Biomedical subjects
P Morlat
Publications and source records attributed to P Morlat.
[Human immunodeficiency virus infection in patients over 60 years of age. A cohort study of 31 patients followed-up at the Regional University Hospital Center of Bordeaux].
Thirty-one patients aged 60 years or more and infected with the human immunodeficiency virus type 1 (HIV-1) were followed up retrospectively and prospectively at the Regional University Hospital of Bordeaux. These patients represented 2.3 percent of all HIV infected patients followed up by the AIDS Clinical Epidemiology Group of Aquitaine. The male-to-female sex ratio was 1.4/1. Contamination resulted from blood transfusion in 58 percent of the cases. In 45.2 percent of these patients the belated diagnosis was revealed by a pathology pointing to AIDS. The most frequent clinical signs were candidiasis, herpes zoster or neurological manifestations which created a difficult differential diagnosis problem with senile dementia. The prognosis of the HIV infection was severe, with a 39.7 percent probability of survival at 18 months (confidence limits 95 percent: 18.6%, 60.8%). This prognosis could be improved by an earlier diagnosis and by a treatment suitable for elderly people.
[Panic attack caused by biguanides].
We report the case of a patient born in 1923 who had been treated with metformin since 1977 and experienced panic attacks. Lactic acid levels, measured during an attack for the first time since metformin was prescribed, were found to be elevated on two occasions. Metformin was discontinued, and during a 9-month follow-up period the patient was free from any psychiatric disorder. The role of lactic acid in the triggering of panic attacks is discussed.
[Multicenter study of intrafamilial transmission of hepatitis C virus in human immunodeficiency virus infection].
OBJECTIVE: Intrafamilial transmission of hepatitis C virus in human immunodeficiency virus and hepatitis C virus co-infections is not well documented. This cross-sectional study evaluated the transmission of hepatitis C virus in the sexual partners of hepatitis C virus and human immunodeficiency virus co-infected patients. METHODS: Hemophiliacs and transfused hepatitis C virus and human immunodeficiency virus co-infected patients who were being seen in three French university hospitals, and their sexual partners were studied by a face-to-face interview using an epidemiological questionnaire and by biological tests: antibodies against hepatitis C virus, hepatitis C virus RNA, and ALT activity. RESULT: Fifty-two subjects were included: 26 cases and their 26 sexual partners. Three sexual partners (11.5 %) had anti-hepatitis C virus antibodies, two of whom had an undetermined RIBA test. All three had a risk factor for hepatitis C virus infection (transfusion, intra-muscular injections with re-usable needles). Two of these three partners were also human immunodeficiency virus antibody positive. Hepatitis C virus RNA was negative in all sexual partners. CONCLUSION: This study provides evidence of a low prevalence of anti-hepatitis C virus antibodies in sexual partners of hepatitis C virus and human immunodeficiency virus co-infected patients. It does not support intra-familial transmission of hepatitis C virus.
[Action profile of a semisynthetic human isophane zinc insulin compared with customary isophane insulin].
Addition of zinc to a protamine-isophane insulin should probably allow to lengthen its duration of action. Therefore we compared the action of this new type of insulin (NPH Zn) with that of a classical protamine-isophane NPH insulin (NPH); both were manufactured by the same firm. Five healthy volunteers were connected to an artificial pancreas. 0.6 U/Kg of insulin was injected subcutaneously in the low left quarter of the abdominal wall. Insulin action was monitored by the glucose needs delivered by the artificial pancreas working in euglycemic glucose clamp mode. Each insulin were tested in every subject at a ten day interval. The peak plasma insulin levels were observed after 2 h 30 for the NPH insulin (40 +/- 17 microU/ml) and after 3 h (47 +/- 22 microU/ml) for the NPH Zn insulin. The glucose needs reached their top levels after 2 hours (102 +/- 19 mg.kg-1 x 15 min-1) for NPH insulin and after 3 hours (98 +/- 28 mg.kg-1 x 15 min-1) for NPH Zn; the glucose needs decreased on a parallel way for both insulins but a one hour delay for NPH Zn insulin was observed. Addition of zinc to isophane NPH insulin slightly modifies the pharmacokinecinetic parameters, moving forward one hour in the glucose delivery.
Pulmonary granuloma, polyarthritis and antiphospholipids in common variable immunodeficiency: resolution after IVIG and the role of immunoglobulin A.
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[Main epidemiological characteristics of esophageal candidiasis in AIDS (Bordeaux, France 1985-1990. Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA)].
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[Does glycemic level influence the pharmacokinetics of an antibiotic (cefoperazone)?].
Hyperglycemia may modify pharmacokinetics of some antibiotics as shown in the literature. We studied the influence of glycaemic levels on pharmacokinetics properties of cefoperazone in 12 type 1 insulin dependent diabetic patients. Hyperglycaemia was obtained by a reduction of one quarter of their usual insulin dosage and normoglycaemia by an artificial pancreas (Biostator GCIIS). Cefoperazone had a high protein affinity and a high biliary elimination. Pharmacokinetic study was performed during a 8 hour period following one gram intravenous bolus. We did not found any influence of glycaemic level (normoglycaemia or hyperglycaemia) on the pharmacokinetic parameters of cefoperazone.
Action of a semi-synthetic human insulin preparation (30/70 NPH insulin Organon): comparison with another 30/70 NPH (Actraphane Novo).
The action of a new semi-synthetic insulin preparation (30% soluble, 70% NPH insulin from Organon Laboratories Eragny sur Epte France) was studied in 6 healthy male volunteers using the euglycemic clamp technique (Biostator GCIIS) and compared with another 30/70 NPH (Actraphane Novo). Insulin levels, inhibition of C peptide secretion and glucose consumption were determined. There was a time lag between the maximum glucose need (167 +/- 18 mg/Kg/15 min at the 195th minute after the injection) and the peak plasma insulin level (98.3 +/- 8.5 uu/ml at the 105th minute following the injection). The maximum glucose need was followed by a slow fall in insulin levels with a duration of action of 17 hours. The total glucose need was the same as for Actraphane, although Actraphane had a slower action with a lower peak glucose need (144 +/- 18 mg/Kg/15 min at the 280th minute after injection). The two preparations had the same duration of action.
[Ten anti-commandments in epidemiology or how to fail in epidemiology].
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Pathologic correlations between ocular and cerebral lesions in 36 AIDS patients.
The eyes and brain have rarely been studied simultaneously in AIDS patients. We have examined both the eyes and brain of 36 patients autopsied these past 3 years. Ten cases had concomitant involvement of eyes and brain by the same pathology: cryptococcus neoformans in 1, aspergillus in another, cytomegalovirus (CMV) infection in 5, and B cell lymphomas in 2 (1 patient had the last 2 disorders associated). One patient presented pericapillary microhemorrhages in the retina of the left ocular globe as well as in the right occipital lobe. Six other patients had isolated CMV retinopathy and 4 others had B cell cerebral lymphomas. Eleven patients with foci of cerebral toxoplasmosis did not have visible cysts of toxoplasma gondii in their retina, in agreement with the other series devoted to the concomitant study of the eyes and brain in AIDS patients. On the other hand, their simultaneous involvement in an AIDS patient must first point to CMV infection.