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2.
J Eur Acad Dermatol Venereol ; 35(3): 755-761, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33211344

ABSTRACT

BACKGROUND: Very few studies have evaluated the quality of life (QoL) of children suffering from low-flow vascular malformations. This is the first study investigating the influencing factors. OBJECTIVES: To identify the factors influencing QoL in children with low-flow vascular malformations. METHODS: We conducted a qualitative study employing focus group interviews (Clinical Trials Number: NCT03440827). The study was a prospective, interventional, non-comparative, multicentre study performed in four expert centres for vascular anomalies. Qualitative data about personal experiences, feelings, difficulties, needs and various factors influencing behaviours were collected. Theme-based content analysis (manual and specialist textural software guided) were used to analyse the verbatim transcripts of all focus group sessions. Manual qualitative discourse analysis was performed to identify the different themes and categories. Informatics' analyses were subsequently performed for each individual category. RESULTS: Ten focus groups (26 individuals including 10 children aged 11 to 15 years) were conducted until saturation. Influencing factors were related to 4 categories: medical care, self-image, social impact on daily activities and challenging social relationships. These factors were responsible for intrafamily upheavals and may lead to future identity-building problems. CONCLUSIONS: This study provides an essential framework from which physicians can develop strategies to improve patient care and quality of life. These data may also be useful to develop specific age-sensitive QoL questionnaires.


Subject(s)
Quality of Life , Vascular Malformations , Adolescent , Child , Focus Groups , Humans , Prospective Studies , Qualitative Research
4.
Ann Dermatol Venereol ; 145(12): 741-748, 2018 Dec.
Article in French | MEDLINE | ID: mdl-30217683

ABSTRACT

AIM: To describe in a large paediatric cohort the characteristics of hypopigmented and depigmented (hypochromatic and achromic) macules with no clear diagnosis but potentially evocative of tuberous sclerosis (TS). PATIENTS AND METHODS: This was a retrospective multicentre study performed between 2010 and 2017 at a reference centre for rare skin diseases; it included all children consulting for hypochromic and achromic macules. A descriptive analysis was made of the characteristics of macules with no clear diagnosis, enabling them to be classified in three secondary groups: TS certain, TS ruled out, TS uncertain. RESULTS: Of the 3300 children seen during this 7-year period 7,265 were consulting for hypochromic or achromic macules, with no clear diagnosis in 18 cases: 7 girls and 11 boys of median age at 7.21 years (range: 4 months to 16 years and 7 months). The lesions were congenital in 7 cases. The number of macules varied, with over 20 in some cases. The majority were in the form of ash-leaf spots, followed by the oval form. Two children were diagnosed at clinical examination, and 16 underwent it is not examinations, resulting in a diagnosis of certain ST in 6 of these cases. No particular characteristics of the macules appeared to guide the clinical examination towards ST or isolated lesions. Café-au-lait spots were more frequent in the group in which ST was ruled out than in the other two groups: 67% vs. 33% and 33%. Neurologic involvement was more common in children with certain or uncertain ST than in children in whom ST was ruled out (83% and 67% vs. 11%). CONCLUSION: No identified characteristics of stains enabled the clinical examination to confirm or rule out tuberous sclerosis. Screening for acute any signs of ST is essential. Diagnostic efficacy is enhanced by additional exams.


Subject(s)
Hypopigmentation/etiology , Tuberous Sclerosis/epidemiology , Adolescent , Angiomyolipoma/epidemiology , Child , Child Behavior Disorders/etiology , Child, Preschool , Developmental Disabilities/etiology , Diagnosis, Differential , Epilepsy/etiology , Female , Heart Neoplasms/epidemiology , Humans , Hypopigmentation/congenital , Infant , Kidney Neoplasms/epidemiology , Male , Retrospective Studies , Rhabdomyoma/epidemiology , Tuberous Sclerosis/complications , Tuberous Sclerosis/diagnosis
5.
Ann Dermatol Venereol ; 145(6-7): 429-432, 2018.
Article in French | MEDLINE | ID: mdl-29685324

ABSTRACT

BACKGROUND: Regular cannabis use may be associated with several oral changes not usually identified by dermatologists: xerostomia, increased risk of caries, periodontitis, leukoedema, gingival hyperplasia, and higher prevalence and density of Candida albicans, leukoplakia or gingivitis. PATIENTS AND METHODS: We report herein the appearance of a characteristic green tongue in a patient following intensive marijuana inhalation. DISCUSSION: This complication has rarely been reported in the medical literature. Paradoxically, it is clearly described in different Internet search engines, particularly Google.


