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Biomedical subjects

M Micoud

Publications and source records attributed to M Micoud.

108 records · Page 6Linked to original sources
PubMedDate not supplied

Influence of mannitol on the penetration of teicoplanin into infected CSF of experimental Staphylococcus aureus meningitis of rabbits.

We investigated the influence to mannitol injections on the teicoplanin penetration into CSF in experimental bacterial meningitis of rabbits. Experimental bacterial meningitis was obtained by intracisternal inoculation of 10(7) cfu of methicillin resistant Staphylococcus aureus. The experimental bacterial meningitis was controlled 18 h later by cisternal puncture. At this time (T0) mannitol (solution for injection 20%) was injected (bolus), at a dosage of 3 ml/kg, into the carotid arteria. Immediately after the previous bolus, teicoplanin was administered through the same line over 5 min, at a dosage of 5 mg/kg. Cerebrospinal fluid was obtained 30 min and 2 h after injection was completed, and serum samples were obtained at the same time. Results were (mg/l) in cerebrospinal fluid: (Table; see text) (* p less than 0.05 comparing the two regimens at T0 + 2 h, and comparing regimen teicoplanin + mannitol infusion at T0 + 30 sec and + 2 h). This is very promising for the treatment of methicillin resistant Staphylococcus aureus bacterial meningitits and should support further investigations.

Animals↗
PubMedDate not supplied

The polymerase chain reaction for the detection of HIV-1 genomic RNA in plasma from infected individuals.

HIV (human immunodeficiency virus) viraemia in serum or plasma of HIV-infected individuals was investigated by the polymerase chain reaction assay (PCR) in combination with reverse transcription to detect HIV-1 genomic RNA. Before PCR, plasma or serum was ultracentrifuged, precipitated virions were then treated with a RNase-free DNase, and a cDNA from the HIV-1 genomic RNA was synthesized. Thirty-three fresh plasma and seven sera from either HIV-1 antibody-positive individuals or patients treated with AZT were tested. Plasma from three patients were assayed 3 or 6 months apart. Twelve sera from HIV-1 antibody-negative individuals were used as negative control. PCR was performed with primers in LTR, gag and env regions: 11 of 40 samples were positive with three primer pairs, 16 with two primer pairs and 11 with only one primer pair. PCR on HIV-1 genomic cDNA was positive in 38 out of the 40 plasma or serum samples (95%), regardless of the clinical stage of the infection: HIV-1 was detected in 14 of the 15 untreated subjects and in 24 of the 25 AZT-treated patients. HIV p24 antigen was detected in the serum of 38% of subjects (15 of 40). The results suggest that this method is suitable for the detection of viral particles in plasma or serum from HIV-1-infected individuals irrespective of antiviral treatment.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Treatment of Listeria monocytogenes meningoencephalitis with cotrimoxazole in monotherapy].

L. monocytogenes meningo-encephalitis are still a therapeutic problem, with most of the time a poor prognosis. In vitro, cotrimoxazole has about the same bactericidal activity as the ampicillin-aminoglycoside combination. So we treated 8 patients with L. M. meningoencephalitis with cotrimoxazole alone, with a mean duration of treatment of 13 days. All patients recovered without sequellae from their infectious episode.

Aged↗
PubMedDate not supplied

Penetration of sulbactam into the cerebrospinal fluid of patients with bacterial meningitis receiving ampicillin therapy.

Concentrations of sulbactam in the CSF of 18 patients with bacterial meningitis who were undergoing treatment with intravenous (iv) ampicillin were determined. Six patients received single doses of sulbactam (1 g) and 12 patients received multiple doses (four times daily) by the iv route at various intervals before lumbar punctures were performed to monitor their condition. Concentrations of sulbactam up to 12 micrograms/ml were detected in the CSF between 1 and 4 hr after dosing, the higher levels being present in the CSF of patients with the most severe meningeal inflammation. There were no significant differences in the concentrations achieved after single or multiple doses of sulbactam, and the concentrations were generally similar to the concurrent concentrations of ampicillin. It is concluded that these results as well as the antibacterial properties of sulbactam plus ampicillin support the evaluation of this combination as an alternative in the treatment of bacterial meningitis.

Ampicillin↗
PubMedDate not supplied

Ultrastructural changes associated with peripheral neuropathy in HIV/AIDS.

Light and electron microscopic studies were performed on neuromuscular biopsy specimens from 12 neurologically affected seropositive patients, 7 with the acquired immune deficiency syndrome (AIDS), 2 with AIDS-related complex, and 3 with no symptoms except for neuropathy. All patients had an axonal injury associated or unassociated with demyelination and peripheral neurogenic atrophy. Capillary lesions were consistently present, which seems to be a new finding. Moreover, tubuloreticular inclusions (TRIs) were found in endomysial (9 of 12 cases) and endoneurial (7 of 12 cases) vessels. Statistical analysis showed that TRIs in more than 20% of endomysial vessels correlated with a survival time shorter than 12 months (P = 0.028). Thus the quantification of TRIs seems to be one of the vital prognostic elements in this patient population.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Heterophil antibody negative infectious mononucleosis due to Epstein-Barr virus. A clinical, hematological and serological study of 14 cases (author's transl)].

