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Biomedical subjects

J Beytout

Publications and source records attributed to J Beytout.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Distomatosis: diagnosis and treatment].

Distomatosis caused by Fasciola hepatica is fairly common in France. It is due to the ingestion of contaminated watercress or wild dandelions. Fever is frequent. Jaundice and liver pain are inconstant. The disease is often revealed by an isolated eosinophilia. Ultrasonography and/or computerized tomography are useful to evaluate the hepatic lesions. The diagnosis is confirmed by the finding of eggs in the stools or by serological tests. Numerous other flukes may infect people living overseas and particularly in South-East Asia. Clonorchis sinensis and other Opisthorchidae are responsible for distomatosis of the liver and digestive tract. Several types of intestinal distomatosis may also be acquired. Paragonimiasis (a pulmonary fluke) is particularly frequent in that part of the world. The diagnosis rests on the finding of eggs in the stools (digestive tract distomatosis) or in the airways (paragonimiasis) or on serological tests. The prognosis has been improved by treatment with praziquantel, a drug which in most cases stops the development of the disease within a few days.

Animals↗
PubMed1990

Chronic Q fever: diagnosis and follow-up.

Sera from 40 patients (25 men, and 15 women) with clinical features compatible with the diagnosis of chronic Q fever were received. Total or partial clinical data were available. All of them had serological evidence of chronic Q fever (IgG class anti-phase I titer greater than 800). The final diagnosis was vascular infection in four cases (with two positive cultures for Coxiella burnetii), bone infection in two patients (one positive culture), chronic hepatitis in one patient, and endocarditis in 32. The last patient had an isolated fever with a chronic Q fever serologic profile. Among the 32 with endocarditis, valve replacement was performed in 59%, and valve cultures were positive in 14/18 patients. Twenty-nine of these patients had previously known valvulopathy; 23 were exposed to cattle, sheep or goats; and four had an immunocompromised situation. Ten patients died; two before any treatment, five of cardiac failure during or a few weeks after surgery, and three during the medical treatment. For antibiotic treatment, tetracycline alone was employed in seven cases. For the other patients, combined therapy including tetracycline and another drug (rifampin, fluoroquinolones, cotrimoxazole, or erythromycin) was initiated. Three patients were considered to be completely cured.

Adolescent↗
PubMed1989

[Prevention of infections in gynecologic surgery].

Antibiotic prophylaxis is in vogue. It seems effective but is not a panacea. A strict technique and a thorough postoperative monitoring are undoubtedly non negligible means of preventing postoperative infections in gynaecological surgery.

Anti-Bacterial Agents↗
PubMed1989

Rapid evaluation of tetanus immunity by a haemagglutination test in the injured at a hospital emergency unit.

A turkey red blood cell haemagglutination assay (TRBC HA) allowing rapid measurement of the antibodies against tetanus has been set recently. Its feasibility was evaluated in injured patients admitted into an emergency unit during summer 1987. TRBC HA was performed by the same physician who questioned the patient on his/her previous vaccinations and evaluated his/her immunization status. The rapid HA test practiced in emergency was controlled by TRBC HA and ELISA measurement of antibodies carried out in the laboratory. Each method was compared to the others: the results were fitted and no significant difference was found. The preventive procedures which would have followed the antibody measurement by immediate TRBC HA were compared to the decision resulting from clinical evaluation. The immunoprophylactic attitude would have been the same in 82% of cases. TRBC HA is a reliable test, and feasible in an emergency: it could help in making the appropriate decision for immunoprophylaxis to be applied to the injured and other patients at risk of tetanus.

Animals↗
PubMed1989

Comparison of three different regimens in the treatment of acute brucellosis: a multicenter multinational study.

The present study was undertaken to evaluate efficacy, safety and patient acceptability of three antibiotic regimens for the treatment of acute brucellosis. Six different centres were involved: three in France, one in Greece and two in Spain. The regimens were: oral rifampicin 900 mg/day plus oral doxycycline 200 mg/day for 45 days (A), oral doxycycline 200 mg/day for 45 days plus im streptomycin 1 g/day for 21 days (regimen B) [corrected] and the WHO regimen (C) combining oral tetracycline 2 g/day for 21 days plus im streptomycin, 1 g/day, for 14 days. Regimens A and B were randomly allocated in all centres, while regimen C was allocated only in two centres. All patients were suffering from acute brucellosis clinically and biologically proven. 143 patients were allocated for treatment and analysed. Their mean age was 41 years (range 13-70), 49 were female and 94 male, and their mean weight was 64 kg (range 35-98). Among these patients, 14% had localized disease (nine orchitis, eight osteo-articular involvement and one pleural effusion), but there was no statistical difference between the three regimens in regard to this localized disease. Forty-five per cent of the patients had positive blood cultures. The cure rate with regimen A was 95%, 96% with regimen B and 59% with regimen C. Thus regimen A presented the same efficacy rate as regimen B, but regimen C cannot be regarded as the treatment of choice for acute brucellosis.

Acute Disease↗
PubMed1989

[Neurologic involvement in campylobacter infections. 5 cases].

