[Unexplained long-term fever disclosing pulmonary aspergillosis].
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Biomedical subjects
Publications and source records attributed to H Maisonneuve.
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The number of patients with acne in France is unknown. During a Winter period (October, 1985 to January, 1986), 31 dermatologists in private practice in 5 different regions (Paris, Lyon, Marseille, Rennes and Strasbourg) saw 4,597 cases of acne among 28,714 patients (16.0 p. 100); 293 (6.4 p. 100) of these acne patients had severe acne as defined in the official authorization to launch the drug isotretinoin on the French market: "Nodular and/or cystic acne and severe chronic acne resistant to the main conventional treatments". The patients' mean age was 24.0 +/- 6.7 years, and 66 p. 100 were male (39 p. 100 were students or grammar school pupils); they had the disease for a mean period of 8.2 +/- 5.9 years, and they consulted a dermatologist 4.15 times per annum on average. By extrapolating these figures to the total number of dermatologists practising in France, it could be assumed that in any given year about 17,738 to 19,333 patients with severe acne consulted dermatologists in private practice. Each dermatologist selected at random the record-cards of 4 of his severe acne patients (in all, 121 records) and gave those who came to consult him a letter explaining the purpose of the study and asking them to accept being questioned on the cost and repercussions of their disease. Sixty patients were interrogated by a psychosociologist, 27 accepted to be interrogated every 2 weeks for 2.5 months. The data collected were: i) number of times the patient consulted a general practitioner, a specialist, a surgeon, or a member of the paramedical professions.(ABSTRACT TRUNCATED AT 250 WORDS)
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Albendazole, a broad spectrum anthelmintic, was administered as a 400 mg single dose to 20 patients harbouring Ascaris (ten cases), hookworms (four cases each of Ancylostoma duodenale and Necator americanus) and trichuriasis (ten cases). Faeces were obtained before treatment and during the following five days. Coprocultures were made for 90 days for Ascaris and Trichuris eggs, hookworm eggs were cultured by the Harada-Mori technique for at least eight days. Albendazole was ovicidal against all four genera of nematodes.
The pyrimethamine-sulfadoxine combination, active against acute toxoplasmosis in the mouse, was administered to 24 children with congenital toxoplasmosis in doses of 500 mg sulfadoxine and 25 mg pyrimethamine per 20 kg bodyweight once every fortnight. The drug appeared to be as effective as other sulfonamide-pyrimethamine combinations. It was generally well tolerated and was withdrawn in only 3 patients on account of minor side-effects. Giving pyrimethamine-sulfadoxine together with folinic acid is a much simpler treatment of congenital toxoplasmosis than the usual ones.
Treatment of severe symptomatic trichuriasis observed with heavy worm burdens is not satisfactory with recommended doses of mebendazole, flubendazole and albendazole. Higher doses of anthelmintics for longer periods of treatment generally improve the cure rates but treatment of such associated symptoms as diarrhoea is recommended before starting anthelmintic therapy. Such severe cases of trichuriasis should be considered separately; they do not represent the majority of cases infected by this parasite, which usually respond to benzimidazoles.
Nitazoxanide , a nitrothiazole derivative, was tested in 22 patients infected with Taenia saginata and 18 infected with Hymenolepis nana. A single 25 mg/kg body weight dose was effective against T. saginata, while twice this dose level (50 mg/kg), also as a single dose, was required for treating H. nana infection. Tolerance of the drug was good at both dose levels used.
Nitroimidazoles have been extensively evaluated in the treatment of trichomoniasis, giardiasis, liver and intestinal amebiasis. The most widely used are metronidazole, tinidazole, ornidazole, and secnidazole. Tinidazole, ornidazole, and secnidazole have a much longer half-life than metronidazole, allowing single-dose or once daily administration. Nitro-5-imidazoles remain extremely effective drugs for treating protozoans, Trichomonas vaginalis, Entamoeba histolytica, and Giardia intestinalis. Although all are suspected of potential carcinogenicity, they are the drugs of choice for treating protozoal infections.
