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J R Puig

Publications and source records attributed to J R Puig.

15 recordsLinked to original sources
PubMed1999

Prospective, randomized, investigator-blinded study of the efficacy and safety of meropenem vs. cefotaxime therapy in bacterial meningitis in children. Meropenem Meningitis Study Group.

OBJECTIVES: To compare the efficacy and safety of meropenem with cefotaxime for the treatment of infants and children with bacterial meningitis. METHODS: Infants and children with strongly suspected or documented bacterial meningitis were randomly assigned in a prospective multicenter study to receive either meropenem or cefotaxime. Patients were assessed at the end of therapy and at 5 to 7 weeks and 5 to 7 months after the end of treatment for the presence of neurologic and sensory neural sequelae. RESULTS: A total of 258 children were randomized to either treatment group. A further 8 patients with suspected pneumococcal meningitis were treated with meropenem without randomization. Of the randomized patients 154 were fully evaluable, 79 in the meropenem group and 75 in the cefotaxime group. At the end of treatment there were no significant differences in clinical outcome between the two treatment groups. Clinical cure with or without sequelae was achieved in 97 and 96% of the meropenem- and cefotaxime-treated patients, respectively. At the end of treatment and at 5 to 7 weeks, 46 and 54% of meropenem patients were cured with no sequelae, respectively. Corresponding results for cefotaxime patients were 56 and 58%. All pathogens were eradicated. In total 37 patients had seizures during treatment, 15 (12%) in the meropenem and 22 (17%) in the cefotaxime group. None of the seizures was considered to be drug-related. CONCLUSIONS: This trial shows that meropenem is suitable therapy for bacterial meningitis in infants and children and that it offers an efficacy and safety profile similar to that of cefotaxime.

Cefotaxime↗
PubMed1990

Treatment of Pseudomonas meningitis with ceftazidime with or without concurrent therapy.

In ongoing studies in Europe and the United States, 10 pediatric patients with bacterial meningitis caused by Pseudomonas species were treated with ceftazidime. Pseudomonas aeruginosa was isolated from the CSF of 7 patients and other Pseudomonas species from the remaining 3. Eight of the 10 patients had received previous antimicrobial treatment which included aminoglycosides in 6, along with ticarcillin and ureidopenicillins in 3. Ceftazidime was administered 10 to 42 days in dosages ranging from 109 to 300 mg/kg/day. Seven of the 10 patients received ceftazidime only for 10 to 42 days. The other 3 patients received amikacin in 2 and gentamicin and tobramycin in the other. Seven patients were cured clinically and 3 died; 9 were cured bacteriologically and one who was presumed cured on the basis of clinical response subsequently died. Sterilization of the cerebrospinal fluid occurred at 48 hours to 12 days. Ceftazidime appears useful in treating bacterial meningitis caused by Pseudomonas species.

Adolescent↗
PubMed1981

[Multiple site epidermoid cysts. Relation to basal cell naevomatosis and value of systematic pathological examination (author's transl)].

After removal of epidermoid cysts from one side of the mandibular region, further cysts developed on the contralateral side in two patients. No evidence of basal cell naevomatosis was detected. The fact that the lesions recurred even though good cicatrization had been obtained, has to be emphasized. The dental germs, voluntarily left in place, developed in a fairly normal manner. Systematic pathological examination of such lesions would appear to be a valid procedure.

Basal Cell Nevus Syndrome↗
PubMed1977

[Z-plasty technic, applied to hypertrophy of the upper labial frenum].

The authors used the technique of Z-palsty in the surgical treatment of hypertrophy of the superior labial fraenum. They consider that this operation is indicated when there is hypertrophy of the fraenum with a low insertion, associated with an inter-incisor diastema, and that the lateral incisors have appeared without causing the diastema to disappear. This technique eliminates the possibility of a hypertrophic scar, a possible source of failure.

Child↗
PubMed1977

[A poorly reduced fracture with spontaneous consolidation in good position].

The authors present a case of double mandibular fracture in a partially edentulous patient, which was poorly reduced but nevertheless evolved spontaneously to consolidation in a satisfactory position. They feel that only the influence of muscular forces can explain this fortunate outcome. The technique involving the use of plate and screws is felt to be preferable to osteosynthesis using steel wires in such cases.

Aged↗
PubMedDate not supplied

Ceftazidime vs. standard therapy for pediatric meningitis: therapeutic, pharmacologic and epidemiologic observations.

One hundred patients ages 1 month to 15 years received either ceftazidime (CZ) at a dose of 150 mg/kg/day divided every 8 hours or conventional treatment with chloramphenicol and ampicillin (CA). Seventy-eight had isolates recovered from the cerebrospinal fluid: 40 (51%) were Haemophilus influenzae (all ampicillin-susceptible); 16 (21%) were Streptococcus pneumoniae; 14 (18%) were Neisseria meningitidis; 3 (4%) were salmonellae; 1 (2%) was Pseudomonas; and 1 (2%) was Group B Streptococcus. Six patients with negative cerebrospinal fluid culture had positive latex agglutination (two H. influenzae, three N. meningitidis, one S. pneumoniae). Sixty-one patients had positive blood cultures. CZ inhibited 100% of H. influenzae at 0.78 micrograms/ml, S. pneumoniae at 0.39, N. meningitidis at 0.04 and salmonellae at 0.39 micrograms/ml. The mean peak serum concentration of CZ was 36.4 micrograms/ml with a mean cerebrospinal fluid level of 7.4 micrograms/ml. If one eliminates from the statistics those patients who died less than or equal to 24 hours after admission, five (10%) of 49 patients treated with CZ died, one (2%) improved and 43 (88%) were cured. Overall 29 patients died, 12 receiving CZ (20%) and 8 receiving CA (21%). There were no significant CZ-related toxicities. Gross neurologic sequelae were noted in 5% of 38 CZ patients and 4% of 28 CA patients. CZ compared favorably to CA for treatment of meningitis.

Adolescent↗
PubMedDate not supplied

[Tooth transplantation].

In the light of the thesis of J. Thibault, the authors suggest, in association with transplantation of wisdom tooth buds into the alveolus of the first molar, a technique consisting of placing the graft in its pre-eruptive position, removing in a block the bud, the gubernaculum and the sub-jacent gingival mucosa. Under these conditions, eruption occurs at the same time as development of the roots, which represents the most physiological solution. At the same time as formation of the root, the authors noted a paradoxal rhizalysis, hypercementosis resulting in ankylosis and conservation of vitality. In addition, almost all the teeth transplanted proved to be highly vulnerable to caries.

Female↗