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Biomedical subjects

A Fresard

Publications and source records attributed to A Fresard.

17 recordsLinked to original sources
PubMed2005

Arthroplastic and osteosynthetic infections due to Propionibacterium acnes: a retrospective study of 52 cases, 1995-2002.

The cases of 52 patients with Propionibacterium acnes infection of orthopaedic implants are summarized: 20 patients with definite infection (sepsis, with P. acnes recovered from multiple specimens per patient), 15 with probable infection (sepsis, with P. acnes recovered from one specimen), and 17 with possible infection (signs of prosthetic malfunction or pseudo-osteoarthritis, with P. acnes recovered from one specimen). The patient population consisted of 37 males and 15 females with a mean age of 51.8 years (range 17-88). Besides bone surgery, 21% of these patients had severe coexisting illness. The study population was very heterogeneous and clinical presentation very polymorphic; infections became clinically apparent through sepsis, prosthetic malfunction, or a delay in consolidation. The diagnosis was highly dependent on the quality of the samples taken and the methodology used by the microbiology laboratory to isolate this bacterium. Culture time was long, on average 11.4 days. Treatment involved a combination of antibiotic treatments (67% of cases) and ablation of the material (83% of cases). Although P. acnes is considered to be weakly pathogenic, this bacterium may be responsible for infections in patients with implanted orthopaedic material. Ablation of the arthroplastic or osteosynthetic material is necessary in the majority of cases.

Adolescent↗
PubMed2005

[Human immunodeficiency virus type 1 subtypes in cohort of infected patients, Saint-Etienne, France, from 1984 to 2003].

OBJECTIVE: The authors had for aim to study the distribution of HIV-1 subtypes in a cohort of HIV-1 positive patients in the University hospital of Saint-Etienne, France, and to describe the epidemiological characteristics of patients infected with a non-B subtype strain. DESIGN: An epidemiological study was made on 271 HIV-1 positive patients followed up in the Infectious Diseases Department over 20 years. All patients sample were subtyped by serotyping and some samples were also tested by genotyping. RESULTS: Two hundred and sixty-four patients (191 men and 73 women) were found infected by an HIV-1 strain belonging to the M group. After combining serotyping and genotyping results, 195 patients were found infected by a B subtype and 69 by a non-B subtype. Most of the latter strains belonged to an A subtype or related ones. The following factors were shown to be linked to an infection by a non-B strain: being born abroad, having contracted the infection though heterosexual practice, and being a woman. The incidence of non-B strains increased regularly over time (to reach more than 40% in 2003). This progression was especially noted for men born in France with risky sexual behaviour. CONCLUSION: These results indicate that more than 40% of HIV-1 new cases detected in the Saint-Etienne area are related to non-B strains and that strains of A and related subtypes are common in the local population with risky sexual behaviour.

Female↗
PubMed2004

Risk factors for systemic emboli in infective endocarditis.

A retrospective study was undertaken to analyse the risk factors for systemic emboli in infective endocarditis. Patients (n = 80; 70% males; mean age 65 years; range 20-91 years) with infective endocarditis, as defined by the Duke criteria and diagnosed using transoesophageal echocardiography during the period January 1995 to March 2001, were included. The average time between the start of the illness and the beginning of antibiotic treatment was 55 days (range 0-405 days). The pathogens identified were streptococci (n = 47), staphylococci (n = 11), enterococci (n = 9), and others (n = 4). In nine cases, blood cultures were sterile. Thirty patients with at least one embolic episode were compared with 50 control patients. According to univariate analysis, the main risk factor for systemic emboli was the size of the vegetation (12.4 mm vs. 7.8 mm; p = 0.0005). The risk of emboli was 57% when the vegetation measured > 10 mm and only 22% when it was < 10 mm (p = 0.003). The mobility of the vegetation was also a risk factor: 48% if the vegetation was mobile; and 9% if fixed (p = 0.003). Sex, age, pathogen, antibiotic treatment, type of valve and the number and position of the vegetations were not found to be risk factors. With multivariate analysis, only mobility was identified as a risk factor. Overall, mobile vegetations > 10 mm in size were associated with an increased risk of embolic episodes in infective endocarditis.

Adult↗
PubMed1996

[Seroprevalence of viral hepatitis A in France in homosexuals and intravenous drug users].

