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C Regamey

Publications and source records attributed to C Regamey.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Travelers' diarrhea].

More than 12 million international travellers contract diarrhea every year. Today more than 80% of the pathogenic agents can be found: virus (Rotavirus and virus of Norwalk), bacteria or parasites. Most of the aqueous diarrheas are due to E. coli secreting an enterotoxin which acts like the toxin of V. cholerae in stimulating adenylcyclase in the epithelial cells of the small intestine. This enterotoxin is bound to a plasmid and may be transferred to other enterobacteriaceae. In contrast, in the dysenteric form of diarrhea the bacteria penetrate into the mucosa and elicit inflammation and ulcers. The author's usual complementary examinations include methylene-blue coloration of the stool and testing for occult blood. Most traveller's diarrheas subside spontaneously. Treatment with a compound of clioquinol is more hazardous than useful. The antimotility agents are derivatives of opium and should not be given to patients with fever or the dysenteric form of diarrhea. Prophylaxis with a second generation tetracycline or the combination of sulfamethoxazole-trimethoprim may be justified.

Developing Countries↗
PubMed1983

[Factitious fevers as a cause of prolonged fevers. Apropos of 5 clinical cases].

Among the numerous causes of prolonged fever of unknown origin, the factitious fevers are frequently considered last after much diagnostic and therapeutic effort. Five observations of factitious fever are presented including 2 cases of thermometer manipulation in men aged 45 and 80. The latter patient is the oldest in whom such a case has been reported. In the first case the prolonged fever led to exploratory laparotomy with splenectomy followed by antilymphoma chemotherapy before the thermometer manipulation was discovered. This patient had previously been treated successfully for stage Ib Hodgkin lymphoma. In the other case hospitalization had lasted several weeks, and much antibiotic and steroid treatment had been administered, before the manipulation was suspected. A third case of thermometer manipulation was observed in a 57-year-old woman who had been presenting with factitious symptoms for over 10 years. Two other cases of factitious fever due to self-induced infections have been observed in two young women aged 23 and 27, both in paramedical professions. These self-induced infections led to polymicrobial bacteremia, exploratory laparotomy and hemicolectomy in one case, and to probable bacterial meningitis in the other. Certain aspects of these cases agree well with the diagnostic criteria of factitious fever described in the literature. We feel it is important to recognize this cause of febrile states, even if there is an apparent etiology, in order to avoid much vain investigation and prolonged hospitalization.

Adult↗
PubMed1983

Ceftazidime in severe infections: a Swiss multicentre study.

A total of 105 patients (mean age 57, range 15 to 90) with serious infections were treated with intravenous ceftazidime, usually 2 g 8-hourly. Most patients had complicating factors such as major surgery, cancer, chronic obstructive lung disease, catheters or anatomical abnormalities. Eighty-seven infectious episodes in 77 patients could be assessed for efficacy. Bacteraemia was diagnosed in 26% of these episodes. Seventy-five per cent of infections were due to Gram-negative bacteria, Pseudomonas aeruginosa being the most frequent. The major sites of infections were the lower respiratory tract (30), the urinary tract (28), the soft tissues (9), the biliary tract (4), bones (4) and the ears (4). Overall, 67% of the patients were cured, 20% improved, 7% relapsed and 6% failed to respond. Among the 27 infections due to Ps aeruginosa, only two failures (in the same patient) and four relapses were recorded. However, in the two failures and in three other cases with persistent Ps. aeruginosa colonisation, the organism had become resistant to ceftazidime. Three failures were recorded in the seven Staphylococcus aureus infections included in this study. Superinfection occurred in four patients. Adverse events included rash (6), Clostridium difficile toxin-induced diarrhoea (3), transaminase elevation (3), weakly positive Coombs test (10). Ceftazidime appears to be safe and effective for the treatment of severe Gram-negative infections, including those caused by Ps. aeruginosa.

Adolescent↗
PubMed1982

[Development and clinical evaluation of a new electronic device for measuring arterial pressure. Sphygmodigital 4000].

Sphygmodigital 4000 is a new automatic electronic device for measurement of the blood pressure (BP). The authors have tested it in their clinic for 6 months and compared the BP values obtained with those measured by the auscultatory method and intraarterially. The differences between the Sphygmodigital 4000 values and those measured by auscultation were -3.7 mm Hg for systolic BP (this error could be eliminated) and +0.2 mm Hg for diastolic BP. The results of comparison with intraarterially measured BPs were -1 mm Hg for systolic BP and +1 mm Hg for diastolic BP. This device is precise and also allows recording of beats.

Blood Pressure Determination↗
PubMed1978

[Acute epiglottitides in the adult].

Two adults were admitted to the University Hospital of Geneva with acute Haemophilus influenzae type b epiglottitis. The disease was characterized by rapid progression of sore throat, upper dysphagia, fever and dyspnea. Acute upper airway obstruction required emergency tracheotomy in both cases. The patients recovered under ampicillin therapy. All the 100 cases from the literature for which clinical data were available have been analyzed:--Epiglottitis in adult is not exceptional.--Haemophilus influenzae type b is the most common infective organism documented, and was found in all positive blood cultures but one.--The typical presentation is severe sore throat, with upper dysphagia, fever and dyspnea.--Clinical course is rapid and serious, and acute respiratory distress develops in 57% of cases; overall mortality is 27%.--Emergency routine tracheotomy appears to be the most reliable treatment.

