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Biomedical subjects

J Bille

Publications and source records attributed to J Bille.

197 records · Page 11Linked to original sources

[The brain in the aged].

Under the very broad term of brain in the elderly, we cannot consider exhaustively all the anatomical, physiopathological and pathological aspect and, still less, the therapeutic possibilities in diseases of the anesthetist should know concerning the special characteristics of this aging organ. First are recalled the anatomical, macro and microscopic data of the senile brain. The metabolic characteristics are then considered. Investigations which may give the clinician information concerning the organic state and metabolic capacities of the brain of the elderly subject, e.g. cerebral blood flow, fundus oculi, E.E.G. brain arteriography, tacography or tomodensitometry by scanner, are consideres. But in practice, they are difficult to use and their data are only relatively reliable, i.e. clinical examination is of great imporatnce and the overall impression prevails. The therapeutic possibilities are limited and in these elderly subjects with cerebral metabolism in unstable equilibrium, one should be circumspect and careful in treatment.

Aged↗

Evaluation of a rapid latex agglutination test (Directigen) for the direct detection of group A streptococci from throat swabs.

A rapid group A beta-hemolytic streptococci (GAS) antigen detection test using latex agglutination (Directigen, Becton Dickinson) was compared with a conventional culture method for the direct detection of GAS from throat swabs. One throat specimen was collected from each of 229 patients. After standard inoculation onto sheep blood agar plates, all swabs were tested for GAS antigen. Of the 229 specimens tested, 46 (20%) were GAS-positive by culture. Direct latex agglutination agreed with culture in 222 of them (97%). The sensitivity of the test was 93% (43/46), the specificity 98% (179/183), the positive predictive value 91%, and the negative predictive value 98%. The detection of GAS antigen by coagglutination (Phadebact, Pharmacia) was also carried out. 81% (35/43) of the cultures and Directigen-positive specimens gave a positive coagglutination for GAS. 100% (179/179) of the cultures and Directigen-negative specimens were also negative by the coagglutination test. We conclude that the Directigen rapid latex agglutination test for the direct detection of GAS from throat swabs compares favorably with culture and has the advantage of providing same-day results.

Humans↗

Assessment of normal and abnormal prosthetic mitral valves by Doppler echocardiography. Doppler in prosthetic mitral valves.

Pulsed, continuous-wave, and color Doppler were performed in 165 normal mitral prostheses and 58 patients with prosthetic dysfunction (46 regurgitant and 12 obstructive valves) proved by catheterization and/or surgery. Mean mitral gradient (MG) and pressure half-time (PHT) were determined in all cases. Among normal prostheses, a wide range of both MG and PHT was observed in each type of valve and a considerable overlap between valves of different size. St-Jude's valve had the most optimal hemodynamics. Mild mitral insufficiency was detected in 14% of tissue and 24% of mechanical mitral valves. Repeat studies were performed in 30 patients over a 2.4 years period. Nine patients developed Doppler evidence of new prosthetic dysfunction, while Doppler parameters remained unchanged in 21 patients during the follow-up period. Among malfunctioning valves, Doppler correctly identified all cases of prosthetic obstruction (n = 12), and 42 of 46 regurgitant valves. We conclude that Doppler echocardiography is a very useful technique in both non-invasive assessment and follow-up of normal prosthetic valves in the mitral position and in detecting prosthetic dysfunction, especially when prosthetic obstruction is present.

Adolescent↗

Determination of the copy number of the nuclear rDNA and beta-tubulin genes of Pneumocystis carinii f. sp. hominis using PCR multicompetitors.

Multiple copies of a gene may lead to difficulty in the interpretation of typing results because polymorphism of the copies may wrongly lead to the conclusion that different types are present in a specimen. To determine the copy number per genome of the nuclear rDNA and beta-tubulin genes analyzed for the typing of Pneumocystis carinii f. sp. hominis, we developed a strategy based on the use of the same multicompetitor molecule in two different quantitative-competitive PCRs, one for the gene under study and the other for a reference single copy gene, allowing direct comparison of the results of both PCRs. Control experiments showed that the strategy was sensitive enough to detect duplication of a gene. The copy number of the nuclear rDNA operon was determined by amplification of the intron of the 26S rDNA gene and that of the beta-tubulin by amplification of the region surrounding the intron no. 6. The method was first tested on P. c. carinii, the special form commonly infecting rats. Pneumocystis c. carinii was found to contain a single copy of the rDNA operon. The method was then applied to P. c. hominis. The results confirmed that P. c. hominis genome contains a single copy of the nuclear rDNA and beta-tubulin genes.

AIDS-Related Opportunistic Infections↗

Compliance to live oral Ty21a typhoid vaccine, and its effect on viability.

BACKGROUND: Concerns have been expressed that in travelers the efficacy of the live oral Ty21a typhoid vaccine Vivotif could be lower than reported, maybe due to a lack of compliance. The purpose of this study was to examine the level of compliance with the recommendations regarding dosing, timing of dosing with respect to food intake, and storage. METHODS: Travelers were randomized into two groups: one received oral information only, and the second, a combination of oral and written information. Four criteria of compliance were applied to travelers: 3 capsules needed to be swallowed (criterion 1) on day 1, 3 and 5 (criterion 2), at least 1 hour before or 2 hours after a meal (criterion 3) and the vaccine had to be kept refrigerated (2-8 degrees C) (criterion 4). Compliance was evaluated using three different methods: a questionnaire, pill counting, and electronic monitoring using the Medication Event Monitoring System (MEMS). Storage conditions were checked by temperature tags, and viability of the vaccine was assessed by culturing the content of remaining capsules. RESULTS: The data of 115 travelers were analyzed. All the travelers took the 3 capsules. Compliance to all four criteria was complete in 68% of travelers according to the questionnaire, and 53% according to the MEMS (p =.05). Sixty-seven percent of all the doses intervals were of 48 hours +/- 6 hours, 12% being shorter than 36 hours and 7% longer than 60 hours. Eighty-seven travelers (76%) took their capsules on each alternate day. The method of information had no significant impact on compliance. Forty-two percent of tags showed exposure to temperature over 10 degrees C for more than 24 hours. Yet, no difference could be found in the viability of the vaccine compared with controls. CONCLUSIONS: Most travelers take their 3 capsules on alternate days, but many did not follow the other recommendations. Electronic monitoring of compliance provides more accurate results than questionnaires. Emphasis must be put on motivating the travelers to take the vaccine as recommended.

Administration, Oral↗