A Servonnet

Hôpital d'instruction des armées du Val-de-Grâce, Lutetia Parisorum, Île-de-France, France

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Publications (19)6.03 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Plasmodium knowlesi is typically found in macaques and has recently been recognized as the fifth Plasmodium species to cause malaria in humans. Several cases of P. knowlesi malaria have been reported in people in Southeast Asia. Most cases are simple but approximately one in 10 patients develops complications. The morphology of P. knowlesi parasites in human infections closely resembles that of Plasmodium malariae or Plasmodium falciparum, so a molecular method is the optimum diagnostic procedure. The treatment of choice for uncomplicated P. knowlesi malaria is oral chloroquine, whereas severe infection should be treated with intravenous quinine.
    Medecine et sante tropicales. 01/2013;
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    ABSTRACT: Intoxication by glycyrrhizin is a rare cause of hypokalemia. We describe a patient with severe hypokalemia caused by long-term consumption of syrup containing liquorice. The physiopathological mechanism of the intoxication and the differential diagnosis are presented.
    Fuel and Energy Abstracts 12/2011;
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    ABSTRACT: We report the case of a 28-year-old woman who presented with arthralgia during a treatment with propylthiouracil (PTU) for hyperthyroidism. Detection of antineutrophil cytoplasmic antibodies (ANCA) against myeloperoxidase, proteinase 3 and elastase led to suspect PTU induced vasculitis.
    La Revue de Médecine Interne 10/2010; 31(10):e9-e10. · 0.90 Impact Factor
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    ABSTRACT: Neuromeningeal tuberculosis is a rare extrapulmonary location in France. Delayed diagnosis can lead to therapeutic failure and severe sequels. However early diagnosis is a major challenge that requires the proper epidemiological, clinical, radiological and biological resources. Problems related to diagnosis of mycobacteria infection and to shortcomings in certain healthcare systems can hinder early diagnosis. The purpose of this review was to describe the diagnostic value of assaying adenosine deaminase activity in cerebrospinal fluid from patients with neuromeningeal tuberculosis. Evidence from studies published over the last 25 years indicate that the sensitivity and specificity of measuring adenosine deaminase activity range from 36 to 92% and 71 to 100% respectively depending of cutoff values used. Before performing this assay, it is necessary to rule out obvious or frequent etiologies such as purulent bacterial meningitis or cryptococcosis in HIV patients. Taken together these studies show that this simple, inexpensive technique is a valuable tool for early diagnosis and management of tuberculosis patients and that it can be easily implemented in hospital labs regardless of technical or financial resources.
    Médecine tropicale: revue du Corps de santé colonial 02/2010; 70(1):88-93.
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    ABSTRACT: We report the case of a 28-year-old woman who presented with arthralgia during a treatment with propylthiouracil (PTU) for hyperthyroidism. Detection of antineutrophil cytoplasmic antibodies (ANCA) against myeloperoxidase, proteinase 3 and elastase led to suspect PTU induced vasculitis.
    Revue De Medecine Interne - REV MED INTERNE. 01/2010; 31(10).
  • [Show abstract] [Hide abstract]
    ABSTRACT: Intoxication by glycyrrhizin is a rare cause of hypokalemia. We describe a patient with severe hypokalemia caused by long-term consumption of syrup containing liquorice. The physiopathological mechanism of the intoxication and the differential diagnosis are presented.
    Pathologie Biologie 11/2009; 59(6):336-8. · 1.67 Impact Factor
  • A Servonnet, E Leclercq, H Delacour, F Ceppa
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    ABSTRACT: A potentially life-threatening hypersensitive reaction occurs in association with initiation of HIV nucleoside analogue abacavir therapy in 4 to 8% of patients. Preliminary studies appear to confirm the role of the immune system in abacavir hypersensitivity. The reaction is possibly the result of presentation of drug peptides onto HLA, that may induce a pathogenic T-cell response. Hypersensitivity reaction to abacavir is strongly associated with the presence of the HLA-B*5701 allele and prospective HLA-B*5701 genetic screening has now been instituted in clinical practice to reduce the risk of hypersensitivity reaction.
    Pathologie Biologie 03/2009; 58(6):e95-100. · 1.67 Impact Factor
  • Hervé Delacour, Aurélie Servonnet, Céline Roche
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    ABSTRACT: Diagnostic tests are an essential part of clinical medicine, assisting the clinician in formulating diagnoses. Correct use of a diagnostic test requires to know its performance characteristics. Various indices are available to evaluate the test's validity and to help the clinician to choose the most suitable test. Sensitivity and specificity are important test features ; they measure the proportion of test-positive persons who truly are diseased and the proportion of test-negative persons who truly are non diseased. Predictive values provide an estimation of being sick or healthy according to the result of the test. They have the particularity of being sensitive to the prevalence of the disease and can rarely be generalised beyond the study. The likelihood ratio incorporates both the sensitivity and specificity of the test and provides a direct estimate of how much a test result will change the odds of having a disease. Their use in daily practice to calculate the post-test probability of the disease is facilitated by the use of Fagan's nomogram.
