Biomedical subjects
Publications and source records attributed to D Peyramond.
Two cases of Plasmodium falciparum malaria associated with bacterial infections--streptococcus A septicemia and Legionnaires' disease--are described. The association of these two infections is probably not incidental, and the hypothesis of Plasmodium falciparum induced immuno-deficiency is discussed.
We investigated the clinical efficiency and safety of ofloxacin, a new fluoroquinolone, for the treatment of various documented bacterial infections in 26 patients (10 females, 16 males) aged 17 to 84 years. Ofloxacin monotherapy was given orally in a dose of 200 mg twice (25) or three times (1) a day. Antibiotic levels and serum bactericidal activity were measured using a microbiological method on the second and sixth days, before and 2 and 6 hours after a single dose. The infectious episode treated was enterocolitis in 7 cases (5 Shigella, 2 Salmonella), Salmonella septicemia in 9 (7 typhoid fevers and 2 Salmonella minor infections), chronic osteoarthritis in 3 (1 E. coli, 2 S. aureus + P. aeruginosa), a soft tissue infection in 3 (2 S. aureus, 1 E. coli), acute pleuropneumonia in 2 (2 Klebsiella pneumoniae), pyelonephritis with bacteremia in 1 (Klebsiella pneumoniae), and pneumococcal pneumonia with septicemia in 1. Mean duration of therapy was ten days for 23 patients (range 7 to 30 days). The three patients with osteoarthritis were treated for 35, 95 and 270 days respectively. 24 patients recovered free of sequelae or germ carriage. Treatment failed in 1 case of chronic osteitis (S. aureus + P. aeruginosa) and in 1 staphylococcal soft tissue infection. No adverse reactions were observed except a slight increase in transaminases in 3 patients. Peak and through serum ofloxacin levels were 3.70 micrograms/ml and 0.95 micrograms/ml respectively on the second day and 3.25 micrograms/ml and 0.80 microgram/ml respectively on the sixth day.(ABSTRACT TRUNCATED AT 250 WORDS)
We studied the intrahepatic diffusion of ceftriaxone, a new third generation, very potent cephalosporin with a long serum half-life. Sixteen patients had percutaneous liver biopsy for suspected liver disease or protracted fever of unknown origin. Serum samples and liver biopsy specimens were taken simultaneously. Serial determinations of ceftriaxone concentrations showed that the hepatic half-life was significantly shorter than the serum half-life. We suggest that ceftriaxone be used in higher or more closely spaced doses for the treatment of liver infections.
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Hb Knossos (beta 27 (B9) Ala----Ser) is a recently discovered hemoglobin variant endowed with beta-thalassemic properties (1,2) We present the first homozygous cases. The propositus, a 19-year-old man is originally from northeast Algeria, but is unrelated to other Algerians who have hemoglobin Knossos. He has a beta(+)-thalassemia intermedia syndrome, including microcytic, hypochromic anemia, enlargement of the spleen, and an increase in the number of reticulocytes. The reduction of beta-chain synthesis is pronounced (alpha/non alpha:2.76). Whole cells containing Hb Knossos have a dramatically low oxygen affinity (P50:38 mm Hg). The propositus also has homozygous delta(0)-thalassemia. The chromosome carrying these mutations is characterized by the DNA haplotype I.
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The first case of oriental sore reported to Leishmania major is identified in Mali. The characterization of the stain isolated from a left arm lesion of a 30 years old european woman is carried out by electrophoretic analysis using enzymes, i.e. PGM, PGI, G-6-PDH, 6-PGDH, IDH, MDH, ME, GOT.
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Retrospective study of 14 cases of Staphylococcus aureus meningitis and of data from the literature shows that this as yet infrequent disease which carries a high mortality rate (40%) is always related to neurosurgery, primary or iatrogenic septicemia, or local infection, usually in the lumbar area (spinal, abscess, spondylitis). The major clinical problem is the search for the meningeal lead point of Staphylococcus aureus penetration, whose eradication is more essential than in usual bacterial meningitis. Prognosis is mainly dependent upon the eventual existence of associated severe septicemia. Antibiotics active on Peni-M resistant Staphylococcus aureus and meningeal infection are reviewed.
