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Biomedical subjects

A Smail

Publications and source records attributed to A Smail.

51 records · Page 3Linked to original sources

[Treatment of aspiration pneumonia with piperacillin].

Clinical efficacy and safety of piperacillin were evaluated in 30 patients with a severe aspiration pneumonia admitted in our intensive care unit from july 1987 to december 1988. 20 women and 10 men (with a mean SAPS: 14) had a right pneumonia in 17 cases, left in 6, bilateral in 7 cases. A pathogen was isolated in 18 patients by protected distal catheterism, in 3 patients by blood cultures. 25 patients cured. However with a high isolation of Staphylococci it appears reasonable to associate piperacillin with an aminoglycoside before the obtention of bacteriological results.

Adult↗

[Myiasis: facial location. Apropos of a case of Dermatobia hominis infection].

Myiases constitute a parasitic disease always secondary to the presence of the larvae of certain insects, particularly diptera, in skin wounds ("cutaneous myiases") or in the body ("deep myiases") of man or vertebrates. Larvae or maggots are able to invade natural cavities and induce myiasis. They can invade the nasal fossae causing "nasomyiases", the eyes causing "ophthalmomyiases" and the ears causing "otomyiases". They can penetrate further, causing urinary tract "cystomyiases", vaginal or gastrointestinal myiases. They can invade the scalp or complicate surgical wounds "surgical myiases". These diseases are initially confused with other pathologies, but the discovery of a larva in one of these sites is a certain sign of myiases. When the diagnosis has been established, treatment is generally simple and cure is rapidly obtained.

Adult↗

[The role of infection in the precipitation of periarteritis nodosa].

Circulating immune complexes are thought to play an essential part in the pathogenesis of necrosing angiitis. This theory also allows a role to be attributed to certain infectious agents (viral, bacterial, parasitic) in the development of periarteritis nodosa (PAN). An infectious syndrome was found in all our 9 patients, aged 26 to 69 years, with histologically confirmed PAN: previous infection (over 15 days before hospital admission): otitis, hepatitis B, tonsillitis, ascaris (Case n.7), pulmonary tuberculosis, brucellosis, seropositivity for Chlamydia trachomatis (Case n.9), paratyphoid (Case n.5), seropositivity for Yersiniosis pseudo-tuberculosis (Case n.2), seropositivity for Chlamydia trachomatis (Cases 3 and 4), seropositivity for toxoplasmosis (Cases 4 and 6), seropositivity for rubella (Case n.8). Recent infection (less than 15 days before hospital admission): staphylococcus aureus septicaemia (Case n.1); Group A betahemolytic streptococcal urinary infection (Case n.2); Group A betahemolytic streptococcal otitis media; pseudomonas aeruginosa and Klebsiella septicaemia; enterococcal cystitis (Case n.4); progressive pulmonary tuberculosis (Case n.6), acinetobacter pneumonia (Case n.9). The HBs antigen was only found in one patient (Case n.6), who had an active hepatitis.

Adult↗

[Clinical and pharmacokinetic study of ceftriaxone in the treatment of 14 episodes of ascitic fluid infection].

A clinical study and dosages of ceftriaxone were performed during the treatment of 14 ascitic fluid infections. Fourteen cases of ascitic fluid infection were treated with ceftriaxone at doses of 2 grams daily. The isolation of the causative organisms was obtained in 11 out of 14 cases by systematic culture of the ascitic fluid in hemoculture bottles with aerobic and anaerobic medium. Of 11 evaluable infectious episodes ten were cured. Ceftriaxone diffuses rapidly in the ascitic fluid because, within the first hour; mean concentrations were already of 18.6 micrograms/ml largely exceeding the usual MIC for these organisms. A good tolerance for the drug, the well spaced rythm of infections preventing unnecessary parenteral treatment in cirrhotic patients, and its effectiveness against Enterobacteriaceae justify its choice in the treatment of ascitic fluid infections with sensitive organism.

Aged↗

[Chlamydia trachomatis perihepatitis].

