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Biomedical subjects

C Mayaud

Publications and source records attributed to C Mayaud.

At least 127 records · Page 7Linked to original sources
PubMed1991

[Pleurisy in HIV infected patients].

Thirty-seven records of pleural effusion of known cause which occurred in HIV-seropositive patients hospitalized at the Tenon hospital, Paris, between 1985 and 1990 were analyzed retrospectively and divided into two groups: group 1 (n = 21) made up of kaposian effusions, and group 2 (n = 16) of infectious effusions serving as control. Numerous features distinguished group 1 from group 2 pleural effusions: In group 1 the effusion occurred in patients with cutaneous Kaposi sarcoma in 20/21 cases (P less than 0.001), developed slowly (more than 10 days) in 20/21 patients (P less than 0.001), was associated with a specific fever in only 4/21 cases (P less than 0.001), was bilateral in 20/21 cases (P less than 0.001), was regularly associated with bilateral parenchymatous opacities (P less than 0.001) and was haemorrhagic in 18/21 patients (P less than 0.001). Thus, simple semeiological features are sufficient to predict the cause of pleural effusion occurring in HIV-seropositive patients and to guide the diagnostic approach.

Adult↗
PubMed1991

A lectin-binding soluble factor released by CD8+CD57+ lymphocytes from AIDS patients inhibits T cell cytotoxicity.

CD8+CD57+ T cells, expanded in peripheral blood lymphocytes of AIDS patients, inhibit the effector phase of HLA-specific cytotoxic T lymphocytes, natural killer and lymphocyte-activated killer cells in a 4-h chromium-release assay. This inhibitory activity present in supernatants of purified sorted CD8+CD57+ cells is mediated by a non-antigen-specific inhibitory factor which is distinct from prostaglandin E2, T cell growth factor (TGF)-beta, latent-TGF-beta, tumor necrosis factor (TNF)-alpha and TNF-beta. Partial biochemical characterization demonstrates that the CD8+CD57+ inhibitory activity (a) is heat, trypsin and acid resistant, (b) binds to concanavalin A columns, indicating its glycosylation state and (c) is mediated by a 20-30-kDa soluble molecule.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Pleuropulmonary cryptococcosis disclosing AIDS].

The authors report a case of AIDS revealed by pleuropulmonary cryptococcosis. The infection was diagnosed by culture of the pleural fluid and confirmed by microscopic examination of the cerebrospinal fluid, using Indian ink as stain. Apyrexia and return to normal of chest radiography were obtained with oral fluconazole. Twelve months after this episode the patient is alive and had no relapse under maintenance treatment with this drug.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Respiratory involvement in AIDS].

This review paper is divided into three parts. The first two parts are devoted to an analytical description of the clinical, diagnostic, prognostic and therapeutic aspects of the various bronchopulmonary and pleural lesions observed in AIDS. The third part presents an overall view of the main diagnostic and therapeutic approaches in the main clinical situations covering all respiratory disorders.

Acquired Immunodeficiency Syndrome↗
PubMed1990

HIV-1 infection of lung alveolar fibroblasts and macrophages in humans.

We have studied the infected cell populations in the lungs of four human immunodeficiency virus type 1 (HIV-1) seropositive patients suffering from lymphocytic alveolitis or lymphocytic interstitial pneumonitis. Adherent cells were obtained by bronchoalveolar lavage (BAL) and were analyzed by various technical approaches. The cells considered here were alveolar macrophages and fibroblasts, and could be clearly identified morphologically and by the expression of specific cell-surface markers using monoclonal antibodies. The presence of HIV-1 in both of these cell types was established by serological, virological, and molecular procedures. Our results show that alveolar macrophages and fibroblasts are naturally infected in the lungs of HIV+ patients. Both cell types express the CD4 receptor molecule, in contrast to skin fibroblasts which are negative. Alveolar macrophages and fibroblasts thus may act as eventual HIV-1 reservoirs in vivo, and are probably involved in the induction of inflammatory reactions because they are targets for CD8 cytotoxic T lymphocytes (CTL).

