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Biomedical subjects

G Berthelot

Publications and source records attributed to G Berthelot.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Sigmoiditis with lower rectal and perirectal development].

Lesions of sigmoiditis do not extend beyond the recto-sigmoid junction and Douglas' pouch. However, in 9 out of 271 patients operated upon for sigmoiditis the lesions invaded the rectum either anteriorly by perforating Douglas' pouch, or around it and posteriorly through the meso-rectum. These cases of "lower" sigmoiditis have several features in common: a long history of infection, frequent haemorrhages and fistulae, pseudo-tumoral lesions, sometimes very large, detectable by rectal palpation. Surgery is indicated only in cases with serious complications, since many technical problems may be encountered. Wide resection of the rectum followed by low-sited anastomosis ensure stable results.

Aged↗
PubMed1987

Epidemiological survey of a major outbreak of nosocomial legionellosis.

Forty-seven nosocomial cases of legionellosis due to Legionella pneumophila serogroup 1 were diagnosed in one major outbreak from November 1982 to March 1983 in a 960-bed teaching hospital. Contaminated water was considered to be a possible source of infection because, during that period, monthly samples were found to be positive with averages of 10(4) CFU/l. After chlorination of hot water associated with flushing of outlets, nearly all samples taken in the next two years were found to be negative. A case-control study was performed to examine potential risk factors. Three groups of controls were randomly selected among eligible patients. In a multivariate analysis, only three clinical factors were found to be associated with legionellosis patients: malignant illness (relative risk, RR = 3.5), presence of an ultimately fatal disease (RR = 2.6), and exposure to corticosteroids prior to admission (RR = 7.9). Investigations of in-hospital exposures suggest that during this nosocomial outbreak diagnostic or therapeutic respiratory procedures had not increased the risk of illness. Although the epidemiological association between water contamination and disease remains unclear, the eradication of L. pneumophila from the identified supply seems to have been effective in preventing disease in this hospital.

Adolescent↗
PubMed1987

[Present status of nitroxoline].

Nitroxoline (8-hydroxy-5-nitroquinoline) has been used since 1962 in the treatment of urinary tract infections especially those due to gram negative bacilli (E. coli). The current renewal of the drug is in relation to the recently shown activity of nitroxoline against fungi (Candida, Torulopsis), Mycoplasma and U. urealyticum, as well as Trichomonas. In order to update the knowledge of the drug, the aim of this study was a pharmacokinetic study in serum and urines collected after administration of one single dose (2 X 100 mg) and after multiple doses (200 mg X 3). Eight healthy volunteers were included in the study. The assays were carried out by means of the microbiological procedure and HPLC comparatively in the same samples. From the results several comments should be made: 1) In all subjects, serum levels were measurable 15 to 30 min. after administration, suggesting a rapid absorption. 2) Despite individual variations due to oral administration, pharmacokinetic parameters could be calculated: Tmax: 1.75 +/- 1.04 h; Cmax: 5.59 +/- 3.15 mg/l; t 1/2 beta: 2.63 +/- 2.66 h. 3) The hepatic metabolization of the drug into conjugated derivatives occurs early as shown by early levels of conjugated nitroxoline as measured by means of HPLC; the metabolization seems to be variable according to the subjects quantitatively and as for its kinetics. 4) The urinary elimination of nitroxoline is extremely rapid, and high levels of free drug and conjugated derivatives were measured at the 1st hour after the administration. Persistent high levels were measured at the 10th and 24th hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Penetration of ciprofloxacin into bronchial secretions.

