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Biomedical subjects

P Gehanno

Publications and source records attributed to P Gehanno.

At least 91 records · Page 5Linked to original sources
PubMed1990

Short-course cefotaxime compared with five-day co-amoxyclav in acute otitis media in children.

This randomized, multicentre prospective study was undertaken to compare the efficacy and tolerance of a one day course of injectable cefotaxime with a five day oral course of co-amoxyclav (amoxycillin plus clavulanic acid) in the treatment of acute otitis media in children. The study was conducted in 116 patients between the ages of three months and 12 years. No significant difference in efficacy was observed between the two treatment groups, but tolerance to the treatments differed significantly. There were no unwanted side-effects in the cefotaxime group whereas 22% of children in the amoxycillin plus clavulanic acid group suffered side-effects (P 0.0007). Short-course antibiotic therapy with cefotaxime appears to be a valuable alternative to conventional treatment regimens for acute otitis media in children.

Acute Disease↗
PubMed1990

Concentrations of cefpodoxime in plasma and tonsillar tissue after a single oral dose of cefpodoxime proxetil.

Seventeen patients undergoing tonsillectomy received cefpodoxime proxetil orally in a dose equivalent to 100 mg cefpodoxime 4, 7 or 12 h before operation. Plasma and tonsillar tissue concentrations of cefpodoxime were assayed by a microbiological method. Tonsillar tissue concentrations after 4 and 7 h were 0.24 and 0.09 mg/kg respectively--being 23% of the plasma concentration. The tonsillar tissue concentration after 12 h was less than 0.06 mg/kg. As the MIC for Streptococcus pyogenes is less than 0.06 mg/l, cefpodoxime proxetil may be of value in acute tonsillitis.

Administration, Oral↗
PubMed1990

Comparison of cefpodoxime proxetil with cefaclor in the treatment of sinusitis.

The efficacy and tolerance of cefpodoxime proxetil were compared with those of cefaclor in a multicentre, international, prospective, double-blind, placebo-controlled study in adult outpatients suffering from acute sinusitis. At the end of treatment, cefpodoxime proxetil was more effective than cefaclor, producing complete clinical cure in 84% of cases (102/122) vs 68% of cases (77/114) in the cefaclor group (P = 0.01). The overall clinical efficacy (cure + improvement) was similar in the two groups with 95% (116/122) satisfactory responses in the cefpodoxime proxetil group and 93% (106/114) in the cefaclor group. Bacteriological response was similar with 95% eradication in the cefpodoxime proxetil group (55/58) vs 91% with cefaclor (63/69).

Acute Disease↗
PubMed1990

[Activity of cefapirin against bacterial strains isolated from acute otitis media in children].

The antibacterial activity of cefapirin was tested against 210 strains isolated from the auricular exudate of childrens' acute otitis media. For 112 strains of Haemophilus studied (20% secreted a beta-lactamase), the MIC 50 and 90 of cefapirin were 2 and 4 mg/l respectively. Ten strains of Branhamella catarrhalis were tested (9 secreted a beta-lactamase) and the MIC ranged from 0.25 to 4 mg/l. Against Streptococcus pneumoniae, cefapirin has an extremely high activity with MIC 50 and 90 less than 0.06 mg/l. Of the strains of Staphylococcus aureus sensitive to meticillin, one had a MIC less than 0.06 mg/l, and 11 had a MIC = 0.25 mg/l. For 14 strains of Enterobacteriaceae studied, we obtained a MIC 50 of 8 mg/l and a MIC 90 of 32 mg/l. The results show that cefapirin is an antibiotic particularly suitable for the treatment of acute otitis media.

Anti-Bacterial Agents↗
PubMed1990

[Conservative transmandibular lateral pharyngectomy in cancer of the lateral oropharyngeal wall].

The authors present conservative transmandibular lateral pharyngectomy (CTLP) as a substitute for BPTM operations in cancers of the tonsillar region. The mandible is sectioned along the symphyses and the oropharynx is widely exposed through an incision of the pelvilingual sulcus. The authors propose a primary operability criterion that allows to salvage the mandibular angle, which is usually sacrificed. This can be assessed peroperatively by testing the possibility to cleave and spread inwardly the pharyngomandibular region following detachment of the pterygoid muscles. The functional and cosmetic benefits of this method are obvious and should commend its more frequent utilization.

