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Biomedical subjects

C Martin

Publications and source records attributed to C Martin.

At least 91 records · Page 5Linked to original sources
PubMed2003

Long-term epidemiological survey of Candida species: comparison of isolates found in an intensive care unit and in conventional wards.

The aim of this study was to compare the distribution of Candida species in patients hospitalized in an intensive care unit (ICU) and in conventional wards. A retrospective analysis was performed covering an 18-year period in a 700-bed teaching hospital. Various body sites were investigated in all patients admitted during the study and isolates were identified by microscopic and macroscopic morphology, and by commercially available kits. The susceptibility of strains to amphotericin B and flucytosine was assessed by the ATB-fungus system, itraconazole and fluconazole by Etest. No difference was observed between the distribution of Candida species in ICU and in conventional wards. Candida albicans represented about 70% of isolates and Candida glabrata was the second most common species involved in infection or colonization. The small number of C. glabrata resistant to fluconazole suggested this antifungal agent as suitable empirical treatment for non-immunocompromized patients in whom a fungal infection was suspected.

Antifungal Agents↗
PubMed2003

[Indications of vasopressin in the management of septic shock].

OBJECTIVE: Vasopressin (antidiuretic hormone) is emerging as a potentially major advancement in the treatment of septic shock. Vasopressin is both a vasopressor and an antidiuretic hormone. It also has haemostatic, gastrointestinal, and thermoregulatory effects. This article reviews the physiology of vasopressin and all the relevant clinical literature on its use in the treatment of septic shock. DATA SOURCES AND EXTRACTION: Extraction from Pubmed database of French and English articles on the physiology and clinical use of vasopressin. The following key words were selected: vasodilatory shock, vasopressin, septic shock, catecholamines, norepinephrine, renal function, diuresis, mesenteric haemodynamic. The collected articles were reviewed and selected according to their quality and originality. DATA SYNTHESIS: Vasopressin mediates vasoconstriction via V1-receptor activation on vascular smooth muscle. Septic shock causes first a transient early increase in blood vasopressin concentrations that decreases later to very low concentrations compared to other causes of hypotension. Vasopressin infusion of 0.01-0.04 U min(-1) in septic shock patients increases plasma vasopressin concentrations. This increase is associated with a lesser need for other vasopressors. Vasopressin has been shown to produce greater blood flow diversion from non-vital to vital organ beds than does adrenaline. A large randomized clinical trial should be performed to assess its place as a therapeutic agent of septic shock patient.

Clinical Trials as Topic↗
PubMed2003

[Activation of adhesion molecules in patients with septic shock].

OBJECTIVE: To analyze the pattern of adhesion molecules in patients with septic shock. Data sources. - References obtained from Pubmed databank. DATA EXTRACTION: Models of inflammation linking endothelial dysfunction, adhesion molecules and septic states were analyzed. DATA SYNTHESIS: The endothelium has been identified as the central effector in the inflammatory response. Adhesion molecules are strongly involved in the inflammatory process by modulating the leukocyte trafficking. The most important adhesion molecules are the selectins (E-, L-, and P-selectins) and members of the immunoglobulin superfamily (intercellular adhesion molecule-1 and vascular cell adhesion molecule-1). Plasma levels of these molecules are increased in septic shock patients, which may be related to a marked activation of the endothelium. However, a dichotomous profile is observed between plasma and tissue expression. The inhibition of adhesive molecule actions could make it possible to control the inflammatory response.

Animals↗
PubMed2003

Target-controlled sedation-analgesia using propofol and remifentanil in women undergoing late termination of pregnancy.

Twenty-one women undergoing termination of pregnancy for severe fetal abnormality received remifentanil and propofol using a target-controlled infusion system and were studied prospectively. Target concentrations were initially set at 1 ng.mL(-1) for remifentanil and 0.8 microg.mL(-1) for propofol. Remifentanil concentration was adjusted to obtain visual analog scores <50 mm with preservation of ventilation. Visual analog scores assessed by the patients and physiologic data were recorded every 15 min until delivery. The median duration of administration was 150 min [10th-90th centiles: 42-282 min). Visual analog scores decreased within the first 5 min (P < 0.05) and remained under 50 mm for 91.7% of time. The median rate of infusion of remifentanil was 0.056 microg.kg(-1) min(-1) [10th-90th centiles: 0.037-0.15 ng.mL(-1)]. At delivery, the median target concentration was 2.2 ng.mL(-1) [10th-90th centiles: 1.25-4 ng.mL(-1)] for remifentanil and 0.8 microg.mL(-1) [10th-90th centiles: 0.32-1.12 microg.mL(-1)] for propofol. Remifentanil requirements were statistically correlated to gestational age, parity and duration of labor. No episodes of ventilatory depression, nausea, vomiting or pruritus were noted. Patients scored analgesia as excellent in 12 cases, good in 7 cases and moderate in 2 cases. Further studies are required to determine the place and the best regimen of remifentanil infusion for pain management in labor in those cases when epidural analgesia is contraindicated.

