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Biomedical subjects

T May

Publications and source records attributed to T May.

At least 73 records · Page 4Linked to original sources
PubMed1998

[Cerebral toxoplasmosis in HIV infected patients intolerant of cotrimoxazole].

Using results of a multicentric randomized prospective trial of primary prophylaxis of Pneumocystis carinii pneumonia in HIV-infected patients which compared sulfamethoxazole-trimethoprim and pentamidine isethionate, the risk to develop cerebral toxoplasmosis was analyzed in the two assigned groups and in the groups of patients who stopped sulfamethoxazole-trimethoprim prophylaxis. The risk to develop cerebral toxoplasmosis appeared significantly higher in the group of patients who stopped sulfamethoxazole-trimethoprim consecutively to cutaneous hypersensitivity.

AIDS-Related Opportunistic Infections↗
PubMed1998

Effects of nutrient supplementation in beef cows of poor body condition fed snakeweed (Gutierrezia spp).

Two replicate trials determined the effects of dietary supplementation on snakeweed toxicity in beef cows of poor condition. Cows were stratified by weight and randomly assigned to 3 dietary treatments. Dietary treatments were control (n = 3/trial; medium quality hay, 9.49% crude protein), corn supplementation (n = 3/trial; control diet + 628 g cracked corn), and protein supplementation (n = 3/trial; control diet + 800 g 42% protein supplement). Corn and protein dietary treatments were fed to be isocaloric. Each trial consisted of 2 phases (68 days/phase). Phase 1 consisted of dietary treatments without snakeweed. In phase 2 dietary treatments contained snakeweed as 10% of the dry matter. Phase 1 and 2 dietary treatments were isocaloric/isonitrogenous. Dry matter intake of the control diet was limited to 1.3% of body weight/d. Body condition score and back fat were measured on days 0, 21 and 68 of each phase. Serum samples were collected at the onset of each trial and on days 28, 42 and 56 of each phase. Serum bromosulphthalein (BSP) elimination half life (t1/2) was estimated during week 6 of each phase. Serum BSP elimination t1/2 was higher for the control diet versus corn and protein treatments. Increased blood urea nitrogen (BUN) was found by day 28 of phase 2. Serum total bilirubin increased by day 28 in phase 2 compared to baseline for the control and corn dietary treatments. Additionally, serum indirect bilirubin was higher by day 28 in phase 2. Likewise, serum direct bilirubin increased during phase 2 on day 28 in the corn diet, but decreased by day 28 for the protein diet. Alkaline phosphatase levels were higher (P < 0.05) in the controls by day 28, but lower in the protein treatment by day 28 in phase 2. Changes were noted during phase 2 for some of the serum clinical profiles; however, these changes appear due to dietary restriction. In contrast, changes during phase 2 point to possible hepatotoxic and renal toxic effects of snakeweed. Phase 2 data suggest a benefit of protein supplementation for improving animal tolerance to snakeweed.

Alanine Transaminase↗
PubMed1998

Protease inhibitors, diabetes mellitus and blood lipids.

We report the case of a patient with human immunodeficiency virus (HIV) and no familial or personal history of metabolic disease, who experienced two diabetes decompensations (severe hyperglycaemia without ketonuria) associated with severe hypertriglyceridaemia, after the introduction of protease inhibitors. Initial insulin therapy at high doses (2 IU/kg/day) was required, and metabolic control was restored within several weeks without treatment after withdrawal of protease inhibitors. This case confirms that due attention must be paid to both blood glucose and plasma triglyceride levels in HIV-infected patients treated with protease inhibitors.

Adult↗
PubMed1997

[Complications of cardiac hydatid cyst. 2 cases].

