Search PubMed⌕ Search

Biomedical subjects

P Hartemann

Publications and source records attributed to P Hartemann.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Effects of different procedures of disinfection on the bacteriologic quality of hemodialysis monitors of the Cobe CS3 and AK 100 type].

]n recent years, hemodialysis treatment for chronic renal failure has been increasing. Although the technical evolutions have improved the therapy, the problem of microbial, toxic and chemical contamination of the dialysis fluid is now re-emerging. Most of all, because of increasing use of high-flux dialysis and its potential for transmembrane transport of bacteria into patients, one should be aware that dialysis fluid pathways may be colonised with bacteria. On the bacterial point of view, the French legislation proposed 100 CFU/mL as a maximum for total count of aerobic bacteria in the bi-osmosed water used for dilution of the dialysis concentrate. This study took place during 8 weeks in the children-hospital dialysis unit in Nancy (France). Our laboratory have succeeded in validating an aseptic bacteriological sampling procedure within fluid pathways of haemodialysis monitors Cobe CS3 and AK 100. It has also be shown that 6 to 12 hours of dialysis monitoring doesn't affect the quantitative and qualitative bacterial contamination of the biosmosed water (mean: 5 CFU/100 mL) drained through the 5 years' old internal pipes of the 2 monitors. So it has whatever the 4 different disinfection procedures applied and on the monitors (Formol or Formol + Citric acid + Chlorine or Heat or Heat + dehydrated Citric acid).

Child↗
PubMed1993

[Severe hyponatremia disclosing adenohypophyseal insufficiency with empty sella syndrome].

We report a case of extremely severe hyponatraemia which led to the discovery of anterior hypophysis insufficiency associated with empty sella turcica in a dysimmune context. This type of hyponatraemia is consecutive to corticotropic and thyreo-tropic hormones deficiency and to inappropriate secretion of arginine vasopressin. These endocrine abnormalities are of suprapituitary origin. They can be explained by a hypothalamo-hypophyseal dysregulation of little known mechanism, or by a lesion of the hypothalamus.

Aged↗
PubMed1993

[Value of ketoconazole in the treatment of Cushing disease].

Ketoconazole has been successfully used in short-term treatment of Cushing's syndrome. We treated 4 patients who had Cushing's disease with ketoconazole administered during 5 to 18 months. Two of them are still controlled after 15 months of treatment and 7 months after treatment was withdrawn. In the other two patients, treatment was ineffective primarily and after 5 months. Our data confirm the usefulness of ketoconazole in the treatment of Cushing's disease, but they also show that primary resistance and tachyphylaxis in long-term treatment may occur, as previously reported.

Adult↗
PubMed1993

[Conservation of tap water in metallo-plastic bags: observed modifications and possible health risks].

Conservation of tap water kept in soft plastic bags and stocked at different temperatures (20, 37 and 55 degrees C) and its health incidences were studied over one year by samples taken at regular intervals. Pollutants generated were studied by investigating the consequences of the choice of the plastic and of the aseptic agent used at different temperatures versus the length of the period of contact. Microbiological, chemical, and physico-chemical characteristics reported here showed the existence of an exchange between the contents and the container. The presence of two toxic substances indicates that one should be careful when using inadequate material. This is a matter to think about without further speculation.

Environmental Health↗
PubMed1992

[Pituitary adenoma revealed by Traquair's syndrome].

Junction scotoma is a classic field defect initially described by Traquair in 1917. Sparse cases have been reported until today. The authors report a silent pituitary adenoma in a 58 year-old female revealed by a junction scotoma. The field defects secondary to insult of chiasma from pituitary tumors besides usual bitemporal hemianopsia are reviewed by the authors. The possibility of minor ophthalmologic symptoms despite voluminous tumor has to be emphasized.

Adenoma↗
PubMed1991

Dynamic changes in soluble interleukin-2 receptor levels during treatment of Graves' disease. Correlation with disease activity.