    Revue Francophone des Laboratoires 01/2009; 2009(412):41-48.
  • Revue Francophone des Laboratoires 01/2009; 2009(416):93-96.
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    ABSTRACT: To test whether heart-Fatty Acid Binding Protein (h-FABP) is a useful plasma marker for the detection of acute coronary syndrome during muscular exercise. Plasma concentrations of h-FABP were measured in 42 volunteers before and after muscular exercise (military aptitude test). Myoglobin and troponin Ic were measured for comparison. Significant increase were found in plasma myoglobin (mean = 195,9 microg/L) and h-FABP (mean = 5,71 microg/L). Myoglobin and h-FABP concentrations were already significantly elevated (p < 10(-6)) at 60 minutes after exercise and h-FABP concentrations were superior to baseline values in 15 volunteers. Whereas h-FABP decreased to normal levels within 24 hours, myoglobin remained elevated in 12 volunteers. The myoglobin to h-FABP ratio in plasma is between 8,0 and 57,0 which is different from the reported plasma ratio after myocardial injury (<6). h-FABP can be used to exclude an acute coronary syndrome during exercise. The myoglobin to h-FABP ratio seems to be useful to identify the type of muscle injured. New studies are necessary to evaluate its diagnostic accuracy.
    Annales de biologie clinique 01/2007; 65(1):27-32. · 0.30 Impact Factor
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    ABSTRACT: The Unicel DXC 600 is an automated analytical system from Beckman Coulter for measuring usual biochemistry parameters (electrolytes, substrates and enzymatic activities), therapeutic drugs, drugs of abuse and specific proteins. According to the "Société française de biologie clinique (SFBC)" validation protocol, we tested the following parameters: electrolytes (sodium, potassium, chloride, total CO2), substrates (uric acid, calcium, phosphate, glucose, creatinine, urea, cholesterol, HDL cholesterol, bilirubin, iron, triglycerides), enzymes (ALAT, ASAT, amylase, CK, GGT, LDH, lipase, ALP), total proteins and specific proteins (albumin, CRP, haptoglobin). The results confirm the excellent analytical performances regarding imprecision. The comparison study shows differences between values obtained with Unicel DXC 600 and Integra 800 (Roche diagnostics), leading to the use of correcting factors for some parameters.
    Annales de biologie clinique 01/2007; 65(5):555-62. · 0.30 Impact Factor
  • Revue Francophone des Laboratoires 01/2007; 2007(390):63-65.
  • A Servonnet, H Delacour, C Dehan, V Gardet
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    ABSTRACT: Heart Fatty-Acid Binding Protein (h-FABP) is a small cytosolic protein that is abundant in the heart and found at lower concentrations in muscle or in the brain. h-FABP is released into the circulation shortly after the onset of ischemia. Several studies indicate its usefulness in cardiology: exclusion of acute myocardial infarction, detection of reperfusion, prognostic value... A rapid immuno-chromatographic assay (Cardiodetect) was recently commercialized in France with a result obtainable within 15 minutes. We review the strengths and weakness of h-FABP for detecting myocardial injury.
    Annales de biologie clinique 01/2006; 64(3):209-17. · 0.30 Impact Factor
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    ABSTRACT: Chloroquine is the mainly and mostfrequently drug used as antimalaric in the world, in spite of the extension of resistance phenomena. Due to the narrow margin between therapeutic and toxic dose, fatal chloroquine poisoning come to notice from time to time in Africa and more exceptionally in Europe. Acute intoxication is responsible of grave cardiovascular disturbances, which may be rapidly life threatening. Cardiovascular toxicity is linked to a potent membrane-stabilising effect provoked by its quinidine-like action. Treatment is based on diazepam, adrenalin, and assisted ventilation. Its effectiveness will be increased in case of premature coverage. Seriousness of poisoning is estimated by means of various clinical (systolic blood pressure, rhythm disorders), biological (hypokalemia) and toxicological (chloroquinaemia) parameters. Thus, hospital laboratories possess a fundamental role by asserting diagnosis and by estimating poisoning's gravity by chloroquine's determination preferentially in whole blood. Analytical techniques are essentially spectrophometric (UV) or chromatographic (HPLC or GPC). Unfortunately, chromatographic methods are adapted with difficulty to the urgency because of their delay of result's depiction. Molécule à index thérapeutique étroit, la chloroquine est Vantimalarique le plus utilisé dans le monde. Elle est à l'origine d'intoxications aiguës graves rencontrées dans les zones impaludées et plus rarement en Europe. Leur sévérité est essentiellement liée aux troubles cardiovasculaires provoqués par son action quinidine-like. Le traitement thérapeutiquefait appel principalement au diazepam, à l'adrénaline et à la ventilation artificielle. Le protocole de traitement spécifique ne doit être appliqué dans son intégralité qu'en cas d'intoxications graves et non systématiquement. Son efficacité sera augmentée en cas de prise en charge pré-hospitalière précoce. La gravité des intoxications est évaluée à l'aide de différents paramètres cliniques (pression artérielle systolique, troubles du rythme), biologiques (hypokaliémie) et toxicologiques (chloroquinémie). Les laboratoires hospitaliers possèdent donc un rôle fondamental en affirmant le diagnostic et en évaluant la gravité de l'intoxication par le dosage de la chloroquine, réalisé préférentiellement sur sang total. Les techniques analytiques utilisées sont essentiellement spectroscopiques (UV) ou chromatographiques (C.L.H.P. ou C.P.G.). Malheureusement, ces dernières, méthodes de référence pour les analyses médico-légales, sont difficilement adaptées à l'urgence du fait de leur délai de rendu de résultat.
