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Biomedical subjects

C Chouaid

Publications and source records attributed to C Chouaid.

49 records · Page 3Linked to original sources
PubMed1993

[Extrapulmonary intrathoracic pneumocystosis. Apropos of 4 cases in HIV positive patients].

The authors report 4 cases of intrathoracic extrapulmonary pneumocystosis; 3 of them involved the pleura and 1 the mediastinal lymph nodes. As in other rare but apparently increasingly frequent cases, everything seemed to incriminate the use of prophylactic Pentamidine aerosols, but only a prospective study of systemic versus aerosol prophylaxis can confirm this suspicion.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Mercury pulmonary embolism after voluntary injection].

We describe a case of pulmonary emboli due to mercury in a female drug addict who was HIV positive and had voluntarily injected herself with mercury. The diagnosis was guided by the history and by the characteristics of the chest radiograph and was confirmed by blood and urine levels of mercury and the radiograph taken of the site of the intravenous injection. Three years after the injection the patient did not reveal any signs suggesting disturbance due to the chronic pulmonary exposure to mercury, but there was a reduced carbon monoxide transfer, whose interpretation was difficult due to the past respiratory history and to the drug addiction.

Adult↗
PubMed1993

Cost effectiveness of the induced sputum technique for the diagnosis of Pneumocystis carinii pneumonia (PCP) in HIV-infected patients.

The purpose of this study was to assess: 1) the percentage of human immunodeficiency virus (HIV)-infected patients with suspected Pneumocystis carinii pneumonia (PCP) but unable to undergo the induced sputum procedure, together with the reasons involved; 2) the sensitivity and specificity of induced sputum procedure, using conventional stains and an immunofluorescence test; and 3) the cost of introducing induced sputum procedure for the diagnosis of PCP. One hundred and thirty eight HIV-infected patients with suspected PCP underwent induced sputum procedure and bronchoalveolar lavage (BAL). P. carinii was identified in induced sputum and BAL samples using conventional and immunofluorescence staining. The economic analysis took into account the direct costs of the two procedures. The induced sputum procedure was either not feasible or unsuccessful in 29% of the patients. The sensitivity of induced sputum, using conventional and immunofluorescence staining, was 0.27 and 0.56 respectively. The economic analysis showed that the two strategies (systematic BAL versus BAL only after negative induced sputum) are equivalent in cost terms when the induced sputum to BAL cost ratio is equal to the product of the prevalence of PCP by the sensitivity of induced sputum procedure. We conclude that the immunofluorescence test should be the reference technique for induced sputum samples, whilst conventional stains are more clinically relevant for BAL samples. The cost of introducing induced sputum should take into account the sensitivity of induced sputum and the prevalence of PCP in the suspected population.

AIDS-Related Opportunistic Infections↗
PubMed1992

Modulation of arachidonic acid metabolism and cyclic AMP content of human alveolar macrophages.

The exposure of human alveolar macrophages to inflammatory mediators such as PAF (1 microM), fMLP (1 microM) or the calcium ionophore A23187 (1 microM) induced a rapid decrease in their intracellular concentration of cAMP. Inhibition of TXA2 synthesis by the specific thromboxane synthase inhibitor ridogrel (1-10 microM) or by non-specific inhibitors as indomethacin (1-10 microM), the cyclooxygenase inhibitor, or BW A4C (1-10 microM), the 5-lipoxygenase inhibitor, partially prevented the decrease in cAMP induced by the different inflammatory stimuli. Evidence for an indirect control of cAMP levels in human alveolar macrophages by inflammatory mediators through the production of arachidonic acid derivatives from the cyclooxygenase pathway is supported by this study.

Adult↗
PubMed1992

[The diagnostic contribution of complementary tests].

The increasing number of complementary examinations in pneumology often makes it difficult to choose the appropriate tests for optimal investigation. After specifying the conditions in which reference values are established, the authors discuss the general principles of decisional analysis, i.e. sensitivity and specificity, probability ratios, the role of the disease prevalence in interpreting results (Bayes' theorem) and the odds ratio. Practical applications of these principles with regard to diagnosis and therapy in pneumology are also discussed.

Decision Support Techniques↗
PubMed1991

[Disseminated toxoplasmosis in a patient with HIV infection].

The authors describe a case of toxoplasmosis occurring in a subject who is HIV positive who presented with a cough and an infectious syndrome. Toxoplasma gondii was identified in the broncho-alveolar lavage even though the X-ray, the fibroscopy, blood gases and the broncho-alveolar lavage were normal. The frequency of pulmonary disease in the course of a toxoplasma infection in HIV subjects was underlined. Amongst the non invasive diagnostic methods the authors stress the value of broncho-alveolar lavage with a close search for toxoplasma even in the absence of any suggestive paraclinical anomalies.

Adult↗
PubMed1991

[Filarial eosinophilic lung. Apropos of a case].

Pulmonary eosinophilia due to filariasis is a form of filarial infection which is frequent in endemic zones but very much rarer in Europe where it is always "imported". In this case report the authors specify the clinical characteristics and pathophysiology of this disease.

Adolescent↗
PubMedDate not supplied

Pulmonary cryptosporidiosis in the acquired immunodeficiency syndrome.

Since the beginning of the AIDS epidemic, Cryptosporidium has emerged as a pathogen responsible for diarrhea in humans. Cryptosporidiosis confined to the respiratory tract has been documented only rarely in humans. An HIV-infected patient is described here, who developed pulmonary and intestinal cryptosporidiosis. Lung involvement was proven by biopsy, which also revealed bronchiolitis but no other pathogens. The patient died of respiratory failure 2 months after the onset of respiratory symptoms.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Evaluation of low molecular weight heparin prescription at the Centre Hospitalier Intercommunal de Créteil].

Low-molecular-weight heparin (LMWH) represents a great expense in general hospitals. At the Centre Hospitalier Intercommunal de Créteil (CHIC), the Quality Assessment Council had set up a study on the prescription of LMWH in order to assess concordance between prescriptions and local guidelines on the preventive uses of LMWH. Adherence to the consensus was found in 73 per cent of cases, overprescription in 10 per cent of cases and underprescription in 26 per cent of cases. It is planned to modify the local consensus, taking into account some clinical situations highlighted by this study, and to perform another evaluation in the near future.

Anticoagulants↗
PubMedDate not supplied

Value of an immunofluorescence assay for the detection of Pneumocystis carinii in Bronchoalveolar lavage.

An indirect immunofluorescence monoclonal antibody assay was found to have higher sensitivity than usual stains for the detection of Pneumocystis carinii, particularly in bronchoalveolar lavage fluids in which there are only a few parasites, as in HIV-patients or in HIV+ patients with prophylaxis or treatment. For patients without any therapy, when different stains give conflicting results, decisions on therapeutic approaches to be used should consider the patient's clinical and biological status. Prospective studies are necessary to evaluate the predictive value of low parasitism in asymptomatic immunosuppressed patients.

Bronchoalveolar Lavage Fluid↗