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Biomedical subjects

J Modai

Publications and source records attributed to J Modai.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Tuberculous meningitis in adults. Diagnostic elements: analysis of 32 cases].

The aim of this study was to determine the value of paraclinical investigations in the diagnosis of 32 adults with TB meningitis. Mycobacterium tuberculosis was found in spinal fluid cultures of 21 patients (66 p. 100). But only two had positive smears. In five with positive cultures the sampling was performed between one and 13 days after the beginning of chemotherapy. In 7 patients with negative spinal fluid cultures, mycobacterium tuberculosis was found in gastric contents aspiration (3); urine (2); bone marrow (1) and abscess (1). Cytochemical analysis of first spinal fluid samples showed an elevation of protein from 0.5 to 7 g/l in all patients (mean 2.1 +/- 1.6 g/l); sugar was low in 26 (mean 0.30 +/- 0.26 g/l); cell count was less than 500/mm3 in 26, with a mononuclear response in 24. 20 patients had lymphocytic and hypoglycorrachic meningitis. Cytochemical findings were independent of the delay between the first clinical symptoms and lumbar puncture. A. C. T. scan of the brain was performed in 8 patients with neurologic complications. Hydrocephalus was found in 3, and after the injection of contrast material, focal high-density areas in the basal cistern and the sulci of the cerebrum were observed in 2. Chest X ray showed miliary TB in 13 patients; but positive skin test for tuberculosis and hyponatremia were rarely helpful. To confirm adult tuberculous meningitis, we suggest that two spinal fluid samplings are necessary, but mycobacterium tuberculosis must be looked for simultaneously in the sputum, gastric contents, urine and bone marrow. Specific treatment can be started immediately after the first spinal fluid sampling. Chest X ray may be helpful, but C.T. scan of the brain and tuberculin test are of no value.

Adult↗
PubMed1983

[Tuberculous meningitis in adults. Prognostic factors].

Clinical and biochemical data likely to constitute prognostic factors were investigated in a retrospective study of 32 cases of tuberculous meningitis. Age appeared to be a much more important factor than the initial clinical severity of the disease and the delay of treatment. Over the age of 50 years, the mortality rate was doubled. There was no correlation between age and initial severity of the clinical picture. The number of cells and level of glucose in the CSF on admission were of no prognostic significance. CSF protein levels were higher in patients who died or developed complications than in those who made an uneventful recovery (p less than 0.05). The time required for temperature and CSF protein and glucose levels to return to normal had no prognostic value. An unfavourable or complicated course should be feared when CSF protein levels are higher than 7 g/l and in the presence of persistently low CSF glucose levels.

Adult↗
PubMed1983

AIDS in a black Malian.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1983

[Treatment of 18 cases of purulent meningitis with moxalactam. Pharmacokinetic data].

The diffusion of moxalactam into cerebrospinal fluid was studied in 18 hospital patients with purulent meningitis treated with this antibiotic. Moxalactam was administered by intravenous infusion in doses of 2 g 8-hourly (6 g/24 h). Treatment lasted from 10 to 30 days depending on the pathogen involved. The antibiotic was assayed by high performance liquid chromatography simultaneously in serum and CSF at the time of lumbar puncture. Depending on the time elapsed since the end of the infusion, the mean CSF concentrations ranged from 32.8 to 9.37 micrograms/ml at the beginning of the disease and from 23.75 to 3.78 micrograms/ml toward the end of treatment. These values were notably higher than the MIC for most of the micro-organisms encountered. All patients were cured.

Adult↗
PubMed1983

Penetration of ceftazidime into cerebrospinal fluid of patients with bacterial meningitis.

Four 2-g doses of ceftazidime were infused intravenously over 30 min at 8-h intervals, first between days 2 and 4 and again between days 11 and 20, in 11 patients with bacterial meningitis undergoing treatment with other antibiotics. Concentrations of ceftazidime in serum and cerebrospinal fluid samples obtained 120 or 180 min after dose 4 were measured by high-pressure liquid chromatography. Concentrations in cerebrospinal fluid ranged from 2 to 30 micrograms/ml, depending on the sampling time and the time elapsed since the onset of the disease.

Adolescent↗
PubMed1983

[Evaluation of the clinical activity of cefotiam (SCE 963). Multicentric study in 7 centers].

Cefotiam (SCE 963), a new, broad-spectrum, third generation cephalosporin was used in the treatment of 136 patients suffering from respiratory tract infections, urinary tract infections, septicemia, meningitis, biliary tract infections and osteoarthritis infections. Cefotiam was administered in monotherapy to 98 patients at the mean posology of two grams per day (extreme doses: 1 to 6 g). The following clinical effectiveness was noted: 83 successes and 18 failures on 101 available clinical reports. The general, biological tolerance and renal tolerance was good in all patients.

Adolescent↗
PubMed1982

Moxalactam penetration into cerebrospinal fluid in patients with bacterial meningitis.

Penetration of moxalactam into the cerebrospinal fluid was studied in 11 patients with bacterial meningitis undergoing treatment with other antibiotics. Moxalactam at a dose of 20 mg/kg was administered as three 30- to 45- min infusions at 8-h intervals, once between days 2 and 4 and a second time between days 11 and 20 of treatment with the other antibiotics. Serum and cerebrospinal fluid were sampled 60, 90, or 120 min after the third moxalactam dose for measurement of the concentration of this drug by high-performance liquid chromatography. The concentration of moxalactam in cerebrospinal fluid ranged from 1.5 to 11 micrograms/ml, depending on the sampling time and the time elapsed since the onset of the disease. These concentrations in cerebrospinal fluid were equal to or higher than the minimum inhibitor concentrations for Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae (including ampicillin-resistant strains), and most of the gram-negative bacilli except for Pseudomonas aeruginosa. These results show that moxalactam has good penetrability when the meninges are inflamed and that it might be considered in cases of bacterial meningitis when the susceptibility of the pathogen indicates its usefulness.

Adult↗