Search PubMed⌕ Search

Biomedical subjects

J Raymond

Publications and source records attributed to J Raymond.

At least 55 records · Page 3Linked to original sources
PubMed2001

High levels of resistance to metronidazole and clarithromycin in Helicobacter pylori strains in children.

The aim of the study was to evaluate the prevalence of resistance to amoxicillin, metronidazole, and clarithromycin before treatment of Helicobacter pylori infection in children and to assess the evolution of resistance with time. The study was carried out between 1994 and 1999 with 150 H. pylori-positive children through gastric culture (antimicrobial susceptibility) and histology. All cultured H. pylori strains were sensitive to amoxicillin, 64 (43%) were resistant to metronidazole, 32 (21%) were resistant to clarithromycin, and 14 (9%) were resistant to both metronidazole and clarithromycin. The overall prevalence of resistance to metronidazole and clarithromycin did not change significantly with time. The study highlights the generalized high-level and stable metronidazole and clarithromycin resistance of H. pylori strains from children.

Adolescent↗
PubMed2001

Clonal relationship between U.S. and French serotype V group B streptococcus isolates.

We examined the genetic diversity of serotype V group B streptococcus (GBS) isolates in the Paris area and compared them with the predominant American serotype V clone. Pulsed-field gel electrophoresis yielded 11 patterns for 64 French GBS. One pattern was obtained with 60% of the isolates tested and was indistinguishable from that of the predominant American clone.

Bacterial Typing Techniques↗
PubMed2001

Procalcitonin in children admitted to hospital with community acquired pneumonia.

AIMS: To assess the sensitivity, specificity, and predictive value of procalcitonin (PCT) in differentiating bacterial and viral causes of pneumonia. METHODS: A total of 72 children with community acquired pneumonia were studied. Ten had positive blood culture for Streptococcus pneumoniae and 15 had bacterial pneumonia according to sputum analysis (S pneumoniae in 15, Haemophilus influenzae b in one). Ten patients had Mycoplasma pneumoniae infection and 37 were infected with viruses, eight of whom had viral infection plus bacterial coinfection. PCT concentration was compared to C reactive protein (CRP) concentration and leucocyte count, and, if samples were available, interleukin 6 (IL-6) concentration. RESULTS: PCT concentration was greater than 2 microg/l in all 10 patients with blood culture positive for S pneumoniae; in eight of these, CRP concentration was above 60 mg/l. PCT concentration was greater than 1 microg/l in 86% of patients with bacterial infection (including Mycoplasma and bacterial superinfection of viral pneumonia). A CRP concentration of 20 mg/l had a similar sensitivity but a much lower specificity than PCT (40% v 86%) for discriminating between bacterial and viral causes of pneumonia. PCT concentration was significantly higher in cases of bacterial pneumonia with positive blood culture whereas CRP concentration was not. Specificity and sensitivity were lower for leucocyte count and IL-6 concentration. CONCLUSIONS: PCT concentration, with a threshold of 1 microg/l is more sensitive and specific and has greater positive and negative predictive values than CRP, IL-6, or white blood cell count for differentiating bacterial and viral causes of community pneumonia in untreated children admitted to hospital as emergency cases.

Adolescent↗
PubMed2001

Neck-bridge device for endovascular treatment of wide-neck bifurcation aneurysms: initial experience.

PURPOSE: To report the authors' initial experience in treating patients with wide-neck aneurysms with assistance from a recently developed neck-bridge device (TriSpan; Target Therapeutics/Boston Scientific, Fremont, Calif). MATERIALS AND METHODS: Twenty-five patients were examined. Aneurysms were most frequently at the basilar bifurcation (n = 19). Sixteen aneurysms were treated electively: six aneurysms that recurred after coil-only embolization and 10 nontreated aneurysms (including four that had failed coil-only embolization). Nine aneurysms were treated acutely following subarachnoid hemorrhage. All lesions except one had a wide neck. A dual-catheter technique was used in 23 patients. Immediate angiographic results, technical incidents, and complications were recorded. Follow-up angiography was performed in 16 patients. Clinical follow-up ranged from 1 to 12 months. RESULTS: Neck-bridge device-assisted coil packing was successfully performed in 23 lesions, with complete obliteration in three, residual necks in 13, and a minimal residual sac in seven patients. Parent vessel protection failed, with coil protrusion and arterial occlusion, in one of these patients. Other complications that were not directly related to use of the neck-bridge device included retroperitoneal hematoma, rebleeding, coil perforation, and transient embolic arterial occlusion. One patient died of vasospasm and heart failure. Follow-up angiography revealed complete obliteration in four, a residual neck in one, a persistent residual sac in four, and recurrent aneurysm in seven patients. One patient had a small occipital infarction 5 weeks after treatment. CONCLUSION: The described neck-bridge device is useful for assisting coil embolization of wide-neck bifurcation aneurysms.

