Search PubMed⌕ Search

Biomedical subjects

J Grosset

Publications and source records attributed to J Grosset.

At least 127 records · Page 7Linked to original sources
PubMed1986

[Routine use of 6-month antitubercular treatment in 300 patients].

Over a 2-year period, all patients with incipient tuberculosis seen in a hospital unit were given a 6-month treatment consisting of rifampicine, isoniazide, pyrazinamide and ethambutol. A retrospective study of these 300 patients showed that the treatment was effective, with no failure if taken for more than 2 months. Relapses were rare when the drugs were taken regularly, the responsible M. tuberculosis strain was sensitive, and there was no associated malignancy (present in 1.4% of the cases). The drugs were moderately well tolerated, and treatment had to be modified because of side-effects in 4.6% of the patients. It also appeared that 57% of the patients fully complied with the prescription, and 16% were lost sight of by the hospital unit. Treatment was altered in 36% of the cases, but in 16% changes were introduced by private doctors for reasons which retrospectively proved to be without medical grounds. It is concluded that this 6-month chemotherapeutic regimen was effective in more than 98% of the cases, and that the main problem in management of tuberculosis is the patient's compliance with treatment.

Adolescent↗
PubMed1986

Superinfection by Aspergillus fumigatus of a pulmonary lesion caused by Mycobacterium xenopi.

A 36-year-old man had a pulmonary infection with a cavity in the right upper lobe caused by Mycobacterium xenopi. A superinfection by Aspergillus fumigatus occurred 1 year later. Both organisms were found in the resected lung specimen. The patient remained asymptomatic after surgery. The superinfection of healed tuberculous lesions by 'atypical' mycobacteria or Aspergillus species is well known but the co-existence of the 2 organisms is very rare.

Adult↗
PubMed1985

[Prevention of resistance to rifampicin by pyrazinamide in experimental tuberculosis in the mouse].

The capacity of Pyrazinamide (PZA) to prevent the selection of Rifampicin (RMP) resistant mutants was tested by the intravenous innoculation of 160 mice with 2 X 10(6) c.f.u. of M. tuberculosis, and two weeks later, the treatment of the mice either with 10 mg/kg/day RMP alone or with RMP + PZA 150 mg/kg/day. After three months of treatment, lungs and spleen were culture positive in respectively 95% and 90% of the mice treated with RMP alone and in 37% and 24% of the mice treated by RMP + PZA (p less than 10(-5). The strains isolated from lungs and spleen were resistant to Rifampicin in respectively 87% and 75% of the mice treated with RMP alone and in none of those treated with RMP + PZA.

Animals↗
PubMed1984

[Mycobacterioses].

Mycobacteriosis are opportunistic infections caused by atypical mycobacteria. These have microscopic features resembling those of tubercle bacillus but differ in their cultural and biochemical characteristics and above all, their resistance to antituberculous antibiotics. The lesions chiefly involve the lungs, the lymph nodes or the skin and usually mimick those of tuberculosis. The diagnosis rests on repeated isolation in pathological specimens of the same atypical mycobacterium with a sufficient number of colonies, or on its sole presence in effusion fluids, biopsies or surgical specimens. Treatment with antibiotics is disappointing, except for M. kansasii. Surgical treatment can only be considered in those exceptional cases when the patient is young, has limited lesions and is not immuno-depressed.

Abscess↗
PubMed1984

Survey of the phenotypes of susceptibility to beta-lactams in Enterobacteriaceae at the Pitie-Salpetriere Hospital.

The phenotypes of susceptibility to ampicillin, carbenicillin, cephalothin, cefamandole, cefoxitin and cefotaxime were determined by the disc-diffusion method in 10,994 Enterobacteriaceae consecutively isolated from in-patients during 18 months. The susceptible phenotypes were much more frequent among Escherichia coli, Proteus mirabilis and Klebsiella (67.4 to 84.8%) than among Serratia, Enterobacter and Citrobacter (8.8 to 35.5%). In all species the most common resistance phenotypes were to ampicillin and carbenicillin: E. coli (28%), Pr. mirabilis (15.2%), Klebsiella (23.8%), indole-positive Proteus (33.3%), Serratia (74.4%), Enterobacter (61.4%) and Citrobacter (74.8%). Among E. coli 4.6% of the strains were resistant to ampicillin and cephalothin but susceptible to carbenicillin. Among E. coli, Pr. mirabilis and Klebsiella the strains susceptible only to cefotaxime represented 0.3 to 5% and no cefotaxime-resistant strain was isolated; whereas among Serratia, Enterobacter and Citrobacter the former represented 28.3 to 58.3% and the latter 7.5 to 18.5%. Some important differences in the distribution of the phenotypes according to the type of ward were observed.

Anti-Bacterial Agents↗
PubMed1984

The management of thirty immunocompromised patients with tuberculosis.

