Search PubMed⌕ Search

Biomedical subjects

C Leport

Publications and source records attributed to C Leport.

At least 163 records · Page 9Linked to original sources
PubMed1990

Vancomycin-aminoglycoside combinations in therapy of endocarditis caused by Enterococcus species and Streptococcus bovis.

Between 1974 and 1986, five patients with enterococcal endocarditis (three of whom had a prosthetic valve) and three patients with Streptococcus bovis endocarditis were treated with a combination of vancomycin and an aminoglycoside for a mean duration of 40 days. This regimen was prescribed because of allergy to beta-lactam (n = 7) and/or failure of previous treatment (n = 4). Three of the eight patients underwent valve replacement. In the six evaluable patients cure was achieved with the vancomycin-aminoglycoside combination. An increase of the creatinine serum levels was observed in all cases but it was never necessary to discontinue treatment, adjustment of the vancomycin and aminoglycoside dosage according to the serum and/or serum creatinine levels allowing continuation of therapy.

Adult↗
PubMed1990

Antibiotic prophylaxis of late bacteremic vascular graft infection in a dog model.

This study was undertaken to determine the efficacy of a single-dose antibiotic injection to prevent late bacteremic vascular graft infection. Twelve dogs had thoracoabdominal aortic bypass with expanded polytetrafluoroethylene grafts. One month later, a bacteremic challenge was produced by rapid intravenous injection of 5 x 10(8) Staphylococcus aureus. Dogs were treated by pairs, each dog of a pair being randomly assigned to receive either 0.5 g ceftriaxone (group I, n = 6) or saline (group II, n = 6), intramuscularly, 90 minutes before challenge. Grafts were harvested seven days after bacteremic challenge. They were cut into 10 fragments, each of which were submitted to bacterial counts. Results of bacterial counts were expressed as colony forming units per square centimeter of graft segment. The overall infection rates were zero of six grafts in group I and four of six in group II (p less than 0.05). In group I, none of the 60 graft fragments were found to be culture positive (p greater than 0.01). Bacterial counts from the 24 infected fragments were highly variable, ranging from 12 colony forming units/cm2 to 64 x 10(3) colony forming units/cm2. Serial quantitative blood cultures revealed a similar decrease of bacteremia in both groups with 2.4 +/- 0.9 x 10(2) (group I) and 1.2 +/- 0.9 x 10(2) (group II) colony forming units/ml at three hours. Mean ceftriaxone serum level was 26 +/- 18 mg/L at the time of bacteremic challenge. These data suggest that a single dose of ceftriaxone given before bacteremic challenge is sufficient to prevent late bacteremic vascular graft infection in this model.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Hypoglycaemia and diabetes mellitus following parenteral pentamidine mesylate treatment in AIDS patients.

Of 18 AIDS patients with Pneumocystis carinii pneumonia treated with pentamidine mesylate parenterally, four developed serious to severe hypoglycaemia, three hypoglycaemia followed by insulin-requiring diabetes, and two others diabetes alone. Hypoglycaemia (blood glucose 2.1 +/- 0.2 (+/- SE) mmol l-1) occurred 9 (2-22) days after starting treatment, and diabetes (initial blood glucose 30 +/- 6 mmol l-1) after 60 (20-90) days. The other patients remained euglycaemic. The dysglycaemic patients (hypo- and hyper-glycaemic) had a higher pentamidine dosage (p less than 0.01), and higher serum creatinine levels at end of treatment (p less than 0.001), consistent with drug accumulation and dose-dependent toxicity. Plasma C-peptide levels were low in the diabetic patients, in the basal state (0.25-0.28 nmol l-1) and following stimulation by IV glucagon (0.35-0.40 nmol l-1), vs 0.80 +/- 0.06 nmol l-1 (basal) and 1.83 +/- 0.16 nmol l-1 (stimulated) in 23 healthy control subjects (mean +/- SE). Islet cell or insulin antibodies were not detected. Serum amylase levels rose abnormally in the dysglycaemic group, and pancreatitis was proved in one, and suspected in another patient. None of 28 similar AIDS patients whose P. carinii pneumonia was treated with cotrimoxazole showed blood glucose disturbance.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Varicella in patients infected with the human immunodeficiency virus.

In a retrospective study of 421 patients infected with human immunodeficiency virus, 15 (3.5%) had varicella. Twelve patients had a typical varicella. Complications were as follows: profuse eruption, 6; hemorrhagic eruption, 1; hepatitis, 5; and pulmonary involvement, 1; 1 patient developed an intravascular disseminated coagulation and died of varicella. Three patients with acquired immunodeficiency syndrome, having a history of varicella, presented with an atypical form of varicella with a small number of disseminated cutaneous poxlike lesions; 1 of these patients experienced three relapses of atypical varicella. Assay of serum antibodies to varicella zoster virus showed that, while typical varicella was the primary varicella zoster virus infection, atypical varicella was a reactivation of varicella zoster virus infection. Acyclovir was given to 11 patients and vidarabine to 1 patient. The one patient who died and the one who suffered a relapse had received acyclovir. Thus, varicella in patients infected with human immunodeficiency virus may be complicated and even lethal. Atypical forms of varicella could be, as is the case with herpes zoster, a reactivation of endogenous varicella zoster virus.

