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Biomedical subjects

C Martin

Publications and source records attributed to C Martin.

At least 469 records · Page 26Linked to original sources
PubMed1997

[Emergence of Enterobacter aerogenes strains producing derepressed cephalosporinase at CHU in Limoges: molecular epidemiology by the RAPD technique].

From the beginning of the year 1996, an increase of multiresistant Enterobacter aerogenes isolates was observed. These strains overproduced their chromosomally cephalosporinase. From February to September 1996, we studied the genotypic diversity of multiresistant E. aerogenes isolates. Fifty-seven strains were analysed with the RAPD technique. These strains were isolated from 38 patients in 25 different units. These isolates were collected from urines (37), respiratory tracts (14) and wounds (6). We have observed two distinct profiles. The predominant profile (A) was recovered from 55 strains (36 patients) and the second profile (B) from 2 strains (2 patients). The clonal relatedness of strains isolated (profile A) showed an epidemic spread in our hospital. The RAPD technique is easy to perform and gives results in less than 48 h with a good discriminatory power.

Cephalosporinase↗
PubMed1997

[Prescribing practice for beta blockers at patient discharge to ambulatory care. A health care economic evaluation in a cardiology patient sample with special reference to drug budgeting].

Beta blockers are known to reduce mortality from hypertension and coronary heart disease after myocardial infarction. Recent health care laws in Germany did impose a medication budget for ambulatory patients only. To evaluate the effects of this administrative instrument we studied prescribing practices of beta blockers in patients transferred from inpatient to ambulatory care. Specifically, we aimed of assessing the quality and cost effectiveness of beta blocker prescriptions. In a prospective cohort study of 142 patients discharged from a tertiary care center, the beta blocker medication was continued in 130 patients (91%). Adequate quality of the medication, defined as continuation of a beta blocker in sufficient dosage, was found in 77% of patients. Cost effective prescribing practices, defined as adequate quality at a lower cost than at discharge, were documented in 10% of the patients. However, inadequate dosage or even omitting of a beta blocker was found in 23% of patients. Overall, we found high-quality prescribing practices in more than two-thirds of our patients, but documented inadequate care in more than 20%. Our study did not document any consistent pattern between medication changes and cost-effective prescribing practices attributable to medication budgeting in Germany.

Adrenergic beta-Antagonists↗
PubMed1997

Response of human ciliated respiratory cells to a mixture of menthol, eucalyptus oil and pine needle oil.

Nasal respiratory cells were harvested from 45 healthy individuals using a microcurette technique. Following harvest, cells were placed on microporous polycarbonate membranes and exposed for 30 min using a gas/liquid interface technique to a mixture of menthol, eucalyptus oil and pine needle oil (MEP), eucalyptus oil alone (ECO), and pine needle oil alone (PNO) at concentrations ranging between 0.2 and 11 g/m3. Ambient air served as control. Ciliary beat frequency (CBF) was assessed before and after exposure using video-interference-contrast microscopy. Control exposure to air (n = 10) did not alter CBF (7.1 +/- 0.9 Hz before and 7.0 +/- 0.9 Hz after exposure, -1.3% decrease), whereas a dose dependent decrease of CBF following exposure to MEP (max. decrease -22.6% at a concentration of 10 g/m3, p < 0.01), ECO (max. decrease -32.5% at a concentration of 7.5 g/m3, p < 0.01) and PNO (max. decrease -56.1% at a concentration of 9.4 g/m3, p < 0.01) was observed. The data show that essential oils in high concentrations can reduce in-vitro ciliary activity of human respiratory cells not protected by a mucus layer. These effects have to be verified by in vivo investigations.

Administration, Inhalation↗
PubMed1997

Chronic disease in children. A cross-sectional perspective based on an analysis of the Australian Morbidity and Treatment Survey (AMTS) 1990-1991.

