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Y Mouton

Publications and source records attributed to Y Mouton.

At least 109 records · Page 6Linked to original sources

[Cardiac hydatidosis: contribution of magnetic resonance imaging. Report of a case].

Cardiac hydatid cyst is a rare condition. The diagnosis is difficult and is based on a series of findings amongst which hydatid serology and cardiac imaging play important parts. The values and limitations of echocardiography, coronary angiography and CT scanning are well known. Nuclear magnetic resonance imaging is a recent technique which theoretically should provide valuable diagnostic information. The authors report a case in which this technology, though confirming the presence of a polycystic intrapericardial mass, did not show the true extension of the disease.

Adult↗

[Acyclovir and specific anti-varicella-herpes zoster immunoglobulins in the treatment of varicella-zoster virus infection in 113 adults].

From January 1978 to December 1988, 54 males and 59 females were treated for varicella, zoster and disseminated zoster by varicella-zoster immunoglobulin (group I) or acyclovir (group II). 67 patients had immune deficiency disease. Treatment was successful for 92/100 patients in group I and for 100/100 patients in group II. Thrombophlebitis and renal failure were observed in group II and regressed when acyclovir was stopped. Varicella-zoster immunoglobulin and acyclovir are two effective therapeutics in the treatment of varicella and zoster in adults including immunocompromised patients. The use of acyclovir could not reduce the duration of hospitalization.

Acyclovir↗

[Nosocomial pneumopathies].

The criterion used for the diagnosis of nosocomial pneumonia is an infiltrate on X-ray of the chest, not present on admission, associated with new sputum production. The main causative pathogens are Staphylococcus spp. and Gram-negative bacilli. The most common pattern in the development of pneumonia is colonization of the oropharynx followed by aspiration into the lungs in patients with impaired normal defences. The factors which significantly predispose to nosocomial pneumonia are tracheal intubation, low level of consciousness, chronic lung disease, thoracic or upper abdominal surgery, large volume aspiration and age over 70 years. The fatality rate is high (32 p. 100 to 55 p. 100). In most cases the curative treatment requires a combination of antimicrobial agents. At the moment, preventive measures remain an elusive goal.

Cross Infection↗

[Can nosocomial infections be prevented?].

Nosocomial infections constitute an important problem in terms of morbidity, wHich can be measured as excess hospital stay, mortality and extra-cost. A third of these infections can be prevented by an effective control programme, as shown by the results of the SENIC Project, but this requires a close co-operation between infection control nurses, physicians interested in infection control and practising epidemiological supervision and hospital personnel. Data concerning the four main sites of nosocomial infections (surgical wounds, urinary tract, lower respiratory tract and bloodstream) are reviewed, and the main guidelines regarding their prevention are summarized.

Cross Infection↗

Nosocomial infections associated with long-term radial artery cannulation.

From January 1987 to December 1987, 193 radial artery cannulations were performed in 112 patients (87 males, 25 females; mean age = 57.5 years). The mean duration of cannulation was 6.45 days. After removal, the tip of the catheter was cultured using a semiquantitative culture technique: 164 catheters were cultured and positive results were seen in 37 cases (22.5%); 98 samples of infusate were cultured. Positive results were observed in 23 cases (23.5%). No bacteriological correlation was found between these two culture results. During the study, no catheter-related or infusate-related bacteraemia was detected. It is concluded that nosocomial infections associated with long-term radial artery cannulation are not commonly seen, in particular no catheter or infusate-related bacteraemia occurs even if the duration exceeds 4 days.

Catheterization, Peripheral↗

Antibodies to the nef protein and to nef peptides in HIV-1-infected seronegative individuals.

The silent period that follows infection by the human immunodeficiency virus (HIV-1) and precedes seroconversion remains a problem for the screening of blood supply, and knowledge about the mechanism involved in the maintenance of latency is only fragmentary. Using purified nef recombinant protein and six synthetic nef peptides, antibodies to the product of an HIV-1 regulatory gene, the negative regulatory factor (nef) involved in maintenance of proviral latency, were detected by Western blot and radioimmunoassay techniques in HIV-1-seronegative, viral antigen-negative, and virus culture-negative individuals at risk for HIV infection. This antibody response to nef was correlated in eight individuals with the detection of HIV-1 proviral DNA by oligonucleotide hybridization, following enzymatic amplification of HIV DNA in peripheral blood mononuclear cells. Such latent HIV infections have now been followed for up to 6 or 10 months in five individuals. In addition, retrospective and prospective analysis of HIV-1-seropositive individuals have shown (1) antibodies to nef preceding seroconversion, and (2) the persistence of antibodies to nef and of HIV-1 proviral DNA in a case of spontaneous complete HIV-1 seronegativation. Since DNA amplification cannot be currently considered for routine use, screening for anti-nef antibodies followed by confirmation by DNA amplification could represent a basis for new diagnostic strategies. Beyond their diagnostic implications, these findings, suggesting that regulatory genes of the HIV-1 provirus can be expressed prior to the initiation of virion synthesis, may also be applicable in the design of alternative vaccines against the acquired immunodeficiency syndrome.

DNA, Viral↗

Production of tumour necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) in patients with AIDS. Enhanced level of TNF-alpha is related to a higher cytotoxic activity.

