[Pneumococcal peritonitis].
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Biomedical subjects
Publications and source records attributed to J C Legrand.
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A total of 101 patients with proven Staphylococcus aureus infection were included in a double-blind, placebo-controlled study; this study compared oxacillin (12 g/day, intravenously) or vancomycin (2 g/day, intravenously) plus rifampin (1,200 mg/day, orally) with oxacillin or vancomycin plus placebo. We evaluated 65 patients. Of the patients tested, 33 received oxacillin plus rifampin (13 bacteremias), and 32 received oxacillin plus placebo (16 bacteremias). Clinical cure was achieved in 61% of the patients treated with oxacillin plus rifampin and in 56% of the patients treated with oxacillin plus placebo. Improvement was noted in 27 and 25%, respectively, and failure occurred in 9 and 18%, respectively. These differences were not statistically significant. Bacteriological failure occurred in 3 and 28%, respectively (P less than 0.05). None of the failures within the rifampin-treated group was associated with the emergence of a rifampin-resistant mutant. The rates of superinfection were similar in both groups. The geometric means of the serum bactericidal activity after 1, 6, and 11 h were, respectively, 22, 17, and 9 after treatment with oxacillin plus rifampin and 25, 3.4, and 2.3 after treatment with oxacillin plus placebo. It was suggested that the addition of rifampin to oxacillin or vancomycin might only be beneficial to severely ill patients.
Rats with a portacaval anastomosis are known to be susceptible to develop uric acid stones. The present studies were undertaken to investigate urinary Mg, Ca and oxalate excretion in such rats. We found that their Mg excretion was doubled, Ca excretion tripled, and oxaluria somewhat decreased. The Ca crystallization attributed to the increased Ca2+ in the urine is, therefore, somewhat held in check by the increased presence of Mg in the urine and by decreased oxalates.
Twenty patients with severe infections were treated with a fixed combination of ticarcillin + clavulanic acid. Nineteen of them had severe underlying diseases. Fifteen were bacteraemic; four of these were in shock. Eleven were infected with microorganisms resistant in vitro to ticarcillin. Eleven were clinically cured, 6 improved and 3 failed to respond, the latter being infected with ticarcillin-resistant microorganisms (2 E. coli, 1 P. mirabilis). Six patients experienced side-effects, which were usually mild and reversible, consisting mainly of moderate elevation of serum transaminases. In one patient ticarcillin-clavulanic acid was stopped due to worsening of a pre-existing drug hepatitis.
Pure calcium oxalate monohydrate lithiasis is rare--about 5 to 10% of total renal lithiases. The proportion is the same in men and women. Pure calcium oxalate stones are a polished dark brown color, and are very hard. They are visualized radiologically as regular and homogeneous. From a biological standpoint, this type of stone is frequently associated with normal calciuria and oxaluria. Pure calcium oxalate monohydrate stones rarely evolve.
Tyrosine hydroxylase (TH) and dopamine beta-hydroxylase (DBH) activities, dopamine (DA), noradrenaline (NA), adrenaline (A), met 5-enkephalin (Met-Enk), leu5-enkephalin (Leu-Enk), dynorphin (Dyn) and beta-endorphin (beta-end) were measured simultaneously in ten human pheochromocytomas = 1 - TH activity was highly variable, from 22 to 2220 U/g tissue. 2 - DBH activity, in contrast, was rather constant, from 96 to 582 U/g. 3 - Catecholamines (A and NA) concentrations showed only small variations. 4 - The four opioid peptides were detected in all cases and exhibited a wide range of tissue concentrations (Enk much greater than Dyn greater than beta-end). 5 - Met-Enk and Leu-Enk concentrations were highly correlated; no correlation was observed with the other opioid peptides. 6 - A very strong correlation was observed between enkephalins concentrations and both catecholamines concentrations and DBH activities. These results are discussed in term of the significance of the co-localization of these various biologically active substances, principally with regard to the possible regulation of catecholamine synthesis by opioid peptides and conversely.
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Calculi of pure calcium oxalate monohydroxide are hard, polish, dark brown stones, of a very tenuous crystalline structure. On the contrary, calculi of pure bihydroxide oxalate are clear irregular stones with a spiky surface. They are more friable and less hard than monohydroxide oxalate stones. Monohydroxide oxalate stones radiologically are regular and homogeneous, whereas bihydroxide oxalate stones have an irregular aspect. Monohydroxide oxalic lithiasis is less frequent than bihydroxide oxalic lithiasis. The proportion of monohydroxide lithiasis is the same in men and women whereas bihydroxide lithiasis is more frequent in men. Of a biologic point of view, in monohydroxide lithiasis, calciuria and oxaluria are often normal while proportion of hypercalciuria and hyperoxaluria is more important in bihydroxide lithiasis. Evolutivity is clearly inferior in monohydroxide lithiasis than in bihydroxide lithiasis.