Fourteen patients admitted to the hospital for heterophil antibody negative infectious mononucleosis (IM) were studied; the causative agent was Epstein-Barr virus, as confirmed by the presence of anti-VCA antibodies (IgG and IgM) and the absence of anti-EBNA antibodies. The patients were from 2 to 69 years old, 7 being less than 10 years old while 4 were more than 45 years old. In all cases, asthenia and adenopathy were found and a deterioration in liver functions was present whenever it was looked for; jaundice occurred in 3 patients. In 6 cases fever persisted for several weeks. Leukocytosis and a high level of mononuclear cells were present in 8 patients and atypical lymphocytes in 10. Anti-EA titers were found to be high in the severe forms of illness. Clinical and laboratory features of these 14 heterophil negative IM patients were compared with a group of 21 heterophil positive IM patients studied under the same conditions; the most striking differences between the two groups were the frequency of patients under 10 and over 45 years old in the heterophil negative group, the frequency of abnormal liver function tests and of persistent fever, and a lower frequency of atypical lymphocytes.

Adult↗
PubMedDate not supplied

[Immune and autoimmune manifestations of autochthonous visceral leishmaniasis with liver, kidney and vascular involvement].

The authors report a case of visceral leishmaniasis in the adult contracted in the South or South-East of France, primarily with an important involvement of the liver and a production of antinuclear and smooth muscle auto-antibodies, rheumatoid factors, cryoglobulins and probable circulating immune complexes, and secondarily complicated with transient involvement of kidneys and skin vessels. The geographic origin of the infection and the pathogenesis of these disorders are discussed. A cross reaction between specific antibodies and auto-antibodies was looked for.

Adult↗
PubMedDate not supplied

[Autoantibodies in human african trypanosomiasis (smooth muscle antibodies during a Trypanosoma gambiense disease) (author's transl)].

The authors report the case of a patient with a T. gambiense african trypanosomiasis who presented up to one year after treatment autoimmune disorders seemingly related to this infection, and especially smooth muscle autoantibodies with high titres, antinuclear antibodies, antibodies to erythrocytes, and rheumatoid factors, with probably production of immune complexes and complement activation by both pathways. The particularity of this case is the production of smooth muscle autoantibodies, which has never been reported before in african trypanosomiasis. It seems that other usual conditions of smooth muscle antibodies production may be eliminated, and no antigenic community between some components of smooth muscles and trypanosomes has been found. So it may be an autoimmune disorder induced by trypanosomiasis and possibly linked with cytotoxicity effects.

Adult↗
PubMedDate not supplied

[Hepatitis C virus infection in internal medicine and infectious diseases departments in France. Preliminary results of a national epidemiological survey].

OBJECTIVES: In order to know the number and the main clinical features of patients with hepatitis C virus (HCV) infection, we conducted a national epidemiological study of patients followed in Internal Medicine and in Infectious Diseases departments in France. METHODS: For each patient with HCV infection seen between 13/03 and 13/04/1995 (in- or out-patients), a chart was completed. RESULTS: The response rate was about 30% with 2002 charts being analyzed. There were 59% males and 39% females, with a peak of frequency between 25 and 40 years, including 1241/2002 (62%) patients. Most patients were of French origin (85.7%). We found that 1436/2002 (72%) patients came from provinces of southern France and Paris. In 10% of cases the diagnosis was made during the study period. A route of transmission was identified in 86.4%, mainly drug abuse 60.4% and blood product transfusion 19.3%. At the time of diagnosis, main clinical features were: no symptom 47%, liver biological abnormalities 52%, cirrhosis 7.4%, cryoglobulinemia 2.7%, auto-immune disease 3%, hepatocellular carcinoma 0.85%. We frequently found a viral co-infection: HIV 56.1%; HBV 22.2%. A confirmation RIBA test was done in 67.8%, measurement of viremia in 33.4%, genotyping in 6.7% and liver biopsy in 28.7% of cases. Finally, 407 (20.3%) patients received a specific anti-HCV treatment. CONCLUSION: These preliminary results underscore: 1) the large percentage of the population with HCV infection followed outside of hepatogastroenterology departments in France. 2) the high probability that the HCV epidemic is underestimated as we noted 10% of new diagnosis during the study period. 3) the requirement for a multidisciplinary approach for these HCV patients.

Adult↗