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E Bernard

Publications and source records attributed to E Bernard.

At least 73 records · Page 4Linked to original sources
PubMed1994

Effect of hyaluronan on the elastase-type activity of human skin fibroblasts.

The influence of hyaluronan (HA) on the expression of human skin fibroblast elastase-type protease (HSFEp) (Homsy et al, 1988) was studied. At confluency of HSF cultures, hyaluronan increased the level of HSFEp in a time and dose-dependent fashion. Optimal effect was observed after 48 h of culture and at 2 mg/ml HA concentration; the stimulatory effect of HA could be suppressed by 1 microM cycloheximide. The enhancement of enzyme biosynthesis by HA was dependent on cell proliferation but quasi invariant with HSF passage number (from 7-21).

Cell Division↗
PubMed1994

Guillain-Barré syndrome associated with acute Q fever.

Several bacterial and viral agents have been implicated in the pathogenesis of the Guillain-Barré syndrome, an acquired immune-mediated disorder. A case of Guillain-Barré syndrome associated with acute Q fever is described. Coxiella burnetii should therefore be added to the list of microorganisms capable of inducing the Guillain-Barré syndrome.

Adult↗
PubMed1994

Possible prevention of in vitro selection of resistant Streptococcus pneumoniae by beta-lactamase inhibitors.

The development of resistance in vitro in five strains of Streptococcus pneumoniae (3 with full susceptibility and 2 with intermediate susceptibility to penicillin) was investigated by serial passages in the presence of subinhibitory concentrations of amoxicillin and ampicillin. At the end of passaging, MICs of antibiotics for all the strains increased by a factor of four or more, reaching at least intermediate levels. MICs of cephalosporins, ampicillin and amoxicillin increased for almost all variants obtained. Similar results were obtained with amoxicillin plus clavulanic acid at a ratio of 2:1 and at a constant concentration of 2 micrograms/ml, and with ampicillin plus sulbactam at a ratio 2:1. In contrast, no significant modification of MIC was seen with ampicillin plus sulbactam at a constant concentration of 4 micrograms/ml sulbactam. These results suggest interaction of sulbactam with penicillin binding proteins as described previously for other bacterial species, and merit further investigation.

Amoxicillin↗
PubMed1994

Pharmacokinetics and suction blister fluid penetration of a semisynthetic injectable streptogramin RP 59500 (RP 57669/ RP 54476).

RP 59500 is a new semisynthetic injectable streptogramin with excellent activity against most gram-positive bacteria. In order to assess its potential for the treatment of tissue infections, the pharmacokinetics and penetration into suction blister fluid were studied in a pilot phase I study in six male volunteers following a single infusion of 12 mg/kg over 1 h. Plasma and suction blister fluid concentrations were determined by microbiological assay. The mean peak concentration in plasma was 8.65 mg/l at the end of infusion. The mean plasma elimination half-life was 1.48 h. The mean peak concentration in interstitial fluid was 2.41 mg/l and was reached after 1 h in two volunteers and after 2 h in the other four. The mean percentage penetration for the interval 0-6 h was 82.5%. RP 59500 was still detectable in interstitial fluid at 6 h at a mean concentration of 0.92 +/- 0.25 mg/l. The data of this pilot study demonstrate good penetration of RP 59500 into non-inflammatory interstitial fluid.

Adult↗
PubMed1994

Risk factors associated with malnutrition in rural Jamaica.

Risk factors associated with malnutrition were examined in rural Jamaica. Socioeconomic data were obtained on 63 well-nourished and 14 malnourished children. Risk factors associated with malnutrition were birth weight less than 2.5 kg (P < 0.01), maternal age equal to or greater than 25 years (P < 0.05) and landlessness (P < 0.05). Interventions aimed at reducing these factors can go a long way in reducing the malnutrition problem in developing countries.

Child, Preschool↗
PubMed1994

Intestinal and extraintestinal Isospora belli infection in an AIDS patient. A second case report.

A 30-year-old black female, from Burkina Faso, had AIDS in 1990. She died in March 1993 following a cachexia secondary to a chronic intestinal isosporiasis. The autopsy revealed a massive parasitic infection by I. belli of the small intestine mesenteric and mediastinal lymph nodes and liver and spleen. The parasite stage observed in extra intestinal sites corresponded to unizoite tissue cysts. This is the first report of I. belli infection in liver and spleen.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Antibiotic prophylaxis in colorectal surgery].

