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Biomedical subjects

B Dautzenberg

Publications and source records attributed to B Dautzenberg.

104 records · Page 6Linked to original sources
PubMed1979

[Study upon oxygen conveyance in severe anaemia. About a very serious case of hemolytic anaemia which led to a myocardial infarct (author's transl].

To understand the orientation the metabolism of a sick person whose arterial content in oxygen had collapsed (CaO2 reaching 1,9 vol/100 ml) the cardiac output and the rate myocardic extraction of the lactates have been measured. The cardiac index was very high 7,4 l/m/m2 and in spite of a low D (a-v) (2,5 vol/ml) the consumption of oxygen was normal. Three days after a first measure the steep (or brutal) fall of the cardiac and the reversal of the rate of myocardic extraction of lactate led up to diagnose an acute coronary insufficiency. The electrocardiogramm only cortoborated the myocardic necrosis in a second time. This result invites (or calls for) a constant electrographic watching of sick persons who suffer from severe anaemia, even with sane coronary vessels, to avoid diagnosing coronary insufficiency through so circuitous means.

Anemia, Hemolytic↗
PubMed1979

[A comparative study of three procedures used for studying bronchopulmonary bacterial flora (author's transl)].

Three methods of taking samples of bronchopulmonary secretions; transtracheal aspiration (TT), sputum collection, and fibro-aspiration, were compared in 43 patients with severe pneumopathies. There was no significant difference in the number of times a pure or dominant germ was isolated by using the three procedures in these 43 cases. In contrast, however, there was a significantly lower number of polymorphous flora and more sterile samples observed when using TT than with the other two methods. When antibiotics are given 1 to 7 days before taking the samples, there is a significant reduction in the number of cultures having a germ in the pure state.

Adult↗
PubMedDate not supplied

A randomized comparison of two clarithromycin doses for treatment of Mycobacterium avium complex infections.

Two dosages of clarithromycin were compared for treatment of disseminated Mycobacterium avium disease of AIDS patients: high-dose (HD): 1,000 mg or 750 mg b.i.d. according to body weight, and low-dose (LD): 1,000 mg or 750 mg q.d. Patients with high probability of M. avium positive blood culture on day 0 received a 42-day clarithromycin treatment with HD (n = 27) or LD (n = 28) at random after stratification according to body weight. Assessment procedures, including quantitative blood cultures, were performed at days 14, 28 and 42. Forty-five patients were eligible for clinical and 28 for bacteriological evaluation. Bacteriological success was observed in 12 HD and 11 LD patients, partial success in one HD and two LD and failure in none of the HD and two LD (p = 0.33). Between days 0 and 42, log decreases in CFU counts/ml were (mean +/- SD) 3.13 +/- 0.82 (HD) and 2.67 +/- 1.8 (LD) (p = 0.38). Fever and night sweats significantly improved similarly in both groups; no change in spleen and liver size was observed on CT scans. Eight patients died during the study but no death was reported as drug related. Sixteen patients (HD = 6, LD = 10) discontinued the treatment because of side effects. A trend towards improved bacteriological effectiveness and reduced tolerance was observed in the HD group but the difference was not significant. With a power of 0.70, no dose effect was demonstrated between the two tested dosages. A daily dose of 1,000 mg clarithromycin was tested in drug combinations to treat disseminated M. avium infection in AIDS patients.

Adolescent↗
PubMedDate not supplied

The use of rifabutin in Europe for the treatment of mycobacterial infection in AIDS patients.

The MICs of rifabutin on Mycobacterium avium are compatible with its efficacy in clinical infections. Two North American trials established the prophylactic effect of rifabutin in disseminated M. avium disease in AIDS patients. Several prospective non-randomized trials show the clinical and bacteriological efficacy of rifabutin. A large European study conducted from 1990 to 1993 randomized 382 patients, selected on a clinical basis, to receive a combination of ethambutol + clofazimine + isoniazid + placebo or rifabutin for 12 weeks. Of these, 200 were eligible, i.e. had a positive blood culture at day 0. The percentage of patients with fever decreased from 78% to 23% in the rifabutin arm and from 76% to 11% in the placebo group (difference statistically not significant). The percentage of positive blood cultures decreased from 100% to 70% and 29% in the placebo group and from 100% to 45% and 18% in the rifabutin group at weeks 0, 6 and 12 respectively. The rate of adverse events was 35% in the placebo and 30% in the rifabutin group (difference statistically not significant). Two other French randomized trials are being analysed: the first one compares a 14-day regimen of rifabutin to placebo. It shows a 70% success rate in the rifabutin arm and a 8% success rate in the control group. The second trial demonstrates that when given in addition to clarithromycin, unlike clofazimine a combination of rifabutin + ethambutol is effective in decreasing the relapse rate with acquired resistance to clarithromycin. After clarithromycin, rifabutin is the second drug which was proven to be active against disseminated M. avium disease in a controlled placebo trial.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Comparison of two oral antibiotics, roxithromycin and amoxicillin plus clavulanic acid, in lower respiratory tract infections.

