Search PubMed⌕ Search

Biomedical subjects

G Auregan

Publications and source records attributed to G Auregan.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Comparison of routine therapeutic protocols used in Madagascar for the treatment of smear-positive pulmonary tuberculosis (preliminary results)].

A survey was undertaken in April 1993 to compare the respective benefits of 2 regimens containing either streptomycin (SHRZ) or ethambutol (EHRZ) in the first two months of treatment of smear-positive pulmonary tuberculosis in Madagascar. This operational research was justified by the risks related to the use of parenteral streptomycin in a country where single use material is rare and its purpose was to provide arguments for an eventual recommendation to replace this drug by oral ethambutol which is also less expensive. 907 patients were included. The compliance was not significantly different between the 2 groups, although it was traditionally assumed to be better with streptomycin. The frequency of side effects was significantly lower with EHRZ. Overall treatment failure rates were not significantly different, but all of 6 patients who were negative at 5 months and were again positive at 8 months had received EHRZ. This point obliged to be careful before concluding, because 24% of patients were lost for follow-up. A 2 years surveillance will be necessary to compare the frequency of recurrences.

Adolescent↗
PubMed1995

[660 cases of histologic extra-pulmonary tuberculosis at the Pasteur Institute in Madagascar].

A 33 months retrospective study (from September 1992 to May 1995) of 8525 patients indicated that the incidence of histologic extrapulmonary tuberculosis (EPT) was 7,7%. The 8341 malagasy native patients presented an incidence of 7.8%. Male are more frequently infected than female. Most samples came from Antananarivo, with a prevalence reaching 12,5% while it was only 2,9% in the provinces. Most pathologic EPT were pleural tuberculosis (55,6%) and ganglial tuberculosis (34%). Peritoneal tuberculosis were much less frequent. According to literature data in Madagascar, the incidence of histologic EPT is obviously increasing.

Adolescent↗
PubMed1995

[Laryngeal tuberculosis in Antananarivo].

From September 1989 to December 1992, 49 patients had been observed at the Centre Hospitalier de Soavinandriana and 31 cases at the prison infirmary of Antananarivo from April 1990 to December 1992. The 31 laryngeal tuberculosis observed in prison existed among 9.1% of tubercular patients, were associated to 10.9% of pulmonary tuberculosis and represented 24.2% of extrapulmonary tuberculosis. The 49 laryngeal tuberculosis of the CENHOSOA were present among 4.6% of tubercular patients, were associated to 7.9% of pulmonary tuberculosis and represented 8.4% of all the extrapulmonary tubercular localizations. Voice disorders, even if always present, rarely represented (<30%) a reason for tuberculosis discovery. Comparison with the whole of tuberculosis cases showed that laryngitis was not most frequent in retreatments and that there was no statistically significant difference in death risk. Laryngeal tuberculosis being mostly in the shadow of pulmonary tuberculosis, it develops in the same way under the same treatment, except when a very ancient laryngitis has given rise to irreversible fiber lesions. Recall of this very early known localization is made in a didactic perspective: in a developing country, all chronical voice disorders must induce to research of tuberculosis.

Adult↗
PubMed1995

[Pericardial tuberculosis in Madagascar. 23 cases].

A 56 months retrospective study, from October 1990 to May 1995, at the Centre Hospitalier de Soavinandriana in Antananarivo pointed out 29 tuberculous pericarditis among the 97 pericardial effusions discovered by the echocardiography of 5600 patients. The sex-ratio was 0,81 and the mean age 38,6 years old (+/- 14,3). Hospitalization was justified by dyspnea (18 cases), thoracic pain (18 cases), lower limbs edema (6 cases) and ascitis (3 cases). Moreover, electrocardiography showed microvoltage in 18 cases and thoracic radiography showed one heart enlargement. Even if for 15 cases a pleural effusion was associated, only 2 patients had a pulmonary image suggestive of tuberculosis. Tuberculous pericarditis has been proved by the following examinations: pericardium puncture (21 cases), pericardium and pleural biopsy (respectively 11 and 13 cases), ganglionic biopsy and search of alcohol-acid-fast bacilli in sputum: 1 case. Histologic proof has been obtained 8 times out of 9 pericardial biopsies and 6 times out of 7 pleural biopsies. Bacteriological proof has been obtained 11 times by pathological samples cultivation: twice from fresh caseous material taken from the pericardium, once from 13 pleural fluids, 5 times from 6 pericardial biopsies, 3 times from 3 pleural biopsies. The patients have been put under antituberculous treatment associated with prednisone. 20 patients have been declared cured at the end of the treatment, 5 were dead and 4 were lost out of sight. Tuberculous pericarditis has become rare in developed countries but it is still challenging in Madagascar. In spite of the antituberculous treatment associated with corticoids, prognosis is severe (evolution towards pericardial constriction death.