The penetration of ciprofloxacin into bronchial secretions was evaluated in 21 patients after a single oral dose of 500 mg of ciprofloxacin. Ten successive serum samples were collected in the interval 0-12 h after administration, and bronchial samples were taken 2, 3, 4 and 6 h after administration. Concentrations were measured in all samples using a standard microbiological assay. The results showed that the kinetics in serum did not differ from those determined in previous studies, a peak level of 2.2 +/- 1.3 mg/l being achieved at 2 h followed by a slow decrease of the levels to 0.6 +/- 0.4 mg/l at 6 h. The bronchial concentrations reached about 0.5 mg/l at 2 h and remained stable until 6 h, ranging between 0.5 and 0.8 mg/l. The ratio between simultaneous bronchial and serum levels ranged from 0.19 at 2 h to 0.95 at 6 h. These data indicate that ciprofloxacin might be suitable for treatment of severe respiratory infections, especially pneumonia caused by Pseudomonas aeruginosa, since the MICs of ciprofloxacin for most bacteria involved in bronchopulmonary infections are very low and tissue diffusion of the drug in the respiratory tract is good.

Aged↗
PubMed1986

[Diffusion of aztreonam in the tissues and biological fluids of the female genital tract].

Diffusion of aztreonam into female genital tract tissues was investigated. After a single IV injection of 1 g, aztreonam was assayed in uterine tissue, uterine tube tissue and peritoneal fluid in 15 patients undergoing coelioscopy or hysterectomy. In addition, to evaluate placental transfer of aztreonam, maternal blood, amniotic fluid and cord blood samples were collected in five women undergoing cesarean section. Concentrations of aztreonam were determined using a microbiologic method. Mean concentrations 1 to 2 hours after administration of the drug were 11 to 25 micrograms/g in the endometrium and uterine tube tissue and 18 to 30 micrograms/g in the myometrium. Concentrations in peritoneal fluid samples were lower, ranging from 4.7 micrograms/ml (0.5 h) to 16 micrograms/ml (1 to 2 hours after the injection). The ratio of tissue concentrations to serum concentrations found at the same time, expressed as a percentage, ranged from 50 to greater than or equal 100%. Placental transfer of aztreonam proved comparable to that of other recently studied beta-lactams: the amniotic fluid/maternal blood and cord blood/maternal blood ratios ranged from 27 to 33% thirty minutes after administration of the antibiotic. No adverse effects were recorded in the offspring. These results indicate that diffusion of aztreonam into female genital tract tissues is good, producing concentrations capable of preventing or curing gynecologic and obstetrical infections caused by Gram negative bacilli.

Aztreonam↗
PubMed1986

[Diffusion of piperacillin into bronchial secretions].

Piperacillin is a ureido-penicillin characterized by the presence of a piperazine group at the position 6 of the beta-lactam ring. This group confers a broader spectrum that includes Pseudomonas. In vitro studies have shown that piperacillin is active against clinical strains recovered from intensive care unit patients with severe lower respiratory tract infections. The purpose of our study was to investigate the usefulness of piperacillin in such patients by evaluating the drug's diffusion into bronchial secretions. A single 4 g dose of piperacillin was given intravenously over three minutes to each of 6 intensive care unit patients. Serum and bronchial secretion samples (obtained through a tracheal intubation or tracheostomy tube) were taken 1/2 hour, 2 h, 4 h and 6 h after the injection to evaluate piperacillin kinetics. Serum piperacillin concentrations were maximal 30 mn after the IV (mean value: 90.6 +/- 23.8 micrograms/ml) and thereafter fell gradually (mean value after 4 hours: 40.4 +/- 27.5 micrograms/ml). Peak concentrations in bronchial secretions were recorded at 2 hours (12.2 +/- 8.5 micrograms/ml); the mean residual value at 6 hours was 4.9 +/- 8.7 micrograms/ml. The diffusion ratio (ratio of bronchial secretion concentration to simultaneous serum concentration) was 15.5% to 24.5%. Our results show that the diffusion of piperacillin into bronchial secretions is outstanding and support the use of this drug in severe respiratory tract infections.

Adult↗
PubMed1985

[Choledochoduodenal fistula of ulcerous origin. 2 cases].