BACKGROUND: Cardiac localization of hydatiosis is uncommon, involving 0.5 to 2% of all cases. CASE REPORTS: The first patient was a 15 year old adolescent whose cardiac hydatidosis was revealed by tamponade. The second case was discovered in a 28-year-old woman without cardiac signs who was explored for allergy manifestations with fever, urticaria and joint point. Both patients underwent surgery. Eighteen months after the operation, the second patient developed hemiplegia leading to the discovery of multi-organ localizations (brain, spleen, kidney) which were not evidenced at the initial work-up. The neurological deficit and brain cysts regress with albendazole treatment. DISCUSSION: The risk of rupture of the cardiac hydatic cyst requires rapid surgical cure. Medical treatments are discussed. Anti-hydatic drugs can be used alone in case of a contraindication for surgery. In other patients they are given during the perioperatie period and for a prolonged period after surgery.

Adolescent↗
PubMed1997

Influence of ethosuximide on valproic acid serum concentrations.

In the therapy of absence epilepsies, a combination of ethosuximide (ESM) and valproic acid (VPA) is sometimes necessary for a successful seizure control. Previous studies of the interaction between ESM and VPA revealed contradictory results. We investigated the influence of ESM on VPA serum concentrations in children with epilepsy. In case of ineffectiveness of the drug, ESM was withdrawn (n = 9). Four children treated with VPA got ESM additionally because their seizure control was insufficient with VPA alone. Two children had bromide, and one clobazam as comedicament. Both of these antiepileptic drugs (AEDs) do not have any known interactions with ESM or VPA. Serum levels of VPA were higher in monotherapy than in combination with ESM (120.0 +/- 20.1 micrograms/ml; range, 88.9-153.4 micrograms/ml; vs. 87.0 +/- 13.1 micrograms/ml; range, 67.4-108.0 micrograms/ml). The difference was statistically significant (P < 0.01). After stopping ESM the serum concentrations of VPA rose about 36.7%; when combined with ESM they fell about 28.3%. Neither the age of the patients nor the serum concentrations of ESM influenced significantly the changes of VPA serum levels in either group. The mechanism of ESM to influence the serum levels of VPA remains unknown. ESM has no known enzyme inducing properties. The interaction of ESM and VPA ought to be considered in a combination therapy of these drugs.

Adolescent↗
PubMed1997

Parathyroid hormone prevents 1,25 (OH)2D3 induced down-regulation of the vitamin D receptor in growth plate chondrocytes in vitro.

1,25(OH)2D3 has an antiproliferative effect on growth plate chondrocytes when given in high doses, whereas low doses stimulate chondrocyte proliferation. In the present in vitro study we investigated the effects of parathyroid hormone (PTH) when given concomitantly with 1,25(OH)2D3 on cell proliferation and vitamin D receptor (VDR) regulation. Freshly isolated rat tibial chondrocytes were grown in monolayer cultures or in agarose stabilized suspension cultures (10% charcoal-treated FCS). VDR expression was determined by RT-PCR generating a 297 bp fragment and by binding assays (Scatchard analysis) with [3H]-1,25(OH)2D3. Cell proliferation was measured by [3H]-thymidine incorporation, growth curves in monolayer cultures and by colony formation in agarose-stabilized suspension cultures. Optimal concentration of 1,25(OH)2D3 (10(-12) M) and of PTH fragments [bPTH(1-34) or hPTH(28-48), 10(-10)M] showed additive effects on DNA synthesis of and colony formation by growth plate chondrocytes. This may be explained in part by an up-regulation of VDR by PTH: PTH increased both mRNA expression of VDR and binding capacity. 1,25(OH)2D3 (10(-12) M) induced an up-regulation of the VDR within 24 hours followed by a down-regulation after incubation for more than 24 hours. PTH fragments added concomitantly prevented the down-regulation seen with 1,25(OH)2D3. These findings provide evidence that PTH is a growth promoting hormone that also modulates the effects of 1,25(OH)2D3 by regulating the VDR status of 1,25(OH)2D3 target cells.

Animals↗
PubMed1997

Comparison of combination therapy regimens for treatment of human immunodeficiency virus-infected patients with disseminated bacteremia due to Mycobacterium avium. ANRS Trial 033 Curavium Group. Agence Nationale de Recherche sur le Sida.