Between 1978 and 1981, 30 of 870 bacteriologically confirmed cases of tuberculosis occurred in immunocompromised hosts. One year after the diagnosis, 11 patients were dead, only 2 of them of tuberculosis. In the other 19 patients, the course of tuberculosis under standard chemotherapy was the same as in nonimmunocompromised hosts. Among the 24 patients still alive more than 2 months after the diagnosis of tuberculosis, the treatment of the underlying disease was changed in 14 patients to avoid worsening of the course of tuberculosis; 5 patients died and 4 kidney transplant carriers rejected their transplants. The treatment of the underlying disease was not changed in 10 patients: all of these remained alive 1 yr later, and 2 were kidney transplant carriers who did not reject their transplants. We conclude that the clinical response of the immunocompromised tuberculous host was good and that treatment of the underlying disease should not be modified.

Adult↗
PubMed1984

[Pulmonary mycobacteriosis due to a non-chromogenic, slow-growing, unclassified mycobacterium].

A case is reported of a bilateral atypical mycobacterial infection, occurring in a 44 year old male with antecedent silicosis. Successful surgical resection was performed after 17 months of failed chemotherapy. The atypical mycobacterium which is unclassified is intermediate between Mycobacterium avium-intracellulare. Mycobacterium terrae complex and Mycobacterium gastri. It has some similarities with the newly described species, Mycobacterium malmöense.

Adult↗
PubMed1984

[Potential value of the amoxicillin-clavulanic acid combination in general medicine, gynecology-obstetrics and pediatrics departments].

This study compares the probability of in vitro activity of amoxicillin-clavulanic acid combination (AMOX-CLA) with those of amoxicillin (AMOX), cephalothin (CEPH), cotrimoxazole (COT) and nalidixic acid (NAL) on the 2 003 strains isolated during the first semester of 1983 in 5 wards of medicine (MED), 2 of gynecology-obstetrics (GYN) and 1 of pediatrics (PED) at the Pitié-Salpêtrière Hospital. As expected, AMOX-CLA was active on most of the strains of S. aureus, E. coli, P. mirabilis, Klebsiella and Bacteroides resistant to AMOX. AMOX-CLA was active on 70 to 86% of all strains, a higher rate than that of AMOX in all situations taken in concert. AMOX-CLA was more often active than AMOX on urinary strains by 17% in MED and GYN, 26% in neonates and 37% in children; it was more often active by 16% on strains isolated from the genital tract and from specimens taken at birth, and by 43% on strains isolated from pus. AMOX-CLA showed the same activity rate as CEPH whatever the infection and was as often active as COT and NAL on urinary strains in MED. On the opposite, activity rates of AMOX-CLA were lower by 6 to 15% than those of COT and NAL on urinary strains in GYN and PED of COT on strains isolated from pus in MED, GYN and PED. Therefore, AMOX-CLA was superior to AMOX in every case, and comparable to CEPH and often COT and NAL, whose use is restricted in pregnant women and neonates owing to side effects.

Amoxicillin↗
PubMed1983

[Cefotaxime, moxalactam and ceftriaxone: comparison of in vitro activity against hospital strains of Enterobacteriaceae belonging to the 4 principal phenotypes of sensitivity to beta-lactams].

MIC of ceftriaxone, moxalactam and cefotaxime is determined for 827 strains of Enterobacteriaceae isolated in the Central Laboratory of the Pitié-Salpêtrière Hospital between december 1981 and september 1982. Results are distributed according to the species involved and the pattern of sensitivity (S) and resistance (R) to ampicillin (A), carbenicilline (Ca) and cephalotin (Ct). Among the strains ASCaSCtS and ARCaRCtS cefotaxime and ceftriaxone have the lowest MICs. Among the most sensitive strains ARCaSCtR and ARCaRCtR cefotaxime, ceftriaxone and moxalactam have the similar MICs, whereas among the less sensitive ones moxalactam has the lowest MICs. The latter might be the cephalosporin of choice for the treatment of serious infection due to the less sensitive Enterobacteriaceae. On the other hand, cefotaxime and ceftriaxone might be the cephalosporins of choice for the treatment of serious infections due to the most sensitive Enterobacteriaceae.

Anti-Bacterial Agents↗
PubMed1983

[In vitro synergy between sulfamethoxazole and trimethoprim on strains of Staphylococcus aureus sensitive and resistant to methicillin].