OBJECTIVE: To investigate general practitioner's (GPs) involvement in childhood chronic disease care. METHOD: An analysis of GP consultations which involved chronic childhood disease, using the national AMTS survey of encounter morbidity and treatments. RESULTS: Almost 16% of childhood encounters included a chronic disease diagnosis. Asthma accounted for 50%. Major reasons for encounter included: common respiratory and other childhood problems; prescriptions; and immunisation. Chronic disease encounters had multiple diagnoses with high levels of continuity. Specialist referral (but not referral to other agencies) was common. Psychosocial and general physical care were rarely recorded in these encounters. CONCLUSIONS: General practitioners provide the broad range of care for children with chronic conditions. Interpretation of possible gaps is problematic because the study represents a cross-sectional picture of longitudinal care. However, with the current coordinated care reforms, it is imperative that GPs reappraise and demonstrate the extent of their involvement in all aspects of chronic care.

Adolescent↗
PubMed1997

[Surgical treatment of invalidating musculo-tendinous retractions in the dependent elderly].

The authors have reviewed 37 patients aged 64 to 91 years or their charts in the purpose to evaluate the results of surgical treatment of severe acquired contractures of arms hands and legs. They describe the deformations, surgical technique, morbidity, and the results. 4 patients deceased within the first week after surgery; morbidity was very low. The results were satisfactory: nursing was greatly facilitated and pain during nursing care and toilet disappeared, the patients could again seat in a wheel chair. They conclude that this surgery can be very helpful for these disabled patients.

Aged↗
PubMed1997

[Pristinamycin versus oxacillin in the treatment of superficial pyoderma. A multicenter randomized study in 293 outpatients].

BACKGROUND: Superficial pyoderma occurs frequently. Generally, the benign infection is caused by Staphylococcus aureus and/or a group A streptococci. The subject is controversial, but treatment usually is based on narrow-spectrum antibiotics active against both germs. PATIENTS AND METHODS: A multicentric, randomized, double-blind, double-placebo study was conducted to compare pristinamycin (1 g b.i.d.) with a reference antibiotic, oxacillin (1 g b.i.d.) for 10 days. Inclusion criteria were: both sexes, age 15-80 years, clinical diagnosis of superficial pyoderma (impetigo, wound infection within the last 15 days, furunculosis, carbuncle, perionyxis), informed consent. The general practitioner investigators (n = 52) were assisted by 9 dermatologist-coordinators. Clinical diagnosis was validated by a committee of experts at the end of the study after analyzes of the photos and bacteriological results obtained on samples taken at the practitioner's office on visit 1 (D0), visit 3 (D14 +/- 3) and visit 4 (D25 +/- 3). Successful treatment was defined by clinical, bacteriological and photographic efficacy at visit 3 (equivalence analysis: one-way 95 p. 100 confidence interval). RESULTS: There were 293 included patients given pristinamycin (n = 151) or oxacillin (n = 142). Mean age of analyzed patients was 40 +/- 17 years. Diagnosis was confirmed in 255 patients in accordance with the protocol: furunculosis or carbuncle (n = 100), recently superinfected wound (n = 97), impetigo (n = 41), acute perionyxis (n = 17). Thirty-five patients (12 p. 100) were considered to have been wrongly included. The germs most often isolated were: Staphylococcus aureus (n = 126), group A streptococci (n = 13), group B streptococci (n = 5) and P. multocida (n = 3). At visit 3, the two treatments were found to be equivalent with a success rate of 86.7 p. 100 for pristinamycin and 89.8 p. 100 for oxacillin (CI [*9.97]). Tolerance was statistically comparable between the two treatments (27 to 32 percent minor side effects). DISCUSSION: This study is the first performed in outpatients attended by general practitioners with diagnostic confirmation on both bacteriological and photographic evidence of superficial pyoderma. The results obtained demonstrate the good reliability of such studies although 12 p. 100 of the patients were wrongly included, a factor which should be taken into account for future studies. The efficacy and tolerance of pristinamycin were statistically equivalent to those of oxacillin for all the patients with superficial pyoderma. Nevertheless, the subgroup of patients with folliculitis gave rather heterogeneous bacteriology and therapeutic results.

