Search PubMed⌕ Search

Biomedical subjects

C Morel

Publications and source records attributed to C Morel.

At least 109 records · Page 6Linked to original sources

[Bypass for limb salvage. A matter of the veins? Preliminary report apropos of 100 femoro-distal revascularizations].

The authors have performed a prospective study on 100 cases of limb salvage. The reference procedure was the in situ femoro-subinguinal bypass (67 observations). If no vein could be used, replacement material was thin-wall PTFE (33 observations). Both groups are clinically and radiologically homogeneous. The longest delay is 30 months. The cumulated patency rate is 86% for venous bypass grafts against 62% for prostheses. The difference is less marked for limb salvage: 96% with venous bypass and 84% with a PTFE bypass. Without trying to oppose both techniques, the authors emphasize the need for revascularization, even when distally seems to be compromised.

Acute Disease↗

[In vitro antibacterial activity of a new macrolide, miokamycin. Results of a multicenter study].

Minimal inhibitory concentration (MIC) of miokamycin (M) were evaluated by agar dilution for 1,024 bacterial strains isolated in 6 hospitals and classed as a function of susceptibility and resistance to macrolides, lincosamides, streptogramins group (MLS). MIC of M ranged from 0.25 to 4 micrograms/ml (mode MIC 1-2) on Staphylococcus susceptible to MLS and on MLSB inducible strains; M was inactive on MLSB constitutive strains. MIC of M ranged from 0.016 to 4 micrograms/ml (mode MIC 0.12 to 0.5) for Streptococci and Pneumococci susceptible to erythromycin (E) and from 0.12 to greater than 128 for strains resistant to E. Enterococci susceptible to E were inhibited by 0.5 to 2 micrograms/ml (mode MIC 1) and strains resistant to E by 4 to greater than 128. Haemophilus were inhibited by 2 to 64 micrograms/ml (mode MIC 32), Neisseria by 0.12 to 4 (mode MIC 0.5-1) and B. catarrhalis by 0.12 to 8 (mode MIC 1). L. pneumophila was very susceptible to M: MIC 0.016 to 0.12 (mode MIC 0.06). MIC of M ranged generally from 0.5 to 2 micrograms/ml (mode MIC 1) for C. perfringens and from 0.03 to 2 (mode MIC 1) for B. fragilis. Thus, M was shown to be among macrolide antibiotics of resistance non-inducing type on MLSB inducible resistance strains. Its activity was similar to that of spiramycin slightly superior on Staphylococci, slightly inferior on Streptococci and Enterococci, similar on Pneumococci, very superior on Neisseria, Legionella and anaerobes. M had a good activity on Branhamella and, as others macrolides, was poorly active on Haemophilus.

Bacteria↗

[Use of an antibioprophylaxis with pefloxacin and fosfomycin in cardiac surgery in patients with beta-lactam hypersensitivity].

An association of pefloxacin plus fosfomycin was used as antibioprophylaxis in beta lactam allergic patients who underwent cardiac surgery with cardiovascular-bypass. Pefloxacin (800 mg), was administered orally, one hour before anesthetic induction and fosfomycin (60 mg/kg) was injected at the time of induction. The whole course of prophylaxis wat 24 hours. Antibiotic concentrations were measured in serum before (P1, P2) during (C1, C2, C3, C4) and after cardiovascular-bypass (P3) and in bone, endocardiac and pleural tissues. The efficacy was evaluated on clinical and biological data. Antibiotic levels of pefloxacin were measured by HPLC and those of fosfomycin by bacteriological method. Antibiotic concentrations are high in blood and tissues, without evidence of cardiovascular-bypass influence. The tissue penetration of both drugs is excellent. Two patients have presented serious post-operative infections. The pharmacokinetic of pefloxacin associated with fosfomycin is appropriate during cardiovascular-bypass and the local antibiotic concentrations are above the MIC of the strains commonly responsible of post operative infections in cardiovascular surgery. The clinical efficacy of this prophylaxis must be studied in a large population of patients.

Aged↗

Evolution of parasitism: kinetoplastid protozoan history reconstructed from mitochondrial rRNA gene sequences.

