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J M Ragnaud

Publications and source records attributed to J M Ragnaud.

At least 91 records · Page 5Linked to original sources
PubMed1992

Tuberculosis in patients infected with human immunodeficiency virus 1. A retrospective multicentre study of 123 cases in France. The Groupe des Infectiologues du Sud de la France.

In order to study the epidemiological, clinical, and progressive characteristics of TB in HIV-infected individuals, a retrospective study was conducted in nine infectious disease centres of university hospitals located in the southern half of France. Among the 5730 HIV-seropositive in- and out-patients, 123 (2.1 per cent) had TB (121 infections caused by M. tuberculosis, 2 by M. bovis). Tuberculosis was pulmonary in 53 patients (43.1 per cent), extrapulmonary in 36 patients (29.3 per cent), and combined in 34 patients (27.6 per cent). There was no statistically significant difference among these three locations as to the mean CD4 count/mm3 (160 +/- 17), the type of antituberculosis therapy, the length of treatment (10.8 +/- 0.6 months) and the outcome. Fifty-two (45.2 per cent) patients received an initial antituberculosis therapeutic regimen of four drugs: isoniazid, rifampicin, ethambutol, pyrazinamide; 54 (46.9 per cent) were started on three drugs: isoniazid, rifampicin, ethambutol; and nine (7.8 per cent) received a two-drug combination: isoniazid, rifampicin. Fourteen of 75 patients subsequently received secondary preventive therapy. The mean follow-up time was 252 +/- 290 days. Clinical healing was obtained in 57.7 per cent of patients. Forty-six patients died, 33 during treatment: 23 from AIDS and eight from TB (in the first 3 weeks of treatment). Five patients suffered from relapses due to poor treatment compliance. Patients had a good prognosis if tuberculosis was diagnosed early.

Adult↗
PubMed1992

Women and HIV infection: a cohort study of 483 HIV-infected women in Bordeaux, France, 1985-1991. The Groupe d'Epidémiologie Clinique du SIDA en Aquitaine.

OBJECTIVES: To study the epidemiological trends, clinical patterns, evolution and prognosis of HIV infection in women. DESIGN: Cohort study of 1816 HIV-infected patients. RESULTS: Up to 1 January 1991, 483 (26.6%) of the patients reported to the Groupe d'Epidemiologie Clinique du SIDA en Aquitaine surveillance system were women. The male-to-female ratio has decreased progressively (3.4:1 in 1985; 2.7:1 in 1990) over time. Fifty per cent of HIV-infected women are or have been intravenous drug users (IVDU). The proportion of heterosexually acquired HIV infection increased from 11.6 to 34.6% over the last 5 years; 46.9% of the women infected through heterosexual intercourse reported sexual contacts with male IVDU. Excluding Kaposi's sarcoma, no significant difference was observed between men and women in the overall distribution of AIDS-defining events. The observed trend of a slower progression to AIDS in women, compared with men, disappeared when controlling for prognostic variables. However, female sex significantly enhanced survival after AIDS diagnosis in multivariate analysis (relative risk, 2.7; 95% confidence interval, 1.1-6.2). CONCLUSION: Early diagnosis of HIV infection in female patients and prevention of HIV infection among women is now a priority for public health interventions, both in industrialized and in developing countries.

AIDS-Related Opportunistic Infections↗
PubMed1991

IgM cryoglobulin deposits in the peripheral nerve.

In a patient with Waldenström's macroglobulinaemia and peripheral neuropathy, direct immunofluorescence of a peripheral nerve revealed the presence of abundant IgM and kappa light chain deposits in the endoneurium. Electron microscopic examination showed the microtubular structure of these endoneurial deposits, which strongly suggested the presence of cryoglobulin; this was then found in the serum.

Aged↗
PubMed1991

[Flash antibiotic prophylaxis in endoscopic resections of the prostate: cefamandole versus ceftriaxone].