In elective colorectal surgery, the benefit of preoperative antibiotic prophylaxis is well established, with a reduction in wound infection rate to less than 10%. The antimicrobial agent used has to be active against aerobic and anaerobic pathogens such as Escheria coli and Bacteriodes fragilis. The efficacy of three schemes of administration: oral and/or parenteral prophylaxis associated with a mechanical preparation, has been demonstrated. Oral antibiotic administration is current practice in USA; the most widely used oral regimen is the combination of erythromycin and neomycin given the day before surgery. Parenteral prophylaxis with a cephalosporin active against Bacteriodes fragilis such as cefoxitin and cefotetan, is preferred in Europe. The issue of whether a systemic prophylaxis should be added to the oral regimen or not has not yet been resolved. However it seems that the association should be proposed in various situations: patients with a high risk factors score (rectal resection and operations lasting more than three hours), patients with incomplete mechanical preparation, delay of the onset of surgery after the last oral dose.

Anti-Bacterial Agents↗
PubMed1993

Pathological features of intestinal microsporidiosis in HIV positive patients. A report of 13 new cases.

Enterocytozoon bieneusi is a microsporidian parasite found only in the enterocytes of the small bowel of HIV positive patients, producing chronic diarrhea and malabsorption. Since January 1990, we have seen the 13 first Mediterranean cases, diagnosed on duodenal pinch biopsy samples. Diarrhea was the major symptom in all instances, and E. bieneusi was the sole identified pathogen in 6 cases. The diagnosis was made on HES or Giemsa-stained paraffin sections and on Giemsa-stained smears (9 cases). In 3 cases, the parasite was also found on ileal biopsies, but was never encountered in the colonic mucosa. In all patients, transmission electron microscopy of the duodenal mucosa was used, and it confirmed the diagnosis of intestinal microsporidiosis. No instance with negative optic examination had evidence of an infection by E. bieneusi with electron microscopy. Due to the small size of the spores, routine fecal parasitological diagnosis is still a difficult procedure, but it is possible that greater experience may avoid many of today's invasive investigations. Cytologic and histologic routine examination of paraffin sections of the distal duodenal or ileal mucosae is a reliable method to diagnose intestinal microsporidiosis in HIV-positive patients with diarrhea.

Animals↗
PubMed1993

Extracerebral toxoplasmosis in the acquired immunodeficiency syndrome (AIDS).

Although Toxoplasma gondii frequently causes lesions of the central nervous system in AIDS, the exact incidence of extracerebral toxoplasmosis in these immunodepressed patients remains difficult to determine. Isolation of the parasite outside the central nervous system is rarely performed ante mortem, and most diagnoses of extracerebral toxoplasmosis are made post mortem. This article describes 23 cases of extracerebral toxoplasmosis diagnosed between 1987 and 1991 in an autopsy series of 170 patients infected with the human immunodeficiency virus (HIV). Ante mortem diagnosis of extracerebral involvement was affirmed in 4 of these 23 patients by identification of trophozoites in bronchoalveolar lavage fluid (2 cases), a surgical pulmonary biopsy specimen, and a bladder biopsy. Clinical and paraclinical findings suggested cardiac involvement in 4 other patients. Post mortem examination demonstrated disseminated toxoplasmosis in 18 cases and extracerebral monovisceral involvement in 5 cases. Extracerebral toxoplasmosis was directly responsible for the death of 6 patients. The most frequent extracerebral sites of Toxoplasma gondii involvement were the heart (21/23 cases; 91%), the lungs (14/23 cases; 61%) and the pancreas (6/23 cases; 26%). The tissular consequences of toxoplasmic involvement varied considerably, from formation of pseudocysts or cysts without any surrounding inflammatory reaction to necrotic lesions rich in neutrophilic polynuclear cells containing numerous free parasites. Immunoperoxidase study using antitoxoplasmic antibodies contributed to the diagnosis of 8 extracerebral localizations. Electron microscopy examination of a surgical lung biopsy and myocardial specimens (2 cases) demonstrated the ultrastructural characteristics of Toxoplasma gondii trophozoites.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1993

Cutaneous spindle-cell pseudotumors due to Mycobacterium gordonae and Leishmania infantum. An immunophenotypic study.

