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Biomedical subjects

M Danis

Publications and source records attributed to M Danis.

At least 145 records · Page 8Linked to original sources
PubMed1987

A comparison of patient, family, and nurse evaluations of the usefulness of intensive care.

As patient advocates, critical care nurses need to be cognizant of which treatments the patients and their families prefer. Therefore, we conducted a study to compare how nurses, their critically ill patients, and their families evaluate the usefulness of intensive care. A group of former medical intensive care patients (n = 72), or their family members if the patient had died, were asked how willing they would be to undergo (or to subject their relative to) intensive care again, if necessary. All nurses (n = 15) caring for these patients were asked a parallel, hypothetical question about the usefulness of intensive care to these patients and to themselves, were they to become sick. Analysis of matched pairs of patient (or family member) and nurse questionnaires (n = 38) revealed that: nurses underestimate the usefulness of intensive care as evaluated by their patients and families; and patients believe that quality of life is a less important factor in judging the usefulness of intensive care than do their nurses.

Attitude↗
PubMed1987

[Development of drug resistance in cases of P. falciparum malaria of African origin in a Parisian hospital. Comparison with field data and therapeutic consequences].

The number of P. falciparum malaria cases, contracted in Africa, diagnosed by the department of Parasitology and Tropical diseases of the Pitié-Salpêtrière Hospital Group has shown a significant increase in 1985-1986 when compared with the 15 past years (+23%). This fact is related to the spread of chloroquine or amodiaquine resistant falciparum malaria from East Africa (1980-1983: 54%) to Central Africa (1985: 54.5%) and now to a country of west Africa (Benin 1986).

Africa↗
PubMed1987

[Malaria prevention today and tomorrow].

Individual chemoprophylaxis against malaria remains mandatory for all trips of brief or intermediate duration in endemic areas. The selected anti-malarial drug must be taken regularly from the beginning of the stay, during the stay and for the 30 days after return (The 30 days following the departure from regions at risk). Presently the following drugs are available: amino-4-quinolines, quinine, antifolinic agents, the association antifolinic-antifolic agents and mefloquine. Specific advantages, side-effects and adverse reactions, as well as dosage used for prophylaxis are given for each drug. The risk of agranulocytosis and severe hepatitis related to amodiaquine forbids its use until more information has become available. The association sulfadoxine + pyrimethamine is no longer recommended for prophylaxis by the French authorities and recently by the W.H.O., because of its potential, although seldom, risk of severe muco-cutaneous disorders. Detailed schemes of prophylaxis are given; they rely on sensitivity or resistance of Plasmodia strains, the length of the stay in at risk areas, and the local situation concerning the hazard of infection and drug resistance of Plasmodia. Chloroquine must be used in priority in areas characterized by sensitivity or low grade resistance to chloroquine. In order to avoid resistance to mefloquine, its administration has to be limited to prophylaxis for short stays and to the treatment of attacks resulting from infections acquired in areas known for resistance against the other drugs. Today, indeed, mefloquine is the single agent efficient in case of multiresistance to Plasmodium falciparum. The treatment of suspected or proved cases of malaria attacks occurring in temporary or permanent expatriates or in local, semi-immune residents, has become strongly advisable. In areas of resistance to chloroquine, either quinine (repeated injections), sulfadoxine-pyrimethamine (per os or unique parenteral injection) or if possible, mefloquine (full dose during 1 day) are to be used for the therapy of acute attacks. Continuous chemoprophylaxis is no longer encouraged for populations living in holoendemic areas. Treatment of suspected or overt malaria crises is, however, mandatory. The limitation to curative therapy is opening the way to more specific prophylaxis: pregnancy, delivery, intercurrent pathological events, such as surgery, trauma, infection... It is hoped that, until the forthcoming of anti-malaria immunoprophylaxis, these newly adjusted designs for chemotherapy will help to keep the progress of malaria and the development of plasmodial resistance under control.

Animals↗
PubMed1987

[Value of cytapheresis in the treatment of loaiasis with high blood microfilaria levels. Results in 7 cases].

Seven patients infected with the filarial worm Loa loa received a treatment by cytapheresis in an attempt to lower the microfilaraemia. Microfilarial levels of between 6,000 and 38,500 ml, before extraction, were reduced, according to the case, by between 47 and 97% (mean 76%). The diethylcarbamazine chemotherapy which followed in 6 of 7 patients showed no sign of any of the serious side-effects which often occur in these type of cases. Due to its practicality and the fact that it is well tolerated, both clinically and biologically, cytapheresis would seem to represent the best method for initially treating loaiasis with high microfilaremia.

Adult↗
PubMed1986

High level of sensitivity to chloroquine of 72 Plasmodium falciparum isolates from southern Cameroon in January 1985.