Journal Article↗
PubMed2003

Chloramphenicol and florfenicol susceptibility of fish-pathogenic bacteria isolated in France: comparison of minimum inhibitory concentration, using recommended provisory standards for fish bacteria.

AIM: To investigate the distribution of antimicrobial resistance to phenicols in the fish pathogenic bacteria Aeromonas salmonicida, motile Aeromonas, Yersinia ruckeri, lactic bacteria and the nutritionally fastidious Flavobacterium psychrophilum. The last species was screened on two media (diluted Mueller-Hinton and peptone-enriched Anacker and Ordal), both supplemented with horse serum. METHODS AND RESULTS: Minimal inhibitory concentration (MIC) assessment, using the agar dilution method according to proposed standards, confirmed that chloramphenicol resistance was more frequent and expressed at higher levels than florfenicol resistance. A significant resistant population, highlighted by the bimodal distribution of MICs, was detected only for chloramphenicol in A. salmonicida. No link could be found with the geographical origin of the isolates or fish species. Other cases of resistance appeared randomly distributed or related to the natural properties of the bacterial species. Although the two media used for testing F. psychrophilum resulted in comparable performances in dilution methods, Anacker and Ordal was more adapted to disc diffusion tests. CONCLUSION: Despite wide use, resistance to florfenicol does not seem to occur frequently in French fish farms. SIGNIFICANCE AND IMPACT OF THE STUDY: It is important to maintain a surveillance, as development of florfenicol resistance has occasionally been documented. For this purpose, and for the species studied in this work, the recently proposed standards appear generally well-adapted.

Animals↗
PubMed2003

Target concentration of propofol required to insert the laryngeal mask airway in children.

BACKGROUND: The aim of this prospective study was to determine the target concentration (CPRED) curves for laryngeal mask airway (LMA) insertion in children. METHODS: The CPRED of propofol required for insertion of the LMA was determined in 72 unpremedicated children, aged 3-10 years, ASA physical status I. CPRED was reached in 2 min according to a sequential allocation. LMA insertion was then performed by an experienced anaesthetist who was unaware of the concentration. Insertion conditions were noted as satisfactory (jaw relaxed, no coughing, gagging, swallowing or laryngeal spasm, minimal limb movement), excellent (no movement at all) or unacceptable if otherwise. RESULTS: The CPRED50 and CPRED90 were 7.86 microg.ml(-l)[95% confidence interval (CI) 6.46-9.26] and 10.71 microg.ml(-l) (95% CI 9.31-12.12), respectively, in the satisfactory group and 10.86 microg.ml(-l) (95% CI 10.14-11.57) and 13.71 microg.ml(-l) (95% CI 12.99-14.42) in the excellent group when calculations were based on Kataria's pharmacokinetics. These figures were increased 1.5-fold when calculations were based on Marsh's pharmacokinetics. With Schüttler's pharmacokinetics, CPRED50 were 4.62 microg.ml(-l) and 13.66 microg.ml(-l) for satisfactory and excellent groups, respectively. CONCLUSIONS: The target-controlled infusion technique for anaesthesia induction and insertion of the LMA was a safe and effective technique in our study.

Anesthesia, General↗
PubMed2003

Litomosoides yutajensis n. sp., first record of this filarial genus in a mormoopid bat.

Twenty-five bats were trapped in Yutaje (Amazonas, Venezuela) and examined for Litomosoides (Filarioidea: Onchocercidae). Of the nine recovered bat species, only Pteronotus parnelli was infected; it is a cave-dwelling species belonging to a family, Mormoopidae, which has not previously been included in the host range of the genus. The new species, L. yutajensis n. sp., has two median cephalic bosses covered with rugosities and differs from the 15 recognized species and subspecies from bats in several characters. Alike L. molossi Esslinger, 1973, L. chandleri Esslinger, 1973 and L. chitwoodi Bain, Guerrero, Rodriguez 2003, the new species has cuticular lateral bosses on the body. Eight of 10 P. parnelli were microfilaraemic, but only three had adult worms, showing that microfilariae survive longer than adults, which could lengthen the period of transmission. No infective larvae were detected in the following macronyssid mites: 58 Ornithonyssus bacoti, Ornithonyssinae, experimentally fed on microfilaraemic bats and dissected 15 days later, and a few Radfordiella sp., Macronyssinae, recovered from P. parnelli.