Adult↗
PubMed1994

[HIV infection in tuberculosis patients in Madagascar. Situation in 1-93].

In Madagascar, the estimated incidence of tuberculosis is high (320 per 100,000) when human immunodeficiency virus (VIH) infection progress slowly. The authors have studied HIV seroprevalence in a group of tubercular patients and in two reference groups (general population and outpatients of the Clinical Biology Centre of Institut Pasteur). Circulation of HIV1 virus was observed with a low prevalence rate in all the 3 groups. There was no significant difference between tubercular patients and healthy population. Tubercular people ought to be a watch group for the epidemiological surveillance of HIV infection evolution in Madagascar.

AIDS-Related Opportunistic Infections↗
PubMed1993

Identification of a Mycobacterium bovis BCG 45/47-kilodalton antigen complex, an immunodominant target for antibody response after immunization with living bacteria.

Increased protection against a virulent challenge with Mycobacterium tuberculosis is induced mainly by a previous immunization with living avirulent mycobacteria, usually Mycobacterium bovis BCG. Only a transient and marginal protection is obtained after immunization with bacterial extracts or dead bacteria. Both living and heat-killed bacteria share a number of common antigens. In order to identify mycobacterial molecules which are dominant antigens during immunization with living bacteria, a two-step selection method was used. Two groups of guinea pigs were immunized either with living or with heat-killed BCG. Sera were then collected and used to select and counterselect antigens present in BCG culture filtrates. Each major fraction eluted from a series of high-pressure liquid chromatography columns (gel filtration, DEAE, and reverse-phase chromatography) was run on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred on polyvinylidene difluoride sheets. The molecules present on twin immunoblots were stained with antibodies raised in guinea pigs immunized either with living or with heat-killed BCG. Cross-reactive antigens stained in twin immunoblots were eliminated. Major antigens interacting with antibodies raised after immunization only with living bacteria were further purified. A complex of 45- and 47-kDa major molecules (45/47-kDa complex) was thus identified and further purified. The complex was found to interact only with antibodies present in sera of guinea pigs immunized with living bacteria and not at all with antibodies raised after immunization with dead bacteria. The 45/47-kDa antigen complex molecules were resolved on two-dimensional electrophoresis in three major and seven minor proteins detected with silver staining. All the molecules interacted with the antibodies present in sera of guinea pigs immunized with living BCG. The three major proteins (two at 47 kDa and one at 45 kDa) were amino-terminal sequenced. The sequence A-P-E-P-A-P-P-V-P-P-A-A-A-A-P-P-A, which was not previously reported, was the same for these three molecules. By using a competitive enzyme-linked immunosorbent assay, the concentrations of the 45/47-kDa antigen complex were measured in BCG culture filtrates, freeze-dried BCG, and dried heat-killed BCG; they were, respectively, 2, 0.01, and 0.001% of the total mass. The low or very low values compared with the high antibody concentration emphasized the ability of the 45/47-kDa complex delivered through live BCG to trigger an antibody response.

Amino Acid Sequence↗
PubMed1990

[Mediastinal tuberculous adenopathies in Djibouti. Report of 159 cases].

One hundred and fifty-nine cases of confirmed mediastinal tuberculous adenopathy were analysed retrospectively. This series, which is the first reported in French-speaking Africa, shows that the disease is not uncommon there, and not restricted to black Africans living in Europe. The clinical symptoms are not specific. Radiography is more interesting, and the extreme scarcity of bacillys-containing expectoration encourages endoscopy. The finding of a fistula at fibroscopy confirms the diagnosis. This easy examination is particularly useful since M. tuberculosis can be grown in cultures from ground bronchial fistula biopsies in 86% of the cases. Associated tuberculous lesions in other sites are very frequent (45%), as is extension of the disease from lymph nodes to lung tissue (79%). This clinical form of tuberculosis can be treated with modern short course chemotherapy which is remarkably effective.

Adolescent↗
PubMed1990

[Intrathoracic Pott's abscesses, radiologic pitfalls for the pneumologist].