Bone Plates↗
PubMed1990

[Mouth and pharyngeal hyperalgesic syndromes in AIDS].

In a series of 12 patients suffering from an HIV infection, including 9 with confirmed AIDS, who complained about pharyngeal pain in a fixed site, having a progressive intensity and not relieved by antalgics and the specific treatments that were prescribed empirically, and for whom etiological investigation yielded negative results, Thalidomide proved to be the only effective means of healing the exulcerated, nail-mark lesions or the ulcerated, budding, neoplastic-like lesions, and of completely suppressing pain.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Efficacy and tolerability of cefixime in the treatment of otorhinolaryngeal infections in adults].

Cefixime was used in the treatment of 59 patients, 44 of whom had sinusitis, 9 otitis media and 6 various ENT infections. The clinical and bacteriological effectiveness of the drug could be evaluated in 44 patients and its safety in all 59 patients. The most common responsible pathogens were Haemophilus influenzae, streptococci including Streptococcus pneumoniae and various Enterobacteriaceae. In more than 50 per cent of the cases, the clinical picture was one of acute exacerbation of a chronic infection. The patients received cefixime 200 mg b.d. for a mean duration of 12 days. Clinical cure was achieved in 80 per cent. Fourteen out of 44 patients underwent surgery. Minor abdominal discomfort was reported by 15 per cent of the patients, and one discontinued therapy because of side-effects. Cefixime was effective and well tolerated. It is suitable for the treatment of ENT infections in adults, such as those treated in this study.

Adolescent↗
PubMed1989

Clinical experience with 1000 patients treated with cefetamet pivoxil.

Clinical studies have been carried out world-wide on cefetamet pivoxil, a new orally active cephalosporin. This paper reports on the first 1000 patients treated with the antibiotic; another 505 patients received standard antibiotics, mainly cefadroxil and cefaclor, for comparison. The results show that single doses of 1500 and 1200 mg cefetamet pivoxil were fully effective in gonorrhoea. Comparative trials in uncomplicated urinary tract infection indicate a significant superiority of a single dose of 2 g cefetamet pivoxil (n = 158; 90.0% cure) versus 2 g cefadrox (n = 162; 77.0% cure). In complicated urinary tract infections, a comparable outcome was achieved with a single daily dose of 2 g cefetamet pivoxil for 10 days (n = 99; 90% cure) and 1 g cefadroxil twice daily for 10 days (n = 98; 76.5% cure). The clinical response rate in acute exacerbation of chronic bronchitis was 89.4% in the group receiving cefetamet pivoxil (136 patients) and 83% in the cefaclor-treated group (n = 122). Treatment with 1000 or 2000 mg cefetamet pivoxil achieved a (bacteriological) success rate of 96% compared to 95% with cefaclor in acute ear, nose and throat-infections (n = 91). Overall, based on 894 isolated pathogens prior to therapy, the bacteriological response rate was 90% and it would appear that in vivo the spectrum of this cephalosporin covers a wide range of Gram-negative and Gram-positive pathogens, including urinary pathogens, but excluding Enterococci and Pseudomonas. Cefetamet pivoxil proved to be well tolerated. Mild to moderate adverse events were reported in 7.1% of patients but only 2 of the 1000 patients treated with cefetamet pivoxil were withdrawn because of diarrhoea, which subsided rapidly. There were no clinically relevant deviations in laboratory parameters.

Adult↗
PubMed1989

[Anatomical basis of the transposition of the serratus anterior muscle. Study of 40 dissections].

