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Biomedical subjects

F Vachon

Publications and source records attributed to F Vachon.

At least 55 records · Page 3Linked to original sources

Resting energy expenditure is increased in stable, malnourished HIV-infected patients.

Resting energy expenditure (REE) was measured by reference to body composition in 50 malnourished patients with human immunodeficiency virus (HIV) infection and compared with that of 14 healthy subjects. Among HIV patients, 40 had acquired immune deficiency syndrome (AIDS) and 10 had AIDS-related complex (ARC). All were in stable condition and had a previous history of progressive wasting, ie, a mean body weight loss of 14.2 +/- 8.1 kg over 16.6 mo (range 2-49 ms). The mean REE was 14% higher than estimated basal energy expenditure (EBEE), according to the Harris and Benedict formula. Thirty-four patients (68%) were classified as hypermetabolic (REE greater than 110% EBEE). The best predictable variable for REE was fat-free mass (FFM), as determined by an anthropometric method (r = 0.72; P less than 0.001). The mean REE was 12% higher in HIV patients than in the control group FFM (156 +/- 19 vs 124 +/- 17 kJ.kg FFM-1.d-1). We concluded that in stable and malnourished HIV patients, the progressive wasting may be partly related to an increase in REE. The mechanism of this hypermetabolic state remains to be established.

Body Composition↗

[HIV infection and "malignant" strongyloidiasis].

Disseminated Strongyloides stercoralis infection occurs in immunocompromised patients. Despite the epidemiological overlap of HIV infection and strongyloidiasis observed in certain parts of the world, only six cases of dissemination have been reported in AIDS patients. The clinical presentation has no special features, except for the frequency of other opportunistic infections. The prognosis is poor. This lack of association between disseminated strongyloidiasis and HIV infection had led to the exclusion of extra-intestinal forms of this paraistosis from the revised classification of AIDS.

HIV Infections↗

Diffusion of ofloxacin into cerebrospinal fluid of patients with purulent meningitis or ventriculitis.

The penetration of ofloxacin was studied in 22 patients with purulent meningitis or ventriculitis treated with conventional antibiotics. Three successive doses of 200 mg were infused at 12-h intervals during the acute stage of the disease. Ten patients received three additional doses when the meninges were considered to be healed. Cerebrospinal fluid (CSF) was drawn 0.5, 3, 6, or 12 h after the last infusion. Serial plasma and CSF samples were also obtained from patients with ventricular drainage. Concentrations in CSF ranged from 0.96 +/- 0.15 to 1.80 +/- 0.29 microgram/ml, depending on sampling time. The percentage of penetration in ventricular fluid, expressed as the ratio of the CSF area under the curve from 0 to 12 h to the plasma area under the curve from 0 to 12 h, was 73 +/- 6. Ofloxacin readily diffuses into CSF of patients with meningitis or ventriculitis and may be useful for treatment of CSF infections caused by susceptible pathogens.

Adolescent↗

[AIDS in elderly patients. Apropos of 22 cases observed in the Paris region].

If geriatric AIDS is defined as the occurrence of this disease in individuals over 60 years old, it represents about 5% of the cases reported to the Direction Générale de la Santé by the end of 1988. We retrospectively analyzed 22 clinical cases of geriatric AIDS observed between 1985 and 1987, i.e. 21% of the cases reported at that time. In 55% of them, infection resulted from contaminated blood transfusions. Initially, hospitalization was indicated due to a significant deterioration of the patient's general condition, however, neuropsychiatric disorders and intellectual degeneration were present in 18% of the cases. Biological anomalies at the time of admission were classical with the exception of a high frequency of leukopenia often associated with anemia or thrombopenia. During the evolution of the disease, opportunistic infections were very common (90% of the cases). However, the major characteristic of this clinical form of AIDS is the high percentage (55%) of patients suffering from major neurological and psychiatric disorders, including subacute encephalitis in more than half of these patients. The prognosis is very bad, with an average survival time of 4.3 months from the time of diagnosis (median 2.5 months). The cumulative effect of the delay in diagnosing AIDS during the first hospitalization and the classical seriousness of encephalitis suffice to explain the very poor prognosis in patients whose age can play a role in altering the immune response.

AIDS Dementia Complex↗

[Arsenical-induced encephalopathy during the treatment of African trypanosomiasis. Apropos of a case with a favorable outcome].

We describe one case of reactive encephalopathy as a complication during treatment of human trypanosomiasis (T.b. gambiense) with melarsoprol (Arsobal, Mel B.). A 37 year white man who had typical T. gambiense sleeping sickness and secondary convulsions, coma and hemiplegia after three days of treatment by melarsoprol. Within 48 hours of intensive care the symptoms and signs released. In the encephalomeningeal period of trypanosomiasis the therapy currently available is the parenteral administration of organic arsenicals as melarsoprol used since the 1940s. This drug remains highly effective but severe untoward reactions occur and the incidence of mortality attributable to melarsoprol is not negligible. Choice and optimal condition of treatment are discussed.

Adult↗

Acute bronchopulmonary infections: treatment with i.v. spiramycin.

This paper reports the results of an open study to assess the efficacy (433 patients) and tolerance (453 patients) of spiramycin adipate given by slow intravenous infusion to treat severe acute bronchopulmonary infections in adults. Efficacy was good in 80.4% of patients. More specifically, high efficacy was obtained in 76.5% of 85 pneumococcal respiratory infections, 72% of 50 Haemophilus influenzae and H. parainfluenzae infections, 100% of 18 Mycoplasma infections, 100% of 16 Chlamydia infections and 93% of 14 Legionella infections. Tolerance was good in 83.5% of patients, moderate in 15.4% and poor in 6%. Venous irritation was the most frequent complication, observed in 16.3% of patients. No serious complication or sequel was observed. The authors conclude that spiramycin adipate constitutes an appropriate first-line treatment of acute bronchial and/or pulmonary infections in adults. While inferior to benzylpenicillin against Mycoplasma, Chlamydia and Legionella, spiramycin is as active as, and better tolerated than, erythromycin.

Adolescent↗