Animals↗
PubMed2003

A phase I/II study of oral uracil/tegafur (UFT), leucovorin and irinotecan in patients with advanced colorectal cancer.

BACKGROUND: The aim of this study was to determine the maximum tolerated dose (MTD), toxicity profile and response rate of the oral 5-fluorouracil prodrug UFT (tegafur/uracil) and leucovorin (LV) in combination with irinotecan in patients with advanced or metastatic colorectal cancer. PATIENTS AND METHODS: Patients with histologically proven advanced or metastatic colorectal adenocarcinoma received first-line chemotherapy comprising UFT 250 mg/m(2)/day and LV 90 mg/day given on days 1 to 14, with escalating doses of irinotecan (200-300 mg/m(2)) administered intravenously on day 1 of a three-weekly cycle. Eligibility criteria were standard. The MTD was defined as the dose at which >33% of six patients experienced a dose-limiting toxicity (DLT) during cycle 1. RESULTS: A total of 32 patients were studied. Initially, six patients were treated at each of the irinotecan dose levels (200, 250 and 300 mg/m(2)) combined with UFT 250 mg/m(2)/day and LV 90 mg/day. DLTs consisting of grade 3 or 4 diarrhoea and febrile neutropenia were observed in one of 20 patients at 250 mg/m(2) and three of six patients at the 300 mg/m(2) irinotecan dose level. Having defined the MTD, the 250 mg/m(2) dose level was established as the recommended dose (RD) and expanded to 20 patients in whom treatment was generally well tolerated. The overall response rate was 19%, with five patients having a partial response (PR) and 18 stable disease (SD) out of 32 response-evaluable patients. CONCLUSION: UFT and LV can be safely combined with irinotecan. The RDs for future studies are UFT 250 mg/m(2)/day and LV 90 mg/day given on days 1-14, with irinotecan 250 mg/m(2) administered on day 1, every 3 weeks. This combination is well tolerated and active. Further investigation of UFT and LV in combination with irinotecan is warranted in patients with colorectal cancer.

Adenocarcinoma↗
PubMed2003

Tea consumption, apoptosis, and colorectal adenomas.

Induction of apoptosis has been suggested as a mechanism for the anti-carcinogenic effect of tea constituents in animals and in vitro studies. We addressed this hypothesis in a human study. Study participants were consecutive patients who underwent colonoscopy at the UNC Hospitals (August 1998 to March 2000). Biopsies were taken from normal rectal mucosa. Apoptosis was scored by the terminal deoxyribonucleotide transferase-mediated digoxigenin dUTP nick end labeling (TUNEL) method and by standard morphological criteria. The analysis included 171 patients with adenomas (cases) and 323 adenoma-free controls. After adjusting for sex, age, race, and BMI, apoptotic score was inversely associated with adenoma: the odds ratios (ORs) for linear trend associated with tertiles were 0.3 (0.3-0.5) for morphologic score and 0.5 (0.4-0.6) for the TUNEL score, respectively. Tea consumption (2-3 and >3 versus <2 servings/day) showed a weak negative association with adenoma: the ORs were 0.7 (0.3-1.4) and 0.5 (0.2-1.1), respectively. Neither measurement of apoptotic score changed by the level of tea consumption (P value for Kruskal-Wallis test > or =0.5). We did not find statistical interaction between apoptotic score and tea consumption. Tea exposure is not associated with apoptosis in normal rectal tissue in vivo.

Adenoma↗
PubMed2003

p16INK4A as a marker for cervical dyskaryosis: CIN and cGIN in cervical biopsies and ThinPrep smears.

