID: mdl-18971105

RESUMO

Urachus pathologies are very rare but require to be known by urologists. Lack of appropriate treatment exposes the patients to the risks of symptoms recurrence, infectious complications or adenocarcinomatous degeneration. A partial or total defect of obliteration of the urachus channel after the fifth month of gestation can be at the origin of four benign pathologies. The ombilicovesical fistula (47.6%) is diagnosed at the native period. In the adult, the most frequent form is the cyst (30.7%) whereas the external (16.4%) and internal sinus (3.2%) are rarer. Diagnosis depends on the clinical examination and the association of sonography and TDM. The risk of complications must systematically result in proposing a surgical treatment for these benign pathologies. The umbilicus resection is not recommended, but the surgeon has to remove the urachus and its implantation base on the bladder. Laparoscopic surgery seems to be an interesting route for this intervention.


Assuntos
Úraco/anormalidades , Anormalidades Congênitas/diagnóstico , Anormalidades Congênitas/terapia , Humanos , Úraco/embriologia
19.
J Pathol ; 214(5): 627-36, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18266309

RESUMO

Fetal mesenchymal stem cell (fetal MSC) therapy has potential to treat genetic diseases with early onset, including those affecting the kidney and urinary tract. A collagen type I alpha 2-deficient mouse has a deletion in the alpha2 chain of the procollagen type I gene, resulting in the synthesis of abnormal alpha1(I)(3) homotrimers, which replace normal alpha 1(I)2 alpha 2(I)1 heterotrimers and a glomerulopathy. We first confirmed that col1 alpha 2-deficient homozygous mice show abnormal collagen deposition in the glomeruli, which increases in frequency and severity with postnatal age. Intrauterine transplantation of human MSCs from first trimester fetal blood led postnatally to a reduction of abnormal homotrimeric collagen type I deposition in the glomeruli of 4-12 week-old col1 alpha 2-deficient mice. Using bioluminescence imaging, in situ hybridization and immunohistochemistry in transplanted col1 alpha 2-deficient mice, we showed that the damaged kidneys preferentially recruited donor cells in glomeruli, around mesangial cells. Real-time RT-PCR demonstrated that this effect was seen at an engraftment level of 1% of total cells in the kidney, albeit higher in glomeruli. We conclude that intrauterine transplantation of human fetal MSCs improves renal glomerulopathy in a collagen type I-deficient mouse model. These data support the feasibility of prenatal treatment for hereditary renal diseases.


Assuntos
Colágeno Tipo I/deficiência , Doenças Fetais/terapia , Células-Tronco Fetais/transplante , Nefropatias/terapia , Glomérulos Renais/ultraestrutura , Transplante de Células-Tronco Mesenquimais/métodos , Animais , Colágeno Tipo I/biossíntese , Colágeno Tipo I/metabolismo , Modelos Animais de Doenças , Feminino , Terapias Fetais/métodos , Sobrevivência de Enxerto , Humanos , Nefropatias/metabolismo , Nefropatias/patologia , Glomérulos Renais/metabolismo , Masculino , Camundongos , Microscopia Eletrônica
20.
Rev Chir Orthop Reparatrice Appar Mot ; 93(4 Suppl): 2S33-46, 2007 Jun.
Artigo em Francês | MEDLINE | ID: mdl-17646827

RESUMO

Pertrochanteric fractures constitute a major public health concern. This retrospective multicentric study evaluated outcome after treatment in patients aged over 75 years hospitalized for pertrochanteric fractures over a one year period (May 2004-May 2005). Five University Hospitals in the cities of Angers, Brest, Rennes, Tours, Nantes participated in this evaluation. The quality of the reduction and the position of the osteosynthesis were the two main criteria for good outcome. The type of material implanted had little effect on outcome. The results emphasized the importance of preventing osteoporosis. Fracture prevention and treatment of osteoporosis are crucial, even after fracture.


Assuntos
Fraturas do Quadril/cirurgia , Idoso , Idoso de 80 Anos ou mais , Árvores de Decisões , Feminino , Fraturas do Quadril/etiologia , Humanos , Masculino , Osteoporose/complicações , Osteoporose/cirurgia , Complicações Pós-Operatórias/etiologia , Pseudoartrose/etiologia , Estudos Retrospectivos , Falha de Tratamento
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