The synergy between sulfamethoxazole (SMZ) and trimethoprim (TMP) is studied on 91 methicillin sensitive S. aureus strains (methi.S) and 95 methicillin resistant S. aureus strains (methi.R). In methi.S strains, the MIC 90% of SMZ, TMP and SMZ + TMP (19 SMZ/1 TMP) is respectively 64, 0.5 and 2 mg/l. 98% of methi.S strains have a FIC index less than or equal to 0.6 and only one strain has a FIC index greater than or equal to 0.6. In methi.R strains, the MIC 90% of SMZ, TMP and SMZ + TMP is respectively 256, 0.5 and 4 mg/l. 77% of methi.R strains have a FIC index less than or equal to 0.6. The relationship between FIC index and disc diffusion method is studied: bridging inhibition zone between SMZ 200 mcg disc, and TMP 2.5 micrograms disc and difference of the inhibition diameter between SMZ + TMP disc and TMP 1.25 micrograms disc. There is a good correlation only in methi.S strains in the first method and in methi.S and methi.R strains in the second method.

Drug Synergism↗
PubMed1983

[Activity of rifampicin administered daily and intermittently on experimental tuberculosis in mice].

Intermittent regimens with rifampicin (RMP) for chemotherapy of pulmonary tuberculosis are cheaper and can be usually supervised more easily than daily regimens. They are recommended, specially, in developing countries. The present study is designed to evaluate the reduction of RMP activity as the interval between doses is increased in experimental mouse tuberculosis. The mice are given 10 mg/kg oral doses of RMP once, twice, three times or six times a week. The RMP activity is measured as the decrease of viable counts (cfu) in the spleen of mice. RMP given once a week has no activity neither in combination with isoniazid and streptomycin on a large population of organisms nor alone on a small population. RMP given alone twice a week has an activity slightly better than RMP given once a week. RMP given alone three times a week has a weak but not worthy activity: the mean number of cfu after a three times weekly treatment is significantly lower than the mean number of cfu in control (p less than 0.001) but significantly higher than the mean number of cfu after a six times weekly treatment (p less than 0.001). These experimental results are consistent with the experimental data on the effects of RMP on the RNA polymerase. They are not favourable to the intermittent administration of RMP in the chemotherapy of tuberculosis.

Animals↗
PubMed1983

[Resistance of the Koch bacillus to antibacillary agents in the Department of the Lower Rhine].

The aim of this work was to study drug resistance of M. tuberculosis to Streptomycin (SM), Isoniazid (INH), Ethambutol (EMB) and Rifampicin (RMP) in the department of the Bas-Rhin from 1971 to 1978. On 2,995 original culture plates which were positive, 1,561 antibiograms were performed at the C.E.R.P. The proportion of those tested has increased over the years from 27.8% in 1971 to 80.6% in 1978 because of the increasing number of laboratories participating in the study. The research is based on 1,511 cultures of M. tuberculosis and the population was split into two groups: 1,386 untreated subjects or treated for less than 15 days (primary resistance) and 125 subjects who had already been treated (acquired resistance). Over all the years, primary resistance to at least one drug was 6.9%. Primary resistance to SM was 3.0%, to INH 2.2% and to both 1.4% (the levels of primary resistance to EMB and RMP were practically nil). Acquired resistance to at least one of these antibiotics was 16.0% with the same order as for primary resistance: resistance to SM alone = 7.2%, to INH alone 4.0% and both together 2.4%. The proportions were greater than for primary resistance but concerned fewer subjects as only 8% of the population had been previously treated. There were no cases of primary or acquired resistance to Rifampicin alone.

Adult↗
PubMed1983

[Adjusting or not adjusting isoniazid dosage?].

Between the 24 October 1977 and the 31 December 1978 a series of 299 patients were treated with triple therapy--Rifampicin, Ethambutol and Isoniazid; the latter was given in a standard dose of 5 mg/kg. Between the 1 January 1979 and the 31 December 1981 a second series of 448 patients were treated with the same combination, Isoniazid was given in a dose adjusted for acetylator status (Vivien et coll.). In all the patients the serum concentration of Isoniazid at 3, 6 and 12 hours (after a single oral dose of 5 mg/kg) were measured and the two series of patients were comparable. No significant difference was noted between the two groups regarding either efficacy or toxicity. The adjustment of Isoniazid dosage according to acetylator status has not resulted in any statistically significant benefit in those patients studied.

Acetylation↗
PubMed1983

[Activity of intermittently administered rifampicin and cyclopentyl rifamycin (or DL473) on experimental tuberculosis in the mouse].

The results of recent experiences with experimental tuberculous chemotherapy in the mouse give information on the activity of rifampicin (RMP) administered intermittently and on the activity of Cyclopentyl-Rifampicin (or DL473). The activity of RMP decreases as one spaces the treatment without increasing the dose. These observations are compatible with the known facts concerning the mechanism of action of RMP on RNA polymerase, and are unfavourable as regards the intermittent administration of RMP. Cyclopentyl-Rifampicin, a new derivative of Rifamycine SV, administered once per week, is as active as RMP administered six days per week, both in the initial as well as the continuation phase of treatment.

Animals↗