AIDS-Related Complex↗
PubMed1990

Comparison of the activity of three antibiotic regimens in severe Legionnaires' disease.

Comparison of the activity of different antibiotic regimens in Legionnaire's disease has never been made because of the rarity of well documented cases of that disease. We have retrospectively compared severe cases of Legionnaires' disease treated with pefloxacin alone or in combination with erythromycin and/or rifampicin using computer-matched cases treated either with erythromycin or with erythromycin in combination with rifampicin. This study suggests that: (1) combined therapy including erythromycin, rifampicin and/or pefloxacin is superior to therapy with erythromycin alone; (2) combinations including pefloxacin may be the most active ones; and (3) pefloxacin alone may be as active as combination therapy. Although these results are in agreement with data obtained in cell and in animal models of legionella infection they need to be further confirmed by the study of larger number of patients.

Cause of Death↗
PubMed1990

[Pulmonary and pleural localizations of Kaposi's sarcoma in AIDS].

Intrathoracic Kaposi's sarcoma (KS) in AIDS is remarkable for its frequency and severity. It is responsible for 10% of "pneumonias" and almost 50% of pleurisies observed in these patients. The time elapsed between the discovery of the lesion and the patient's death does not exceed a few months on average. The initial manifestations of pulmonary KS are usually discreet and consist of cough and/or dyspnoea in patients with KS of the skin and mucosae. Fever is lacking or moderate. The most suggestive radiological findings are dense, nodular, tumour-like opacities and bilateral linear and/or micronodular opacities around the bronchi and vessels. The diagnosis rests on bronchial fibroscopy which shows red, non friable lesions which, to a trained endoscopist, are very characteristic. When these lesions are absent, thoracotomy may be necessary for diagnostic purposes. Treatment essentially consists of chemotherapy; zidovudine therapy and prophylaxis of pneumocystosis are indicated if the circulating CD 4 cell count falls below 200/mm3. When its symptoms are predominant, pleural KS is typically progressive, with normal or slightly elevated temperature, associated parenchymal lesions that are clearly visible on CT scans and copious, bilateral, blood-stained serous or chylous pleural fluid. When these signs are absent throacoscopy or thoracotomy may be necessary. Future advances in this field will be due not only to improvements in chemotherapy but also to a better understanding of the physiopathology of intrathoracic Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Bronchial cancer in patients infected with human immunodeficiency virus (HIV). Report of 3 cases].

We report 3 cases of bronchial carcinoma in patients with human immunodeficiency virus (HIV) infection. Like the other 13 cases found in the literature, these were characterized by their occurrence in young subjects, their often adenocarcinomatous nature and their abnormally severe course. These clinical features raise the problem of the role played by HIV in the development and, above all, the clinical expression of bronchial carcinoma.

Adenocarcinoma↗
PubMed1990

[Cavitary pneumocystis carinii pneumonia in AIDS: a new semiologic aspect. Apropos of 3 cases].

Three cases of AIDS patients hospitalized for Pneumocystis carinii (PNC.C) pneumonia are reported. These cases are of interest because of the unusual radiological semiology of these pneumocytoses, i.e., their partially or totally pitted nodules. In addition, 4 related facts merit attention: the occurrence of pneumocytosis in 1 patient under prophylactic aerosol pentamidine therapy: the rarity, unusual in AIDS, of PNC.C in the bronchoalveolar lavage fluid from 2 patients; the association of pitted nodules with mediastinal adenopathies due to PNC.C in 1 patient; and the favorable outcome in all cases.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Recurrence of atypical pulmonary pneumocystosis treated with pentamidine aerosol].