The activation of T lymphocyte is accompanied by the release of soluble interleukin-2 receptors (sIL-2R) which can be assessed in biological fluids. A prospective study of the dynamic changes in sIL-2R levels was performed in the serum of 10 patients undergoing a medical treatment for Graves' disease. All patients received carbimazole during the study and, when necessary, L-thyroxine to compensate hypothyroidism. sIL-2R levels were measured before (M0) and after the 1st (M1), 3rd (M3) and 6th month (M6) of treatment. The levels of sIL-2R were high at M0 and M1, and decreased significantly between M1 and M3 (p = 0.03). At M0, the levels of sIL-2R were highly correlated with triiodothyronine (T3) levels (p = 0.0003), early [131I] uptake (p = 0.007) and, to a lesser degree, with anti-thyrotropin receptor antibody levels (p = 0.02). At M6, no correlation was found anymore. We conclude that sIL-2R levels are increased in patients with untreated Graves' disease. They are highly correlated with the markers of Graves' disease activity and decrease during medical treatment.

Adult↗
PubMed1991

[Contribution of a 3% solution of boric acid in the treatment of deep wounds with loss of substance].

The correct application of antiseptics to major surgical wounds must comply with appropriate protocols. Compliance with the protocol established by the CHRU of Nancy was evaluated by means of a questionnaire assessing the understanding of the protocol by the nursing staff and by a survey in the wards in which it was applied. The defects observed cannot be explained by a lack of efficacy for superficial wounds and deep wounds, as a randomised study of 42 wounds demonstrated the superiority of the protocol in relation to the use of another product which is widely used in the wards. In contrast, for deep wounds with loss of substance, the proposed protocol does not always achieve therapeutic success. This finding has led the authors to propose the use of a 3% boric acid solution based on a case-control study which demonstrated a significantly superior efficacy. All of the epidemiological and clinical elements are summarised in order to demonstrate the solid basis for compliance with antiseptic protocols of surgical wounds which can only be beneficial in terms of therapeutic success, length of hospital stay and cost savings.

Anti-Infective Agents, Local↗
PubMed1991

[Short-term effect of delayed-action injectable bromocriptine in macroprolactinoma. French multicenter study].

In this prospective multicenter trial, 61 patients presenting with a macroprolactinoma were studied over a 1 month-period following a single 50 mg intragluteal injection of the long-acting repeatable (L.A.R.) form of bromocriptine. The effects of the drug were evaluated mainly by repetitive plasma prolactin measurements on days 1, 3, 7, 14 and 28 after injection, and by repeated visual-field and computed tomography scanning examinations. Normalization of PRL levels was obtained in 23% of patients during the first month following injection. In 6 patients (9.8%), PRL values remained within normal range on day 28 after injection. In these latter patients, PRL levels were significantly lower than in the patients whose PRL values were not normal on day 28 (312 +/- 111 vs 2454 +/- 484 ng/ml [m +/- SEM]). The mean lowest PRL levels were achieved on day 3. The mean percent maximal decrease in PRL levels ranged between 70 and 72% from days 3 to 14 but constantly remained below 50% in 6 patients. An improvement in visual field was observed by day 7 in 45% of patients presenting initially with visual field defects. In particular, in half of the patients with bilateral quadranopsia or hemianopsia, such visual impairments had disappeared after 1 month of treatment. Computed tomography scanning examinations showed in 11% of the patients a more than 20% reduction in tumor mass by day 7 following injection. On day 28, the percent reduction in tumor size was 20-40% in 28% and above 40% in 10% of the patients. Most adverse effects (digestive symptoms, dizziness, postural hypotension) were observed during the first 24 hours of treatment. Local and systemic tolerability was in general good. In macroprolactinoma patients, a single 50 mg injection of bromocriptine LAR was thus able to achieve in the short-term a clear cut reduction in tumor size in 2/5 patients and normalization of PRL levels in 1/10 of patients. A study of the effects of monthly administration of bromocriptine LAR is currently under progress to assess the long-term efficacy of this drug.

Adult↗
PubMed1991

Cushing's disease and cutaneous alternariosis.

