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Biomedical subjects

M A Piens

Publications and source records attributed to M A Piens.

At least 73 records · Page 4Linked to original sources
PubMed1989

New perspectives in the chemoprophylaxis of toxoplasmosis.

The usual chemoprophylaxis of toxoplasmosis consists of spiramycin or the combination of pyremethamine-sulfamide. This chemoprophylaxis can be used: 1 - In the pregnant woman: spiramycin avoids or has low fetal damage. In case of maternal contamination after 33 weeks of pregnancy, pyrimethamine-sulfadiazine combination should be used in spite of its potential toxicity. 2 - In the newborn infant, chemoprophylaxis prevents the emergence of retinochoroiditis. 3 - In congenital toxoplasmic retinochoroiditis, systematic repetitive cures of pyrimethamine-sulfamide reduce frequency of recurrences. 4 - In immunocompromised patients, the systematic use of pyrimethamine and sulfadoxine prevents neurotoxoplasmosis, in case of kidney, heart, and allogeneic bone marrow transplantations, and also in case of patients with malignant hemopathy or AIDS.

Chorioretinitis↗
PubMed1989

Disseminated Geotrichum capitatum infection in a patient with acute myeloid leukemia.

A case of invasive Geotrichum capitatum infection is reported; a young patient had an acute leukemia for which he received a chemotherapy, and presented sepsis with blood cultures for Geotrichum capitatum, namely Dipodascus spicifer; this pathogen only described in cactus rot, is responsible for the first case of a human disseminated infection reported in literature. Then he developed a splenic and epididymic infection, with positive cultures for Geotrichum capitatum after splenectomy and castration. Treatment with amphotericin B and itraconazole was started with low minimal inhibitory concentration (0.1 microgram/ml). The patient died of massive hemoptisis. Autopsy findings demonstrated a lung, brain and kidneys seeding.

Adult↗
PubMed1989

[Monitoring and treatment of toxoplasmosis in the pregnant woman, fetus and newborn].

A protocol of monitoring and treatment in toxoplasmosis is suggested by the authors. During pregnancy, the administration of spiramycine at a 9 m UI daily dose remains the basic preventive treatment when a seroconversion occurs after a 4 week post-conception period. In the fetus, the antenatal diagnosis is made by ultrasound started on the 18th week after conception and repeated every 4 weeks, amniocentesis and eventually umbilical cord puncture associated with a pyrimethamine-sulfamide drug treatment in case of positive diagnosis. A therapeutic pregnancy termination is considered when lesions have been detected by ultrasound. In the newborn (neonatal or post-natal period), the diagnosis is made by transfontanel ultrasonography, ocular fundi and spinal fluid examination, detection of specific IgM antibodies in cord blood and the evolution and importance of serum antibodies response requiring a drug treatment during 15-18 months with spiramycine and pyrimethamine + sulfadoxine (Fansidar).

Amniocentesis↗
PubMed1989

[Intra-operative precautions and a proposition for a postoperative monitoring protocol in hepatic hydatidosis].

In the expectation of new biological technics, immunoelectrophoresis is currently the most valuable one owing to its very high specificity. Precipitation line 5 which develops usually disappears after surgery, provided there is no recurrence. However, it may persist in many cases despite repeated negative check-ups. In view of such observations, there is some concern about the peroperative sampling methods commanded for the test, as well as regarding the postoperative follow-up procedure and schedule considering costs that are involved.

Animals↗
PubMed1989

[Leishmania braziliensis Vianna, 1911 in French Guiana].

A new case of cutaneous Leishmaniasis to L. braziliensis Vianna, 1911, contracted in French Guyana is reported. The parasite, isolated in culture, is identified by enzymatic typing (13 zymoden). The identified zymodem is zymodem MON-43. It is the same of the WHO reference strain L. braziliensis s. st.

Adult↗
PubMed1989

[Praziquantel in human hydatidosis. Evaluation by preoperative treatment].