A phylogenetic tree for the evolution of five representative species from four genera of kinetoplastid protozoa was constructed from comparison of the mitochondrial 9S and 12S rRNA gene sequences and application of both parsimony and evolutionary parsimony algorithms. In the rooted version of the tree, the monogenetic species Crithidia fasciculata is the most deeply rooted, followed by another monogenetic species, Leptomonas sp. The three digenetic species Trypanosoma cruzi, Trypanosoma brucei, and Leishmania tarentolae branch from the Leptomonas line. The substitution rates for the T. brucei and T. cruzi sequences were 3-4 times greater than that of the L. tarentolae sequences. This phylogenetic tree is consistent with our cladistic analysis of the biological evidence including life cycles for these five species. A tentative time scale can be assigned to the nodes of this tree by assuming that the common ancestor of the digenetic parasites predated the separation of South America and Africa and postdated the first fossil appearance of its host (inferred by parsimony analysis). This time scale predicts that the deepest node occurred at 264 +/- 51 million years ago, at a time commensurate with the fossil origins of the Hemiptera insect host. This implies that the ancestral kinetoplastid and its insect host appeared at approximately the same time. The molecular data suggest that these eukaryotic parasites have an evolutionary history that extends back to the origin of their insect host.

Animals↗

[In vitro antibacterial activity of apalcillin on aerobic bacteria and the regression curve].

Minimal inhibitory concentrations (MICs) of apalcillin (APL) were evaluated by agar dilution on 1,201 bacterial strains isolated simultaneously in four university hospitals; agar diffusion tests (disks APL: 75 micrograms) were performed on these strains to establish relationship between MIC and zone diameters. For Enterobacteriaceae naturally non beta-lactamase-producing (E. coli and P. mirabilis), mode MIC was 0.5 microgram/ml; some acquired penicillinase-producing strains were only inhibited by concentrations greater than or equal to 16. Chromosomal penicillinase producing Klebsiella were inhibited by 2 to 8 micrograms/ml but APL was inactive on acquired penicillinase-producing strains. For chromosomal cephalosporinase-producing species (Enterobacter, Citrobacter, Serratia, indole + Proteus and Providencia) two populations of strains were observed: one sensitive and the second resistant to carboxypenicillins: on the first population, mode MIC of APL was 1 to 4 micrograms/ml; on the second MIC were generally greater than or equal to 64 micrograms/ml. P. aeruginosa strains sensitive to carboxypenicillins were inhibited by 1 and 2 micrograms/ml; this activity was diminished on strains resistant to these antibiotics (MIC APL 8-32). MIC of Acinetobacter varied to 0.25 to greater than 128 with a majority of strains inhibited by 4 to 64 micrograms/ml. APL was active against non penicillinase producing Staphylococci; mode MIC was 2 micrograms/ml for Enterococci. Correlation coefficient of regression curve was 0.87. For critical concentrations less than or equal to 8 and greater than 64 micrograms/ml, critical diameters could be greater than or equal to 19 and less than 12 mm.

Acinetobacter↗

[Diffusion, in the bronchial mucus, of enoxacin administered by oral route in man].

The diffusion of Enoxacin into the bronchial mucus was studied in 34 patients admitted because of an acute infectious episode over chronic bronchopathy. They received via the oral route 400 mg of Enoxacin twice daily. The antibiotic concentrations were measured in sputum and serum by microbiological assay and HPLC. The patients were divided into 5 groups according with the timing of sampling: 1, 3, 6, 12 hours after dosing at day 3 (group I, II, III, IV), 3 hours after dosing at day 1, 2 and 3 (group V). Serum concentrations of Enoxacin were low (2.46 mg/l at 3rd hour). Bronchial concentrations exceed blood levels (mean 3.06 mg/l at 3rd hour). The bronchial levels of Enoxacin were above the mean MIC of many respiratory bacterial pathogens.

Aged↗

[Effectiveness of piperacillin in the antibacterial treatment of intra-abdominal infections in children].

The effectiveness of piperacillin was investigated in 30 children operated upon for peritonitis: 13 had acute appendicitis with puriform peritoneal reaction, or a recently perforated appendix; 5 had generalized peritonitis of appendicular origin, and 13 had intraperitoneal abscess. In the 12 children who underwent right iliac appendicectomy (with post-operative drainage in 3), piperacillin was administered alone during 5 days; clinical and bacteriological cure was obtained in all cases; the mean duration of stay in hospital was 7 days. The 5 cases of generalized peritonitis required drainage; piperacillin was given alone in 4 of them and combined with an aminoglycoside and metronidazole in one who was in poor general condition. Bacteriology showed a predominance of Escherichia coli alone or associated with other organisms. Clinical and bacteriological cure was obtained in 3 patients; the mean duration of stay in hospital was 12 days. Seven of the 13 cases of intraperitoneal abscess needed drainage. Piperacillin was administered alone for 7 days on average in 10 cases and combined with an aminoglycoside and metronidazole in 2 cases. Eight patients had a favourable course, 5 developed complications. In all 3 groups piperacillin was tell tolerated. A patch of urticaria was noted in 2 cases and a transient skin rash in 2 other cases. No neutropenia was observed in these children whose treatment never exceeded 10 days.

