Search PubMed⌕ Search

Biomedical subjects

P Geslin

Publications and source records attributed to P Geslin.

At least 109 records · Page 6Linked to original sources
PubMed1992

In-vitro antibacterial activity of RP 59500, a semisynthetic streptogramin, against Streptococcus pneumoniae.

The in-vitro activity of the new streptogramin RP 59500 was determined against 100 strains of Streptococcus pneumoniae. In all, 48 erythromycin-sensitive strains and 52 erythromycin-resistant strains were tested by an agar dilution method (MIC determination), 20 strains (eight erythromycin-sensitive and 12 erythromycin-resistant) were tested by a broth microdilution technique (MIC and MBC determination) and ten strains (two erythromycin-sensitive and eight erythromycin-resistant) were tested for bactericidal kinetics. The study showed that RP 59500 had good bacteristatic and bactericidal activity against both erythromycin-sensitive and erythromycin-resistant strains. On the basis of these results, and because the number of erythromycin-resistant strains of S. pneumoniae isolated in France has increased steadily since 1985, RP 59500 might be useful for the treatment of pneumococcal infections and warrants further investigation.

Erythromycin↗
PubMed1992

[Changes in the sensitivity of pneumococci to antibiotics. Therapeutic consequences].

Streptococcus pneumoniae has a prominent role in infectious bronchopulmonary diseases. This organism is normally sensitive to a vast number of antibiotics. However, in recent years, acquired resistance against tetracyclines, macrolides, and, more recently, penicillins, has emerged. Since 1987, there is indeed a regular increase in the frequency of strains that have a lower sensitivity to penicillin G (less than 1% before 1986; 12% in 1990). However, this percentage of strains with a lower sensitivity is much more important among non-invasive as opposed to invasive organisms that are isolated from blood, pleural and spinal fluid cultures (3.3% in 1990). Among strains with abnormal sensitivity to penicillin G, there are very selective serotypes or serogroups: 4 types or groups (23, 19, 6 and 14) represent 80% of these strains. More than 80% of the strains of MIC greater than 2 mg/l are among only one stereotype, 23F. This abnormal sensitivity to penicillin G implies a modification of sensitivity to all beta-lactams, but MIC increase to a variable extent depending on the antiinfectious agent. The most efficient agents against strains of lower sensitivity are amoxicillin, imipenem and parenteral third generation cephalosporins. On the other hand, for all oral first, second and third generation cephalosporins, MIC increase to levels for which seric levels that are reached hardly demonstrate convincing efficiency. Even if resistance levels are less marked as shown by strains isolated from pulmonary infections as compared to what is seen in ENT, the trend in the development of abnormal sensitivity of pneumococci to beta-lactam agents urges the clinician to take into account these data in the therapeutic coverage of bronchopulmonary infections.

Anti-Bacterial Agents↗
PubMed1991

[Isolated impairement of the regional filling of the left ventricle in the coronary patient with normal systolic function. A study by isotopic ventriculography during rest].

The aim of this study was to assess whether resting radionuclide angiography could detect isolated regional left ventricular filling abnormalities due to chronic ischemia. The authors studied global and regional (10 segments) variations of LV volume using an original computerised system in 29 patients with single vessel coronary artery disease and normal systolic function without any other known pathology which could have altered left ventricular filling. Purely diastolic regional wall abnormalities were detected in presumed ischemic territories in over 60% of patients. They were then observed mostly in early rather than late diastole and affected the chronological indices (time to 1/3 LV filling, or to peak early diastolic filling rate) more than those of velocity (peak E or A velocities) or volume (filling fraction at 1/3 and half-diastole or that due to atrial contraction). They suggested delayed relaxation in these regions. These segmental changes are associated with a significant increase in asynchronous filling as judged by the variation in the intervals to peak early diastolic filling (tE) (p less than 0.001) and to one third filling (T 1/3R) (p less than 0.02), in the absence of increased physiological asynchronous contraction. An inversed relationship was observed (p less than 0.01) between the global value of peak early diastolic velocity and the indices of early diastolic asynchronous filling tE (r = -0.48) and T1/3R (r = -0.54). As previously reported, these regional abnormalities are, however, generally too small to cause changes in global diastolic function.

Adult↗
PubMed1991

[An open randomized trial, Pediazole versus cefaclor in the treatment of acute otitis media in children].

The combination of erythromycin ethylsuccinate and acetyl sulfafuroxazole (Pediazole = ES) is effective against Hemophilus influenzae, including beta-lactamase-producing strains, and against Streptococcus pneumoniae, including macrolide-resistant strains. In this study, mean daily dosage was 40-50 mg/kg for cefaclor and 50 mg/kg ES + 150 mg/kg sulfamide for Pediazole. Both products were given in three divided doses per day for ten days. Tolerance was evaluable in 106 children and effectiveness in 103 children including 52 in the ES group and 51 in the cefaclor group. Mean age was 23.5 months and both groups were comparable as concerns age, weight, previous ENT disease, and severity of the otitis media. Tolerance was satisfactory in both groups. Clinical results were as follows: failures before or at completion of the course, 5/52 in the ES group versus 13/51 in the cefaclor for the treatment of children with acute otitis media.

