[Pancreatic Castleman's tumor revealed by prolonged fever].
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Castleman Disease↗
Biomedical subjects
B Leng
Publications and source records attributed to B Leng.
[Syndrome of macrophagic activation with hemophagocytosis in human immunodeficiency virus infection].
The authors report two cases of hematophagic histiocytosis in HIV positive patients. In the first case, a patient with Kaposi sarcoma and Mycobacterium avium infection had a rapidly deteriorating course with progressive pancytopenia and death, as generally described in the literature. In the second case, hematophagic histiocytosis appeared during HIV primo infection and reversed spontaneously. Although few cases of hemophagocytic syndrome have been reported in HIV positive patient, it could represent an underestimated cause of pancytopenia. Both opportunistic microorganisms and HIV are able to cause hematophagic histiocytosis.
Adult↗
[Gayet-Wernicke's encephalopathy caused by gravidic vomiting].
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Adult↗
In vitro activities of vancomycin and teicoplanin against coagulase-negative staphylococci isolated from neutropenic patients.
This study reports the in vitro activities of vancomycin and teicoplanin against 185 coagulase-negative staphylococcal strains isolated from 80 neutropenic patients who received different antibiotic treatments. All strains were susceptible to vancomycin: MICs for 50 and 90% of strains tested were 2 and 4 mg/liter, respectively. Teicoplanin was less active, and MICs displayed a wider range. For only teicoplanin was there a correlation between resistance and previous treatment. At the 4- and 32-mg/liter breakpoint levels, only 20% of the strains isolated from patients without glycopeptide treatment were intermediate or resistant, whereas 49.2% of the strains from patients who had received vancomycin or teicoplanin or both were intermediate or resistant.
Agranulocytosis↗
[Randomized prospective study of ceftazidime versus a cefotaxime-tobramycin combination in acute leukemia in therapeutic aplasia].
In a prospective study, 157 patients with prolonged aplasia (PMN less than 500/mm3 during more than 21 days), hospitalized in a protected environment unit, were randomly assigned to receive ceftazidime alone or cefotaxime + tobramycin for initial febrile episodes. Age, sex, underlying diseases, duration of neutropenia, digestive decontamination regimen, clinical and microbiological characteristics of infections were similar in the two groups. Patients were evaluated for their initial response to antibiotics (defervescence in 48 hours, maintained 7 days) and long term response (prevention of another infection during aplasia). The overall initial response to ceftazidime was 48/71 (68 per cent) and to cefotaxime + tobramycin 55/86 (64 per cent). The long term response to ceftazidime was 33/71 (46.5 per cent) and to cefotaxime + tobramycin 31/86 (36 per cent). In conclusion, ceftazidime alone was as effective as cefotaxime + tobramycin in the first line treatment of febrile episodes in neutropenic patients.
Adolescent↗
Hepatic perfusion index in cirrhotic livers--investigation of imaging and analytical procedures.
Dynamic hepatic scintigraphy was performed in a group of cirrhotic patients to evaluate the optimum imaging and analytical procedures necessary for the measurement of the hepatic perfusion index (HPI). Patients were studied in the posterior (n = 19) and the anterior (n = 14), positions, with either 0.2 or 0.5 ml of 99Tcm sulphur colloid administered as a rapid bolus injection. In each subject, three ROIs (small, medium and large) were drawn over the liver, and time-activity perfusion curves were generated. Analytical techniques were developed to allow flexibility in selecting the arterial and portal venous phases of the liver perfusion curve. The quality of the bolus, expressed as the full width at half-maximum of the left ventricular time--activity curve, was independent of the bolus volumes and patient positioning. The dispersion in the data and the inter-observer variation were less in the anterior view using medium and large ROIs, compared with the anterior small ROI and all the posterior ROI sizes. A time delay between liver and kidney arterial phases, if ignored, produced statistically significant effects on the values of the HPI. We conclude that HPI investigations are best performed in the anterior projection. Data analysis using a large liver ROI is preferred, and flexible data-processing techniques are recommended, particularly in the presence of a liver and kidney arterial time delay.
Adult↗
Uncompacted lamellae in three patients with POEMS syndrome.
Three patients with POEMS syndrome were studied: two of them had myeloma, whereas the third had M protein without myeloma. Peripheral nerve biopsies showed no deposits of anti-Ig sera at direct immunopathological examination. Ultrastructural study revealed myelino-axonal degeneration in all three cases. This was associated in the first case with a dramatic loss of myelinated fibers and there were lesions consistent with acute degeneration in the second case. In addition, all three had some fibers showing uncompacted myelin lamellae. This peculiar modification has previously been reported only in cases of dysglobulinemia, lymphoma and inflammatory demyelinating polyneuropathy, but its mode of formation remains unclear.
Aged↗
[Genital ulceration in infectious mononucleosis].
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Adolescent↗
[Intestinal decontamination in the neutropenic patient. Apropos of a prospective randomized study].
Sixty-five patients undergoing remission-induction chemotherapy for acute leukemia in a protected environment unit were randomly assigned to selective antimicrobial modulation of the intestinal flora (SAM) with trimethoprim-sulfamethoxazole, or total antibiotic decontamination (TAD) with gentamicin, vancomycin and colimycin. Digestive tract colonization with Streptococcus D was more prevalent in the SAM group (p less than 0.01); colonization with yeasts was more prevalent in the TAD group (p less than 0.001). However, there was no difference between the two groups as regards to clinically and microbiologically documented infections, septicemias and survival. Selective antimicrobial modulation with trimethoprim-sulfamethoxazole is as effective and cheaper than total antibiotic decontamination with gentamicin, vancomycin and colimycin.