Abscess↗

[Multicenter study of the activity of pefloxacin on bacteria isolated in a hospital milieu].

Minimal inhibitory concentrations (MICs) of pefloxacin were evaluated by agar dilution for 3422 bacterial strains isolated in nine hospitals. Enterobacteriaceae proved very sensitive to pefloxacin: 62 p. 100 of 1743 strains tested had MIC less than or equal to 0.12 and 90 p. 100 less than or equal to 1 microgram/ml; but the percent of strains with MIC greater than or equal to 2 varied among the different groups of Enterobacteriaceae: 2.7 p. 100 for E. coli to 39 p. 100 for Serratia. 55 p. 100 for Pseudomonas and 81 p. 100 of Acinetobacter were inhibited by 1 micrograms/ml or less (mode MIC 1 and 0.5 micrograms/ml). Haemophilus sp.: 0.03 and 0.06 micrograms/ml and Gonococci were very sensitive to pefloxacin. The spectrum of pefloxacin extended to Gram positive cocci: MIC of Staphylococci were 0.06 to 8 micrograms/ml (mode MIC: 0.5); Enterococci, other Streptococci and Pneumococci were less sensitive: 2 and 4 micrograms/ml for the majority of strains. Concerning anaerobic bacteria, pefloxacin was more active against Clostridium (0.5 to 1 microgram/ml generally), than against Bacteroides (4 to 16 micrograms/ml).

Bacteria↗

[Pharmacokinetics of ceftazidime injected peritoneally in continuous ambulatory peritoneal dialysis].

Peritonitis is the most frequent complication in patients under continuous ambulatory peritoneal dialysis. Intraperitoneal administration of ceftazidime in a dose of 125 mg per liter dialysate achieved serum concentrations higher than the minimal inhibitory concentrations of most organisms in spite of low peritoneal clearance. Serum concentration was stable up to the 120th hour. Dialysate osmolarity had no influence on serum concentration, peritoneal absorption or clearance of ceftazidime. Peritoneal inflammation did not cause changes in ceftazidime pharmacokinetics. Ceftazidime used alone as the first choice treatment was successful in 85%, of cases.

Absorption↗

[Diffusion of an orally administered single dose of ofloxacin into human bronchial mucus].

As part of a systematic investigation of the penetration of antibiotics into human bronchial mucus, we assayed ofloxacin concentrations following ingestion of a single dose. 25 patients with acute superinfection of a chronic lower respiratory tract disease were studied. Each patient had single drug therapy with ofloxacin in a daily dosage of 200 mg taken in the morning on an empty stomach. Patients were divided into five groups according to the time interval between ingestion of ofloxacin and collection of samples (bronchial mucus and serum): 1 hour, 3 hours, 6 hours, 12 hours or 24 hours. Duplicate determinations of ofloxacin on individual samples were done using a microbiologic method. Mean serum concentrations were 1.85, 1.64, 1.32, 0.75 and 0.20 mg/l respectively, with a half-life of 6.7 hours; the corresponding concentrations in mucus were 1.83, 1.51, 1.20, 0.66 and 0.19. These results demonstrate ofloxacin's outstanding penetration into bronchial mucus.

Administration, Oral↗

[Multicenter study of ofloxacin activity on bacteria isolated from a hospital environment].

Minimal inhibitory concentrations (MICs) of ofloxacin were evaluated by agar dilution for 1508 bacterial strains isolated in five hospitals. For Enterobacteriaceae sensitive to nalidixic acid, MICs ranged from 0.008 to 1 microgram/ml (mode MIC: 0.12); the different species of Enterobacteriaceae exhibited similar mode MICs (0.12) with the exception of E. coli (0.06-0.12), P. mirabilis (0.5) and Providencia (0.25). Among strains intermediate and resistant to nalidixic acid, most of which were Serratia, Providencia and Citrobacter, 41% had a MIC within the susceptibility range, while the others had a MIC of 2 to 8 micrograms/ml, or even 64 micrograms/ml in a few instances. Ofloxacin also exhibited satisfactory activity against P. aeruginosa, with MICs ranging from 0.25 to 16 micrograms/ml (mode MIC: 2) for 87% of strains, and A. calcoaceticus, with MICs from 0.25 to 2 micrograms/ml (mode MIC: 1). Haemophilus sp. (MIC: 0.008 to 0.06 microgram/ml; mode MIC: 0.03), Gonococci (mode MIC: 0.008), and Meningococci (mode MIC: 0.016) were very sensitive to ofloxacin. The spectrum of ofloxacin included Gram positive cocci: MICs of Staphylococci were 0.06 to 2 micrograms/ml (mode MIC: 0.5); Enterococci, other Streptococci and Pneumococci were less sensitive, with MICs of 2 to 4 micrograms/ml for the majority of strains. As for anaerobic bacteria, ofloxacin proved more active against Clostridium (0.5 to 2 micrograms/ml) than Bacteroides (0.5 to 16 micrograms/ml).