Two cases of choledochoduodenal fistula due to a duodenal ulcer located below the bulb are reported. Both patients were operated upon. Truncular vagotomy and antrectomy were performed, followed by gastro-duodenal anastomosis; the fistula itself was left untouched. Subject to some technical precautions, this operation, feared by most authors, is perfectly adequate, as it provides optimal conditions for healing of the ulcer, which is the main purpose of any surgical intervention in such cases.

Aged↗
PubMed1985

Placental transfer of cefmenoxime in late pregnancy.

The broad spectrum of activity and the beta-lactamase stability of cefmenoxime provide this new cephalosporin a possible efficacy in the treatment of obstetrical infections. This study was designed to evaluate the placental transfer of cefmenoxime. The study group consisted of 21 pregnant women undergoing a cesarian section. After a single intramuscular injection of 1 g of cefmenoxime, samples of maternal blood and amniotic fluid were taken 30 min before and at delivery; the same samples as well as umbilical cord blood samples were also taken 1, 2, 3 or 4 h after the injection, in order to evaluate the kinetics of the drug. The antibiotic assay was carried out by microbiological procedure. The results of the study showed (1) a peak level of 16 micrograms/ml in maternal serum, with a slow decrease and a residual value of 3 micrograms/ml at 4 h; (2) increasing levels of the drug in cord blood, with a peak value of 4.8 micrograms/ml; (3) a progressive diffusion of cefmenoxime in amniotic fluid, reaching the highest value of 4.7 micrograms/ml at 3 h, and (4) parallel kinetics of the drug in amniotic fluid and in cord blood. On the whole, this study showed a significant placental transfer of cefmenoxime, achieving therapeutic concentrations required against microorganisms responsible for obstetrical infections.

Amniotic Fluid↗
PubMed1985

[Concentrations of antibiotics (josamycin, trioleandomycin and amoxicillin) in the secretions of the ear, sinus and adenoids].

This was a comparative study of antibiotics in the pus of otitis and from the sinuses as well as in the adenoids. Three antibiotics were chosen: Trioleandomycin, Josamycin, Amoxicillin. The study protocol was strict. Results obtained were as follows: high concentrations of macrolids in discharge of otitis and the sinuses as well as in the adenoids. Concentrations were higher than serum concentrations. By contrast, in the case of amoxicillin tissue concentrations were lower than the serum concentration. This leads to the conclusion that there is good penetration of infectious ENT sites by macrolids.

Adenoids↗
PubMed1985

[Ceftazidime absorption into bronchial secretions in mucoviscidosis patients].

Penetration of ceftazidime into bronchial secretions was studied in 23 patients, of which 18 had cystic fibrosis. Ceftazidime was used as the single drug for treating exacerbations caused by Pseudomonas aeruginosa. Dosage was 6 g/1.73 m2/day divided into three intravenous injections for 14 to 21 days. Bronchial secretion samples were obtained by fiber-optic bronchoscopy or physical therapy. Serum and bronchial secretion ceftazidime concentrations were assayed using a microbiological method. Ceftazidime concentrations in both media were lower in children than in adults : elimination half-life is shorter (1.7 h against 2.45 h in adults), extravascular distribution is faster, with earlier (1 h against 2 h in adults) achievement of the peak bronchial secretion concentration (2 micrograms/ml). The ratio of bronchial secretion concentration to concomitant serum concentration did not exceed 5% at the time of peak bronchial concentration. These results suggest that in cystic fibrosis patients, the faster and lower bronchial penetration of ceftazidime may be due to faster elimination as compared to adults. Although transient elimination of Pseudomonas aeruginosa was achieved in 12 study patients, our findings support the use of higher dosages or alternative administration modalities designed to increase in situ ceftazidime concentrations.

Adolescent↗
PubMed1985

Influence of a fluidifying agent (bromhexine) on the penetration of antibiotics into respiratory secretions.