    http://dx.doi.org/10.1051/ata:2005025. 01/2005;
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    ABSTRACT: Laboratory test's diagnostic performances are generally estimated by means of their sensibility, specificity and positive and negative predictive values. Unfortunately, these indices reflect only imperfectly the capacity of a test to correctly classify subjects into clinically relevant subgroups. The appeal to ROC (receiver operating characteristic) curve appears as a tool of choice for this evaluation. Used in the medical domain since the 60s, ROC curve is a graphic representation of the relation existing between the sensibility and the specificity of a test, calculated for all possible cut-off. It allows the determination and the comparison of the diagnostic performances of several tests. It is also used to consider the optimal cut-off of a test, by taking into account epidemiological and medical - economic data of the disease. Used in numerous medical domains, this statistical tool is easily accessible thanks to the development of computer softwares. This article exposes the principles of construction and exploitation of a ROC curve.
    Annales de biologie clinique 01/2005; 63(2):145-54. · 0.30 Impact Factor
  • Hervé Delacour, Aurélie Servonnet, Véronique Gardet
    http://dx.doi.org/10.1051/ata:2005020. 01/2005;
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    ABSTRACT: The present report describes a case of disseminated Trichosporon asahii infection. Trichosporon species has emerged as opportunistic infectious yeast in immunocompromised patients and is resistant to echinocandins. These antifungal drugs are not recommended for trichosporonosis treatment and yeast species identification be attempted for all clinical isolates, particularly with respect to the choice of antifungal therapy for specific Trichosporon species.
    Annales de biologie clinique 68(3):363-6. · 0.30 Impact Factor
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    ABSTRACT: Résumé. Les performances diagnostiques des tests de laboratoire sont généra-lement évaluées à l'aide de leur sensibilité, spécificité et valeurs prédictives positives et négatives. Malheureusement, ces indices ne reflètent qu'imparfaite-ment la capacité d'un test à distinguer les malades des non malades. Le recours à la courbe ROC (receiver operating characteristic) apparaît comme un outil de choix pour cette évaluation. Utilisée dans le domaine médical depuis les années 1960, la courbe ROC est une représentation graphique de la relation existante entre la sensibilité et la spécificité d'un test, calculée pour toutes les valeurs seuils possibles. Elle permet la détermination et la comparaison des performances diagnostiques de plusieurs tests à l'aide de l'évaluation des aires sous la courbe. Elle est aussi utilisée pour estimer la valeur seuil optimale d'un test en tenant compte des données épidémiologiques et médicoéconomiques de la maladie. Utilisée dans de nombreux domaines médicaux, cet outil statistique est facilement accessible grâce au développement de logiciels informatiques. Cet article expose les principes de construction et d'exploitation d'une courbe ROC. Mots clés : courbe receiver operating characteristic, sensibilité, spécificité, performance diagnostique, valeur seuil Abstract. Laboratory test's diagnostic performances are generally estimated by means of their sensibility, specificity and positive and negative predictive values. Unfortunately, these indices reflect only imperfectly the capacity of a test to correctly classify subjects into clinically relevant subgroups. The appeal to ROC (receiver operating characteristic) curve appears as a tool of choice for this evaluation. Used in the medical domain since the 60s, ROC curve is a graphic representation of the relation existing between the sensibility and the specificity of a test, calculated for all possible cut-off. It allows the determina-tion and the comparison of the diagnostic performances of several tests. It is also used to consider the optimal cut-off of a test, by taking into account epidemiological and medical -economic data of the disease. Used in numerous medical domains, this statistical tool is easily accessible thanks to the develop-ment of computer softwares. This article exposes the principles of construction and exploitation of a ROC curve.
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    ABSTRACT: Cushing's syndrome is rare and remains a challenge to diagnose. Particularly difficult are the differentiation between Cushing's syndrome and Pseudo-Cushing's states and between the two forms of ACTH dependent Cushing's: Cushing's disease and ectopic ACTH syndrome. We report the case of a patient diagnosed with a metastatic small cells lung carcinoma associated with ectopic ACTH-syndrome. Hypokalaemia was a clue to diagnosis. We focus on critical questions addressing diagnosis and differential diagnosis of Cushing's syndrome and we explain the mechanism of hypokalaemia.
    Annales de biologie clinique 65(4):425-30. · 0.30 Impact Factor

Publication Stats

30 Citations
6.03 Total Impact Points

Institutions

  • 2010
    • Hôpital d'instruction des armées du Val-de-Grâce
      Lutetia Parisorum, Île-de-France, France
  • 2007
    • Percy Army Training Hospital
      Clamart, Île-de-France, France