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Biomedical subjects

C Regamey

Publications and source records attributed to C Regamey.

At least 55 records · Page 3Linked to original sources
PubMed1990

Severe infections treated with intravenous ofloxacin: a prospective clinical multicentre Swiss study.

In this open prospective clinical trial of iv ofloxacin, 87 patients were treated for severe bacterial infections. Overall results showed a clinical cure rate of 75% and 79/87 87 patients improved. 86% of causative organisms (all sensitive to ofloxacin) were eliminated. The best results were obtained in urinary tract infections where all 30 patients were clinically cured and 27 organisms (Escherichia coli, group D streptococcus, Proteus mirabilis and Klebsiella pneumoniae) were eliminated. Rapid clinical cure was observed in five patients with prostatitis. Good results were seen in arthritis and osteomyelitis. Less than three days of parenteral therapy were required before improvement was seen in patients presenting with severe enterocolitis. Ofloxacin treatment was used for the treatment of lower respiratory tract infections in 35 patients. Clinical improvement was noted in 28 patients. Five patients had unsatisfactory responses, mainly due to underlying diseases. There were two failures, both in pneumococcal pneumonia. Three minor side effects were recorded. Ofloxacin can be given for severe bacterial infections due to Enterobacteriaceae, other Gram-negative rods and other sensitive organisms. It can be given in penicillin allergic patients but it should not be used in pneumococcal pneumonia.

Adolescent↗
PubMed1989

[Effect and tolerance of ofloxacin in bronchopulmonary infections in comparison with amoxicillin].

Ofloxacin and amoxicillin in the treatment of 121 bronchopulmonary infections were compared in a randomized, open clinical trial. 64% of the infections were pneumonias. S. pneumoniae, H. influenzae and B. catarrhalis accounted for 76% of the etiologic agents. The clinical and bacteriological responses were positive in more than 90% of the patients and comparable in both groups. None of the isolated agents was resistant to ofloxacin, whereas 21% were amoxicillin-resistant. Ofloxacin was used without randomization in the treatment of 26 atypical pneumonias and opportunistic infections, all of which were cured or improved. Occurrence of side-effects was rarely observed in either treatment group.

Aged↗
PubMed1989

[Light chain myeloma or the pitfalls of myeloma diagnosis].

The diagnosis of multiple myeloma is often suggested by disturbances found in routine laboratory tests such as sedimentation rate, electrophoresis of serum proteins and search for proteinuria. In light chain myeloma these tests are nonspecific and therefore misleading. We present 8 cases of light chain myeloma and discuss the diagnosis of multiple myeloma with its associated pitfalls.

Aged↗
PubMed1988

X-linked lymphoproliferative syndrome. Identification of a large family in Switzerland.

Observation of a patient with acquired hypogammaglobulinemia associated with a mononucleosis syndrome led to the identification of one of the largest families affected by the X-linked lymphoproliferative (XLP) syndrome in the world. It is the first such family identified in Switzerland and the largest in Europe. At least nine male subjects over two generations presented phenotypic expressions consistent with the XLP syndrome. Study of the pedigree extending over seven generations suggests that the mutation occurred in the proband's great-grandmother. In the next generation, a second mutation of the X chromosome in one branch of the family resulted in expression of hemophilia A in the children. This remarkably large family, comprising six living obligate female carriers, displays a wide spectrum of the XLP syndrome and offers valuable information for future genetic linkage studies and for genetic counseling.

Adult↗
PubMed1988

Teicoplanin, a new antibiotic effective against gram-positive bacterial infections of the skin and soft tissues.

Teicoplanin is a new glycopeptide antibiotic chemically related to vancomycin with a similar bactericidal activity against aerobic and anaerobic Gram-positive bacteria but with a longer plasma elimination half-life of 40-100 h allowing a once daily parenteral administration. In an open prospective study, we treated 20 patients with skin and soft tissue infections such as erysipelas, cellulitis, folliculitis and furunculosis with a a success rate of 84%. The peak and trough serum levels of teicoplanin were above the minimal inhibitory concentrations of the bacteria isolated and the therapeutic index measured at the plateau level was between 24 and 146. We observed a moderate increase of the transaminases in 3 patients which returned to normal at the end of treatment. We conclude that this new antibiotic, teicoplanin, is safe and effective in the treatment of skin and soft tissue infections. It can be administered once daily and is well tolerated even in long-term therapy.

Adult↗
PubMed1987

[Disseminated histoplasmosis due to Histoplasma capsulatum in a patient with acquired immunodeficiency syndrome (AIDS)].