The authors have conducted a retrospective study of 200 cases of tuberculous spondylitis, and wish to draw attention to the clinical and, chiefly, radiological aspects of the disease. Intrathoracic Pott's abscesses are principally observed in developing countries but they are not exceptional in France, and their varied semeiology deserves to be described.

Adolescent↗
PubMed1990

[Pulmonary tuberculosis secondary to fistulization of Pott's abscess. A case report].

The authors report a case of pulmonary tuberculosis appearing after an endobronchial fistula from a Pott's abscess. Such a clinical presentation is rare even in a developing country (PVD), where there is experience of more than 200 cases of tuberculous spondylodiscitis seen over a period of six years. The frequency of paravertebral abscess during the course of Pott's disease is around 52%, in the thoracic lesion their exteriorization by endobronchial fistula is around 4% (5 out of 114). The outcome is generally more simple and here a cure was achieved after six months of chemotherapy.

Abscess↗
PubMed1989

[Bronchial fistula caused by Pott's abscesses. Report of 3 cases].

The authors report 3 cases of intrabronchial fistulisation of paravertebral abscesses due to tuberculous spondylitis of the thoracic spine. This complication is relatively rare (these 3 cases were in a series of 178 cases of Pott's disease) and is easy to diagnose due to its characteristic radio-clinical features. As mentioned in old publications, this type of fistulisation does not seem to have serious consequences. There are no particular aspects of treatment.

Adult↗
PubMed1988

[Aspergilloma and tuberculous sequestration].

In an 18-year old male patient a large cavity of the right upper lobe was occupied first by a tuberculous sequestration, then 2 years later, by a fungus ball. This case shows that the so-called "sleigh-bell" image is not pathognomic of aspergilloma and that this disease is far from being exceptional in Africa.

Adolescent↗
PubMed1983

[Reexpansion unilateral pulmonary edema].

One case of unilateral pulmonary oedema a vacuo is reported and the 38 cases published in the literature are reviewed. Contributing factors are essential, the main ones being the duration and severity of lung collapse and the rate of reexpansion. The clinical signs and symptoms are described, together with the various possible courses of the disease, and the severity factors are deduced from 8 lethal cases. A therapeutic approach is proposed but not formalised, since pathophysiological data are still scarce.

Adult↗
PubMed1983

[Round atelectasis].

The authors report 4 cases of round atelectasis seen over a period of 3 years. They review the very limited literature on this subject. In the light of their experience and according to the work of Hanke, they believe this to be a fairly common disease. This condition was first described during collapsotherapy, but now, it is essentially seen following pleurisy. For Hanke, round atelectasis may occur in almost one quarter of cases of pleural effusion. The authors also believe that this condition is common and that it is usually confused with or grouped together with "pleural sequelae". However, their original mechanism of formation, the reversible parenchymal involvement, and not pleural, and their radiological appearance clearly distinguish them. Round atelectasis is an interesting topic of discussion in terms of diagnosis, in the broad framework of round intrathoracic opacities (especially when the initial pleural episode has not been recognized) and also in terms of treatment, which consists of decortication when they are large.

Adult↗
PubMedDate not supplied

[Mycobacteria encountered in Djibouti].

The authors studied 198 strains of mycobacteriae from different sources, but mainly from bronchial secretion and adenoid pus or poundings. Because the preponderance of peripheral adenoid tuberculosis, we might fear a focus of Mycobacterium bovis. But this study gives leave to state positively that Mycobacterium tuberculosis hominis is almost exclusively the responsible and consequent by that there is an human reservoir almost exclusive. On the other hand, study of primary and secondary resistances to anti-bacillary drugs leads to express some concern particularly vis a vis modern treatments utilized as a matter of routine.

Africa, Eastern↗
PubMedDate not supplied

[Peripheral lymph node tuberculosis in Djibouti].

153 well documented records, gathered in one year in a Tuberculosis Center, were studied. Adenoid localization represents on fourth of all tuberculosis, and 95% of all etiologies of peripheral adenopathies. Value of bacteriological tests is studied and compared to the one of histology. The almost sole presence of Mycobacterium tuberculosis hominis is an uncommon datum, interesting in the field of epidemiology. The recorded outstanding efficacy of modern anti-tuberculosis drugs is less known, perhaps because of scarcity of recent works on such localizations. Some easy and reliable guidance is proposed within the context of a Communicable Diseases Program.

Adolescent↗