Two cases are reported of atypical relapses of pneumocystosis in AIDS patients treated with aerosol pentamidine for 14 and 22 months. These pneumopathies are unusual because of their pitted aspect and recurrent spontaneous pneumothoraxes in spite of repeated drainage. They are difficult to diagnose because bronchoalveolar lavage fluid is negative for Pneumocystis carinii, despite their presence in lung biopsies. Histological lesions vary, being granulomatous, necrotizing and invasive, with involvement of the pleura and lymph nodes. Although a highly effective therapy against P. carinii pneumonia, aerosol pentamidine may play a role in these atypical episodes: either by causing bronchial obstructions beyond which the pneumocytotic lesions cannot be reached by lavage and become necrotic, or by favoring the extrapulmonary spread of P. carinii.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Cell-mediated suppression of HIV-specific cytotoxic T lymphocytes.

CTL specific for HIV have been described in lungs of infected patients at early stages of HIV disease. In order to characterize the evolution over time of HIV-specific CTL, we have analyzed the cytotoxic function and the cell surface phenotype of the alveolar lymphocytes from 41 patients at various stages of HIV disease. We demonstrated a progressive decline of alveolar anti-HIV CTL activity and detected Ts cells from the lungs of patients with advanced HIV disease. These alveolar T cells strongly suppressed the effector phase of anti-HIV CTL lysis. They lacked a marked specificity of function because they also block anti-HLA CTL response and were not restricted by the HLA-class-I transplantation Ag. They displayed the CD3, CD8, and HNK1 markers, were CD4 and CD16 negative, and lacked NK activity. The presence of Ts cells at late stages of HIV disease could thus partly explain the inefficiency of host defenses against HIV.

AIDS-Related Complex↗
PubMed1989

[The staging of bronchial cancer].

The variety of individual opinions encountered in the evaluation of lung cancer is due to the multiplicity of investigations. The intrathoracic extent is basically assessed by bronchial fibroscopy with tiered biopsies and computerized tomography. The specificity of computerized tomography in the evaluation of lymph node involvement never exceeds 75 per cent, and although this figure is higher as regards mediastinal or direct chest wall involvement, it never reaches 100 per cent. The information provided by magnetic resonance imaging is not better. Metastatic extension is evaluated by abdominal ultrasonography and computerized tomography of the brain and of the upper abdomen. Systematic radionuclide bone scanning is debatable and some other examinations must be reserved to certain histological types; this is the case with bone marrow biopsy (completed, if necessary, by monoclonal antibodies) or magnetic resonance imaging of bones in small cell carcinomas. The levels of some markers are well correlated with tumoral dissemination.

Biomarkers, Tumor↗
PubMed1989

Unusually high frequencies of HIV-specific cytotoxic T lymphocytes in humans.

CTL specific for the HIV belong to the CD8 subset of T lymphocytes, and their activity is restricted by class I HLA transplantation Ag. In this report, HIV-specific CTL and their precursor cells were quantified by limiting dilution analysis. CTL were recovered from the lungs, lymph nodes, and blood of asymptomatic seropositive carriers and of patients with AIDS. HIV was found to be very immunogenic. High frequencies of both HIV-specific CTL and CTL precursor cells were detected in infected individuals. These CTL killed autologous HIV-infected macrophages and T4 lymphoblasts. They also killed doubly transfected P815-A2-env-LAV mouse tumor cells, which express the human HLA-A2 gene and the HIV-1 env gene. In the longitudinal studies of two HIV-infected patients, CTL and CTL precursor cell frequencies decreased as the clinical and immunologic status of the patients deteriorated. Most surprisingly, PBL from seronegative donors also responded to HIV stimulation in vitro and generated large numbers of HLA-restricted, HIV-specific CTL.

Animals↗
PubMed1989

[A new case of necrotizing pneumocystosis in AIDS].

The authors report the case of an AIDS patient presenting with both Streptococcus pneumoniae pneumoniae and pneumocystosis. What was remarkable in that case was the appearance, in an otherwise favourable course, of a large excavation in the territory of the pneumonia. The responsibility of Pneumocystis carinii in this excavation is discussed.

Acquired Immunodeficiency Syndrome↗