Very commonly encountered in the United States, histoplasmosis is rare in Europe, where only 27 patients have so far been infected by this mycosis. In Africa, two varieties of histoplasmosis have been observed: those due to H. capsulatum and H. duboisii. Histoplasmosis due to H. capsulatum is one of the twelve secondary infectious diseases listed in the surveillance definitions of AIDS. This complication has been described only in approximately 20 patients with AIDS; all patients had stayed on the American Continents. We report the case of a 30-year-old African male who lived in Switzerland and in Zaïre. With AIDS and multiple Kaposi's sarcoma, the patient died from disseminated histoplasmosis due to H. capsulatum; a peripheral blood smear obtained a few hours before death revealed numerous typical yeast forms of H. capsulatum inside polymorphonuclear leukocytes. Post-mortem examination and cultures confirmed the diagnosis of disseminated histoplasmosis. Histoplasmosis should be suspected in AIDS patients even in Europe, especially where they have stayed in endemic areas. Examination of blood smears and bonemarrow aspirate may allow early recognition of the disease and permit appropriate treatment with amphotericin B and ketoconazole.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Roxithromycin (RU 28965), a new macrolide effective against pulmonary infections].

Roxithromycin, a new macrolide, has favorable pharmacological properties: it is acid stable and well absorbed, and its prolonged half-life allows b.i.d. prescription of 150 mg. In our open prospective study we found an etiologic infectious agent in 16 (80%) of 20 patients presenting with "atypical" pneumonia. Ten of the 16 pneumonias were due to an organism sensitive to roxithromycin (gram+ cocci, gram- rods, mycoplasma and chlamydia), and 6 to a virus. Therapeutic success was obtained in greater than or equal to 90%. The treatment was well tolerated with fewer gastrointestinal disorders than with erythromycin.

Adult↗
PubMed1986

[Cholera in Fribourg. Apropos a case].

A 41-year-old man from Cameroon was admitted to the Hospital of Fribourg (Switzerland) for watery diarrhea 3 months after cholera vaccination. Stool cultures were positive for Vibrio cholerae, biotype El Tor. Treatment consisted of rehydration (up to 9 litres per day) and correction of metabolic acidosis. No antibiotics were administered. The diagnosis of cholera should be considered in the presence of watery diarrhea in travellers or immigrants from countries suffering from the pandemic, even though, before this case, there had been no registered case for four years in Switzerland and none for twenty years in Fribourg.

Adult↗
PubMed1985

[Neurologic complications of Behçet's syndrome. Apropos of a clinical case].

The case is reported of a Swiss woman with neuro-Behçet. She displayed all major findings of this disease, e.g. oral and genital ulcers, chorioretinitis, dermatologic lesions and arthritis, as well as a severe neurological syndrome consisting of conjugated paralysis of the vertical gaze (Parinaud's syndrome) and disorientation. Lumbar puncture confirmed meningoencephalitis. The success of cortisone therapy in the treatment of neuro-Behçet, and the potential of colchicine for prevention of new attacks of the disease, are discussed.

Adult↗
PubMed1985

Pharmacokinetics of ceftriaxone and its relation to concentrations in extravascular compartments. Comparison with cefotaxime.

Two of the 3rd generation cephalosporins, ceftriaxone and cefotaxime, have an almost identical antibacterial spectrum, but completely different pharmacokinetics. After an intravenous dose of 1 g, peak levels of both cephalosporins were greater than or equal to 100 micrograms/ml. Cefotaxime levels fall rapidly with a T 1/2 of 1.1 h, whereas ceftriaxone persists for 24 h with an unique T 1/2 of 8 h. Cefotaxime is eliminated by the kidneys and metabolized to desacetyl-cefotaxime resulting in a high total clearance. In contrast, ceftriaxone is not metabolized and highly protein bound with a total clearance of only 14 ml/min. Peak concentrations of antibiotics are lower in extravascular compartments than in serum. They depend on the dose administered and the serum T 1/2; they are lower with highly bound drugs. Concentrations of ceftriaxone and cefotaxime were measured by Andrews and Wise in blister fluids, in ascites and pleural fluid by us. We found concentrations of 20-26 micrograms/ml ceftriaxone up to 12 h in ascites, but only 7-15 micrograms/ml cefotaxime. The levels persisted for 24 h for ceftriaxone, whereas they fell rapidly for cefotaxime. Because the minimum inhibition concentrations increase in the presence of proteins, and because free, unbound, microbiologically active ceftriaxone is lower than the measured total antibiotic concentrations, we suggest that 2-gram doses should be administered--at least at the beginning of the treatment of an infectious disease--and for prophylaxis.

Animals↗