We measured simultaneously circulating and cell-generated TNF-alpha and IL-1 after lipopolysaccharide (LPS) stimulation of peripheral blood mononuclear cells (PBMC) by radioimmunoassay (RIA) in HIV-infected individuals at different stages of infection, classified according to CDC classification. TNF-alpha production, both in vitro and endogenous in sera, remained at the normal level in group II patients but was significantly increased in most patients in group IV (P less than 0.05). Most patients of group II and IV displayed normal level of IL-1 in their sera, whereas the level of this monokine generated in vitro was significantly reduced in both groups (P less than 0.05). The cytotoxic effect of factor(s) secreted by PBMC from HIV-infected individuals was evaluated towards a fibroblast cell line L929. The higher titre of cytotoxicity was directly related to a higher production of TNF-alpha by the cells from group IV patients and the effect could be removed by pre-absorption with anti-TNF-alpha monoclonal antibody.

Acquired Immunodeficiency Syndrome↗

[Enterobacter, Serratia, Acinetobacter or Pseudomonas septicemias].

During 1985 and 1986, 48 bacteremias due to Enterobacter spp, Acinetobacter spp, Serratia spp or Pseudomonas spp were collected by the SES Group. The mortality rate of those infections due to multiresistant organisms appeared high (27.9%). Among all factors influencing the prognosis, the following, age over 75 years, hospital-acquired infections, occurrence of shock and single antimicrobial therapy, are those associated with a high fatality rate. Given that clinical signs are not specific, nosocomial bacteremias should be treated by antimicrobial agents having wide spectrum, rapid onset of action and most often in combination.

Acinetobacter Infections↗

[Prospective randomized controlled study of a ceftazidime and pefloxacin combination versus a ceftazidime and amikacin combination in the empirical treatment of pneumonia and nosocomial septicemia at intensive care units].

Three hundred fifty-two patients from 20 intensive care units, suffering from pneumonia or nosocomial septicemia were treated at random with either ceftazidime + pefloxacin (CP) or ceftazidime + amikacin (CA). After exclusion of patients who did not comply with the protocol and of cases where no organism was isolated, 108 assessable patients received CP and 114 received CA. The cure rates achieved in infections due to a single organism were 82 per cent in the CA group and 62 per cent in the CP group. In infections due to multiple organisms, the cure rate was 67 per cent with both antibiotic regimens.

Amikacin↗

[Treatment of pneumonia caused by Legionella, Mycoplasma, Chlamydiae and Rickettsia using ofloxacin].

To asses the efficacy and the safety of ofloxacin as therapy of pneumonia caused by intracellular pathogens, 35 patients were studied (26 male, 9 female, mean age: 52.5 +/- 16.6 years). Causative pathogens were Chlamydia psittaci (n = 13), Legionella pneumophila (n = 10), Mycoplasma pneumoniae (n = 7) and Coxiella burnetii (n = 5). Ofloxacin was administered orally in 32 cases (200 mg b.i.d. in 80% of cases) and by I.V. route in 3 cases. All patients were cured without any side effects. In conclusion, ofloxacin appears, in our study, as an efficient therapy for these pneumonias. It could be considered as a valuable alternative to other antimicrobial agents with intra-cellular activity.

Adult↗

[Contribution of experimental models to the treatment of respiratory tract infections].

The need for more effective and potentially less toxic antimicrobial agents than aminoglycosides for treatment of gram negative bacilli pneumonia specially Pseudomonas aeruginosa, explains the interest for experimental models of pneumonia. These models allow to study the efficacy and safety of antibiotics alone or in combination. Aminoglycosides and new quinolones are more effective than beta-lactams for life threatening infection with high inoculum, the only exception to this finding has been for N-formimidoyl thienamycin, whereas for less severe infections aminoglycosides and beta-lactams are equivalent in efficacy. In contrast to high inocula pneumonia, combining beta-lactams with aminoglycosides give additive of synergic benefits for treating low inocula. Experimental models allow to compare continuous versus intermittent administration of antibiotics, different regimens of the same antibiotics (single daily dose of aminoglycosides versus conventional administration) and new antiinfectious agents as anti-pseudomonas hyperimmune globulins.

4-Quinolones↗

[Controlled randomized prospective study of a ceftazidime-pefloxacin combination versus a ceftazidime-amikacin combination in the empirical treatment of nosocomial pneumonias and septicemias of resuscitation. Preliminary results].

The preliminary results obtained in 212 patients from 20 intensive care units, suffering from pneumonia or nosocomial septicemia and treated at random with either ceftazidime + pefloxacin (CP) or ceftazidime + amikacin (CA) were analyzed. After exclusion of patients who did not comply with the protocol and of cases where no organism was isolated, 57 assessable patients received CP and 72 received CA. The cure rates achieved in infections due to a single organism were 85 per cent in the CA group and 63 per cent in the CP group. In infections due to multiple organisms, the cure rate was 74 +/- 2 per cent with both antibiotic regimens.

Amikacin↗

[Pulmonary valve endocarditis caused by Streptococcus D bovis in a patient with a colorectal adenocarcinoma].

A case of pulmonary endocarditis caused by Streptococcus D bovis in a female patient with colorectal adenocarcinoma is reported. The M-mode and two-dimensional echocardiographic and pulsed doppler ultrasound findings are described. A review of the literature shows that Streptococcus D bovis pulmonary endocarditis is rare. Any septicaemia or endocarditis caused by this organism calls for invasive exploration of the digestive tract, and especially the colon.

Adenocarcinoma↗