Search PubMed⌕ Search

Biomedical subjects

J L Vilde

Publications and source records attributed to J L Vilde.

At least 73 records · Page 4Linked to original sources
PubMed1988

Treatment of central nervous system toxoplasmosis with pyrimethamine/sulfadiazine combination in 35 patients with the acquired immunodeficiency syndrome. Efficacy of long-term continuous therapy.

Thirty-five patients with the acquired immunodeficiency syndrome (AIDS) and central nervous system toxoplasmosis, seen over a 30-month period, were treated with the combination pyrimethamine/sulfadiazine. All patients had clinical and computed tomographic scan findings consistent with active neurotoxoplasmosis. Mean duration of total therapy was six months. During the first two months of therapy, four patients died of acute neurotoxoplasmosis and 31 showed improvement. Of the 24 patients evaluable for long-term therapy, 14 (58 percent) achieved complete resolution and 10 had late clinical (n = 7) and/or computed tomographic scan (n = 6) sequelae. Six patients experienced 10 relapses, which occurred within six weeks of treatment discontinuation in seven of 10. Reintroduction of the combination led to complete resolution of the relapse in eight cases. These clinical results were correlated with brain anatomic findings in the 15 autopsied cases. Side effects, noted in 25 of 35, were mainly hematologic toxicity (n = 21) and cutaneous rash (n = 12). However, the combination had to be definitively stopped in only two cases and sulfadiazine alone had to be withdrawn in eight other cases. These data suggest that pyrimethamine/sulfadiazine is highly efficacious in neurotoxoplasmosis and that life-long therapy is needed to prevent relapses in patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Susceptibility of Plasmodium falciparum to a peroxidase-mediated oxygen-dependent microbicidal system.

The viability of Plasmodium falciparum in culture was assessed by [3H]hypoxanthine incorporation during 24 h of incubation with lactoperoxidase, glucose-glucose oxidase, hydrogen peroxide, halides, or thiocyanate, alone or in combination. Synergistic inhibition was produced by the following combinations: lactoperoxidase plus hydrogen peroxide, lactoperoxidase plus glucose-glucose oxidase, and lactoperoxidase plus hydrogen peroxide plus halides or thiocyanate. These inhibitory effects were reversed by catalase and glutathione. The presence of plasmodial crisis forms inside the erythrocytes suggests that the oxygen-dependent microbicidal system of phagocytes has a killing effect.

Animals↗
PubMed1988

[Stimulation of the chemiluminescence of human polymorphonuclear leukocytes in various stages of the intraerythrocyte development of Plasmodium falciparum].

The synchronized cultures of Plasmodium falciparum were used to stimulate in vitro the chemiluminescence of human polymorphonuclear leukocytes in the presence of immune serum. The schizonts were concentrated by Percoll gradient centrifugation method (density 1.085 and osmolarity 285 mOsmol), and placed in culture, treated 6 hours later by sorbitol. Under incubation at constant temperature and pressure, the rate of synchronization reached 85% for schizonts during 5 replicative cycles. Every asexual stages of Plasmodium falciparum were used separately to stimulate polymorphonuclear leukocytes: merozoites were the most effective, followed by schizonts, trophozoites, and lastly supernatants of cultures containing degradation products of parasites.

Animals↗
PubMed1988

[Pharmacokinetics and tolerance of ceftriaxone after subcutaneous administration].

Having affirmed that a dose of 2 g ceftriaxone (CTRX) administered subcutaneously (SC) to healthy volunteers was well absorbed, the same dose administered to eight patients first intravenously (days 1 to 3), then SC (days 4 to 6). Plasma levels obtained after SC administration are similar to those obtained after IV administration and are consistent with drug therapeutic efficacy. The poor tolerance of CTRX when administered SC represents a very important limiting factor on the administration of a 2 g dose via this path.

Adult↗
PubMed1987

Fifty cases of late prosthetic valve endocarditis: improvement in prognosis over a 15 year period.

The clinical course, prognostic factors, and management of 50 cases of late prosthetic valve endocarditis, occurring more than two months after valve replacement, were reviewed. Twenty nine cases that presented from 1971 to 1980 were compared with 21 cases that presented from 1981 to 1985. Apart from an appreciable decrease in the frequency of neurological complications between the first period (38%) and the second period (10%) no differences in clinical or bacteriological features were seen. Seventeen (59%) of the 29 cases in the earlier period and four (19%) of the 21 cases in the later period died. The rationale for antimicrobial treatment was similar during both periods. Cardiac surgery was performed in eight of 29 cases between 1971 and 1980 and in 11 of 21 between 1981 and 1985; the mean (SD) time between diagnosis of endocarditis and operation was 28 (19) days and 43 (44) days respectively. Six of the eight cases operated on in the first period died as did two of the 11 operated on in the second period. Twenty seven of the 29 cases presenting between 1971 and 1980 were treated with anticoagulants--either warfarin (15 of 27) or heparin sodium (12 of 27). Sixteen of the 21 cases presenting later were given anticoagulants and 15 of these cases were given heparin sodium. Control of anticoagulation was inadequate in nine of the 27 cases treated with anticoagulants during the first period and in only two of 16 treated during the second period. During the first treatment period neurological complications were more frequent when control of anticoagulation was inadequate.

Adult↗
PubMed1986

Efficacy of pefloxacin in comparison with erythromycin in the treatment of experimental guinea pig legionellosis.