The aim of this study is to compare the efficiency of Cefamandole and Ceftriaxone in short-term antibioprophylaxis after transurethral prostatectomy. Ceftriaxone reduces significatively postoperative febrile reactions, although no difference is seen between the 2 regimens: 27% in group Cefamandole versus 18% in group Ceftriaxone. Postoperative urinary tract infections do not depend neither on time resection nor on weight of resected tissues. Bladder catheter removal should be treated by short-term antibiotics in order to further reduce postoperative infections.

Aged↗
PubMed1989

[Treatment of peritonitis under continuous ambulatory peritoneal dialysis using intraperitoneal ceftazidime].

Management of peritonitis related to chronic ambulatory peritoneal ceftazidime. In 15 patients under CAPD, 22 cases of bacterial peritonitis were observed with clinical manifestation in 14. The mean cell count in peritoneal dialysis fluid was 3 580/mm3 with 3 040/mm3 polymorphonuclear leukocytes. Causative pathogens were: Staphylococcus in 11 cases, Streptococcus in 3, Sarcines in 2, Corynebacterium in 2, Micrococcus varians in 1, Gram negative in 3. First choice treatment was a intraperitoneal injection of 1 g of ceftazidime every 48 hours, 54.5% of patients recovered within 5 days. Failures were due to 4 Staphylococcus aureus, 3 Staphylococcus epidermidis, 1 Sarcine, 1 Streptococcus liquefaciens, 1 Corynebacterium hofmanii. Mean ceftazidime concentrations 48 hours after the intraperitoneal injection were 35 mg/l (range = 14-54 mg/l) in serum and 5.5 mg/l (E: 2.8,8 mg/l) in dialysate. These concentrations in dialysate, are not greater than most of ceftazidime'S CMI for susceptible bacteria. A single daily intraperitoneal injection of ceftazidime is desirable.

Adolescent↗
PubMed1989

[Actinobacillus ureae meningitis. Apropos of a case].

A case of Actinobacillus ureae meningitis in a 52 year old man with an history of chronic sinusitis and previous skull fractures is reported. Actinobacillus ureae, called for a long time Pasteurella ureae, is a rare cause of meningitis as shown by a short review of the literature (eight cases reported). We have searched the bacteria in the rhinopharynx of the patient's four dogs: this search was unsuccessful in agreement with the literature data which has not yet established an animal host for Actinobacillus ureae.

Actinobacillus Infections↗
PubMed1989

[Use of a thin wall Impra prosthesis for a vascular approach in chronic hemodialysis. Short- and middle-term evaluation. Apropos of 66 cases].

The authors report their experience of thin wall PTFE IMPRA prostheses in providing vascular access for chronic haemodialysis. Sixty-six prostheses were inserted between 14/10/1983 and 31/10/1986, with review of all patients at 31/6/1987. Twenty-three per cent of patients died during the study period. Patency analysed by the actuarial method was 49.07 +/- 15.7% at 2 years. There was no evidence of any significant difference between use of the forearm and of the arm. The main cause of failure was early (responsible for the loss of 9.2% of prostheses) or secondary (after the first month) thrombosis. A total of 30.3% of prostheses were lost by thrombosis by the end of 2 years, the principal cause being anastomotic or post-anastomotic venous stenosis. The use of thin walls in no way modified the incidence of this complication. The authors suggest its preventive protection by routine ansography. False aneurysms occurred beyond 18 months of dialysis requiring removal of the prosthesis in 3 cases. Thinning of the wall is one of the probable factors involved in this complications, justifying the abandonment of this type of prosthesis in this indication despite technical advantages at implantation and during use.

Adolescent↗
PubMed1989

[Comparative study of 2 antibiotic prophylaxis regimens in endoscopic prostatic surgery].