The sensitivity to chloroquine, quinine and mefloquine of Plasmodium falciparum isolates from 3 areas of southwest Cameroon was evaluated using an in vitro microtest with estimation of parasite growth by 3H-hypoxanthine incorporation. Among 2,429 children examined, P. falciparum was found on thin smears in 124 of them, 76 isolates were submitted to in vitro tests and 72 were successful. In the locations studied, some of which are close to the area of Limbe where in vivo resistance has been reported, all 72 isolates were found fully sensitive to low concentrations of chloroquine (mean EC50 5.9 ng/ml or 18.5 nmol/l of medium). In 47 of these isolates simultaneously tested using WHO microtest predosed plates, the sensitivity was identical. Out of 39 tests performed with quinine, 35 were successful. While most strains responded to low concentrations, some showed a decreased sensitivity to the drug, the EC50 of 4 of them being in the range 230-300 nmol/l. Each of the 17 isolates tested with mefloquine was susceptible to very low concentrations of freshly prepared drug solution. While chloroquine-resistant strains may already exist in Cameroon, the present study suggests that they would be restricted to a limited area and are not widespread. Data also suggest that monitoring of the sensitivity of P. falciparum to quinine might soon be necessary.

Animals↗
PubMed1986

Decreased sensitivity to chloroquine and quinine of some Plasmodium falciparum strains from Senegal in September 1984.

The in vitro sensitivity of 135 Plasmodium falciparum isolates collected in the areas of Thies and Kaolack, Senegal, were studied in September 1984, by means of the 48 hr microtest with 3H-hypoxanthine incorporation. Results are available in 110 of 135 cases studied (81%). The isolates collected around Kaolack were found on average less sensitive to chloroquine than those from Thies (mean EC50 28 and 17 nmol/l of medium, respectively, P less than 0.05) and in 1 isolate a high degree of resistance was found (EC50 178 nmol/l). Some of those isolates also were studied using the WHO standard microtest and similar results were recorded. With both assays probit regression lines show EC99 in Kaolack greater than 114 nmol/l. These data suggest that in 1984 chloroquine resistance was possibly emerging in the extreme west of Africa. Sensitivity to quinine could be evaluated in 15 of 24 isolates tested. One of them, originating from Thies, was highly resistant to this drug (EC50 760 nmol/l) and 2 additional isolates with EC50s of 370 and 274 nmol have decreased sensitivity. These results suggest that quinine, as well as chloroquine, sensitivity should be monitored in the African region.

Adolescent↗
PubMed1986

[Is it necessary to perform sensitivity tests for malaria in the hospital environment?].

From January 1984 to June 1985, 20 out of 65 P. falciparum strains isolated in an hospital in Paris were epidemiologically suspect of resistance to chloroquine. 15 of them were submitted to in vitro chemosensitivity tests with several antimalarials drugs. In cases of suspected chloroquine resistance the initial choice of an alternative drug is mainly presumptive and is generally not guided by the in vitro chemosensitivity assay which results are too much delayed. When in vitro assay shows sensitivity to amino-4-quinolines treatment can be modified accordingly. The determination of plasma concentration of drugs are required in any case. However in vitro sensitivity assays would probably appears essential to physicians in cases of resistance to quinine.

Antimalarials↗
PubMed1985

Inhibition of p-nitroanisole O-demethylation in perfused rat liver by oleate.

p-Nitroanisole O-demethylation in perfused livers from fasted, phenobarbital-treated rats was rapidly and reversibly inhibited by sodium oleate (0.3 to 0.6 mM). Xylitol partially reversed this inhibitory effect. The inhibition was not mediated by a direct effect of oleate on microsomal components since concentrations of oleate ranging up to 1.0 mM did not affect p-nitroanisole O-demethylation by isolated microsomes. Infusion of 0.6 mM oleate did not alter the measured intracellular NAD+/NADH ratio but did cause a significant increase in the intracellular NADP+/NADPH ratio. A significant decrease in the ATP/ADP ratio was also observed. Oleoyl CoA inhibited p-nitroanisole O-demethylation in microsomes (Ki about 30 microM), and both oleoyl CoA and palmitoyl CoA inhibited the energy-linked nicotinamide nucleotide transhydrogenase in submitochondrial particles (Ki about 1 microM). Thus, inhibition of mixed-function oxidation in the intact liver by oleate is most likely mediated by oleoyl CoA. Oleoyl CoA inhibits mixed-function oxidation in the intact liver by acting directly on cytochrome P-450 and by decreasing generation of NADPH via inhibition of key enzymes of the citric acid cycle and the energy-linked transhydrogenase.

Acyl Coenzyme A↗