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Sixty minutes intravenous infusions of Acyclovir were given at 5 to 10 mg/kg 3 times daily for 6 to 11 days in 20 immunodeficient children with varicella (9 cases) and herpes zoster (11 cases) in a controlled open study. Twelve patients had a life-threatening illness. All patients who received therapy before the first 4 days had a more rapid cessation of new vesicles formation and more rapid scarring. Fourteen controlled children had accelerated clearance of viral antigens from vesicles. In 19 cases, virus was no longer isolated after the 3rd day. Eighteen patients recovered within 6 to 10 days. No relapse of varicella zoster virus infections had been observed 1 to 18 months after the end of treatment. Two children with varicellous interstitial pneumonia died 8 and 32 days after the end of treatment. In 3 cases, zoster pains reappeared 8 days after Acyclovir therapy was stopped. The drug was well-tolerated, but control of renal functions is necessary.
A case of viral hepatitis with hemolytic crisis is an Algerian boy presenting a G-6-P-D deficiency is reported. Hemolysis in G-6-P-D deficient individuals may be precipitated by some viral infection particularly viral hepatitis. During the course of this disease, the destruction of erythrocytes may be explained by an accumulation of metabolites capable of oxidizing hemoglobin SH groups, in the same way as a direct viral perturbation of the red cells glycolytic ways. The two mechanisms do not permit the normal reduction of oxidized hemoglobin. Though, these two diseases are very usual in some countries, this case in uncommon and must be well known.
Mechanism of aminoglycoside nephrotoxicity is yet unclear. Reduction of 20 p. cent of glomerular filtration initial value is observed in 10 p. cent of cases. Aminoglycoside nephrotoxicity appears to be related to high doses, to duration of treatment and also to individual factors such as age and preexisting renal impairment. No mean of predicting aminoglycoside nephrotoxicity without any error is available. Meanwhile, accurate measurement of glomerular filtration and of beta 2-microglobulin urinary elimination seems clinically more usefull for detection of impaired renal function than uneasy measurement of urinary enzyme excretion and than monitoring the aminoglycosides serum concentrations.
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A solid-phase reverse ImmunoSorbent Test (SPRIST) was developed for the detection of mumps-specific IgM in serum samples. This technique involves antibody attachment to a solid-phase using anti-human IgM followed by the addition of hemagglutinin and erythrocytes. In a retrospective study on 40 sera, total agreement was obtained between SPRIST and hemagglutination-inhibition after density gradient centrifugation of sera. Neither rheumatoid factor nor heterophil antibody seemed to affect the reaction. This preliminary study was fully confirmed when 2438 sera were prospectively examined; 84 sera yielding positive results originated from patients with clinical symptoms of mumps. SPRIST might offer an interesting alternative to routine detection of recent mumps infections.
We evaluated Acyclovir therapy in 16 immunodeficient children with varicella (7 cases) and zoster (9 cases) in a controlled open study. infections were serious in 12 patients. Each patient had daily clinical, biological and virological tests. Sixty minutes intra-venous infusions of Acyclovir were given three times a day (5 to 10 mg/kg/8 hours) for 6 ou 11 days. All patients who received therapy before the first four days, ahd a more rapid cessation of new vesicles formation and more rapid scaring, than those with delayed treatment. Ten controlled children had accelerated clearance of viral antigens from vesicles. In 15 cases, virus was not isolated after the third day. Two children with varicellous interstitial pneumonia died, 8 and 25 days after the end of treatment. Fourteen patients recovered in 8 to 10 days. No relapses of varicella-zoster virus infections had been observed 1 to 14 months after therapy. The drug was well-tolerated, but supervising of renal functions is necessary. Acyclovir had a good therapeutic efficacy to treat chickenpox and shingles in the immunocompromised patients.
Mechanism of aminoglycoside nephrotoxicity is yet unclear. Reduction of 20 p. cent of glomerular filtration initial value is observed in 10 p. cent of cases. Aminoglycoside nephrotoxicity appears to be related to high doses, to duration of treatment and also to individual factors such as age and preexisting renal impairment. No mean of predicting aminoglycoside nephrotoxicity without any error is available. Meanwhile, accurate measurement of glomerular filtration and of beta 2-microglobulin urinary elimination seems clinically more useful for detection of impaired renal function than uneasy measurement of urinary enzyme excretion and than monitoring the aminoglycosides serum concentrations.