The authors report the results of a study designed to evaluate the possible increase of penetration into bronchial secretions of antibiotics when combined with a fluidifying agent: bromhexine. The study was carried out in a double-blind experiment: erythromycin in 22 patients (group I) or amoxycillin in 26 patients (group II) were administered orally; in both groups several patients were given a placebo, instead of bromhexine. Antibiotics were administered at the usual dosage: 0.5 g X 2 for erythromycin (3 days); 1 g X 2 for amoxycillin (7 days); with the latter, two different doses of bromhexine were administered simultaneously: 48 mg/day and 96 mg/day in ten and eight patients respectively. Samples of bronchial secretions were collected by means of fibreoptic bronchoscopy at the second hour for erythromycin and for amoxycillin; simultaneous serum samples were also collected. The results of the study showed in both groups a significant increase of the ratios between bronchial levels and simultaneous serum concentrations when combined with bromhexine; in patients receiving amoxycillin with 96 mg of bromhexine the percentage penetration was noticeably higher (7.5%) than in those treated with 48 mg bromhexine (4.3%). These results confirm the efficacy of bromhexine as a drug able to disrupt mucopolysaccharides of bronchial secretions and, as a result, to increase the bronchial penetration of antimicrobial drugs as evaluated on the basis of percentage penetration ratio.

Bromhexine↗
PubMed1984

Penetration of cefsulodin into bronchial secretions.

The objective of this study was to evaluate the penetration of cefsulodin, a new cephalosporin active against Pseudomonas aeruginosa, into the bronchial secretions. The study was carried out in 28 patients with respiratory infections; 11 patients received a single dose of 1 g i.v. (bolus); 17 patients received multiple doses of 1 g every 8 h for 48 h. Simultaneous samples of blood and bronchial secretions were collected 30 min and 1, 2, 4 and 6 h after injection. Bronchial secretions were obtained from 23 patients by means of fiberoptic bronchoscopy and in 5 tracheostomized patients (with severe respiratory insufficiency) through a tracheostomy cannula. The assays of cefsulodin were performed by means of the microbiological agar diffusion technique. The results of the study showed a noticeable penetration of the drug into the bronchial secretions, with a mean peak reaching 3.1-5.3 micrograms/ml at the 3rd or 4th hour, a slow elimination and residual levels at 6 h ranging between 2.0 and 6.0 micrograms/ml. The rate of penetration was not influenced by the administration of multiple doses of the drug. The ratios between bronchial concentrations and simultaneous serum concentrations ranged between 10 and 30%, corresponding to the usual values found for other cephalosporins. In conclusion, this study provides satisfactory results and confirms the presence of bronchial levels capable of inhibiting P. aeruginosa.

Bronchi↗
PubMed1984

[Transplacental passage of cefmenoxime].

The broad spectrum of activity of cefmenoxime, its beta-lactamase stability and its harmlessness for the fetus, confer upon this new cephalosporin, a possible efficacy in the treatment of obstetrical infections. This study was designed to evaluate the placental transfer of cefmenoxime. The study group consisted of 21 pregnant women undergoing a cesarian section. After a single IM injection of 1 g of cefmenoxime, samples of maternal blood and umbilical cord blood samples were both taken 1, 2, 3 or 4 hours after the injection, in order to evaluate the kinetics of the drug. Amniotic fluid samples were also taken at delivery. The results of the study showed : a peak level of 16 micrograms/ml in the maternal serum with a slow decrease and a residual value of 3.08 micrograms/ml at the 4th hour ; increasing levels of the drug in the cord blood, with a peak value of 4.8 micrograms/ml ; progressive diffusion of cefmenoxime in amniotic fluid, reaching the highest value of 4.7 micrograms/ml at the 3rd hour ; parallel kinetics of the drug in amniotic fluid and in cord blood. On the whole, this study showed a significant placental transfer of cefmenoxime, achieving therapeutic concentrations required against microorganisms responsible for obstetrical infections.

Cefmenoxime↗
PubMed1984

[Bronchial diffusion of new anti-pseudomonal beta-lactams. Clinical significance].