Bacteria↗

[Aztreonam. Diffusion into bronchial mucus].

In a prospective study of antibiotics' diffusion into human bronchial mucus, we compared serum and mucus concentrations of aztreonam, a new beta lactam belonging to the monobactam group. Twenty patients were given aztreonam (1 g twice a day) for an acute purulent exacerbation of chronic bronchitis and divided into four groups according to the time of sampling (0.5, 1, 1.5 or 3 h). Samples were taken on the first and third treatment days. Antibiotic concentrations were assayed using agar diffusion and HPLC. Aztreonam concentrations were low, similar to those achieved with other beta lactams. According to the time sampling, levels ranged from 0.27 to 1 mg/l and 0.4 to 1.15 mg/l on the first and third treatment days respectively. Corresponding serum levels were 90 mg/l and 30 mg/l, respectively 30 mn and 3 h after dose ingestion.

Aztreonam↗

[Pefloxacine: diffusion into bronchial mucus].

Pefloxacin is a new quinolone with significant in vitro antibacterial activity and a broad spectrum. It was included in an extensive study of antibiotic diffusion into bronchial mucus. Pefloxacin was given to 35 patients divided into five groups according to the timing of sputum sampling. Plasma specimens were taken simultaneously. Pefloxacin was measured by microbiological assay. Mean pefloxacin concentrations in bronchial mucus was high, exceeding 5 mg/l. Concentrations on the first and third days were similar. The ratio of mucus concentrations to plasma concentrations was high in each case, around or often above 1. These findings show that diffusion of pefloxacin into bronchial mucus is outstanding.

Anti-Infective Agents↗

Cefotetan: comparative study in vitro against 226 Gram-negative clinical isolates.

The activity in vitro of the new cephamycin, cefotetan, was compared with that of cephalothin, cefoxitin, cefuroxime and cefotaxime against 226 recently isolated Gram-negative pathogens (207 Enterobacteriaceae and 19 Acinetobacter). Cefotetan was consistently more potent than cephalothin, cefoxitin and cefuroxime. Cefotaxime and cefotetan were essentially similar in activity against the Enterobacteriaceae with the singular exception of Enterobacter spp. which were markedly more susceptible to the former drug. None of the five agents was especially active against acinetobacter but cefotaxime was the best. Limited tests of bactericidal activity showed that the MBC differed from the MIC by a factor of 4 at most. Increasing the inoculum tested from 10(2) to 10(8) per ml had little adverse effect on the MIC of cefotetan. If the recommendations of the National Committee for Clinical Laboratory Standards for susceptibility to cephalosporins are applicable to cefotetan and the breakpoint criteria of less than or equal to 10 mg/l (sensitive) and greater than or equal to 32 mg/l (resistant) are acceptable, then only a few of the Enterobacteriaceae in this study were resistant. These resistant organisms were amongst Enterobacter spp. and Citrobacter spp.

Anti-Bacterial Agents↗

[In vitro activity of azthreonam on hospital Gram-negative bacilli. Results of a multicenter study].

This work reports a multicenter study of antibacterial activity of azthreonam, a new antibacterial agent of the monobactam group, on Gram negative rods. Enterobacteriaceae are very sensitive to azthreonam (modal MIC: 0,06 micrograms/ml); some strains have higher MIC greater than or equal to 8 micrograms/ml, particularly among Enterobacter, Serratia and Citrobacter. Azthreonam has a good activity on Pseudomonas aeruginosa: 90% of the strains are inhibited by 8 micrograms/ml or less. Acinetobacter are less sensitive with a modal MIC of 32 micrograms/ml. Haemophilus are inhibited by low concentrations, 0,06 to 0,12 micrograms/ml usually.

Anti-Bacterial Agents↗

[Diagnosis of listeriosis. Value and limitations of the leukocyte migration inhibition test].

A human leucocyte migration inhibition test (HLMT) was performed in 50 healthy subjects and in 23 patients with bacteriologically confirmed listeriosis, using Listeria monocytogenes as antigen. Considerable inhibition was found in most patients, whereas the test was negative in all controls. In view of this consistent relationship between test and disease, it is suggested that the HLMT could be used for the indirect diagnosis of listeriosis, taking into account the delay between the onset of infection and the positivity of the test.

Cell Migration Inhibition↗