Adult↗
PubMed2001

Endovascular treatment of unruptured aneurysms.

BACKGROUND AND PURPOSE: We sought to better define the morbidity of endovascular Guglielmi detachable coil (GDC) treatment of unruptured cerebral aneurysms and to discuss its role in the prevention of subarachnoid hemorrhage. METHODS: We conducted an observational study from August 1992 to June 1999 of 125 unruptured aneurysms treated with GDC in 116 patients: 91 women (78.4%) and 25 men (21.6%), aged 30 to 78 years (mean age, 50.6 years). Immediate and late clinical results were recorded for any neurological event or hemorrhage related to the treated unruptured aneurysm. Angiographic results are reported as immediate, early (2 to 12 months), intermediate (12 to 30 months), and late follow-up (>30 months). RESULTS: Immediate angiographic results showed complete obliteration (class 1) in 59 (47.2%) or residual neck (class 2) in 53 aneurysms (42.4%), leaving 6 residual aneurysms (4.8%) and 7 failures (5.6%). Early follow-up angiograms, available in 100 treated aneurysms (84%), revealed class 1 in 52% and class 2 in 41%. Intermediate angiograms, available in 53 aneurysms (44.5%), showed class 1 in 47.2% and class 2 in 43.4%, while late results, available in 37 lesions (31.1%), had class 1 and 2 in 48.6% and 37.8%, respectively. Six patients suffered a permanent neurological deficit at last follow-up (5.2%), with a good outcome in 5 patients and fair outcome in 1 patient. There was no mortality. There was no aneurysmal rupture during a mean clinical follow-up of 32.1 months. CONCLUSIONS: Endovascular treatment with GDC for unruptured aneurysms is relatively safe. Its role in the prevention of aneurysmal rupture remains to be determined, preferably by a randomized study.

Adult↗
PubMed2001

Meningoencephalitis in a Boelen's python (Morelia boeleni) associated with paramyxovirus infection.

An adult male Boelen's python, Morelia boeleni, presented with acute neurologic disease and was euthanatized. Histologic examination revealed nonsuppurative meningoencephalitis. Occasional eosinophilic intracytoplasmic inclusions were noted in glial cells. On the basis of clinical signs and histopathology, inclusion body disease of boid snakes was suspected, but inclusions were not seen in other organs commonly affected with the disease. Moreover, electron microscopy revealed that the inclusions contained stacks of filaments 13-14 nm wide. With the use of a generic paramyxovirus cDNA probe, sections of brain and esophageal ganglion demonstrated hybridization. The findings indicate that paramyxovirus was the likely cause of the encephalomyelitis in this python, and this virus should be included in the differential diagnosis of pythons exhibiting central nervous system disease.

Animals↗
PubMed2001

Distal superior cerebellar artery aneurysm presenting with cerebellar infarction: report of two cases.

SUMMARY: We report two cases of aneurysm of the distal branches of the superior cerebellar artery presenting with cerebellar infarction. In both cases, the diagnosis required close correlation of the findings from different imaging techniques, as catheter angiography failed to opacify the lesions. In one patient endovascular parent vessel occlusion was performed, whereas in the second patient the aneurysm thrombosed spontaneously. We describe the clinical and radiologic presentation of these aneurysms and discuss their pathogenesis, diagnosis, and treatment.

Adult↗
PubMed2000

Postnatal developmental changes in AMPA and NMDA receptors in the rat vestibular nuclei.