Pefloxacin was compared to erythromycin in the treatment of guinea pigs severely infected with Legionella pneumophila. In this experimental model, two single intraperitoneal injections of either pefloxacin (10 mg/kg at 48 h and 5 mg/kg at 55 h) or erythromycin (40 mg/kg at 48 and 55 h) were administered 48 h post-infection (2 X 10(7) virulent L. pneumophila intraperitoneally). Counts of bacteria in blood monocytes and lungs of animals killed at different times after the completion of treatment, demonstrated a quick and highly significant reduction of the pretreatment bacterial load in pefloxacin-treated guinea pigs. Conversely, in erythromycin-treated animals the number of bacteria was only slightly reduced 17 h after the completion of the treatment and then multiplication up to pre-treatment levels occurred. The overall mortality was significantly lower in pefloxacin-treated animals with this therapeutic protocol. The remarkable results of pefloxacin in this model, were obtained with serum and lung levels of this drug lower than those achieved in man with the currently accepted regimens. Thus, pefloxacin appears to be a new promising antimicrobial agent for Legionnaire's disease.

Animals↗
PubMed1986

Role of immune serum and complement in stimulation of the metabolic burst of human neutrophils by Plasmodium falciparum.

Interaction between human neutrophils (polymorphonuclear leukocytes [PMN]) and Plasmodium falciparum in the natural defense of the host remains to be elucidated. In patients with acute malaria, oxygen consumption (QO2) of PMN at rest and after stimulation by zymosan was significantly increased compared with that in the controls. With 10% immune serum, both QO2 and chemiluminescence of normal PMN were significantly increased after stimulation by a P. falciparum erythrocyte culture. This activation was not observed with a nonparasitized erythrocyte culture and was correlated with parasitemia. Immune serum and complement were required to trigger this metabolic activation of normal PMN. With normal serum or heat-inactivated immune serum, a parasitized erythrocyte culture did not significantly stimulate QO2 or chemiluminescence of normal PMN. The classical complement pathway was essential for this stimulation, whereas the alternate pathway was less involved. Hyperimmune sera from subjects residing in endemic areas were more able to trigger the metabolic burst than were immune sera from subjects from other sources. The use of synchronous cultures showed that PMN were more stimulated by cultures rich in merozoites than by the same cultures which contained only intraerythrocytic forms. Giemsa staining showed granules of hemozoin and occasional merozoites or parasitized erythrocytes within PMN. This increase in production of activated oxygen radicals could damage intra-or extraphagocytic parasitic forms. As P. falciparum is sensitive to oxidant stress and PMN is the phagocyte with the most intense metabolic burst, the role of PMN in defense against malaria should be considered.

Antigen-Antibody Complex↗
PubMed1986

[Association of bacterial endocarditis and alcoholic cirrhosis in 9 patients].

Ten cases of bacterial endocarditis were observed in cirrhotic patients. In 7 cases, endocarditis was due to group D Streptococcus, 5 of which were Streptococcus D. bovis. Special features were the involvement of tricuspid valve and the involvement of two or more valves in 4 cases. Surgery was necessary in the acute phase in 5 patients: cure was definitely obtained in 8 cases after a particularly long interval. A colonic lesion could have been the portal of entry in some cases. Liver cirrhosis was considered as a predisposing factor for bacterial endocarditis, especially due to group D Streptococcus or to other bacteria of intestinal origin. This is probably related to the frequency of the colonic origin of group D Streptococcus endocarditis. Loss of filter function of the liver may partly explain the features of these forms of endocarditis.

Adult↗
PubMed1986

[Ultrastructural markers in LAV-HTLV III virus infection: study of the rectal mucosa in 16 patients].

Ultrastructural study of rectal mucosa was performed in 6 patients with AIDS related complex (ARC) and in 10 patients with AIDS. There were 16 men (mean age: 39.1 years): 8 homosexuals, 3 Haitians, 2 Africans and 3 IV drug abusers, all having significant titers of LAV antibodies. Two types of ultrastructural markers were observed: tubuloreticular structures (TRS) were found in endothelial cells, lymphocytes and macrophages in 1/6 ARC patients and 10/10 AIDS patients. TRS have already been described in various pathological situations and seem to be related to alpha-interferon, test tube and ring shaped forms (TRF) were observed in lymphocytes and macrophages in 0/6 ARC patients and 6/10 AIDS patients. TRF have been rarely reported previously. The 6 AIDS patients with TRF were 4 homosexuals and 2 Haitians. In two of three of these patients in whom repeated ultrastructural studies were performed, the same markers were found. All AIDS patients with TRF died within a mean time of ten months after the diagnosis had been established, whereas 1/4 AIDS patients without TRF died within seven months and the three others survived for more than 14 months. These data suggest that the association of TRS and TRF in the rectal mucosa could be specific of AIDS. In LAV/HTLV III retro-virus infection, this association is an aggravating factor.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Clinical and echocardiographic observations in pulmonary valve endocarditis.

Clinical and echocardiographic data from 12 patients with pulmonary valve endocarditis are described. Seven patients had isolated pulmonary endocarditis and in 5 patients other valves were infected (aortic, tricuspid, mitral or all 3). Two patients were heroin addicts and 4 had underlying heart disease (congenital heart disease in 3 and aortic regurgitation in 1 patient). The organisms involved were alpha streptococci in 3 patients (all with underlying heart disease), Staphylococcus aureus in 4, Streptococcus D bovis in 1 patient and Candida guillermondii in 1. M-mode and 2-dimensional echocardiography was performed in 10 patients and revealed vegetations in 8. Pulsed Doppler echocardiography was performed in 6 patients and revealed pulmonary regurgitation in all 6. Seven patients had pulmonary emboli. Four patients underwent surgery. Four patients died, including 1 after cardiac surgery. Five patients, including the patient infected with Candida guillermondii, recovered with antibiotic treatment.

Adolescent↗