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D Salmon-Ceron

Publications and source records attributed to D Salmon-Ceron.

At least 19 recordsLinked to original sources
PubMed2005

Short peripheral venous catheters: effect of evidence-based guidelines on insertion, maintenance and outcomes in a university hospital.

This study was designed to evaluate the impact of hospital-wide guidelines for short peripheral venous catheters (SPVC) insertion on the frequency of local catheter-related complications. In a 1051-bed Parisian university hospital, two observational, point prevalence surveys were undertaken in 1996 and in 1998, separated by implementation of written guidelines for SPVC insertion. The outcomes of SPVC insertion were defined as the presence or absence of local catheter-related complications (erythema, purulence around the insertion point, tenderness or induration along the cannulated vein). The proportion of polyurethane catheter materials used (56% vs. 81%, P<0.001), correct and sterile fixation (80% vs. 92%, P<0.05), non-movable catheters (92% vs. 98%, P=0.03) and insertion record (58% vs. 76%, P<0.01) increased between 1996 and 1998. The frequency of local catheter-related complications decreased (15% vs. 4%, P<0.01). Age >73 years [odds ratio (OR) 6.0, 95% confidence interval (CI) 1.28-28.05] was positively associated with local catheter-related complications, whereas duration of insertion (until 72 h) (OR 0.29, 95% CI 0.09-0.89) and the implementation of guidelines (OR 0.26, 95% CI 0.09-0.67) were negatively associated with local catheter-related complications. The implementation of guidelines was independently negatively associated with local catheter-related complications (OR 0.31, 95% CI 0.09-0.97). The results suggest that hospital guidelines for SPVC insertion can improve catheter care and significantly reduce local catheter-related complications.

Adolescent↗
PubMed2004

Health-related quality of life and patient-provider relationships in HIV-infected patients during the first three years after starting PI-containing antiretroviral treatment.

The aim of this study was to investigate factors associated with better health-related quality of life (HRQL) during the first three years after starting PI-containing antiretroviral treatment. Clinical, social and behavioural data from the APROCO cohort enabled us to analyze simultaneously the association between HRQL and patients' relationships with their health care providers. A self-administered questionnaire collected information about HRQL (MOS-SF36) and relationships with medical staff (trust and satisfaction with information). Two aggregate scores, the physical (PCS) and mental (MCS) component summaries (adjusted for baseline HRQL), were used as dependent variables in the linear regressions to identify factors associated with HRQL. We had complete longitudinal data for 360 of the 611 patients followed through M36. Factors independently associated with a high MCS were (male) gender, no more than one change in treatment, (few) self-reported symptoms and trust in the physician. Factors independently associated with high PCS levels were employment, no children, (few) self-reported symptoms and satisfaction with the information and explanations provided by the medical staff. These results underline the need to improve patient-provider relationships to optimize long-term HRQL. Socio-behavioural interventions should focus on this goal.

Antiretroviral Therapy, Highly Active↗
PubMed2001

Cytomegalovirus infection: the point in 2001.

The incidence of cytomegalovirus (CMV) disease, one of the most prevalent opportunistic infections in HIV-infected persons in the early 1990s, has decreased by more than 80% since the introduction of highly active antiretroviral therapy (HAART). The rare cases of CMV disease still observed in Western countries occur mainly in profoundly immunosuppressed patients who have failed to respond to HAART. A new finding is the occasional occurrence of inflammatory retinitis in some patients on HAART with a history of healed retinitis. New tools for CMV detection have become available recently, including use of polymerase chain reaction (PCR) to detect CMV DNA from plasma. It has been possible to redefine, in the HAART period, patients at risk for CMV disease as those who have a low CD4 cell count as well as a blood marker of CMV blood dissemination (plasma CMV DNAaemia or high pp65 antigenaemia). Besides the classical therapeutic approach using ganciclovir (GCV), foscarnet and cidofovir, development of valganciclovir (VGCV), an orally administered prodrug of GCV, appears promising. There is evidence to suggest that it is as effective as intravenous GCV for the treatment of CMV retinitis, and it is currently being studied as a pre-emptive therapy in patients at high risk for CMV disease. Finally, patients with inactive CMV retinitis receiving HAART and with stable immune reconstitution may be able to discontinue maintenance therapy provided a regular ophthalmological and virological surveillance is maintained.