We report two patients with AIDS who had cutaneous spindle-cell pseudotumors caused by Leishmania infantum in one instance and by an atypical mycobacterium in the other. The lesions mimicked neoplasms with predominantly spindled macrophages, similar to those seen in the histoid variant of leprosy. This histoid reaction is known to be related to mycobacteria. To our knowledge, this is the first case of histoid reaction due to leishmania. In both cases, the histiocytic cells were positive for vimentin and desmin but negative for alpha-smooth muscle. In addition, the immunostaining by lysosyme and alpha 1 antitrypsin was positive in both and in one the S-100 protein was positive. This reaction suggests dual myofibroblast and histiocytic differentiation.

Adult↗
PubMed1993

Effects of subinhibitory concentrations of vancomycin and teicoplanin on adherence of staphylococci to tissue culture plates.

Bacterial adhesion is the first step in infection of medical devices. Staphylococcus aureus and Staphylococcus epidermidis are the pathogens recovered most often. The effects of subinhibitory concentrations of vancomycin and teicoplanin on the adherence of eight clinical strains of S. aureus and eight strains of S. epidermidis to tissue culture plates in vitro were tested. The mean relative inhibitions of adherence at one-fourth and one-eighth the MIC were statistically different for teicoplanin and vancomycin. Slime production seemed not to be involved in adherence.

Bacterial Adhesion↗
PubMed1993

Fluoroquinolones and surgical prophylaxis.

The objective of surgical prophylaxis is to prevent wound infections associated with surgery. The rates of wound infections vary according to the procedure: less than 3 infections per 100 for clean procedures; up to 4 per 100 for clean-contaminated procedures; and up to 9 per 100 for contaminated procedures. Surgical antimicrobial prophylaxis has been shown in many randomised clinical trials to reduce the incidence of postoperative wound infections. Such prophylaxis is actually recommended in many clean-contaminated and some clean procedures. Because of their antimicrobial, pharmacokinetic, and antiadhesive properties, the fluoroquinolones have been recently proposed as prophylactic agents. Fluoroquinolones have proved to be useful in surgical prophylaxis and clinical trials have been performed in orthopaedic, cardiovascular, biliary, colorectal and urological surgery. According to the surgical procedure, fluoroquinolones were compared either with the standard antimicrobial regimen or with placebo. Different regimens of fluoroquinolones were also compared. Generally, fluoroquinolones have been demonstrated to be as effective as the reference prophylactic agent. In transurethral surgery, fewer postoperative wound infections were reported in the treated group than in the placebo group. In most studies, single dose prophylaxis was as effective as a multiple dose regimen. It is important to note that strict methodology was limited to a few clinical trials. In most of the studies, patients were not randomised in a double-blind fashion and small patient numbers often prevented the formation of satisfactory conclusions. Further trials are needed to define the role of the fluoroquinolones in surgical prophylaxis. It will be important to evaluate not only the efficacy but also the cost-benefit of perioperative prophylaxis with the fluoroquinolones. Clinical trials are also required in other high risk clean procedures such as neurosurgery involving shunts and ocular surgery. However, the risks related to the extensive use of fluoroquinolones in surgical prophylaxis must be considered, including the development and dissemination of resistant pathogens and the occurrence of adverse effects. In the future, surgical prophylaxis with prosthetic devices coated with fluoroquinolones should be considered.

Anti-Infective Agents↗
PubMed1993

[Visceral leishmaniasis resistant to conventional treatments: value of amphotericin B].