In treating severe respiratory infections due to Pseudomonas aeruginosa and in patients with cystic fibrosis, new anti-pseudomonal beta-lactams constitute a good alternative to the traditional aminoglycoside antibiotic therapy. Among several criteria for the choice of an antibiotic, estimation of intrabronchial levels is to be taken into account. The authors report the results of the study of a new semi-synthetic penicillin, apalcillin, and two cephalosporins (cefsulodin, ceftazidime), active in vitro against Pseudomonas; their penetration into respiratory secretions was evaluated in 48 patients, intubated, tracheostomized, or undergoing fiberoptic bronchoscopy. Antibiotic concentrations were measured by the microbiological procedure. Bronchial penetration of apalcillin was early and noticeable, reaching a bronchial peak representing 20% of the simultaneous seric concentration. The local levels of cefsulodin and of ceftazidime did not differ from those achieved with cephalosporins studied previously; the bronchial peak reached 5,6 micrograms/ml for both drugs 2 hours after administration; this bronchial level corresponded to 15 to 20% of the serum concentration. The clinical response could not be evaluated due to the severe underlying pathology which compromised the outcome of the disease in the patients of this study. However, at least for apalcillin, a significant correlation was noted between bronchial levels, susceptibility of bacteria isolated in patients, and eradication of susceptible organisms.

Anti-Bacterial Agents↗
PubMed1983

[Penetration of netilmicin into respiratory secretions].

Aminoglycosides are often used in the treatment of severe Gram-negative infections, particularly those involving the respiratory tract. The purpose of this study was to evaluate the penetration of netilmicin into bronchial secretions. In 8 tracheostomized patients samples of bronchial secretions were taken at intervals through the tracheostomy cannula after intramuscular injection of netilmicin 2 mg/kg bodyweight. Concentrations of the drug were measured in bronchial secretions and in blood samples taken simultaneously, using the agar diffusion method (Grove and Randall procedure). The results showed significant penetration of netilmicin, with a mean bronchial peak reaching 3.4 micrograms/ml 1 h after the injection. Elimination was slow, with a mean residual level of 2 micrograms/ml at 6 hours. The bronchial to serum levels ratio was high (greater than 30% at 1 hour). Individual variations in both serum and bronchial levels were noted; they were unrelated to the underlying pathology. However, changes in bronchial concentrations correlated with changes in serum concentrations, which suggests passive diffusion across the blood-bronchoalveolar barrier. The fluctuations in bronchial levels and the usually low bronchial concentrations of aminoglycosides previously reported are discussed in relation to the methods used.

Adult↗
PubMed1983

[penetration of fosfomycin into bronchial secretions].

The objective of this study was to evaluate the penetration of fosfomycin in bronchial secretions in 11 tracheostomized patients which allowed sampling at successive times, following intravenous injection of 4 gr of the drug during 4 hours. In simultaneous samples of serum and bronchial secretions, the measurement of fosfomycin was performed according to the agar diffusion microbiological method. The results of the study showed a worthwhile penetration of fosfomycin, with a mean bronchial concentration reaching 13,1 micrograms/ml, half an hour after the end of the injection, decreasing slowly with 7,04 micrograms/ml remaining two hours after the injection. The ratio between bronchial levels and corresponding serum levels reached 13% two hours after the injection. Fosfomycin diffusion from serum to bronchial secretions realizes significant amounts that are superior to the MICs of fosfomycin for most bacteria responsible for serious broncho-pulmonary infections in intensive care units.

Anti-Bacterial Agents↗
PubMed1982

[Repair of hiatus hernia in adults by double gastropexy (author's transl)].

Hiatus hernia was repaired in 108 adult patients by a technique combining posterior gastropexy, as described by Toupet, with anterior gastropexy on the lesser curvature. The purpose of the anterior gastropexy is to avoid intra-hiatal reascension of the anti-reflux montage, a complication which seldom results in recurrence of clinical symptoms but is reflected in radiological images of relapse with often troublesome psychosomatic effects.

Female↗