AIDS-Related Opportunistic Infections↗
PubMed2001

Multidrug-resistant bacteria infection control: study of compliance with isolation precautions in a Paris university hospital.

Isolation practices in a university hospital were analyzed for 137 patients with multidrug-resistant bacteria. Isolation was ordered in writing by physicians for 40% and instituted by nurses for 60%; 74% were isolated. Compliance depended on physician ordering in writing (odds ratio, 36.3; 95% confidence interval, 4.8-274.9). Nurses complied best with hand washing.

Cross Infection↗
PubMed2001

Immunoglobulin G (IgG) and IgA, but also nonantibody factors, account for in vitro neutralization of human immunodeficiency virus (HIV) type 1 primary isolates by serum and plasma of HIV-infected patients.

The factors present in serum and plasma samples of human immunodeficiency virus (HIV)-infected patients that are responsible for the neutralization of four HIV type 1 (HIV-1) primary isolates in vitro have been analyzed. Purification of immunoglobulins (Ig) by affinity chromatography showed that the activities were mostly attributable to IgG and less frequently to IgA. For two samples, we have shown that the high-level and broad-spectrum inhibitory activity was essentially caused by non-Ig factors interfering with the measurement of antibody-specific neutralizing activity.

HIV Antibodies↗
PubMed1998

[Prevalence and incidence of cytomegalovirus infection in patients infected with HIV-1. SEROCO group].

OBJECTIVES: To study prevalence of the cytomegalovirus (CMV) infection as well as incidence of the CMV seroconversions in HIV-infected subjects enrolled in the French multicentric cohort SEROCO. METHOD: Prevalence of CMV infection at inclusion in the cohort was estimated from 1504 HIV-infected subjects. Incidence of the CMV seroconversion was estimated from 184 subjects CMV seronegative at inclusion. Cox model was used to identify independent factors related to CMV seroconversion. RESULTS: CMV prevalence was high (87.2%) mainly in homosexual men. The incidence of the CMV seroconversions was also high (9, 18/100 person-years), particularly in homosexual men, in subjects declaring sexual intercourse with occasional partner, and in those declaring a sexually transmitted disease during the follow-up. CONCLUSION: The risk to develop serious disease related to CMV in subjects with AIDS being particularly high when the CMV primary infection occurs during the course of the HIV infection, the prevention of CMV primary infections is thus a major element in the counselling of HIV-infected subjects.

AIDS-Related Opportunistic Infections↗
PubMed1998

Incidence and sexual risk factors of cytomegalovirus seroconversion in HIV-infected subjects. The SEROCO Study Group.

BACKGROUND: Data on incidence of cytomegalovirus (CMV) seroconversion in HIV-infected (HIV(+)) subjects was sparse. GOAL: To determine the incidence of CMV seroconversion in sexually active HIV(+) subjects and sexual factors associated with CMV seroconversion. STUDY DESIGN: One hundred eighty four persons not infected by CMV at enrollment in a cohort of HIV(+) persons were studied. A case-control study within the cohort was conducted to determine the effect of sexual behavior in the 6 months prior to CMV seroconversion. Thirty seven cases of CMV seroconversion were compared with 136 controls. RESULTS: The overall incidence of CMV seroconversion was 9.18 per 100 person-years (95% confidence interval (CI), 6.67-12.28) and was particularly high among homosexual men. After adjustment for age, socio-professional category, sexual orientation, and casual sex, the risk of CMV seroconversion was higher in subjects who never used condoms than in those who used them systematically (adjusted odds ratio (OR) 3.37;95% CI, 1.05-11.00). CONCLUSIONS: In addition to the need to protect their sexual partners from HIV infection, HIV(+) subjects free of CMV infection should use condoms to avoid CMV infection and its complications.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Acyclovir-resistance zona in a immunocompromised HIV seronegative patient].

INTRODUCTION: Resistance to antiviral therapy is getting actually more frequent. Immunocompromised host are more concerned with this problem. OBSERVATION: We present a case of disseminated zoster resisting to acyclovir (ACV) therapy, but healing with foscarnet in a man treated with chemotherapy for lymphoma and seronegative for HIV. CI50 of VZV strain was 48 microM for ACV, which was 2.8 times higher than value of the reference OKA strain tested simultaneously, which confirmed the resistance for ACV. DISCUSSION: Immunocompromised patients often present varicella zoster virus (VZV) infection. They usually heal in response to ACV therapy, but some HIV infected patients have already presented with resistant strains of VZV. This case is the first described in a non-HIV infected patient. Foscarnet therapy resulted twice in complete healing because of its direct activity on viral DNA polymerase, so it is efficaceous therapy for patients with thymidine-kinase-deficient ACV-resistant VZV infection.