The reference treatment in visceral leishmaniasis is administration of antimonial compounds (Pentostam, Glucantime). Primary and secondary failures have been reported and may involve several mechanisms resulting in alterations in the T-cell-dependent response, particularly in HIV-positive patients. Alternative agents proposed for use as single-drug therapy or in combination with other drugs include Lomidine, which carries a high risk of toxicity, allopurinol, cytokines (IL-2 and interferon gamma), and amphotericin B. Amphotericin B, in addition to effects on the metabolism of sterols in the wall of the protozoan, induces macrophage activation. This article illustrates the difficulty of treatment of visceral leishmaniasis by reporting the case of an immunocompetent 36-year-old patient whose bone marrow cultures remained positive after successive treatment, over 48 months, with two courses of Glucantime (60 mg/kg/day for 15 days), one course of allopurinol (10 mg/kg/4 weeks), two courses of Glucantime in combination with interferon gamma, splenectomy, and one course of Pentostam (20 mg/kg/4 weeks). Bone marrow cultures became negative after administration of amphotericin B (1 mg/kg every 48 hours for 8 weeks). Cytokine studies disclosed defective production of IL-2, IL-1 beta, and IFN gamma. Amphotericin B seems to be a valuable alternative when conventional treatment fails. The liposomal form is especially promising.

Adult↗
PubMed1993

[Cytological study of the duodenal mucosa during chronic diarrhea in HIV-positive patients].

The cytologic findings of duodenal smears in diarrheic HIV-positive patients were compared with results of histologic and ultrastructural studies. This study included 50 diarrheic patients undergoing upper gastrointestinal endoscopy. Duodenal biopsies were taken with touch preparations. Smears were stained with Giemsa and then with Ziehl-Neelsen or the PAS method. The biopsy specimens were then processed in a standard fashion for histologic and electron microscopy examination. Cytologic findings included 8 cases of intestinal microsporidiosis, 4 cases of cryptosporidiosis, and 3 cases of atypical mycobacteriosis. Histologic and ultrastructural studies confirmed these diagnoses and showed 8 cases of CMV enteritis, of which 4 were associated with other enteric pathogens. Duodenal cytology complements endoscopic biopsy in the work-up of diarrhea in AIDS patients and may provide a rapid diagnosis especially in the case of intestinal protozoonosis or atypical intestinal mycobacteriosis.

AIDS-Related Opportunistic Infections↗
PubMed1993

Pharmacokinetic and bacteriological study of cefadroxil-salicylate and josamycin-salicylate drug regimens.

Eye, nose, throat and bronchopulmonary infections are frequently associated with inflammatory symptoms. This often leads the clinician to prescribe a combination of an anti-inflammatory and an antibiotic. Cefadroxil and josamycin are among the antibiotics most frequently used in these infections, and they are often combined with acetylsalicylic acid in various pharmaceutical formulations. The study of possible pharmacokinetic and bacteriological interactions was performed in healthy volunteers who received in a crossover protocol each of the two antibiotics, either alone or combined with acetylsalicylic acid or lysine acetylsalicylate. No marked pharmacokinetic interaction was noted except an increase in the AUC for plasma concentrations of cefadroxil when combined with a salicylate. A greater uniformity of kinetic profiles was seen with cefadroxil than with josamycin. Lastly, with the exception of one strain, the salicylates did not alter the antibacterial activity of cefadroxil.

Adult↗
PubMed1992

Application of DNA amplification to pneumocystosis: presence of serum Pneumocystis carinii DNA during human and experimentally induced Pneumocystis carinii pneumonia.

Pneumocystis carinii pneumonia is a leading cause of morbidity and mortality in patients with the acquired immunodeficiency syndrome (AIDS). Much remains unknown about the basic biology of P. carinii and studies of this infection have been hampered by the lack of cultivation methods. We developed a sensitive and specific assay for P. carinii by utilizing DNA amplification of the P. carinii dihydrofolate reductase (DHFR) gene. By this method, P. carinii DNA was detected in the lungs of rats with experimentally induced P. carinii pneumonia 2 wk before the onset of histopathological changes. DNA amplification analysis of serum demonstrated that by 10 wk of corticosteroid treatment, 12 of 12 (100%) infected rats had circulating DHFR DNA. P. carinii DHFR DNA also was detected in the serum of patients with AIDS and active P. carinii pneumonia (12 of 14 sera collected prospectively). Patients with advanced AIDS but without a history of P. carinii pneumonia were negative by this assay (0 of 6 sera examined). Serum polymerase chain reaction may facilitate investigations into the natural history and epidemiology of P. carinii infection, provide insight into the pathogenesis of parasite dissemination, and offer a useful, noninvasive diagnostic test for the detection of human pneumocystosis.

Acquired Immunodeficiency Syndrome↗