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A total of 870 patients, both males and females, from 3 to 79 years old, received either albendazole or a placebo for the treatment of nematode and cestode infections. Each patient was interviewed and underwent a complete physical examination on the initial visit. In addition, complete blood count, clinical blood chemistry values and routine urinalysis were performed before and at least 24 hours after the last treatment. Stool examinations were performed before, 7 and 21 days after treatment. Direct examination, an egg count using the Kato technique and faecal concentration were carried out for each patient. In ancylostomiasis and strongyloidiasis, faeces were cultured by the Harada-Mori technique. Albendazole, as a single 400 mg oral dose, was highly effective against Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale and Trichuris trichiura; efficacy against Strongyloides stercoralis was observed after three consecutive days of treatment at the same daily dose level. Efficacy against Hymenolepis nana was fair. Based on both clinical signs and biological values, albendazole did not produce any significant side effects.
Albendazole, a new broad spectrum benzimidazole anthelmintic, has been administered in 10 male volunteers. Administration was randomized using 100 mg tablets, 200 mg tablets and a 2% suspension. Blood samples were obtained 0.5; 1; 1.5; 2; 2.5; 3; 3.5; 4; 5; 6; 8; 12; 24; 72 h after treatment. Albendazole sulfoxide, one of the mains albendazole blood metabolites, was assayed by HPLC and the blood half life was calculated as 8 1/2 h. The three different pharmaceutical formulations were considered bioequivalent. Urines were collected, and using T. L. C. Technics, main metabolites were identified and characterized. Hydrolysis of the carbamate function and oxidation of the sulfur atom, the alkyle chain and the aromatic ring were the main biotransformations observed.
378 cases of isolated hypereosinophilia (eosinophils greater than 500 by mm3 of blood) are presented. The diagnosis was done for 189 cases: 184 parasitic diseases and 5 non parasitic diagnosis (3 neoplastic syndromes). The diagnosis was done more often if patients came back from a tropical area, if hypereosinophilia was observed on two samples of blood, if hypereosinophilia was major (greater than 2,500 eosinophils). The diagnosis was not done for 189 cases, but 49 patients have had an allergic disease. Drug etiologies are certainly underestimated.
Multimedia medical education has been demonstrated to be effective, and in some situations, superior to traditional methods of instruction, surgeons being able to acquire new skills from a distance. The purpose of this project was to develop an instructional aid that can be used for surgical education in laparoscopic techniques. A concept of "Virtual University" was developed for surgeons in the field of laparoscopic and minimally invasive surgery. This concept permits surgeons to update their knowledge from a distance any time they want. Using new technologies surgical techniques can be presented in a new fashion, more attractive for surgeons. With the aid of the internet we are now able to add animations and color illustrations with no limits, either in terms of size and number. Contributions were commissioned to international opinion leaders, under the control and seal of approval of national and international societies. The WebSurg site contains surgical techniques (rich illustrated), films presenting surgical procedures and films of expert's opinion. All partners (authors, reviewers, editors, sponsors, owners) must be in agreement with content, and also accept editorial independence. Scientific integrity and academic environment are the key factors to get high quality standards. Codes of ethics have been issued for internet information and must be followed by all websites.
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The effect of flubendazole in human hydatic disease due to E. granulosus has been studied in 22 patients with one or several hydatic cysts of different sites. Flubendazole has been given orally before surgery for a 10 days mean period, at 4 g daily in adults and 1 g daily in children. Flubendazole has been titrated by radioimmuno-assay in sera, urines and bile taken 12 to 24 hours after the last ingestion and in the hydatic cyst (membranes and liquid). The scolex vitality was determined by direct optic microscopy and by intra-peritoneal mouse inoculation. Seven non-treated patients, without hydatic disease, were considered as controls. The flubendazole concentrations in sera (3.01 +/- 3.73 ng/ml) and in urines (7.6 +/- 7.5 ng ml) are low. They are also low in membranes (3.21 +/- ng/mg) and in hydatic liquid, but significantly more elevated in the hepatic localisation than in the pulmonary localisation. The bile concentrations are high (167.9 +/- 133.2 ng/ml). There is no correlation between these concentrations and the amounts of flubendazole administered. The scolex vitality was correlated neither with the amounts of flubendazole administered, nor with the concentrations of flubendazole in the hydatic cyst. Further studies are necessary before judging of the efficacy of flubendazole in the human hydatic disease.
Albendazole was given to some men for the first time. 131 patients (43 children) received different dosages, without clinical intolerance. Biological parameters were normal. Each study was made in two parts: - determination of the good dosage, - administration in a double-blind study (except for Strongyloides Stercoralis). Albendazole has a good efficiency against Enterobius Vermicularis, Trichuris trichiura, Ascaris lumbricoides and Necator americanus. Strongyloides Stercoralis seems to be killed by this drug, but complementary studies will be necessary.