Epiglottis↗
PubMed1977

Microbiological relevance and clinical potential of ampicillin-cloxacillin synergism.

Recent demonstration "in vitro" that combinations of ampicillin and cloxacillin, using concentrations at which neither were previously effective, will kill certain resistant Gram negative bacteria, has important clinical potential. We therefore studied 50 ampicillin resistant Gram negative rods cultured from septicemic patients for synergism. 7 of 23 E. coli strains with a minimal bactericidal concentration (MBC) of 128 microgram/ml were killed by combinations containing 4-32 microgram/ml ampicillin and 16-32 microgram/ml cloxacillin. These same strains were also resistant to cephalothin. Synergism was also noted in 1/4 strains of Enterobacter, 1/3 strains of Serratia, 5/14 strains of Klebsiella and 1/6 strains of Pseudomonas. In separate experiments ampicillin (56 mg/kg) and cloxacillin (14 mg/kg) was administered intravenously over a period of thirty minutes. Peak serum levels measured simultaneously at the end of the infusion were 235 +/- 11 (SEM) microgram/ml for ampicillin and 85 +/- 7 microgram/ml for cloxacillin. Levels of ampicillin/cloxacillin measured one and two hours after the infusion were 117/32 and 43/8 microgram/ml. T 1/2 of ampicillin and cloxacillin were 0.8 and 0.5 h respectively. Since the serum concentrations of both antibiotics measured one hour after the infusion were greater that levels required for "in vitro" synergism, we suggest that combinations of ampicillin and cloxacillin would be of importance in the treatment of Gram negative septicemia, since such therapy would increase the bactericidal effect of the sera without increasing the risk of toxic side effects.

Ampicillin↗
PubMed1976

Persistence of sisomicin and gentamicin in renal cortex and medulla compared with other organs and serum of rats.

Aminoglycoside antibiotics seem to accumulate and persist in the kidney. For a better understanding of this problem, groups of six rats received a single 4 mg/kg i.p. injection of sisomicin and were sacrificed repeatedly from 30 min to 28 days later. Sisomicin concentrations (bioassay) decreased rapidly in the serum, lung and other tissues. There was only a trace at six hours. The situation was totally different for the kidney. Concentrations in the cortex increased up to six hours with a maximum of 99 mug/g, 11 times higher than the peak value in the serum then decreased very slowly to 56, 18, and 7 mug/g, 2, 14 and 28 days, respecitvely, after injection. The concentrations in the medulla were lower than in the cortex but also showed an accumulation and persistence. Similar results were observed with gentamicin. In another experiment, daily injections of sisomicin or gentamicin during seven days demonstrated that the concentrations of both antibiotics six hours after the last injection were nearly three times higher in the cortex and twice as high in the medulla than after a single injection. These data explain why the nephrotoxicity of sisomicin or gentamicin involves chiefly the cortex, increases with the length of the treatment and can persist for several weeks after the last injection. Therapeutic implications need further studies.

Animals↗
PubMed1976

Clinical pharmacology of amikacin and kanamycin.

During and after a 4-hr intravenous infusion of amikacin and kanamycin in a cross-over study in healthy adult male volunteers, average concentrations of drug in serum were similar, with half-lives of approximately 2 hr. Apparent volumes of distribution at the steady state averaged 30% of body weight, and the rate of renal clearance was less than the rate of creatinine clearance (83 vs. 120 ml/min), a finding that indicates tubular reabsorption. The rate of serum clearance was greater than the rate of renal clearance (100 vs 83 ml/min). Urinary excretion in 24 hr averaged 94% of the dose, and there was no binding of serum proteins. In another cross-over study, volunteers received single intramuscular injections of these antibiotics. Peak concentrations of drug in serum after 45 min to 2 hr averaged 19.9 and 19.0 mug/ml for amikacin and kanamycin, respectively. Serum half-lives between 4 and 8 hr after administration of drug were 2 hr, and an average of 94% of the dose was recovered in the urine in 24 hr. Thus, the pharmacologic properties of amikacin and kanamycin were virtually identical.

Adult↗
PubMed1975

Inactivation of cefazolin, cephaloridine, and cephalothin by methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus.

Cefazolin was more susceptible than cephaloridine and cephalothin to in vitro inactivation by coagulase-positive, penicillinase-producing strains of Staphylococcus aureus. Inactivation (which was greater with methicillin-resistant than with methicillin-sensitive strains) was demonstrated by assay of the antibiotics in broth cultures with simultaneous colony counts and by exposure of the antibiotics to penicillinase powders extracted from S. aureus. Cefazolin was destroyed to a greater extent than was cephaloridine, whereas cephalothin underwent little, if any, destruction. The clinical implications of this degradation, thought by some to be of importance for cephaloridine, might also apply to cefazolin.

Cefazolin↗
PubMed1975

[Cephalosporins from the clinical viewpoint].

Cephalosporines are discussed as viewed by the clinician. For the clinician it is difficult to choose among the offer of manifold preparations the most promising. Antibacterial activity, pharmacologial properties and possible side-effects are shown and discussed in all Cephalosporines to make the clinic's choice easier.

Administration, Oral↗