In order to explore the possibility of serratus anterior muscle (SAM) flap transposition in head-neck and thoracic surgery, we performed an anatomical study including 40 dissections of the muscle's vascular pedicle, the subscapular-thoracodorsal axis, which is a branch of the axillary artery (A. subscapularis A. thoracodorsalis). The SAM is characterized by: its location: extending from the anterior and lateral aspect of the thorax to the medial border of the scapula; its easy surgical access; its constant and reliable vascularization by the thoracodorsal artery, a branch of the subscapular artery; its long arc of rotation allowing the utilization of the SAM flap in head and neck and mediastinal surgery without microvascular anastomoses; its versatility in comparison with other perithoracic muscles. These considerations prompted us to use the SAM in head and neck reconstructive surgery, chest wall surgery, chest wall reconstruction following resection for tumor; breast reconstruction; intrathoracic and mediastinal surgery, reinforcement of high-risk tracheobronchial sutures or anastomoses; management of bronchopleural fistulas and empyema spaces; repair of tracheo esophageal fistulas and tracheal or esophageal defects.

Arteries↗
PubMed1989

[Otologic manifestations presenting and predominating in necrotizing angiitis].

The authors report on 5 observations of necrotising angiitis with a specifically otological onset, namely 4 Wegener's syndromes and one periarteritis nodosa. In all 5 cases, the initial symptomatology consisted of otological signs in a feverish context, producing pictures of serous or sero-purulent otitis. Its resistance to usual forms of therapy led in 3 cases to the installation of transtympanic aerators, and in 2 cases to the performance of an antro-attico-mastoidectomy. One of the observations led to the discovery in the middle ear of a histological aspect specific to the disease, from which it can be considered that the otologic impairment could be a specific seat of the disease. The 5th observation is particular in that it was the otological signs which revealed each time a new progression of the disease, enabling the immediate implementation of an adapted treatment prior to the occurrence of the systemic signs. 3 observations proved the difficulty of diagnosis at the initial stage, when at times only the otological signs are present, together with the importance of its discovery prior to the occurrence of systemic lesions that are occasionally irreversible. Any isolated otological symptomatology in a feverish context, resisting usual therapies, should evoke the diagnosis, and lead to the performance of further duly adapted examinations (sedimentation rate, pulmonary X-ray, proteinuria, hematuria).

Adult↗
PubMed1988

Anatomic basis of serratus anterior muscle flap transposition.

In order to explore the possibility of serratus anterior muscle (SAM) flap transposition in head, neck and thoracic surgery, we performed an anatomic study including 40 dissections of the muscle's vascular pedicle, the subscapular-thoracodorsal axis, which is a branch of the axillary artery. The SAM is characterized by its location: extending from the anterior and lateral aspect of the thorax to the medial border of the scapula; its easy surgical access; its constant and reliable vascularization by the thoracodorsal artery, a branch of the subscapular artery; its long arc of rotation allowing utilization of the SAM flap in head and neck and mediastinal surgery without microvascular anastomoses; its versatility in comparison with other perithoracic muscles. These considerations prompted us to use the SAM in head and neck reconstructive surgery; chest wall surgery, including chest wall reconstruction following resection for tumor and breast reconstruction; intrathoracic and mediastinal surgery, including reinforcement of high-risk tracheobronchial sutures or anastomoses, management of bronchopleural fistulas and empyema spaces, and repair of tracheo-esophageal fistulas and tracheal or esophageal defects.

Back↗
PubMed1988

[Buccopharyngeal Kaposi's sarcoma in AIDS. Apropos of 51 cases].

The authors present a series of 51 cases of buccopharyngeal Kaposi's sarcoma observed in patients with AIDS. The diagnosis of Kaposi's sarcoma is generally obvious due to its appearance, its constantly violaceous colour and its site, especially palatine and velar. When Kaposi's sarcoma is the first manifestation of the disease, it appears to be associated with a relatively favourable pejorative connotation when the nevertheless extremely modest median survival of these patients is compared with that of patients who initially presented with an opportunistic infection not associated with Kaposi's sarcoma. Buccopharyngeal Kaposi's sarcoma is usually only an epiphenomenon. It is rare that the local course requires any tumour reduction treatment. When such treatment is required, radiotherapy with 35 Gys is currently considered to be the best solution.

Acquired Immunodeficiency Syndrome↗