In a randomized, multicenter, open-label study, 490 ambulatory adult patients with lower respiratory tract infection (LRTI) were randomized to roxithromycin (ROX) 150 mg b.i.d. orally (n = 244) or amoxicillin plus clavulanic acid (AMX + CA) as 500 mg AMX + 125 mg CA t.i.d orally (n = 24). Clinical results were analyzed in 477 patients with acute bronchitis (79%), chronic bronchitis (CB) (14%), and pneumonia (7%). There were significantly more patients with underlying disease (cardiovascular diseases, p = 0.045; and alcoholism, (p less than 0.001), and more patients over the age of 65 years (p = 0.045) in the ROX group. Overall clinical efficacy was similar in both groups: 88% (206:235) in the ROX group and 85% (205:242) in the AMX + CA group. Side effects were reported in 67 cases (28%) in the AMX + CA group and in 21 cases (9%) in the ROX group (p less than 0.0001), causing withdrawal in 21 and three cases, respectively (p less than 0.001). Thus, despite being administered to a significantly older and more ill group of patients with LRTI, roxithromycin was as effective as amoxicillin plus clavulanic acid and better tolerated.

Acute Disease↗
PubMedDate not supplied

[Aspects of pneumocystosis seen in a French pneumonology department in 1987-1988].

Over a 2 years' period, 49 AIDS patients and 3 non AIDS patients were treated for pneumocystosis in our chest department. Forty-six were male and 6 were female. Pneumocystosis was the first opportunistic infection in 77 p 100 of patients. Fever above 38.5 degrees C was the major symptom in 92 p 100. Cough was present in 90 p 100 and dyspnoea in 94 p 100. Clinical symptoms had begun 21.7 +/- 15.7 days before diagnosis. Mean PaO2 value was 50.9 +/- 15.7 mmHg. Forty-eight patients were initially treated by daily intravenous administration of trimethoprim 960 mg and sulfamethoxazole 4,800 mg. Three patients received a pentamidine aerosol and one received DFMO. Treatment was effective in 39 patients; 11 patients died between the 5th and the 29th days of treatment; 2 had an early relapse. Fever disappeared after 9.8 +/- 6.6 days, and blood gases returned to normal within 10.8 +/- 7.7 days. All patients whose PaO2 was above 56 mmHg were cured. Thus, the trimethoprim-sulfamethoxazole combination proved active in the treatment of pneumocystosis. Other treatments are useful in case of side-effects or failure of the initial therapy. Failures can be suspected on the fourth day of treatment and in such cases CMV co-infection must be looked for and treated.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Study of pulmonary leucostasis by measurement of the alveolo-arterial CO2 difference (author's transl)].

In order to study pulmonary leucostasis in 18 leukemic subjects, the ventilatory flow from ventilated nonperfused zones (VFVNZ) was measured using alveolo-arterial CO2 difference (28 times). This method proved to be simple and accurate in the follow-up of the patients. The number of white cells necessary to increase the VFVNZ by 1% is very different from one histologic type to another. These results are in agreement with in vitro observations.

Arteries↗
PubMedDate not supplied

[Routine bedside measurement of arterio-alveolar CO2 difference (author's transl)].

Deficiencies in pulmonary circulation can economically be demonstrated at the patient's bedside by measuring the difference in CO2 between arterial blood and alveolar air, which reflects the air flow in non-perfused ventilated lung areas. The method does not inform on the cause of the deficiency, but normal values (i.e. lower than 10 %) indicate that pulmonary circulation is unimpaired, whereas high values suggest that it is reduced (emboli, capillary obstruction by leukocytes). That the method is valid is shown by the parallelism observed between the percentage air flow in non-perfused ventilated areas and the angiographic and anatomical findings.

Acute Disease↗