Acyclovir↗
PubMed1998

[Vaccinations].

Explore the source record for details and available documents.

Adult↗
PubMed1997

[Search for a HIV vaccine].

A DIFFICULT SITUATION FOR A VACCINE: The human immunodeficiency virus has an exceptional capacity to mutate and macrophage reservoirs where it is harbored after penetration are highly inaccessible to antibodies. Use of a live vaccine would increase the risk of recurrent virulence and integration into the genome. UNKNOWN IMMUNOLOGY: Induction of cytotoxic cells appears to be essential, but investigations into this type of response are not well standardized and not easily quantifiable. Neutralizing antibodies would have a protective effect, but facilitating antibodies would have the opposite effect. SEVERAL POSSIBILITIES UNDER STUDY: These vaccine use live attenuated viruses with a more or less deleted genome, recombinant live viruses constructed from other viruses or bacteria, pseudo-particles, or recombinant proteins as well as vaccines synthetized from peptides or lipopeptides. An association of different vaccines would appear to be the best solution as live vectors usually induce cytotoxic cells while proteins or peptides induce production of neutralizing antibodies. RESPONSE TO VACCINES IS USUALLY WEAK: Both in animal models and in human volunteers, immune responses obtained to date have been quite variable and of short duration. Canarypox type recombinant vaccines followed by recombinant protein vaccines appear to give the best results at the present time. SEVERAL PROBLEMS: Anti-HIV vaccination protocols raise major ethical problems for the participating volunteers (ELISA test becomes positive, lack personal protection) and for the population involved in phase II/III trials. In addition, the virus rapidly penetrates via the mucosa without yielding sufficient mucosal immune response.

AIDS Vaccines↗
PubMed1997

Sexual factors associated with cytomegalovirus seropositivity in human immunodeficiency virus-infected men. The Seroco Study Group.

BACKGROUND: Many people infected by human immunodeficiency virus (HIV) acquire severe cytomegalovirus (CMV) diseases. Factors associated with CMV seropositivity are poorly documented in sexually active HIV-infected men. GOAL: To study CMV seroprevalence in HIV-infected men according to sexual behavior before the diagnosis of HIV seropositivity. STUDY DESIGN: Cross-sectional study. CMV seroprevalence was studied at enrollment in a prospective cohort of homosexual and heterosexual men infected by HIV through sexual contact. RESULTS: In the study population (n = 723), age, sexual preference, previous lifetime history of sexually transmitted diseases, and multiple sexual partners were independently related to CMV seropositivity. Furthermore, routine condom use during the 6 months before diagnosis of HIV seropositivity was significantly related to CMV seropositivity (adjusted odds ratio [OR]: 0.4, 95% confidence interval [CI]: 0.1-1.0), occasional condom use being of borderline significance [adjusted OR: 0.5, CI: 0.2-1.3]. CONCLUSIONS: This study confirms the importance of sexual factors in the acquisition of CMV infection by HIV-infected men and suggests a protective effect of condom use.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Characteristics of rapid progressors in HIV infection].

Approximately 10% of HIV-infected patients, the rapid progressors, progress to AIDS within the first 2 to 3 years of HIV infection. Their biological characteristics are not clearly known. They have a particular phenotype (DR) of major histocompatibility complex class-II. Anti-HIV antibodies are not neutralizing and may even be facilitators in vitro. Progressors CTL responses are also defective and the production of the cytokines, specially the chemokines RANTES, MIP-1 alpha et MIP-1 beta which may have a role in inhibition of cellular infection by HIV, is impaired. In addition, the rapid progressors have high levels of inflammatory markers which suppose a chronic activation of the immune system. The virological findings are more inconsistent. A uniform finding is a high viral load that does not fall dramatically after primary HIV infection. Some rapid progressors may be infected with more rapidly replicating, virulent HIV strains. However, the question regarding the homogeneity or the other characteristics of viral load remains to be resolved.

Antibody Formation↗