Changes in the expression of the AMPA receptor subunits GluR1-4 and of the NMDA receptor subunits NR1, NR2A-D were investigated in the developing rat medial and lateral vestibular nuclei. Analyses were performed using nonradioactive in situ hybridization and immunoblotting with subunit-specific antibodies. During the postnatal development, glutamatergic receptor subunits were differentially expressed in the vestibular nuclei. The level of expression of GluR1, GluR4 and NR1 subunits was higher in the developing brain as compared to the adult. We observed a gradual increase in GluR2/3, NR2A, NR2B and NR2C levels of expression in the medial and lateral vestibular nuclei during the first 3 weeks of postnatal development. In situ hybridization results were consistent with immunoblot analyses. The differential expression of AMPA and NMDA receptor subunits in immature vestibular neurons is consistent with changes in glutamate receptor properties. This may be related to the postsynaptic regulation of receptor subunits associated with the synaptic plasticity of the vestibular neuron connections during specific sequences of postnatal development.

Animals↗
PubMed2000

[Helicobacter pylori infection in children].

Helicobacter pylori infection is frequent in children. Its incidence in Europe, around 6% in children aged 6-16 years, varies with the socio-economic level and nutritional status. It may reach 46% in Africa and up to 75% in some institutions. Clinical manifestations debated. Vomiting, dyspepsia and acute pain related to ulcer disease may undisputedly be linked to H. pylori, whereas its role in chronic abdominal has yielded contradictory reports. Direct isolation of the bacterium is classically done through perendoscopic antral biopsies followed by culture and histology. Non-invasive diagnosis methods get a wider use in children. Serodiagnosis is reproducible and easy only in older children. The 13C-urea breath test is sensitive and specific, and seems perfectly suitable in pediatrics. The H. pylori stool antigen test for the detection of infection seems promising but not yet of current clinical use. Triple therapy using amoxicillin-clarithromycin (or metronidazole or tinidazole) and anti-secretory agents is recognised as the most efficient association.

Adolescent↗
PubMed2000

Heat-shock protein 90: intrinsic peptidase activity and in vitro long-term self-processing.

When tested on Suc-Leu-Leu-Val-Tyr-MCA as substrate, purified full-length hsp90 displays a low "chymotrypsin-like" peptidase activity which is activated by Ca++ and Mg++ ions. On the other hand, using long-term in vitro experiments, we demonstrate the ability of hsp90 to convert into a 73 kDa truncated product. This autocatalytic degradation proceeds from the C-terminal end of the full-length hsp90 and shifts the oligomers toward monomeric truncated forms. This corresponds to an intermolecular process as addition of exogenous 73 kDa product speeds up the maturation kinetics. The peptidase activity is enhanced in the 73 kDa product and is sensitive to peptide aldehyde inhibitors but only partially to lactone compounds. The degradation process itself presents a great degree of similarity with the peptidase activity toward either the inhibitors or the tested ions. Neither 20S proteasome nor m-calpain are responsible for the observed activities. Indeed, the self-processing is a consequence of the peptidase activity which appears to be an intrinsic property of the chaperone. The functional importance of these findings is discussed.

Animals↗
PubMed2000

Effect of prior exposure to Chlamydia pneumoniae, Helicobacter pylori, or cytomegalovirus on the degree of inflammation and one-year prognosis of patients with unstable angina pectoris or non-Q-wave acute myocardial infarction.

Inflammation and chronic infections may be important features in the pathogenesis of acute coronary syndromes. We describe 6 systemic markers of inflammation in patients with unstable angina or non-Q-wave myocardial infarction and the relations between these markers, seropositivity to chronic infections, and prognosis. C-reactive protein (CRP), serum amyloid A protein (SAA), fibrinogen, interleukin-6 (IL-6), neopterin, procalcitonin, and serum antibody levels to Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus were measured on admission and 48 hours later. One-year clinical follow-up was performed. Plasma levels of acute phase reactants were all elevated on admission and increased further at 48 hours: CRP from 10.1 +/- 2.1 mg/L at baseline to 26.6 +/- 5.1 mg/L at 48 hours (p <0.001); SAA from 27.3 +/- 8.5 to 93.1 +/- 23.2 mg/dl (p <0.005); fibrinogen from 3.2 +/- 0.1 to 3.8 +/- 0.1 g/L (p <0.0001); whereas initial high levels of IL-6 tended also to increase from 9.8 +/- 2 to 15.3 +/- 3.1 pg/ml (p = NS). In contrast, neopterin and procalcitonin remained unchanged. We found no association between levels of each inflammatory marker and the serologic status. Furthermore, levels of inflammatory proteins in patients seronegative to all 3 agents were comparable to those of patients seropositive to 2 or 3 infectious agents. The composite end points of death, myocardial infarction, recurrent angina, or revascularization at 1-year follow-up did not differ according to the serologic status. Thus, in patients with acute coronary syndromes, the acute phase proteins increased over the first 2 days of hospitalization. This initial inflammatory reaction as well as the 1-year clinical outcome did not differ according to the initial serologic status of Chlamydia pneumoniae, Helicobacter pylori, or cytomegalovirus.