Adolescent↗
PubMed1990

[Effect of antibiotics on bacterial adherence to foreign material].

Microbial adherence is the first step of foreign body infection. In vitro and ex vivo experiments have studied the mechanisms of the anti-adherent effect of antimicrobial agents. Adherence of bacteria onto foreign bodies is a complex phenomenon where several factors from the bacteria, the foreign body and the host, are involved. Bacterial factors are physicochemical factors such as cell surface charges, hydrophobicity, and adhesins such as exopolysaccharides or "slime". Foreign body factors are irregularities of the surface and hydrophobicity. Human factors are serum proteins as fibronectin, collagen, laminin and vitronectin, which are deposited onto the material and act as receptors for bacteria. In vitro models can study the interactions between the bacteria, the foreign body and the antimicrobial agent. They can be useful to analyse the molecular mechanisms of the effects of the antimicrobial agents on microbial adherence. Different studies have shown: 1) no relation between the effect of antimicrobial agents on microbial adherence and their bacteriostatic or bactericidal effects, 2) antimicrobial agents of the same class may have different effects on the same strain, 3) no correlation between effect of antimicrobial agents on microbial hydrophobicity, slime production or fibronectin receptors, and effect on adherence.

Animals↗
PubMed1990

[Antibiotherapy in chronic familial granulomatosis].

Antibacterial therapy in chronic granulomatous disease requires antimicrobials active on Staphylococcus aureus and enterobacteria, which also have a good intracellular penetration and activity as rifampicin, fluoroquinolone, fosfomycin, cotrimoxazole. Several trials showed that cotrimoxazole was effective for the prevention of bacterial infection: thus, this antimicrobial can be used as long-term and continuous prophylaxia. Fungal infections require the use of amphotericin B. The place of new imidazole compounds as itraconazole should be assessed.

Amphotericin B↗
PubMed1990

[Mouth and pharyngeal hyperalgesic syndromes in AIDS].

In a series of 12 patients suffering from an HIV infection, including 9 with confirmed AIDS, who complained about pharyngeal pain in a fixed site, having a progressive intensity and not relieved by antalgics and the specific treatments that were prescribed empirically, and for whom etiological investigation yielded negative results, Thalidomide proved to be the only effective means of healing the exulcerated, nail-mark lesions or the ulcerated, budding, neoplastic-like lesions, and of completely suppressing pain.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Ocular toxoplasmosis in AIDS].

Since 1983, we have seen 11 cases of toxoplasmic retinochoroiditis in patients with AIDS. Ocular toxoplasmosis appears to be a growing concern in AIDS: 3.3% in 1983, 6.1% in 1988 and 5.9% during the first trimester of 1989. Anti-Toxoplasma gondii antibody titers in the aqueous humour were not conclusive, therefore the diagnosis was based on ophthalmoscopic criteria and on a rapid response to specific therapy. As for brain toxoplasmosis, treatment must be continued indefinitely to prevent relapse. Seven out of 11 patients had cerebral toxoplasmosis, which was diagnosed by computerized tomography (CT) scan. This suggests that a neurological evaluation and a brain CT scan should be performed in all AIDS patients with toxoplasmic retinochoroiditis.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Chronic bone infections after surgery. Treatment with the new quinolones].

A prospective open study carried out over 5 years and including 20 patients suffering from chronic bone suppuration following orthopaedic surgery has confirmed the value of the new quinolones (NQ) in these indications. The patients received pefloxacin or ciprofloxacin most often combined with rifampicin or fusidic acid for a mean period of 7 months. Single or multiple organism infections were documented in 14 patients, the majority being Staph. aureus (n = 13) and Pseudomonas (n = 14). Samples were sterile in 6 cases. Fourteen therapeutic successes and 5 failures were observed. In one patient, improvement was noted but the post-treatment follow-up insufficient to pronounce a cure. Success was obtained in 14 out of 16 patients who had sensitive organisms or sterile samples. The mean post-treatment follow-up (16 months) was satisfactory but insufficient to speak of cure. However, in these patients for whom further surgery, however desirable, is often refused, NQ constitute an improvement which raises hopes of cure or allows further surgery.

Adult↗
PubMed1989

The spectrum of changes on 20 nerve biopsies in patients with HIV infection.