The efficacy of praziquantel has been studied in human hydatic disease due to E. granulosus, using parasitological and pharmacological criteria of improvement. This evaluation uses a prospective therapeutic trial in 15 patients with one or several hydatic cysts in different sites. Before surgery, nine of these received daily 75 mg/kg of praziquantel in 2 courses of 10 days each. The other six patients are considered as controls. The protoscolices vitality is determined by direct optic microscopy and by intraperitoneal mouse inoculation. According to the results of optic microscopy, praziquantel sterilizes hydatic cysts: 19 sterilized cysts out of 26 coming from treated patients, and 4 out of 11 in control group. This effect seems to be emphasized in hepatic localization. Nevertheless, according to the results of mouse inoculation, praziquantel does not significantly reduce the pathogenicity of inoculated proscolices and germinal layer: 11 mice out of 39 are healthy in the treated group, and 5 out of 15 in controls. Moreover, the determination with a fluorimetric method has not detected praziquantel in the hydatid liquid issued from treated patients. The drug does not pass through the cyst wall, and so, cannot have a scolicidal activity. Praziquantel cannot be considered as a medical treatment in human hydatidosis.

Animals↗
PubMed1988

Evaluation of a Candida antigen detection test (Cand-Tec) in the diagnosis of deep candidiasis in neutropenic patients.

The diagnostic efficiency of a serum Candida antigen detection test Cand-Tec test) was prospectively investigated in 104 leukemic patients treated by intensive chemotherapy or allogeneic bone marrow transplantation. Candida antigen titers were determined on admission and then weekly as long as patients remained neutropenic. Nine patients had a proven disseminated yeast infection (diagnosed only at autopsy in five cases). The highest Candida antigen titers were 1:2 in two patients and 1:4 or more in seven patients (sensitivity: 76% for this last titer). This highest titer was observed 12 days before to 3 days after the diagnosis. Seven out of the 97 patients without proven deep candidiasis had a maximum titer of 1:4 (specificity: 93%). The positive predictive value was 50% for a titer of 1:4 and 24% for a titer of 1:2, whereas the negative predictive value was 100% for a titer of 1:4 and 97% for a titer of 1:2. Patients with elevated titers were mostly treated by chemotherapy, were older and had a worse prognosis than those with negative titers, although the duration of neutropenia was similar. It is concluded that Candida antigen detection is a reliable method of diagnosis of deep candidiasis in neutropenic patients. The clinical interest in this test, with special regard to empiric antifungal therapy, is discussed.

Agranulocytosis↗
PubMed1988

The effect of isatin on the Echinococcus granulosus cyst in an experimental host.

The effect of isatin on the E. granulosus cyst was studied. NMRI mice, which were infected with E. granulosus of sheep origin, were treated daily with isatin at a dose of 50 mg kg-1 for 18 days. Ultrastructural damage was observed in the treated cysts, including accumulation of lamellar stacks, electron-dense granules, autophagosomes and lipid vesicles. Moreover, a biochemical study showed an inhibition of alkaline phosphatase activity, with a decrease in carbohydrate storage and an increase in acid phosphatase activity. In spite of the short duration of the treatment, the results obtained allowed us to conclude that isatin acts on E. granulosus cysts. This activity appears as a process of degeneration linked to the alkaline phosphatase inhibitory effect of isatin.

Acid Phosphatase↗
PubMed1987

Host serum protein levels in cysts of human hydatidosis.

8 proteins (albumin, IgG, IgM, IgA, C3c, C4, orosomucoid and alpha 1 antitrypsin) were determined by laser immunonephelometry in hydatid cyst fluid from cysts and sera from 16 patients. The cystic level of albumin was 34.5 +/- SD 59.1 micrograms/ml (range 3.6-85); of IgG 12.9 +/- 18.7 micrograms/ml (1.9-75); of IgM 10.5 +/- 10.4 micrograms/ml (3-37); and of IgA 7.2 +/- 3.5 micrograms/ml (4-19.7). The 4 other proteins represented a smaller fraction: C3c, 0.9 +/- 0.6 micrograms/ml (0.5-2.5); C4, 1.3 +/- 0.9 micrograms/ml (0.5-3.5); orosomucoid, 2.8 +/- 2.3 micrograms/ml (1.4-9.2); and alpha 1-antitrypsin, 5 +/- 4.5 micrograms/ml (2-19). These 8 host proteins constituted 24.6 +/- 24.5% (2.4-76) of the total hydatid cyst fluid proteins (343.7 +/- 172.1 micrograms/ml, range 180-900). The albumin/IgG ration of 3 +/- 2.8 (0.4-10.8) in hydatid cyst fluid was more variable than that in sera, 2 +/- 0.5 (1.2-2.7).