Campylobacter are a newly recognized class of human infectious agents. Campylobacter fetus subspecies fetus is a cause of sepsis in immunocompromized hosts. Secondary neurological determinations, meningitis and meningoencephalitis appear to be rare. We report 2 cases, and 8 previously reported cases are reviewed. Campylobacter jejuni appears to be a common bacterial pathogen causing a syndrome of enteritis. Since 1982 it has been associated with Guillain-Barré syndrome (GBS). In one serological retrospective study, Campylobacter jejuni was the most common single pathogen identifiable in association with GBS, and these cases were significantly more severe. We report 3 cases with weakness and amyotrophy of distal limbs. Only 10 other cases have been found in the literature. Diarrhoea antedated the neurological illness by 4 to 21 days. In 4 syndromes of Miller-Fisher the prognosis was good. However electrophysiological axonal loss was reported in 6 GBS with poor functional prognosis. The pathogenic role of bacterial toxins and humoral immune response are discussed. Cross-reactivity between Campylobacter jejuni and human sciatic nerve proteins has not been demonstrated using sera from patients with GBS and serological evidence of Campylobacter enteritis.

Adult↗
PubMed1988

[Treatment of infection in granulopenic patients. Lessons from international studies].

In febrile neutropenic patients the initial antibiotic therapy must be active against several bacteria, notably enterobacteria, Pseudomonas, Staphylococci and Streptococci. Broad-spectrum beta-lactam antibiotics (ceftazidime, ureidopenicillins, ticarcillin-clavulanic acid, imipenem, etc.) have given excellent therapeutic results. Bacteraemias due to Gram-positive cocci are increasing, most of them being related to infection of indwelling intravascular devices. In several studies vancomycin has been systematically prescribed as an empirical treatment of neutropenic patients. New antibiotics, such as fluoroquinolones or teicoplanin have been used in combination with beta-lactams. Non-absorbable antibacterial or antifungal agents, or even diffusible antimicrobial agents, could be used prophylactically in deep induced neutropenia and in the initial phase of bone marrow transplantation. Prospective randomized studies of different regimens are currently in progress to try and determine the best therapeutic and prophylactic measures against infections in neutropenic patients.

Agranulocytosis↗
PubMed1988

Four cases of vesicular lesions in adults caused by enterovirus infections.

Echovirus types 4 and 33 and coxsackievirus type B1 were recovered from vesicular lesions in four adults. Patient 1 had cutaneous localized vesicles, patient 2 had a recurrent cutaneous vesicle, and patients 3 and 4 had mucosal vesicles. Three of the patients were suspected of having herpesvirus lesions. One of the patients was a human immunodeficiency virus type 1-seropositive man, and the enterovirus infection was the first clinical manifestation. Our results underline the importance of virological diagnosis before treatment with acyclovir, especially for immunocompromised patients.

Acyclovir↗
PubMed1988

[Brucella endocarditis caused by reinfection of an aortic Starr valve. Apropos of a case with a favorable development after valvular replacement].

We report the case of a 36-year old male patient who was admitted for subacute endocarditis on an aortic prosthetic valve implanted 14 years previously for endocarditic valve regurgitation; no pathogen had been isolated at that time. Nine blood cultures were positive for Brucella abortus. The conventional antibiotic therapy did not prevent the formation of an abscess below the aortic annulus. A third antibiotic combination (quinolone and rifampicin) resulted in pyrexia prior to surgery. An atrioventricular block initially noted raised the problem of an associated myocarditis. The risk of Brucella infection existed before the first operation, and five serological tests were positive for that organism between the two episodes, which makes reinfection highly probable. This is the third case of Brucella endocarditis on a prosthetic valve. Its originality lies in its mechanism.

Adult↗
PubMed1987

[Pseudomonas cepacia septicemias: therapeutic difficulties].

From Summer 1983 to Summer 1986, 34 cases of septicemia due to Pseudomonas cepacia could be detected in several intensive care units in the university hospital in Clermont-Ferrand (France). Intravascular catheters can be involved in the inoculation of this bacterial agent: a previous respiratory tract infection or a drained abscess can be the portal of entry of the bacteremia. Three patients died from the septicemia and the overall prognosis of the intensive care patients looks significatively worsened. The removing of the catheters and drains, the opening of an infected collection were useful but not sufficient to overcome. The choice of a good antibiotic was not easy; only ceftazidime, minocycline and cotrimoxazole have a fair activity in vitro. We only assessed the good results of ceftazidime. Pseudomonas cepacia is also resistant for many antiseptics. The large use of disinfecting procedures in intensive care units promotes the diffusion of this bacteria.

Adult↗
PubMed1987

[Fatal septicemias: factors of mortality. Analysis of 72 fatal cases in the series of 462 case reports collected by the Septicemia Expert System group in 1985].

During the year 1985, 462 cases of septicemia were collected by SES group; 417 observations could be exploited. 73 patients died (17.3%). The statistical analysis of epidemiological and clinical data argued to factors correlated with high mortality rate: a shock, an acute respiratory distress syndrome, a pulmonary portal of entry lead to a high mortality rate. The fatal outcome increased with the age of the patients. A documented immunodeficiency (granulopenia, cytotoxic chemotherapy...), a previous broncho-pulmonary, neurologic or cardiovascular disease were factors of risk. The pulmonary or cutaneous localisations occurring within a septicemic phase were significantly related to death. Among fatal cases of bacteremia, 25% were Staphylococci, 25% Enterobacteria, 20% Pneumococci, 7% Pseudomonas. Pseudomonas, then Pneumococcus, then Staphylococcus bacteremias looks to have a worse prognosis. The more serious cases were prescribed several antibiotics, significantly much more than the mild cases. These results are compared with the results of former series; the main prognosis factors of actual septicemia are elicited in here.

Adolescent↗