We conducted a randomized, open-label trial in 42 French hospitals to compare the clinical and bacteriologic efficacy of combination therapy with clarithromycin/clofazimine (Clm/Clof) with that of combination therapy with clarithromycin/rifabutin/ethambutol (Clm/Rib/Eth) as treatment for Mycobacterium avium bacteremia. One hundred forty-four human immunodeficiency virus-seropositive patients older than 18 years of age who had CD4 lymphocyte counts of <100/mm3 and a blood culture positive for M. avium were enrolled in the study. The main measures of outcome were blood cultures, abatement of clinical symptoms (fever), and survival. Treatment success (defined as patient living, either no fever or a reduction of > or = 1 degrees C in initial body temperature, and a blood culture negative for M. avium) was similar in both treatment groups at months 2 and 6. However, following initial resolution of infection, relapse of M. avium bacteremia occurred in more patients in the Clm/Clof group than in the Clm/Rib/Eth group (22 vs. six, respectively; P < .001); these relapses were accompanied by emergence of strains resistant to clarithromycin in 21 and two patients, respectively. In conclusion, combination therapy with Clm/Rib/Eth prevented relapse of mycobacterial disease and, compared with combination therapy with Clm/Clof, was associated with a significant decrease in the emergence of resistant M. avium strains in HIV-infected patients treated for at least 28 weeks.

AIDS-Related Opportunistic Infections↗
PubMed1997

Localization of epileptic auras induced on stimulation by subdural electrodes.

PURPOSE: This study evaluates the localization of stimulation-induced auras (SIA) and tries to determine whether the SIA can help to define the boundaries of resection in epilepsy surgery. METHODS: Using subdural grid electrodes, 31 patients with drug resistant focal epilepsy were examined in a retrospective and prospective study lasting 2 years. RESULTS: On stimulation by subdural electrodes, we elicited habitual auras in 16 patients (52%). The zone of SIA overlapped the epileptogenic lesion in 12 patients (75%), the EEG seizure onset zone in 12 patients (75%), and the irritative zone of interictal spikes in eight patients (50%). Postoperative results showed a significant correlation with the complete removal of the epileptogenic lesion (p < 0.001). Because the number of patients in the study was small, we could not find a significant correlation with the complete removal of the SIA zone, EEG seizure onset zone, and irritative zone. CONCLUSIONS: Our study confirms previous analyses which indicate that complete resection of the epileptogenic lesion is essential to achieve a good outcome. Frequent overlap of the SIA zone with the epileptogenic lesion and the EEG seizure onset zone indicates proximity of the SIA with the epileptogenic zone. Nevertheless, this study does not support the concept that the SIA zone and the EEG seizure onset zone have additional value in defining the boundaries of resection in epilepsy surgery. Three case presentations suggest that SIA result from facilitated pathways between the stimulated cortex, the epileptogenic zone around the lesion, and the symptomatogenic zone. Functional reorganization in the vicinity of the cortical lesion cannot be ruled out but was not seen in our patients. Thus, SIA often do not reflect the normal function of the stimulated underlying cortex.

Adolescent↗
PubMed1997

Use of different molecular typing techniques for bacteriological follow-up in a clinical trial with AIDS patients with Mycobacterium avium bacteremia.

One hundred ninety-six Mycobacterium avium isolates from blood samples recovered from 93 AIDS patients for several months were typed by serotyping, by IS1245 restriction fragment length polymorphism (RFLP) analysis and in some cases RFLP analysis with plasmids pVT2 and pLR7 as probes, and by pulsed-field gel electrophoresis (PFGE). PCR typing of single colonies was also used to detect polyclonal infections. Strains belonged mainly to serotypes 1, 4, and 8. pVT2- and pLR7-related plasmids were detected in strains from 49% of the patients. The IS1245 RFLP and PFGE analyses showed a 96.8% diversity of the M. avium strains from the 93 patients. The vast majority (95.2%) of infections were monoclonal, indicating that recent infection is unlikely, even at an advanced stage of AIDS. For one patient, sequential isolates gave divergent patterns of sensitivity and resistance to clarithromycin, but all were identified as the initial clone. RFLP analysis and PCR typing of single colonies allowed for the detection of three polyclonal infections during the bacteriological follow-up. Among strains from patients whose samples were positive by culture after treatment for 2 to 15 months, 97.4% were the same as the initial strain. In conclusion, relapses and failures were mostly due to the initial strain. These relapses and failures resulted either from the selection of resistant mutants or the reappearance of sensitive strains, suggesting the persistence of nonsterilized tissue reservoirs.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Cerebellar atrophy and prognosis after temporal lobe resection.