Adolescent↗
PubMed1996

Identification of novel germline hMLH1 mutations including a 22 kb Alu-mediated deletion in patients with familial colorectal cancer.

We analyzed the hMLH1 gene in 17 unrelated families with putative hereditary nonpolyposis colorectal cancer. The complete hMLH1 cDNA was amplified in one step, and after a second amplification, four overlapping segments were directly sequenced. We detected, in five families that did not meet the complete Amsterdam criteria, five alterations, including a double-base change resulting in a missense mutation (Lys-618-Ala), a splicing mutation affecting the intron 4 splice acceptor site, a 2-bp deletion at codon 726, a 7-bp deletion at codon 626, and a deletion of exons 13-16. The latter alteration was shown to result from a 22-kb genomic deletion due to a homologous recombination between Alu repeats located in introns 12 and 16. The detection of five germline hMLH1 mutations in five families that only partially fulfilled the Amsterdam criteria shows that these criteria do not allow the identification of all familial colorectal cancers due to mutations of the mismatch repair genes. The numerous Alu repeats present within the hMLH1 gene and the observation of large genomic deletions suggest that (a) Alu-mediated deletions might frequently be involved in hMLH1 inactivation, and (b) reverse transcription-PCR analysis, which allows the amplification of the entire coding region of the hMLH1 gene in one step, might be the most appropriate method for the detection of hMLH1 alterations.

Adaptor Proteins, Signal Transducing↗
PubMed1996

The major subunit ClpG of Escherichia coli CS31A fibrillae as an expression vector for different combinations of two TGEV coronavirus epitopes.

Previously, two B-cell epitopes from the entero-pathogenic transmissible gastroenteritis virus (TGEV), namely the C epitope (TGEV-C) amino acids (aa) 363-371 and the A epitope (TGEV-A) aa 522-531 of the spike S protein (TGEV-S), have been separately expressed on the CS31A fibrillae at the surface of Escherichia coli following insertion into a same region of ClpG. However, the resulting chimeras induced a marginal TGEV-neutralizing antibody (Ab) response in mice. Here, with the view to improving this response, we introduced TGEV-C alone or in different tandem association with TGEV-A (A::C or C::A) in twelve putatively exposed regions of ClpG. Among the 28 resulting engineered proteins only 15, carrying up to 51 extra aa, had not essentially disturbed the correct CS31A fibrillae formation process. Six partially permissive sites accepting only TGEV-C and three highly permissive sites tolerating A::C or C::A tandem peptide, were identified throughout ClpG. Intact bacteria or extracted CS31A hybrid fibrillae expressing TGEV epitopes at any of the permissive sites, were recognized by Ab directed against the foreign parent protein, providing a direct argument for exposure of the corresponding CIpG region at the cell surface and for antigenicity of the epitopes in the polymeric CS31A fibrillae context. The potential of CS31A fibrillae as carriers of the TGEV peptides indicates that there may be three positions (N terminus, aa 202-204 and 202-218) in ClpG which may turn out to be important fusion sites and therefore be relevant for the eventual design of TGEV vaccines. Unexpectedly, TGEV-A, whatever its position in ClpG, mediated the partial proteolytic degradation of the hybrid proteins, suggesting that it functions as a substrate for a cellular protease, and thereby that its suitability as a vaccine antigen candidate is doubtful.

Amino Acid Sequence↗
PubMed1996

[High-risk surgical patients. Who are they and how should they be treated?].

This review addresses the currently available information that describes the identification of high risk patients undergoing surgery and how they may be treated to improve their outcome. It is clear from this data that high risk patients have a mortality rate of around 30% and that the major cause of death is due to multiple organ failure (MOF) which occurs days or in some cases weeks after the operation. The hypothesis for the onset of MOF is presented and it relates to the breakdown in gut patency which can allow the translocation of initiating inflammatory mediators which sets the MOF cascade in action. Current treatment strategies based on preclinical and clinical data to prevent MOF are discussed which includes the use of catecholamines such as dobutamine and dopexamine (Dopacard). It is concluded that the high risk surgical patient is not well defined and that the most rigorously tested criteria are those developed by Shoemaker. These criteria relate far more to the patients physiological status than the surgery that they are undergoing. The treatment of these patients is far more successful if intervention starts prior to surgery with fluids and vasoactive drugs such as Dopacard where the mortality rate has been shown to be reduced by 75%.