Acute Disease↗
PubMed1990

Detection of anti-listeriolysin O for serodiagnosis of human listeriosis.

To see whether detection of antibodies against listeriolysin O (LLO) could be used to diagnose human listeriosis, sera from 28 patients infected with Listeria monocytogenes and 101 controls were tested by dot-blot titration with purified LLO. 27 patients (96.4%) with listeriosis produced specific anti-LLO. Anti-LLO was detected in 8 (15.6%) of 51 healthy controls and in 6 (12.0%) of 50 controls who had various bacterial, fungal, and viral infections. Anti-LLO titres did not exceed 100 in these two control groups. Anti-LLO could be detected soon after clinical onset of listeriosis, and antibodies persisted for at least several months. This test might be useful for epidemiological surveys and for serodiagnosis of listeriosis, especially when bacteria cannot be isolated.

Adolescent↗
PubMed1990

Factors predicting mortality in idiopathic dilated cardiomyopathy.

A study of factors predicting mortality was performed in 201 patients with dilated cardiomyopathy (163 men, 38 women, mean age: 48 +/- 11 years) by multivariate analysis (Cox Model) of 51 clinical, electrocardiographic, echocardiographic and haemodynamic parameters, 56 patients died during follow-up (mean follow-up: 57.1 +/- 29.9 months). 5 year survival was 77 +/- 3%. The following parameters were independent predictors of mortality: first symptom: pulmonary oedema, peripheral oedema, syncope; duration of symptoms at the time of inclusion; end systolic left ventricular volume; end diastolic left ventricular diameter; pulmonary artery systolic pressure; and their combination had the most accurate predictive value for death. A quantitative score (s) was calculated and used to define three subgroups: A:s less than or equal to 4.5; B: 4.5 less than s less than 6; C:s greater than or equal to 6. Five-year survival was 90 +/- 5% in group A; 84 +/- 4% in B and only 53 +/- 7% in C. In conclusion, overall survival was good in this population of all stage dilated cardiomyopathy; factors related to clinical severity, left ventricular dilation, systolic pulmonary artery pressure and duration of symptoms defined a subgroup of patients with poor prognosis.

Cardiomyopathy, Dilated↗
PubMed1990

[Cardiomyopathy in the peripartum period: current aspects. A multicenter study. 11 cases].

Eleven of 17 case histories recensed after an inquiry addressed to all the French university hospital cardiological departments were attributed to peripartum cardiomyopathy. Three patients (27%) needed cardiac transplantation. Predisposing factors were multiparity and twin pregnancies. Forty five per cent of patients were under 25 years of age. Hypoproteinemia was present in all serious forms of the condition. Hypoproteinemia, a cardio-thoracic ratio of over 0.60, echocardiographic left ventricular fractional shortening of under 15 per cent and presistance of symptoms after one month of medical treatment were poor prognostic factors. The relatively high incidence of myocarditis (1 out of 11 cases) justifies endomyocardial biopsy.

Adolescent↗
PubMed1990

[Brucellosis in a 3 month-old infant].

During the course of a bronchiolitis in a 3 month-old child, one blood culture yielded Brucella melitensis. The diagnosis of brucellosis is difficult in infancy because the symptoms are nonspecific and the disease may be mild and self-limited. The child received only breast milk and dietetic preparations. So, the detection in the maternal serum of a significant titer of Brucella agglutinin enabled us to consider the very rare human-to-human transmission from mother to child. Because the efficacy of ceftriaxone assessed by a favorable initial response, and in order to avoid complications due to the use of tetracyclines and cotrimoxazole in infant, our patient was successfully treated with ceftriaxone plus rifampin.

Breast Feeding↗
PubMed1990

[Analysis of predictive factors of mortality in dilated cardiomyopathy. A cooperative study by the Cardiomyopathy Working Group].

UNLABELLED: An analysis of factors predictive of mortality was undertaken in a group of 201 patients with dilated cardiomyopathy (163 men, 38 women; average age 46 +/- 11 years) using a multivariate analysis (Cox's model) of 51 clinical electrocardiographic, echocardiographic and haemodynamic parameters. The average follow-up period was 57.1 +/- 29.9 months. Fifty-six patients died and the probability of 5-year survival was 77 +/- 3 per cent. The best predictive factor of survival was determined by the combination of the following parameters: presenting symptom: pulmonary oedema, peripheral oedema, syncope; duration of symptoms before inclusion into the study; left ventricular end diastolic volume; left ventricular end diastolic dimension; systolic pulmonary artery pressure. A quantitative score "S" was calculated which enabled identification of 3 subgroups: A (S less than 4.5); B (4.5 less than S less than 6); C (S greater than 6). The probability of 5-year survival was 90 +/- 5 per cent in Group A, 84 +/- 4 per cent in Group B and 53 +/- 7 per cent in Group C. IN CONCLUSION: global survival was relatively long in this patient population with dilated cardiomyopathy at different stages of evolution; the combination of factors related to clinical severity, left ventricular dilatation, systolic pulmonary artery pressure and duration of symptoms allows identification of a subgroup of patients with a poor prognosis.