OBJECTIVES: In industrialized countries with a high level of sanitation, immunity against hepatitis A (HVA) is not acquired during childhood, and infection typically occurs in adults, mainly in travelers returning from developing countries where infection is endemic. However, the introduction of hepatitis A virus (HAV) among certain population groups, such as intravenous drug users (IVDU) or homosexual men, leads to a significant increase in the disease. We conducted a retrospective analysis of seroprevalence of anti-HAV antibodies. METHODS: The study group included 296 patients (174 homosexual men and 122 IVDU) for comparison with 76 control subjects (nurses in pediatric wards and workers in hospital kitchen). RESULTS: We found a significantly higher anti-HAV seroprevalence among less than 35-year old IVDU, HIV positive or negative, in comparison with control subjects but not among homosexual men, whatever their HIV status. CONCLUSION: Our experience illustrates that HVA is a health risk for IVDU in industrialized nations, and given its morbidity among adults population, IVDU should receive HVA vaccine.

Adult↗
PubMed1995

Anti-HIV activity of the combination of didanosine and hydroxyurea in HIV-1-infected individuals.

HIV is known to be present in massive amounts in both resting and actively replicating cells in infected individuals. We tested the combination of didanosine and hydroxyurea, known to suppress viral production in vitro in both of these cell types, in a small number of asymptomatic patients. After 3 months of well tolerated treatment, we observed a large reduction of viral load in the peripheral blood of all 12 patients, down to nonquantifiable levels in 7 of 12 as measured by infectious virus titer, and 6 of 12 as measured by plasma HIV-RNA. In this subgroup of 6 patients, whose baseline HIV-RNA was below 14,000 copies/ml, the median increase in CD4+ count after 90 days of treatment was 244 cells/mm3.

Adult↗
PubMed1993

[Evaluation of three automated blood culture systems. Bio Argod, Bact T/Alert, bactec NR-860].

In 1991 and 1992, three automated blood culturing systems were successively assessed ("Diagnostics Pasteur" Bio Argos: 1,120 Vials, "Organon Teknika" BacT/Alert: 1,400 vials and "Becton Dickinson" bactec NR-860: 2,146 standard vials 6 and 7 and 2,360 resin vials 26 and 27), and compared with the conventional system (C) (Roche aerobic BHI-S Liquoîd, and Diagnostics Pasteur anaerobic prereduced Shaedler). Duplicate blood cultures were collected in various hospital services. They were processed over a 7-day period by the automated instruments and were incubated for 10 days using conventional techniques. The percentage of positivity (clinically significant results) obtained with the automated instruments was similar to that obtained with conventional techniques. Bio Argos: 3.4 p. cent vs 3.8 p. cent with C, BacT/Alert: 3.9 p. cent vs 3.5 p. cent, Bactec standard 6 and 7 vials: 5.6 p. cent vs 6.4 p. cent, and resin 26 and 27: 4.2 p. cent vs 3.1 p. cent. A better sensitivity was found with Bactec resin 26 and 27 vials when compared to C for Staphylococcus aureus (22 p. cent of S. aureus strains were isolated only with resin vials 26 and 27). False positives were as follow: 0.36 p. cent for BacT/Alert, 2.1 p. cent for Bio Argos and 3.5 p. cent for Bactec. The fastest detection rate was observed with the instrument which shakes the vials continuously (BacT/Alert): 73.6 p. cent of positive vials were detected on the day the vials were received at the laboratory. Ninety-four percent of the Bactec resin 26 and 27 positive vials, 90.6 p. cent of the BacT/Alert positive vials, 84 p. cent of the Bactec 6 and 7 positive vials and 73.7 p. cent of the Bio Argos positive vials were detected within twenty-four hours.

Bacteria, Aerobic↗
PubMedDate not supplied

Prolonged treatment of chronic Pseudomonas aeruginosa osteomyelitis with a combination of two effective antibiotics.

Emergence of Pseudomonas aeruginosa resistant to antibiotic monotherapy is one of the causes of therapeutic failure in chronic P. aeruginosa osteomyelitis. We report 15 cases of chronic (> 3 months of evolution) biopsy culture proven P. aeruginosa osteomyelitis included in an open prospective study evaluating the efficacy of prolonged treatment (> 4 months) with two effective antibiotics in combination. Mean post-treatment follow-up was 38 months. A regimen of cefsulodin in combination with oral ofloxacin was used for six patients, cefsulodin-pefloxacin for three patients, cefsulodin-ciprofloxacin for one patient, piperacillin-pefloxacin for one patient, cefsulodin-fosfomycin for one patient, imipenem-ciprofloxacin for two patients and amoxicillin-ciprofloxacin-fosfomycin for one patient as home therapy. The clinical cure rate of 73% and bacteriological cure rate of 93% are far superior to those previously described in the literature. We did not observe adverse drug reactions. We think that a prolonged use of two effective antibiotics in combination is a safe and improved therapeutic schedule for chronic P. aeruginosa osteomyelitis.

Adolescent↗