OBJECTIVE: Experimental data indicate inhibitory effects of the cerebellum on seizure activity. Structural damage such as cerebellar atrophy, which is a common finding in patients with chronic epilepsy, may reduce these effects. METHODS: Outcome after temporal lobectomy was studied in 78 consecutive patients, with or without cerebellar atrophy diagnosed by MRI. RESULTS: Thirty five patients (45%) showed cerebellar atrophy. At a mean follow up of 14.6 (range, 6-40) months, 50 patients (64%) had no postoperative seizures. In these patients, the frequency of cerebellar atrophy was significantly lower (34%) than in patients who relapsed (64%, p < 0.01). Occurrence of generalised tonic-clonic seizures (GTCS) within two years before surgery, occurrence of GTCS at any time preoperatively, long duration of epilepsy, and older age at surgery were also associated with recurrence of seizures. Multiple logistic regression analysis suggested occurrence of GTCS within two years before surgery and cerebellar atrophy as the main predictive indicators. When both factors were present, the percentage of patients remaining seizure free since surgery fell to 30%, compared with 60% when only GTCS were present, 78.6% when only cerebellar atrophy was present, and 87.5% when both factors were absent. CONCLUSIONS: Cerebellar atrophy shown by MRI was a frequent finding in surgically treated patients with temporal lobe epilepsy. The presence of cerebellar atrophy seems to worsen the prognosis after temporal lobe resection.

Adolescent↗
PubMed1997

[Current status in the prevention of Mycobacterium avium complex infections in patients with HIV infection].

Mycobacterium avium complex (MAC) infections in AIDS are increasingly common and contribute to the mortality in severe immunocompromised patients. In this paper, we review the published studies on the prevention of the MAC infections. Rifabutin and the new macrolides (clarithromycin, azithromycin) are shown to be effective in the primary prevention. However, they can fail and are difficult to manage with the antiretroviral treatment, specially antiproteases and prevention of the other opportunistic infections. For the prevention of the relapse of the MAC infections, it is necessary to give a prolonged treatment with a bio-therapy associating at least a new macrolide with rifabutin or ethambutol, which is also difficult to manage with the other treatments.

AIDS-Related Opportunistic Infections↗
PubMed1997

Tuberculosis in Lorraine, France: study of prognostic factors.

AIM: To identify factors predicting short-term mortality in patients with tuberculosis in the Lorraine region of France. METHOD: Retrospective survey in nine voluntarily participating hospitals between January 1990 and December 1994. RESULTS: In total 351 files were analyzed. The average age of patients was 49 +/- 19 years; 77% were of French origin, 60% were male; 35% were in paid employment at the time of the diagnosis, 42% were unemployed and 23% were retired. Twenty-three patients were infected by the human immunodeficiency virus (HIV), and 34 patients had a prior history of tuberculosis; 79% of all cases were exclusively pulmonary, 14% were exclusively extra-pulmonary (more frequent in women) and 7% were mixed. Extra-pulmonary sites of involvement were more frequent in HIV-infected patients. Chest X-ray was suggestive of tuberculosis in 158 patients with pulmonary involvement, and non-suggestive in 145 (more frequently in HIV-infected patients). In univariate analysis, HIV co-infection, increasing age and unemployment were linked to death during treatment. In multivariate analysis (logistic regression), HIV co-infection, old age, unemployment, pulmonary involvement and French origin were significantly linked to the risk of death during treatment.

AIDS-Related Opportunistic Infections↗