Acute-Phase Proteins↗
PubMed2000

Sequential colonization by Streptococcus pneumoniae of healthy children living in an orphanage.

A prospective study of nasopharyngeal colonization by Streptococcus pneumoniae in the exceptional conditions of a closed community of abandoned children was done over a 1-year period; 71 children (age <24 months) were studied monthly. S. pneumoniae was isolated from 58 (81.7%), and 94.5% of the 111 isolates were resistant to penicillin. The mean rate of carriage was estimated at 57.4%, ranging from 42.8% to 70.4%. Children were sequentially colonized by a mean of 3 different isolates. The mean duration of carriage for a given isolate was approximately 2.2 months. Serotyping and molecular typing by pulsed-field gel electrophoresis showed that children were colonized by a limited number of clones belonging to only 4 serotypes and 4 pulsotypes. These clones rapidly spread in the community and colonized the children in waves, with a rapid turnover of S. pneumoniae isolates, facilitated by close contact between children.

Electrophoresis, Gel, Pulsed-Field↗
PubMed2000

[Procalcitonin in pediatric emergencies: comparison with C-reactive protein, interleukin-6 and interferon alpha in the differentiation between bacterial and viral infections].

OBJECTIVE: Procalcitonin concentration increases in bacterial infections but remains low in viral infections and inflammatory diseases. The change is rapid and the molecule is stable making it a potentially useful marker for distinguishing between bacterial and viral infections. PATIENTS AND METHODS: Procalcitonin (PCT) was determined with an immunoluminometric assay on plasma collected at admission in 436 infants and children hospitalized for bacterial or viral infection. It was compared with C reactive protein, interleukin-6 and interferon-alpha measured on the same sample. RESULTS: PCT was 41.3 +/- 77.4 micrograms/l in children with septicemia or bacterial meningitis (n = 53), 0.39 +/- 0.57 microgram/l in children with viral infection (n = 274) and 3.9 +/- 5.9 micrograms/l in children with a localized bacterial infection who had a negative blood culture (n = 109). PCT was > 1 microgram/l in 126 children with a localized or systemic bacterial infection (sensitivity 78%). PCT was < 1 microgram/l in 258 children with a viral infection (specificity 94%). For differenciation between viral and bacterial infections, CRP value > or = 20 mg/l, IL-6 > 100 pg/ml and interferon-alpha > 0 Ul/ml have 85, 48 and 76% sensitivity and 73, 85 and 92% specificity respectively. CONCLUSIONS: In this study, a PCT value of 1 microgram/l or greater had better specificity, sensitivity and predictive value than CRP, IL-6 and interferon-alpha in children for distinguishing between viral and bacterial infections. PCT may be useful in pediatric emergency room for making decision about antibiotic treatments.

Adolescent↗
PubMed2000

Nosocomial infections in pediatric patients: a European, multicenter prospective study. European Study Group.

