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Biomedical subjects

J M Estavoyer

Publications and source records attributed to J M Estavoyer.

At least 55 records · Page 3Linked to original sources

[Value of rifampin in the treatment of staphylococcal septicemia].

Analysis of 20 cases of staphylococcal septicemia, observed over 1 1/2 months in a general hospital, confirms that these infections are frequent and severe. They occurred in compromised hosts and were nosocomial infections in 2/3 of cases. An intravenous device (particularly a central venous catheter) was associated with 70% of staphylococcal septicemia. Study of bacterial susceptibility to antibiotics and clinical course leads to advocate that high risk patients with fever be initially given rifampin combined with netilmicin.

Adolescent↗

[Treatment of human alveolar echinococcosis with flubendazole. Clinical, morphological and immunological study].

Flubendazole has been given at a daily dosage of 50 mg/kg for 16 months (extremes 10 and 24 months) to 10 patients with hepatic alveolar echinococcosis. Clinical, morphological and immunological evaluations have been performed every 2 months during the treatment, and in 6 patients after discontinuation of the drug for 24 months. Jaundice persisted or occurred in 7 patients; infectious complications were observed in 4 patients; portal hypertension appeared in 5 patients; metastatic spread was suspected in 2 patients. Subjective improvement and weight gain were reported by 6 patients during the first 4 months of treatment. Severe complications occurring during the period of FZ therapy or within 2 months after withdrawal of the drug led to surgery in 6 patients, and death occurred in 3 cases. These observations demonstrate the inefficacy of FZ in this series of 10 patients with alveolar echinococcosis, possibly related to the extremely poor bioavailability of FZ. Higher plasma concentrations obtained with mebendazole and albendazole could explain the better efficacy of these two drugs despite their similar chemical structures and experimental toxicity upon larval cestodes.

Adult↗

[Pathogenicity of Fusobacterium. Apropos of 2 cases].

Two cases of severe septico-pyohaemia due to Fusobacterium necrophorum are reported. Clinical data from human cases and experimental results from infections of laboratory animal with Fusobacterium necrophorum suggest: the important role of individual factors which enhance anaerobic growth (i.e. decrease of tissular redox potential); the involvement of thrombophlebitis with septic thrombi increasing the frequency of metastases; the early and long-lasting bacterial localisation in tissues, particularly in the liver where the proliferation of Fusobacterium necrophorum in Küpffer cells impairs macrophage function.

Adult↗

[Skin manifestations of Still's disease in adults. Apropos of 4 cases].

The authors report four new cases of Still's disease in adult. Each time, the clinical picture associated the following triad: fever, joint involvement and skin rashes. The latter consisted in non-pruritic but sensitive maculo-papular and disseminated lesions, the mean course of which lasted 24 to 48 hours and were readily accompanied by the two other components of the basic clinical triad. Laboratory investigations were non-specific but constantly included a polymorphonuclear leucocytosis and a raised ESR, the mean value of which reached 80 mm in the 1st hour. Antinuclear factors were not demonstrated, but circulating immune complexes were found on several occasions in three out of the four reported cases. Histopathological changes observed were those of a superficial and mid cutis edema, associated with a diffuse or perivascular infiltrate in which either mononuclears or polymorphonuclears were prominent. Dermal vessels involvement appeared rather weak, including swelling of the walls by edema with focal fibrinoid necrosis. Direct immunofluorescence showed mainly IgG, IgA and C3 vascular deposits. Based on these data, an immune pathology is discussed, besides the more classic infections pathogenesis.

Adult↗

[Haemorrhagic oedema acute in neonatal skin. Immunological and ultrastructural examination (author's transl)].

There are three reports on acute haemorrhagic oedema of the skin of infants, an illness which English-speaking authors do not individualize but only regard as a clinical variety of Henoch-Schönlein purpura. Yet the features of the disease, as described in children under two years of age, are very characteristic. --Clinical feature is the sudden appearance of oedemas on face and limbs and of cocarde-like purpura with an occasional temperature. --Histological feature is the presence of leukocytoclastic vasculitis. --Immunologically the disease is characterized by the deposit of immune complexes. --Ultrastructural examination confirms the presence of leukocytoclastic vasculitis accompanied by deposit of immune complexes and of platelets. These three reports enable the authors to study the nosological aspects of the illness among the varieties of allergic vasculitis.

Acute Disease↗

[Primary malignant tumor of the liver in children].

Primary malignant tumours of the liver in children are rare. They occur in more than 50% of cases before the age of 2 years. The clinical signs are very often limited to a large mass in the right hypochrondrium. A search for alphafoetoprotein and arteriography are the most useful investigations for diagnosis. The pathology leads one to distinguish hepatoblastomas and hepatocarcinomas. The prognosis in these tumours remains poor for, in spite of progress in liver surgery, a cure is rarely possible. It is important for doctors to recognize the existence of this tumour pathology in order to give a chance for surgery to succeed in these young children. To illustrate this, 5 cases from Besançon are reported here.

Adolescent↗

[Ciprofloxacin: intraocular absorption in man].

The intraocular penetration of Ciprofloxacin in man: authors have studied the penetration of Ciprofloxacin in the aqueous humor of 30 patients (30 eyes). The concentration in the anterior chamber was on average 0.73 mg/l which is 33% of serum level, from 1.30 hours after a single oral dose of 1000 mg till the 4th hour after this dose. The samples were assessed by a microbiological method. These results are over the minimal inhibitory concentration for many bacterial agents found in endophthalmitis. So this antibiotic may be proposed in the treatment of endophthalmitis. Anyway further investigation is mandatory to assess the safety on efficacy of these antibiotics.

Administration, Oral↗