Fifteen observations of perihepatitis due to Chlamydia trachomatis were studied. Occurring in young women (M: 29, 3 years), genital infection is seldom simultaneous, sometimes not even found in the case history (5 times out of 15). Women consult for a biliary type of pain (11 cases out of 15), associated with pelvic pain (2 cases). The diagnosis of perihepatitis is suspected on the normality of usual further investigations, and confirmed by laboratory tests: rarely by direct sighting (2 cases out of 8) but each time with a positive serology and a titer of antibodies higher than 1/64 by the micro immunofluorescence method. Treatment by Cyclins (13 cases) or Macrolids (2 cases) leads to the regression of the painful symptoms during the first week.

Adolescent↗

[Genital sites of giant-cell arteritis].

Temporal arteritis is one of the localisation of the giant cell arteritis. The involvement of the female genital tract had been rarely reported with only 16 cases in the literature. We report 3 cases revealed by a tumor of the genital tract. Histologic features are found in the vessels of ovaries, fallopian tubes and myometrium. Only one patient had symptoms suggestive of temporal arteritis.

Aged↗

[Pulmonary metastasis of meningioma of the falx cerebri].

We report the case of a woman who had been operated upon for a recurrent meningioma of the falx cerebri which, 22 years after it was discovered, produced pulmonary metastases. Metastases from meningiomas are extremely rare; they affect the lungs in 60% of the cases or, less frequently, the liver or lymph nodes. The factors predictive of secondary dissemination are the site of the tumour, the quality of excision, the histological type (haemangiopericytic meningioma) and the presence of cell necrosis, hypercellularity and strong mitotic activity.

Adult↗

[Adult to adult living-related liver transplantation. The Paul-Brousse Hospital preliminary experience].

AIM: Liver-graft shortages justify the development of adult living-related liver transplantation. The preliminary experience with this technique at Paul-Brousse Hospital is reported. PATIENTS ET METHODES: From January to July 2000, 7 adult to adult living-related liver transplantations were performed. Donors were 5 females and 2 males aged 20 to 53 years old (median: 41). A right liver graft was harvested in all cases. Recipients were 5 males and 2 females aged from 17 to 58 years old (median: 50) transplanted for viral cirrhosis (4 cases including 2 with hepatocellular carcinoma), subfulminant hepatitis (1 case), hepatocellular carcinoma on a healthy liver (1 case), and epithelioid hemangioendothelioma (1 case). Follow-up ranged from 41 to 157 days (median: 117 days). RESULTS: One donor had a biliary fistula that healed spontaneously. One donor had asterixis for 24 hours. The 7 donors are alive at home without any late complications. One recipient was retransplanted for hepatic artery thrombosis and 2 recipients had a biliary fistula that healed spontaneously. The 7 recipients are alive at home with normal liver function. CONCLUSION: Our experience and other reports suggest that adult to adult living-related liver transplantation is feasible with rare mortality and low morbidity in donors. Results in recipients are comparable to those obtained with cadaveric grafts. For a given patient the possibility of living related donation might extend the indications for transplantation without penalizing patients waiting for a cadaveric graft.

Adolescent↗

[Clinical and pharmacokinetic study of pefloxacin in spontaneous ascitic fluid infections].

Ten patients with spontaneous ascitic fluid infections received intravenously 400 mg of pefloxacin for pharmacokinetic evaluation of the drug and its diffusion into peritoneal space. The patients were then treated with oral pefloxacin (400 mg every 36 h except for icteric patients: 48 h) during 21 days. Total body clearance was decreased (0.66 +/- 0.16 ml/min/kg) and elimination half life was increased as compared to that observed in normal subject (28.2 +/- 7.6 h), the longest half-lives being observed in the cases with the most severe alteration of hepatic function. Peritoneal concentrations were higher than 1 microgram/ml (i.e. exceeding the minimal inhibitory concentrations for most of the bacterial species involved in ascitic fluid infections) from the first half-hour after infusion to at least 36 hours. 9 of the 10 cases were cured. Pefloxacin provided a well spaced rythm of administration is a suitable antibacterial drug for ascitic fluid infections in cirrhotic patients with two advantages: its effectiveness against Enterobacteriaceae and an oral administration.

Adult↗