OBJECTIVES: To determine the site and bacterial epidemiology of nosocomial infections (NIs) in children. DESIGN: 6-month prospective study with periodic chart review during hospitalization using a uniform prospective questionnaire in each unit, analyzed at a coordinating center. SETTING: 20 units in eight European countries: 5 pediatric intensive care units (PICUs), 7 neonatal units, 2 hematology-oncology units, 8 general pediatric units. PARTICIPANTS: All children hospitalized during the study period with an NI according to Centers for Disease Control and Prevention criteria. RESULTS: The overall incidence of NI was 2.5%, ranging from 1% in general pediatric units to 23.6% in PICUs. Bacteria were responsible for 68% (gram-negative bacilli, 37%; gram-positive cocci, 31%), Candida for 9%, and viruses for 22% of cases. The proportion of lower respiratory tract infections was 13% in general pediatric units and 53% in PICUs. Bloodstream infections were most frequent in neonatal units (71% of NIs) and were associated with a central venous catheter in 66% of cases. Coagulase-negative Staphylococcus (CNS) was the main pathogen. Eleven percent of NI were urinary tract infections. Gastrointestinal infections were most commonly viral and accounted for 76% of NIs in general pediatric units. The prevalence of antimicrobial resistance depended on the type of unit. The highest rates were observed in PICUs: 26.3% of Staphylococcus aureus and 89% of CNS were methicillin-resistant, and 37.5% of Klebsiella pneumoniae had an extended-spectrum beta-lactamase. Mortality due to NI was 10% in PICUs and 17% in neonatal units. CONCLUSIONS: We found large differences in NI frequency and microbial epidemiology in this European study. Viruses were the main pathogens in general pediatrics units. Catheter-related sepsis and CNS were frequent in newborns. A high frequency of multiresistant bacteria was observed in some units. Clinical monitoring of NIs and bacterial resistance profiles are required in all pediatric units.

Child↗
PubMed2000

The effect of recurrent ankle inversion sprain and taping on proprioception at the ankle.

PURPOSE: A common explanation for the tendency for ankle inversion sprains to recur is that proprioception is impaired by the initial sprain. It is further hypothesized that the application of tape prevents further sprains by enhancing proprioceptive acuity. The purpose of this study was to determine whether proprioception was impaired in people with recurrent ankle inversion sprain, and whether taping the ankle provided enhanced proprioceptive ability. METHODS: We compared the ability to perceive passive plantarflexion and dorsiflexion movements imposed at the relaxed ankle in 25 subjects with recurrent ankle inversion sprain, with a group of 18 healthy control subjects, matched for age, height, weight, and activity level. Subjects were tested with the ankle both taped and untaped. Detection thresholds were determined at three velocities, 0.1 degrees x s(-1), 0.5 degrees x s(-1), and 2.5 degrees x s(-1). Velocity of the imposed movements and testing of the taped and untaped conditions were randomized. RESULTS: There was no significant difference in the ability to perceive ankle movements between subjects with sprains and healthy controls at any velocity of movement tested. In addition, there was no significant difference in movement perception between the taped and untaped conditions for either subject group at any velocity. CONCLUSION: The ability to detect passive plantarflexion and dorsiflexion movements is not impaired in subjects with recurrent ankle inversion sprain. Furthermore, the protective effect of taping was shown not to arise from enhanced proprioception in the dorsiflexion-plantarflexion plane.

Adolescent↗
PubMed2000

Immunoblotting and serology for diagnosis of Helicobacter pylori infection in children.

BACKGROUND: The easiest way to identify the presence of current or past Helicobacter pylori infection is to test for antibodies. The aim of this study was to compare an enzyme-linked immunosorbent assay (ELISA) technique based on the detection of IgG antibodies directed against a global antigenic preparation with immunoblotting based on the analysis of IgG antibody reactivity to separate proteins. METHODS: Sera were collected from 80 children (mean age, 9.9 +/- 4.3 years). The reference tests were microbiologic and histologic examination of gastric biopsies obtained at upper endoscopy. RESULTS: The immunoblotting was more sensitive (100%) and specific (88%) than ELISA (96 and 79%, respectively) in the evaluation of H. pylori infection in children. Its positive predictive value was 92%, and its negative predictive value was 100%. The best performance index of immunoreactive bands to detect antibodies was obtained with the 26-kDa (88.7%), 30-kDa (77.5%) and 19.5-kDa (70%) antigens. Antibodies by immunoblot technique against the CagA antigen were present in 43.1% of children. CONCLUSION: Immunoblotting is highly sensitive and more specific than ELISA in children and provides additional information about the full serologic profile. Immunoblotting may therefore be a useful complement to serology, particularly in cases with doubtful ELISA results.

Adolescent↗