Alternaria species are common plant pathogens, but a rare cause of human infection. We present a patient with cutaneous alternariosis that revealed a relapse of an old case of Cushing's disease. Immunosuppression following the excessive glucocorticoid production seemed to contribute to the development of dermatosis. We also present a review of the literature on the association of Cushing's disease and cutaneous alternariosis. Our case is unique because the ketoconazole therapy that we used was successful in the treatment of both diseases.

Aged↗
PubMed1991

[Preliminary study of the antimicrobial activity of traditional plants against E. coli].

The microbiological quality of drinking water is a major public health priority in developing countries. As an alternative proposal to chemical treatment of water, we have studied the antibacterial effectiveness against E. coli of plants traditionally used for antisepsis. Traditional plants were freshly sampled from Burkina Faso and Vietnam. Two of them, Tamarinier and Derris elliptica respectively, were selected for the study. Various part of the plants, i.e. seeds, cloves and fruits were prepared in both decoction and maceration. Their antibacterial activity was assessed using standardized preparations of E. coli (Pasteur 792) in water (10(5), 10(6) and 10(7) germs/ml). Some preparations of Tamarinier showed encouraging results, whereas Derris elliptica was uneffective. Solutions of Tamarinier seeds produced a 4.5 log decrease of the germ concentration in standardized 10(7) germs/ml preparation. Decoction and maceration are still effective 24 h after a 10(4) bacteria/ml overloading. On the other hand, acid pH of clove and fruit solutions explains the slight effectiveness (1 log UFC/g of dry extract/48 h) of these solutions. Though the results are not meeting with the AFNOR requirements for disinfection, this preliminary study demonstrates a bacteriostatic effect of traditional plants against E. coli in water. Further study is needed to valid this property in the field.

Burkina Faso↗
PubMed1990

[Treatment of deep wounds with loss of tissue. Value of a 3 percent boric acid solution].

Following the finding of dramatic improvement in a deep wound with loss of substance treated with a 3 percent boric acid solution, 31 patients hospitalized in a surgical intensive care unit and holding such a wound initially unimproved by classical treatments were subjected, in 1987-88, to a short-time use of this solution. A case-control study retrospectively performed with 12 of the patients demonstrated that after wound granulation was obtained they returned to a normal care unit about three times more rapidly than patients receiving conventional antiseptics (means: 20 and 55 days respectively). This reduction in intensive care duration of stay for these 12 patients saved approximately 2 millions francs. Thus, the 3 percent boric acid solution may be considered an efficient alternative in the treatment of deep wounds with loss of substance, but it is delicate to handle because of toxicity.

Adolescent↗
PubMed1990

[Clinical and bacteriologic course of wounds as a function of various protocols of local antisepsis].

Antiseptics are drugs, and they must be prescribed by physicians. A correct use allows a favourable evolution of the wounds, and could avoid some amputations. The authors have realized a randomized study, to compare the reliability of a sequence using Eosine and an antiseptic (Chlorhexidine or polyvinylpyrolidone (PVP) iodine) to a more usual sequence using chlorhexidine of PVP iodine alone according with the initial pH of the wound. After fifteen days, if no clinical and bacteriological improvement occurred, the Dakin solution was used. The clinical and bacteriological survey has showed that the sequence with Eosine produced significantly more failures and that there was no significant difference between Chlorhexidine and PVP iodine. The use of the Dakin solution 15 days after inefficacy of the antisepsis previously used allowed a cicatrisation of the wound in about six days. There was no demonstrable resistance of microorganisms to the previously used antiseptics.

Adolescent↗
PubMed1990

[Bone complications of fluorotherapy: influence of androgen deficiency].

The use of sodium fluoride for treatment of osteoporosis has led to the arousal of particular complications: osteomalacia and cortical bone fractures which are enhanced by preexisting bone diseases. We report the case of a 55 years old female suffering from autoimmune Addison disease since 10 years and menopaused since 7 years. After an 18 month treatment by sodium fluoride for osteoporosis she presented radiographic, scannographic and scintigraphic evidences of unexpected stress fractures of several ribs, of the sacral part of the left sacro-iliac joint, of the symphyseal joint. The sodium fluoride treatment associated to the lack of adrenal androgens are responsible for the onset of pelvic stress fractures which usually occur in elderly subjects.

Androgens↗