AIM: To examine the potential of p16(INK4A) as a biomarker for dysplastic squamous and glandular cells of the cervix in tissue sections and ThinPrep smears. METHODS: Immunocytochemical analysis of p16(INK4A) expression was performed on 22 normal cervical tissue samples, five cervical glandular intraepithelial neoplasia (cGIN), 38 cervical intraepithelial neoplasia 1 (CIN1), 33 CIN2, 46 CIN3, and 10 invasive cancer cases (eight squamous and two adenocarcinomas). All samples were formalin fixed and paraffin wax embedded, and immunohistochemical analysis was carried out using a mouse monoclonal anti-p16(INK4A) antibody after antigen unmasking. The staining intensity was assessed using a 0 to 3 scoring system. In addition, the expression status of p16(INK4A) was examined in 12 normal ThinPrep smears, one smear exhibiting cGIN, and a total of 20 smears exhibiting mild, moderate, and severe dyskaryosis. Human papillomavirus (HPV) detection was carried out using a modified SYBR green assay system. Fluorogenic polymerase chain reaction (PCR) and solution phase PCR were used for specific HPV typing. RESULTS: p16(INK4A) immunoreactivity was absent in all normal cervical tissues examined. Dysplastic squamous and glandular cells were positive for p16(INK4A) expression in all cases included in this study, except for one CIN3 case. p16(INK4A) expression was mainly nuclear in CIN1 cases, and both nuclear and cytoplasmic in CIN2, CIN3, cGIN, and invasive cases. All cases positive for HPV expressed the p16(INK4A) protein, although not all cases found positive for p16(INK4A) were HPV positive. In general, the p16(INK4A) staining intensity was lower in cases negative for HPV or those containing a low risk HPV type. CONCLUSION: This pattern of overexpression demonstrates the potential use of p16(INK4A) as a diagnostic marker for cervical squamous and also glandular neoplastic lesions. In addition, the technique can be used to identify individual dyskaryotic cells in ThinPrep smears. Thus, p16(INK4A) is a useful marker of cervical dyskaryosis.

Biomarkers↗
PubMed2003

Ceftriaxone (1 g intravenously) penetration into abdominal tissues when administered as antibiotic prophylaxis during nephrectomy.

A pharmacokinetics study was conducted to determine the effects of ceftriaxone administered before nephrectomy on the occurrence of postoperative wound infection. Ceftriaxone was administered as antibiotic prophylaxis in 11 consecutive patients undergoing nephrectomy who received 1,000 mg intravenously 30 min before surgery. Simultaneous blood and tissue samples were collected at three stages of the surgical procedure: opening of the abdominal cavity, nephrectomy, and closure of the abdominal cavity. Samples of following tissues were assayed: abdominal-wall fat, perirenal fat, kidney cortex and medulla, and urine. During the different stages of surgical procedures, ceftriaxone concentrations remained higher than the MIC90 of the potential pathogens (Staphylococcus aureus, Escherichia coli, and Enterobacteriaceae). In selected patients undergoing nephrectomy and requiring antimicrobial prophylaxis such as malnourished, debilitated, diabetic or immunosuppressed patients, the use of a single dose of ceftriaxone (1,000 mg) makes it possible to offer an optimal bacterial coverage for the prevention of postoperative infection. According to our kinetic evaluation, ceftriaxone is potentially a good antibiotic for prophylaxis in urological surgery.

Abdomen↗
PubMed2003

The early allergic response in small airways of human precision-cut lung slices.

To study the role of small airways in the early allergic response (EAR), the method of human precision-cut lung slices (PCLS) was developed and used to examine the bronchoconstriction elicited by passive sensitisation and allergen provocation. Viable human PCLS of 250-microm thickness containing airways <1.5 mm in outer diameter were prepared from lung lobes obtained from lung resection and taken into culture. According to the low release of lactate dehydrogenase and the constant ciliary beat frequency, human PCLS were viable for at least 3 days. Following overnight passive sensitisation with serum from allergic individuals, administration of grass-pollen extract or activating immunoglobulin E antibody resulted in immediate airway contraction that was quantified by videomicroscopy. The extent of the EAR increased with decreasing airway size (outer airway diameter), with the strongest response occurring in the terminal bronchioles. Histamine receptor antagonism was ineffective, and leukotriene or thromboxane receptor antagonism attenuated the early allergic response only in some cases. However, simultaneous blockade of leukotriene and thromboxane receptors almost completely prevented the early allergic response in the precision-cut lung slices from all individuals, suggesting such a dual treatment as a potential future asthma therapy.

Acetates↗
PubMed2003

[Paraneoplastic opsoclonus-myoclonus syndrome associated with small-cell lung cancer].

Opsoclonus-myoclonus syndrome was observed in a patient treated for small-cell lung cancer. Opsoclonus presented as anarchic involuntary eye movements associated with myoclonies of the limbs and trunk. Opsoclonus-myoclonus is exceptional and a specific expression among several paraneoplastic manifestations described in small-cell lung cancer. These manifestations develop late after diagnosis of cancer. Presence of anti-neuronal antibodies in the serum (inconstant) is a factor of very poor prognosis.

Aged↗