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C Lagarde

Publications and source records attributed to C Lagarde.

96 records · Page 6Linked to original sources
PubMedDate not supplied

[Vaccination against hepatitis B virus. Value of intradermal administration in dialysed patients non responsive to intramuscular approach].

OBJECTIVES: Approximately 16-27% of dialysis patients (DP) have no detectable antibodies after 5 intramuscular injections of hepatitis B vaccine and represent a group at high risk to contract hepatitis B virus. We report the efficacy of the intradermal route of a recombinant hepatitis B vaccine (r-HBV) in non-responsive dialysis patients in our dialysis unit. METHODS: Intradermal vaccinations were performed in 20 dialysis patients (mean age 62 years) non-responsive to the intramuscular injections (mean 6.8). Five micrograms of r-HBV (Engerix B, SK and F) were administered intradermally every two weeks (maximum 70 micrograms) until a level of anti-HBV antibodies (anti-HBs) arbitrarily choosen of > or = 230 mUI/ml was attained. Anti-HBs was determined after the fourth and subsequent intradermal injections (IMX, Abbott). RESULTS: Fourteen dialysis patients (70%) developed anti-HBs > 10 mUI/ml (geometric mean titers of 330 mIU/ml). Among these, 9 developed seroprotective levels before the fifth injection. Five patients developed anti-HBs > or = 1000 mUI/ml and 6 others developed anti-HBs > or = 230 mUI/ml. After the intradermal injections were discontinued, 11 patients were monthly monitored for at least 3 months, and 6 for one year. The geometric mean antibody level was at 3 months: 157 (n = 11), at 6 months: 122 (n = 8), at nine months: 117 (n = 6), and at 12 months: 66 mIU/ml (n = 6). The age and the sex, haemodialysis duration, albumin levels or treatment by erythropoietin did not seem to play a role in appearance of anti-HBs. CONCLUSIONS: Our experience in 20 dialysis patients shows that repeated low-dose intradermal injections resulted in long-term seroprotection in a substantial number of dialysis patients non-responsive to the intramuscular vaccinations.

Adult↗
PubMedDate not supplied

[Anticancerous chemotherapy and the general practitioner].

The evolution of anti-cancer chemotherapy has led to long duration treatments, which preferentially are given at home, with the participation of the general practitionner (G.P.). The indications and general supervision of these belong to the oncologist, so thus necessitates a coordinated effort between the many physicians. A postal inquiry has permitted the collection of the opinions of 169 G.P. (more than half of the consulted physicians) from the southwest of France, in the region depending on the Fondation Bergonié. Thus it was possible to establish the importance of this type of treatment for the majority of the G.P., the details of problems of practical application, and the value attached to the relationships with the oncologist, which need further development.

Family Practice↗