Subject(s)
Marijuana Abuse/complications , Tongue Diseases/diagnosis , Tongue Diseases/etiology , Color , Humans , Internet , Male , Young Adult
6.
Ann Dermatol Venereol ; 145(3): 182-186, 2018 Mar.
Article in French | MEDLINE | ID: mdl-29221652

ABSTRACT

BACKGROUND: Chronic HSV infection is a cause of chronic perineal ulcerations. We report a case of a chronic and refractory HSV infection revealing chronic lymphoid leukaemia. PATIENTS AND METHODS: An 85-year-old woman with an 8-month history of chronic perineal ulcerations was referred to our dermatology department. She had no previous medical history of herpes infection. Skin biopsies ruled out carcinoma but were consistent with HSV infection. A local swab was positive for HSV2. Treatment with valaciclovir and intravenous acyclovir (ACV) at the recommended doses was ineffective. Laboratory tests revealed type-B chronic lymphoid leukaemia. Molecular biology studies confirmed the presence of ACV-resistant HSV via decreased thymidine kinase activity (stop codon: M183stop). Foscarnet was administered for a period of 3 weeks with almost complete healing of the ulcerations. Treatment was stopped prematurely due to acute renal insufficiency and the remaining lesions were treated using imiquimod cream. Valaciclovir was prescribed to prevent further episodes. The condition recurred a mere 11 months later. DISCUSSION: The prevalence of ACV-resistant HSV is 0.32 % in immunocompetent patients and 3.5 % in immunocompromised patients. Insufficient dosing regimens or prolonged treatment with TK inhibitors result in the local selection of pre-existing mutant HSV viruses. Foscarnet, a DNA polymerase inhibitor, is the treatment of choice in HSV-resistant infections. ACV-resistant HSV is less virulent and replicates less, with reactivations being mainly due to wild-type HSV latent in the neural ganglia. Valaciclovir can be used as a preventive treatment. To our knowledge, this is the first case of ACV-resistant HSV infection revealing chronic lymphoid leukaemia. CONCLUSION: Chronic perineal ulcerations can be the first manifestation of immunodeficiency seen for example with haematological diseases. In the event of clinical resistance of an HSV infection to recommended thymidine kinase inhibitor regimens, the use of foscarnet should be considered.


Subject(s)
Acyclovir , Antiviral Agents , Foscarnet/therapeutic use , Herpes Simplex/complications , Immunocompromised Host , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Acyclovir/administration & dosage , Adjuvants, Immunologic/administration & dosage , Administration, Cutaneous , Aged, 80 and over , Aminoquinolines/administration & dosage , Antiviral Agents/administration & dosage , Female , Herpes Simplex/drug therapy , Humans , Imiquimod , Perineum/pathology , Perineum/virology
7.
Comput Healthc ; 11(5): 26-7, 30, 35, 1990 May.
Article in English | MEDLINE | ID: mdl-10104507

ABSTRACT

Experimenting with bedside patient care systems has turned up a valuable track record of experiences to shape nursing/physician utilization and future development.


Subject(s)
Health Facilities , Hospital Information Systems , Patient Care Planning/trends , Patients' Rooms , Attitude of Health Personnel , Attitude to Computers , Florida , Hospital Bed Capacity, 300 to 499 , Humans , Local Area Networks , Nursing Service, Hospital/organization & administration
8.
Bioinorg Chem ; 8(2): 133-8, 1978.
Article in English | MEDLINE | ID: mdl-25095

ABSTRACT

Solutions of Busycon canaliculatum have been studied by light scattering. In 0.05 M Trizma buffer +0.1 M NaCl at pH 7.0 at 14 degrees, the weight-average molecular weight is 8.9 X 10(6). In the presence of added CaCl2 (0.02 M), the molecular weight of the protein increases to 10.7 X 10(6), and the second virial coefficient is reduced. At pH 9.95, the molecular weights with and without 0.02 M CaCl2, are 3.7 X 10(6) and 1.3 X 10(6), respectively; and the effect of Ca++ in reducing the second virial coefficient is much greater than at pH 7.0. These results can be understood on the basis that at pH 7.0, ca++ increases the association of hemocyanin, by binding and intermolecular linkage through the carboxyl groups of protein side chains. At pH 9.95, amino groups are deprotonated and therefore also become available for Ca++ binding. The relative effect of Ca++ in enhancing the association of hemocyanin therefore becomes greater at the higher pH.


Subject(s)
Calcium Chloride , Hemocyanins , Animals , Hemolymph , Hydrogen-Ion Concentration , Light , Mathematics , Molecular Weight , Scattering, Radiation , Snails
9.
Macromolecules ; 9(1): 182-5, 1976.
Article in English | MEDLINE | ID: mdl-1249988

ABSTRACT

Some criticisms of our theoretical treatment of the partial exclusion of flexible-chain polymers in solution from cavities of macromolecular size and its application to gel permeation chromatography are examined. In other discussion, it is confirmed by simple reasoning that the identification, explicit or implicit in various studies, of the mean projection of a polymer molecule onto a line as a characteristic dimension governing the extent of permeation of simple pores does not depend on specific molecular models. Our previous calculation of permeation by certain random-flight branched-chain species is shown to lead, incidentally, to the mean projection for these structures. From relations between the mean projection and the hydrodynamic volume of a molecule, it appears that the product of intrinsic viscosity and molecular weight is not a common calibration factor for elution of all molecular species from a gel chromatographic column, but theory and experience do support the validity of this correlation among solutes with similar molecular architecture.


Subject(s)
Chromatography, Gel/methods , Polymers/analysis , Mathematics , Molecular Conformation , Molecular Weight
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