Acute Disease↗
[Diffusion of amikacin in the lungs].
The authors report their findings on amikacin concentrations in serum and in the lungs, its diffusion in the parenchyma of the lungs--evaluated from the ratio tissue/serum concentrations, and they also compare their results with those registered during a study on dibekacin, tobramycin and netilmicin, designed according to the same protocol. Ten patients with bronchial carcinoma who had to undergo chirurgical excision, received 5 IM injections at 12-hourly intervals. The dose administrated at each injection was 7.5 mg/kg. The assay of amikacin was realized by HPLC. Serum concentrations at the presumed peak (17 micrograms/ml) and 12 hours after that were somewhat lower than those reported by other authors. The mean tissue concentrations 2 h 20 min. after the last injection were 14,95 +/- 4,52 micrograms/g in the normal parenchyma, and 16,18 +/- 3,67 micrograms/g in the pathological parenchyma. The ratio concentrations in the tissues and in serum were comparable for both the normal and pathological parenchyma. Compared to dibekacin, tobramycin and netilmicin, this study confirms the large distribution of the aminoglycosides in the lung parenchyma. The behaviour of dibekacin and tobramycin with regard to the pathological parenchyma is rather comparable; netilmicin better penetrates into the normal parenchyma, and the diffusion of amikacin is parallel for both the normal and pathological tissues.
Amikacin↗
[Pseudomonas fluorescens septicemia following transfusion of contaminated blood].
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Aged↗
[Autoimmune hemolytic anemia and Hodgkin's disease].
The authors report 2 cases of autoimmune hemolytic anemia (AHA) and Hodgkin disease. The Hodgkin disease often precedes AHA. Most patients are found to have extensive disease; histologic features are classified as being of high grades of malignancy (mixed cellularity and nodular sclerosis types). Anti I, Rh, IgG auto antibody is commonly observed at 37 degrees C. AHA and Hodgkin disease are equally improved by chemotherapy. The prognosis and significance of this pathological association are unclear.
Adult↗
[The French experience with moxalactam in pneumology].
Twenty-nine patients, aged 19 to 87, were treated for an infection of the lower respiratory tract (pneumonia, bronchopneumonia, bronchitis, pulmonary abscess, pleuritis) due to a pathogen with in vitro sensitivity to the antibiotic (pneumococcus, hemophilus, anaerobic organisms . . .). Patients were given Moxalactam as the only antibacterial treatment. In most instances, excellent results (24 successes, i.e. 84% of cases) were recorded with two daily intramuscular injections of 1 g each. Biologic tolerance was satisfactory. Possible clinical side-effects are rashes and local pain during the injection. We conclude that Moxalactam is very effective in severe lower respiratory tract infections, with a daily dosage of 30 mg/kg.
Adolescent↗
[Current clinical aspects of tuberculous infection].
Case records of 37 patients with tuberculosis were analysed, out of 4 000 patients admitted to our department of internal medicine over a period of four years. The most common localisations are still pulmonary, but these are often atypical. Lymph node involvement is found in immigrants. More exceptional localisations (liver . . .) are reported. Tuberculosis has not yet become obsolete.
Female↗
Pharmacokinetic study of doxycycline polyphosphate+ after simultaneous ingestion of milk.
Pharmacokinetic parameters of doxycycline polyphosphate were studied in healthy volunteers after oral administration of a single 200 mg dose of this antibiotic with a breakfast containing or not 200 ml of whole milk. Ingestion of milk had only mild effect upon absorption parameters of doxycycline; only a moderate increase of the lag-time was significant. Elimination parameters of doxycycline were impaired by milk; a decrease of the terminal half-life from 28 h to 15 h, and apparent decrease of the enterohepatic circulation and an increase in total body clearance from 40 to 62 ml/min. were observed.
Adult↗
[Inappropriate secretion of antidiuretic hormone (ISADH) after head injury (author's transl)].
Two new observations of ISADH following head injury are described. A review of the medical literature is presented. Reports of ISADH after head injury are rare in comparison to the frequent occurrence of hydroelectrolytic disorders in the same situation. Attention is drawn to misleading clinical pictures, suggestive of neurosurgical conditions. Intracranial hematoma is frequently associated with ISADH and should be looked for in patients who fail to respond to therapy.
Aged↗
[Treatment of septicemia with latamoxef. Multicentric study of 60 cases].
Sixty patients including forty two males and eighteen females, age range: 18-87 years, received antibacterial single drug treatment with latamoxef for septicemia. Forty nine patients had underlying conditions including multiple trauma, neoplasm, cardiovascular, metabolic and respiratory tract diseases. Causative pathogens were isolated in all cases. The predominant isolates were E. coli (thirty), Klebsiella pneumoniae (tent) and Enterobacter (seven). A single organism was isolated in fifty seven cases; in the other three cases two organisms were isolated from blood cultures. Mean daily dosage was 46.6 +/- 6.1 mg . kg-1 (range: 14-113 mg . kg-1). In the majority of cases (fifty two) dosage was 3 g . d-1 or less; in thirty cases it was no higher than 2 g . d-1. Duration of therapy ranged from six to thirty eight days. Serum titer was measured in many cases and latamoxef blood levels were assayed in nine patients. A satisfactory clinical response was achieved in fifty eight cases and fifty eight bacteriological cures were also obtained. There was no statistically significant difference in therapeutic response between the 2 g and 3 g daily dosage groups. Tolerance was very good; untoward effects were few and required drug discontinuation in one case only.
Adolescent↗