Adult↗
PubMed1989

[Diagnosis of chronic coronary failure by clinical aspects, ECG and myocardial scintigraphy after infusion of isoprenaline. Comparison with coronarography].

The purpose of this study was to assess the ability of isoproterenol (IPNA) to provoke chest pain, electrocardiographic (ECG) changes and transient defects on thallium 201 myocardial scintigraphy for coronary artery disease (CAD) diagnosis. Thirty patients without prior myocardial infarction who underwent coronary angiography were included. Significant stenosis was found in 15 and absent in the other 15. The most relevant clinical and ECG data were observed in the few minutes that followed IPNA perfusion: 1) angina pectoris occurred in ten patients of whom eight had CAD (sensitivity: 53 p. cent + 13 p. cent; specificity: 87 p. cent + 9 p. cent); 2) ST segment depression was observed in 11 CAD and 3 non-CAD patients (sensitivity: 73 p. cent + 11 p. cent; specificity: 30 p. cent + 10 p. cent); 3) reversible perfusion defects on planar myocardial thallium 201 scintigrams occurred in 16 patients of whom 13 had CAD. Thallium scintigraphy sensitivity was 87 p. cent + 9 p. cent and specificity was 80 p. cent + 10 p. cent. The combined interpretation and stochastic sequential analysis of two or three presumed independent criteria increased significantly the diagnostic value of the test. We conclude that the isoproterenol test is a safe and reliable method to provoke myocardial ischemia with clinical, ECG and myocardial scintigraphic expression. It has an information content nearly identical to exercise stress test for CAD detection. Because it allows a three step sequential probability analysis, the diagnosis is more reliable than with other pharmacological tests which apply only to scintigraphy.

Adult↗
PubMed1988

Percutaneous transvenous caval interruption with the "LGM" filter: early results of a multicenter trial.

From September 1985 to December 1986, 100 patients undergoing percutaneous placement of a transvenous "LGM" caval filter were included in a multicenter prospective trial. Peripheral venograms completed by pulmonary arteriography or scintigraphy were obtained for all patients. Eighty-five patients had experienced pulmonary embolism, 59 had iliocaval thrombosis, while 40 had venous thrombosis confined to the lower limbs. In two instances, insertion or passage of the catheter was impossible. Ninety-eight "LGM" filters were placed percutaneously through the internal jugular vein, 82 of which were correctly positioned in the infrarenal inferior vena cava. Eight filters were positioned with a tilt of more than 15 degrees with respect to the vertical axis, five failed to open correctly, and three were incompletely open and tilted. No postoperative deaths were observed; there were two recurrent embolisms, and seven caval thromboses occurred during the year that followed insertion of the filter. The "user-friendliness" and efficacy of this percutaneous filter makes it a treatment of choice in the partial interruption of the inferior vena cava.

Aged↗
PubMed1987

[Reciprocal changes in the ST segment in acute inferior myocardial infarction. Value of delay in appearance].

The significance of a "reciprocal" ST depression (ST(-)) in the acute phase of myocardial infarction remains controverted. This may be due to ST(-) not having the same determinants when studied at an early stage (less than 6 hours) or later (greater than 6 hours). The purpose of this study was to find out whether "reciprocal" ST(-) correlates with the same parameters when measured on very early ECG's (before 6 hours) or at a distance from the onset of infarction. The parameters concerned are coronary lesions, extent of the infarction and left ventricular function. ECG was performed in 46 patients with inferior infarct aged from 26 to 70 years (mean 50.8 +/- 9.2 years) between 2-6 h, 6-12 h, 12-24 h and 24-48 h from the beginning of pain. The sum of ST(-) on V1V2V2V4 (V1-4), D1aV1V1 to V6 and L1aV1V5V6, and the sum of ST elevation on L2L3aVf were measured at each period of time. The extent of global and anterior territory hypokinesia, the ejection fraction and the left coronary impairment were evaluated between the 2nd and 4th weeks. At 2-6 hours (a) the sum of ST(-) was greater (though not significantly), and the sum of ST elevation on L2L3aVf was significantly greater (p less than 0.001) when the left anterior descending artery (LAD) was not involved than when it was involved; (b) there was no difference between patients with and without ST depression (on all lead groups) in the degree of left ventricular hypokinesia and ejection fraction value.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