Nerve and muscle biopsies were performed on 20 patients with HIV infection and peripheral neuropathy. Nine patients had distal symmetrical peripheral neuropathy (DSPN) (six ARC and three AIDS), six had inflammatory demyelinating polyneuropathy (IDP) (three ARC, one AIDS, and two otherwise asymptomatic patients), one had mononeuropathy multiplex (MM) (AIDS), 1 had mononeuropathy (ARC), one had meningoradiculitis (AIDS), and two had areflexia-associated lymphocytic meningitides (ARC), DSPN exhibited axonal degeneration in four of nine cases and was associated with segmental demyelination in five of nine cases. IDP exhibited segmental demyelination associated with axonal degeneration in four of six cases. Demyelination was more frequent in asymptomatic patients (2 of 2 cases) and in ARC (7 of 12 cases), whereas axonal degeneration was predominant in AIDS (6 of 6 cases). Mononuclear cell infiltration was seen in 1 of 2 asymptomatic patients and in 11 of 12 ARC patients but was exceptionally found in AIDS (1 of 6 cases). Involvement of the walls of small vessels, mostly venules ("subacute microvasculitis"), was found in 1 of 2 asymptomatic patients, in 8 of 12 ARC patients, and never in AIDS. The polyclonal mononuclear cell population was composed mainly of Leu 2 (T8) positive cells in seven cases of ARC. No virions were seen in electron microscopy. HIV was isolated in two cases from the CSF or the nerve biopsy.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Bacterial prostatitis in patients infected with the human immunodeficiency virus.

Bacterial prostatitis was diagnosed in 17 of 209 human immunodeficiency virus-infected men hospitalized from October 1985 to October 1987. A history of urogenital disease was found in 13 of 17 patients. Clinical signs of prostatitis were present in 16 of 17 patients, including fever in 13, urinary symptoms in 11 and tender prostate on rectal palpation in 7. Bacteriuria was found in 14 of the 17 patients. Prostatic ultrasound examination showed an abscess in 11 of 16 patients studied. Prostatitis was diagnosed at autopsy in 1 patient. Within 6 weeks after onset of antimicrobial therapy 9 of 13 patients were cured and 4 of 13 did not respond to therapy. Among the 7 patients followed for more than 2 months after the end of antimicrobial therapy 5 had relapse. The prevalence of bacterial prostatitis among human immunodeficiency virus-infected patients increased from 3 per cent in asymptomatic human immunodeficiency virus-infected patients to 14 per cent in patients with the acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Evaluation of teicoplanin for treatment of endocarditis caused by gram-positive cocci in 20 patients.

Teicoplanin, a new glycopeptide antibiotic similar to vancomycin, was evaluated for the treatment of bacterial endocarditis in an open multicenter study from May 1985 to August 1987. A total of 20 patients with positive blood culture endocarditis received teicoplanin once daily as a mean intravenous injection of 7.3 mg/kg of body weight (range, 4.8 to 10.6 mg/kg); in 17 patients, teicoplanin was combined with another antibiotic, usually an aminoglycoside. The mean duration of therapy was 28 days (range, 7 to 66 days). The diagnosis of endocarditis was confirmed by echocardiography or anatomical findings in 15 patients and established on the basis of clinical manifestations plus positive blood cultures in 5 patients. The tricuspid valve was involved in 11 of the 20 patients. Isolates from blood were 12 Staphylococcus aureus, 1 Staphylococcus hominis, 1 Micrococcus sedentarius, 1 Enterococcus faecalis, 3 Streptococcus bovis, and 2 nongroupable Streptococcus sp. At the end of therapy, bacterial eradication was achieved in 17 of 20 patients (85%), and a favorable clinical outcome had occurred in 14 of 17 evaluable patients (82%). Of these 14 patients, one relapsed 4 months after the end of treatment. Thus, teicoplanin was effective in 13 of 17 patients (76%). Mean peak levels of teicoplanin in serum were lower, 23.1 +/- 2.9 micrograms/ml, in patients who failed than in those who were cured (45.8 +/- 8.4 micrograms/ml). Side effects occurred in 7 of 20 patients (35%), and required premature discontinuation of teicoplanin in 3 patients. These side effects were fever in three patients, rash in three patients, hearing loss in two patients, and increased serum transaminase levels in two patients. This study demonstrates the efficacy of teicoplanin in the treatment of endocarditis and the need for achieving peak levels in serum close to 40 micrograms/ml. Teicoplanin should now be further evaluated in endocarditis caused by gram-positive cocci means of controlled comparative study with standard therapy.

Adolescent↗
PubMed1989

[AIDS in elderly patients. Apropos of 22 cases observed in the Paris region].

If geriatric AIDS is defined as the occurrence of this disease in individuals over 60 years old, it represents about 5% of the cases reported to the Direction Générale de la Santé by the end of 1988. We retrospectively analyzed 22 clinical cases of geriatric AIDS observed between 1985 and 1987, i.e. 21% of the cases reported at that time. In 55% of them, infection resulted from contaminated blood transfusions. Initially, hospitalization was indicated due to a significant deterioration of the patient's general condition, however, neuropsychiatric disorders and intellectual degeneration were present in 18% of the cases. Biological anomalies at the time of admission were classical with the exception of a high frequency of leukopenia often associated with anemia or thrombopenia. During the evolution of the disease, opportunistic infections were very common (90% of the cases). However, the major characteristic of this clinical form of AIDS is the high percentage (55%) of patients suffering from major neurological and psychiatric disorders, including subacute encephalitis in more than half of these patients. The prognosis is very bad, with an average survival time of 4.3 months from the time of diagnosis (median 2.5 months). The cumulative effect of the delay in diagnosing AIDS during the first hospitalization and the classical seriousness of encephalitis suffice to explain the very poor prognosis in patients whose age can play a role in altering the immune response.

AIDS Dementia Complex↗