Humans↗
PubMed1996

[Sedation in intensive care units. Indications and techniques].

Sedation is a technique widely used in intensive care unit patients. The main objective is to ensure a proper level of analgesia and the best physical and psychical comfort possible. For the vast majority of patients a light level of sedation is adequate and the level of sedation can easily be deepened to perform a short but painful procedure. A deeper level of sedation, close to that of a general anesthesia is rarely needed and limited to specific indications: adult respiratory distress syndrome, head trauma, status asthmaticus. Drugs used for sedation are combinations of opioids (fentanyl or sufentanil), benzodiazepines (midazolam) and hypnotic drugs such as propofol. In combination with the pharmacological approach, a psychological approach is of greater interest in conscious patients.

Critical Care↗
PubMed1996

DAG, a gene required for chloroplast differentiation and palisade development in Antirrhinum majus.

We have identified a mutation at the DAG locus of Antirrhinum majus which blocks the development of chloroplasts to give white leaves with green revertant sectors. The green areas contain normal chloroplasts whereas the white areas have small plastids that resemble proplastids. The cotyledons of dark-grown dag mutant seedlings have plastids which also resemble proplastids. The palisade cells in the white areas of dag mutant leaves also lack their characteristic columnar shape. The DAG locus was cloned by transposon tagging: DAG encodes a novel protein with a predicted Mr of 26k, which is targeted to the plastids. Cleavage of its predicted transit peptide gives a mature protein of Mr 20k. Screening of databases and analysis of Southern blots gave evidence that DAG belongs to a protein family with homology to several proteins of unknown function from plants. Expression of DAG is required for expression of nuclear genes affecting the chloroplasts, such as CAB and RBCS, and also for expression of the plastidial gene RPOB encoding the plastidial RNA polymerase beta subunit, indicating that it functions very early in chloroplast development.

Amino Acid Sequence↗
PubMed1996

A PET study of the neural systems of stuttering.

The cause of stuttering is unknown. Failure to develop left-hemispheric dominance for speech is a long-standing theory although others implicated the motor system more broadly, often postulating hyperactivity of the right (language nondominant) cerebral hemisphere. As knowledge of motor circuitry has advanced, theories of stuttering have become more anatomically specific, postulating hyperactivity of premotor cortex, either directly or through connectivity with the thalamus and basal ganglia. Alternative theories target the auditory and speech production systems. By contrasting stuttering with fluent speech using positron emission tomography combined with chorus reading to induce fluency, we found support for each of these hypotheses. Stuttering induced widespread overactivations of the motor system in both cerebrum and cerebellum, with right cerebral dominance. Stuttered reading lacked left-lateralized activations of the auditory system, which are thought to support the self-monitoring of speech, and selectively deactivated a frontal-temporal system implicated in speech production. Induced fluency decreased or eliminated the overactivity in most motor areas, and largely reversed the auditory-system underactivations and the deactivation of the speech production system. Thus stuttering is a disorder affecting the multiple neural systems used for speaking.

Adult↗
PubMed1996

A novel presenilin 1 mutation resulting in familial Alzheimer's disease with an onset age of 29 years.

We have identified a novel Alzheimer's disease family in which affected subjects had a very young age of onset (range 29-35 years). Neuropathological confirmation of the diagnosis was obtained for one patient. Molecular analysis shows that within this family the disease results from a missense mutation at codon 235 of the presenilin 1 (PS-1) gene. Two patients had exhibited generalized tonico-clonic seizures several years before the onset of dementia. Whether this particular clinical feature is a consequence of the PS-1 mutation remains to be established. The Leu235Pro mutation is, to our knowledge, the PS-1 mutation associated with the youngest age of AD onset, which suggests that it has a drastic effect on PS-1 function.

Adult↗