Blood Proteins↗
PubMed1987

Invasive nosocomial pulmonary aspergillosis: risk factors and hospital building works.

A retrospective epidemiological study of 22 observations of invasive pulmonary aspergillosis, of which 18 were fatal, occurring over a period of 30 months, implicated certain building sites within the hospital. The building works were responsible for the diffusion into the atmosphere of fungal spores from normally closed reservoirs, notably false ceilings, fibrous thermal and/or acoustic insulation materials and roller-blind casings. The results of our study permit us to suggest that protective measures should be set up or that immunodepressed patients are evacuated when such works are to be carried out in an in-patient establishment.

Adolescent↗
PubMed1987

[Values and limitations of the detection of circulating Candida antigen (Cand-Tec) in the diagnosis of deep candidiasis].

Diagnosis of systemic candidiasis is difficult and often performed lately. It can be improved by Candida antigen detection, using agglutination of latex particles sensitized with anti-Candida albicans antibody. Candida antigen search was made in 407 sera obtained from 123 patients, in Hematology and in intensive care units. Fourty three patients had, at least, one serum positive for antigen. The titer was 1/2, 1/4 and 1/8. Twenty seven of the 43 patients had C. albicans in one or several localizations. Eight of these 27 patients had a systemic candidiasis: C. albicans grown from three blood samples, at least, and/or from organ biopsy. In these eight patients, the antigen titer was 1/4 ou 1/8. Eighty patients were Candida antigen negative. Thirty eight out of 80 had C. albicans in one or more sites and two of these 38 had systemic candidiasis. Five other patients had other Candida species. Two out of five had C. tropicalis and C. guillermondii septicemia.

Adolescent↗
PubMed1986

[Hydatid cyst fluid (Echinococcus granulosus) biochemistry. Influence of site on cyst permeability].

Eleven metabolites were determined in 19 hydatid cyst fluids of variable size and localization, and in patients plasma before surgery. Specific indirect immunofluorescent antibody titration was carried out. Sodium (132 +/- 5.2 mmol/l), chloride (92.9 +/- 6.5 mmol/l) and bicarbonate (22.1 +/- 1.5 mmol/l) were found at the same concentration than in plasma. Potassium (5.4 +/- 0.3 mmol/l) and calcium levels (4.7 +/- 0.9 mmol/l) were higher than in plasma, and phosphate (0.1 +/- 0.03 mmol/l) decreased tenfold. Glucose (3.4 +/- 0.8 mmol/l), creatinine (39.3 +/- 7.2 mumol/l) and urea nitrogen (4.6 +/- 0.8 mmol/l) showed great variations. Cholesterol levels 0.06 +/- 0.03 mmol/l) were a hundredfold lower than in plasma. Total protein levels (0.34 +/- 0.09 g/l) were found at very low concentrations. Extra-pulmonary cysts showed significantly higher antibody titers than pulmonary cysts. No correlation was observed between the size of the cysts and the level of the immune response. Significant difference about the relative cholesterol concentration (cystic concentration/plasmatic concentration) was observed between pulmonary and extra-pulmonary cysts (respectively 0.0048 +/- 0.0032 and 0.018 +/- 0.01--p less than 0.05). No correlation was observed between the size of the cyst, or the corresponding levels of the immune response, and the cholesterol levels. The hypothesis of a greater membrane permeability in extra-pulmonary cyst is discussed.

Antibodies↗
PubMed1986

[Disseminated histoplasmosis caused by Histoplasma capsulatum and sarcoidosis. Apropos of a case].

Histoplasma capsulatum can, sometimes, simulate sarcoidosis, clinically and pathologically. A case is reported in which disseminated histoplasmosis is proved only by fungus granulomatous tissue. Another similar cases of the literature incite to propose the practice of special stains, above all Gomori-Grocott technical, before sarcoid-like lesions. Lesions pathogeny was discussed. In our case it's not possible to eliminate the role of primary sarcoidosis in disseminated histoplasmosis.

Adrenal Glands↗