This study compares a short antibioprophylaxis of 24 hours to a single injection treatment by cefamandole in endoscopic resection of the prostate. 122 patients were separated in two groups by randomisation. 61 patients received 1.5 g of cefamandole at induction of anaesthesia and 750 mg every six hours during 24 hours after surgery. The other 61 patients received a single injection of 1.5 g of cefamandole at the induction of anaesthesia. Both series were comparable in age, prostatic pathology, time of resection, weight to the resected prostate, the day of removal of the urinary catheter, the day of departure. In the first group, we found eight obvious infections and 10 occult infections with positive urinary microscopic examination; and in the second group, we found 11 obvious ans 4 occult infections with positive urinary microscopic examination. In both infected groups, we found mainly Pseudomonas aeruginosa. Both treatments were equally well accepted. The authors prefer the single injection treatment because of the low cost and absence of statistically significant differences between the two treatments.

Aged↗
PubMed1988

[Treatment of peritonitis in continuous ambulatory peritoneal dialysis with intraperitoneal ceftriaxone].

In 16 patients under CAPD, 29 cases of bacterial peritonitis were observed, with clinical manifestations in 23. The mean cell count in peritoneal dialysis fluid was 5608/mm3 with 4991/mm3 polymorphonuclear, Leukocytes Causative pathogens were Staphylococcus in 14 cases, Streptococcus in 6, Bacillus in one, Enterobacteria in 5, Pseudomonas aeruginosa in 1 and Moraxella in 1. Three cultures were negative. First choice treatment was a daily intraperitoneal injection of 1 g of ceftriaxone. 79.3% of patients recovered within 5 days. Failure were due to a Methicillin-resistant Staphylococcus epidermidis in one case, a Streptococcus faecalis in two cases, and a Staphylococcus aureus in three observations, which two were responsible of abscess round catheter peritoneal. Mean ceftriaxone concentrations 24 hours after the intraperitoneal injection were 50.6 mg/l (range: 3.3-141 mg/l) in serum and 58.1 mg/l (range: 4.3-180 mg/l) in dialysate. These concentrations are greater than most of ceftriaxone's MICs for susceptible bacteria, a finding that confirm the value of treatment with a single daily intraperitoneal injection of ceftriaxone.

Adolescent↗
PubMed1988

[Influence of fever on cefotaxime pharmacokinetics].

The role of fever on cefotaxime disposition was studied in ten hyperthermic patients. Each subject received intravenously 1 g of cefotaxime on two separated occasions, first when the body temperature was more than 39 degrees C then during a basal state (37 degrees C). Blood samples were taken over 12 hours and urine was collected for 24 hours after injection. After dosing cefotaxime and its metabolite by high performance liquid chromatography, the pharmacokinetic parameters were calculated, especially: plasma and renal clearance, volume of distribution at steady state, area under the curve, and elimination half-life. There is no significant difference in cefotaxime and desacetylcefotaxime disposition between these two states. Hyperthermia has no influence on pharmacokinetics of this cephalosporin.

Adult↗
PubMed1987

[Septic localizations in septicemias].

Seventeen university hospitals have joined their observations of septicemias through an informatics system. 461 septicemias have been collected in 1985. 407 are septic localizations, 299 primitives and 108 secondary. The frequent localisations are urologic (20.4%), pulmonary (20.15%), cutaneous (10.56%), abdominal (10.56%), cardiac and neurologic (9.58%). In 51.8%, the organisms are Gram positive cocci (Staphylococcus 23.9%, Streptococcus 27.9%). In 46.9% septic localizations are due to Gram negative bacilli with Escherichia coli (50.2%). The origin of septicemia is urologic (18%), abdominal (15.8%), cutaneous (8.7%), pulmonary (8.7%), stomatologic (7.2%), venous (4.3%). Gram positive cocci infections have more septic localizations than Gram negative bacilli infections. The mortality is more increased in pulmonary localizations (35%) than in the others localizations: venous (20%), cutaneous (19%), urologic (11%) and stomatologic (10%). Septic localizations which required the most of an antibiotics association are osseous (81.5%) and cardiac (80.5%), where as all septicemias require two antibiotics in 51%.

Bacterial Infections↗