When measured in post-mortem human control brains, the ratio of Met5-enkephalin levels to those of Leu5-enkephalin varied from 1 to 13 in the 11 areas examined. In parkinsonian brains a significant reduction in the levels of both peptides was found in the pallidum and putamen whereas only Met5-enkephalin levels were decreased in the substantia nigra and ventral tegmental area. Therefore, Met5-enkephalin and Leu5-enkephalin may be located (at least partly) in different neuronal populations in the human brain.
The normal value of oxaluria, as determined by gasliquid chromatography, is about 30 mg/24 h. In most cases of renal stone formation (60-70%) the stones are composed of calcium oxalate alone or associated with calcium phosphate. The more evolutive the disease, the higher the oxaluria. The part played by oxaluria in renal stone formation and the need to include its determination in regular examinations of stone formers must be stressed. Treatment of hyperoxaluria is both medicinal and dietetic : control of oxalic acid-rich food intake and reduction of the intestinal absorption of oxalate caused by calcium-deprived diets. The diet must be completed by therapeutic measures aimed at reducing the oxaluria and increasing the urinary factors preventing crystallization.
A mitochondrial preparation from adult duck adrenal gland was used to study the mechanism (dehydrogenation or other) of the last step of aldosterone biosynthesis (18-oxidation) by incubation of tritiated 18-hydroxycorticosterone. Results show that the role of citric acid cycle metabolites is to provide reducing power. When reducing power is provided by malate, which yields NADH or NADPH directly, the reoxidation of reduced coenzymes in the oxidative phosphorylation chain is not necessary. In the presence of succinate, the oxidative phosphorylation chain is required, but only to provide ATP. Stimulation of the reaction by low concentrations of KCN in the presence of malate shows that the reducing power is not used in the oxidative phosphorylation chain. These data suggest that the reaction is not a dehydrogenation and that the reducing power is used in a pathway competing with the respiratory chain, most probably a hydroxylating pathway, in mitochondria.
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The ability of latex agglutination (Slidex Pneumokit) and counterimmunoelectrophoresis to detect Streptococcus pneumoniae antigen in body fluids was evaluated. The patients were classified as having proven Streptococcus pneumoniae infection, suspected Streptococcus pneumoniae infection, acute superinfection of chronic bronchitis or non-pneumococcal respiratory infection. Sixty-two non-pneumococcal meningitis patients were also included in the study. Latex agglutination and counterimmunoelectrophoresis tests were performed on serum, urine and cerebrospinal fluid specimens when indicated and repeated each week until the patient was discharged. Latex agglutination was done on samples boiled for 10 min. In vitro sensitivity of counterimmuno-electrophoresis and latex agglutination were 10 and 1 ng/ml respectively for type three antigen. In pulmonary disease (proven and suspected Streptococcus pneumoniae infection) counterimmunoelectrophoresis and latex agglutination had a clinical sensitivity of 72.9 and 87.5% respectively, a specificity of 96.3 and 92.6%, a predictive value for a positive test of 97.2 and 95.4% and for a negative test of 66.6 and 80.6%. Latex agglutination may offer an alternative to counterimmunoelectrophoresis in the rapid diagnosis of Streptococcus pneumoniae infections since it is easier to perform and gives a reliable result within 15 min.
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Radioisotopic competition of angiotensin II (A II) together with the use of structural analogues of this peptide are the two main methods of investigating the physiopathology of this hormone. Of great theoretical interest, the results of radioimmunological assay of plasma A II should be interpreted with caution because of the methodological difficulties related to its measurement and to the metabolic situation of A II. The values of the plasma A II alone do not provide additional information compared to PRA and are not representative of the pressor and biological effects of the hormone. The inhibitors of A II, although they too have a certain agonist activity, represent a method of precise investigation of the peripheral role of the hormone.
The conditions which must be respected to ensure the validity of the biochemical diagnostic criteria of primary hyperaldosteronism, conditions of blood sampling, timing posture and age of the patient, sodium intake and intercurrent drug therapy. As none of the tests is 100 p. 100 specific in distinguishing adrenal adenoma from hyperplasia, an association of several investigations has to be used. In cases of adenoma, the authors recommend the investigations which demonstrate the autonomy of secretion and the prevalence of circadian rhythm over the influence of change in posture. The measurement of aldosterone levels may be completed by that of its precursor, 18-hydroxy-corticosterone (18 OH CS).