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Biomedical subjects

C Mayaud

Publications and source records attributed to C Mayaud.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Asthma and Chlamydia pneumoniae. A future prospect for macrolides in general and roxithromycin in particular?].

A LOGICAL HYPOTHESIS: Recent publications raise the question of an association between Chlamydia pneumoniae and asthma. There has been no formal proof justifying routine search for C.pneumoniae in patients with uncontrolled asthma nor for systematic treatment with an antibiotic. OPEN QUESTIONS: Can Chlamydia pneumoniae infection initiate or aggravate asthma? Are acute manifestations of asthma associated with an overly high frequency of recent C.pneumoniae infection? Is a past history of C.pneumoniae infection abnormally frequent in patients with chronic asthma? PERSPECTIVES: Rigorously controlled clinical trials evaluating the efficacy of antibiotics such as macrolides which are active against C.pneumoniae are warranted to further elucidate these questions.

Anti-Bacterial Agents↗
PubMed1997

[Primary pulmonary lymphoma].

There are three distinct clinico-anatomical entities today covered by the definition of a primary clonal pulmonary lymphoid proliferation. These are pulmonary lymphomas of B cell phenotype, of low grade malignancy, B cell lymphomas of high grade malignancy and finally lymphomatoid granulomatosis whose clonal characteristic is sometimes difficult to confirm. This general review aims to specify the pathophysiological, diagnostic, prognostic and therapeutic aspects of these different types. Low grade B cell lymphoma is the most common pulmonary lymphoma. Their development depends on mucosa associated lymphoid tissue. They are most often indolent and present as a chronic alveolar opacity. Their prognosis is excellent and the modalities of treatment are discussed (no therapy, surgery or monochemotherapy). High grade B cell pulmonary lymphomas are much rarer and may result from the transformation of a low grade lymphoma or arise in a particular situation such as imunodepression. Their prognosis is poor and the therapeutic possibilities depend most often on the underlying disease. The presence of lymphomatoid granulomatosis in this group of pulmonary lymphomas is debatable. The demonstration of a clonal character of this proliferation is practically never obtained and there is often extra pulmonary disease. The prognosis of this type of illness is extremely variable because certain studies have shown a cure using corticosteroids and cyclophosphamide whilst others have found that the disease is always fatal in spite of using strong polychemotherapy.

Humans↗
PubMed1997

[Multicentric Castleman's disease with mediastinal involvement in a patient with HIV infection].

Castleman's disease is most often seen by a thoracic physician as a mediastinal tumour which is discovered fortuitously and whose surgical excision leads to a cure. We report a case of a patient of 30 who was seropositive for HIV and was suffering from Castleman's disease initially localised to the mediastinum. The disease was associated with a cutaneous and bronchial Kaposi sarcoma. The mediastinal disease, associated with cutaneous and bronchial Kaposi sarcoma, was marked by evolving in a multicentric manner. We review the histological definition and recent data concerning the pathophysiology and the diagnostic and therapeutic management of this disorder and the very varied clinical expression.

Adult↗
PubMed1996

[From pseudolymphomas to primary pulmonary lymphomas of MALT type].

Primary lung lymphomas are uncommon and the use of immunohistochemical and molecular biological techniques have widely contributed to their understanding. Generally, they are of low grade malignancy and most develop from mucosa-associated lumphoid tissue (MALT). Cellular analyses of samples obtained routinely by endoscopy (transbronchial biopsy or bronchoalveolar lavage) will probably enable the clinician to avoid invasive diagnostic procedures, such as surgical lung biopsy. Treatment of limited forms is usually surgical. As to bilateral forms or those with lesions of other mucosae e.g. gut, the best therapeutic strategy remains to be defined.

Diagnosis, Differential↗
PubMed1996

Treatment of non-meningeal cryptococcosis in patients with AIDS. Centre d'Informations et de Soins de l'Immunodéficience Humaine de l'Est Parisien.

Amphotericin B, alone or combined with flucytosine, is the reference curative treatment for neuromeningeal cryptococcosis associated with the acquired immune deficiency syndrome (AIDS). Treatment of non-meningeal forms is less well standardized. Out of 75 human immunodeficiency virus (HIV)-infected patients with cryptococcosis, 16 had no meningeal involvement. One died before receiving any treatment, another received amphotericine B and recovered, and the remaining 14 received curative therapy with fluconazole (200-400 mg/day); 11 of the latter entered complete remission, while three deteriorated during the first week of treatment but recovered on amphotericin B combined, in two cases, with fluconazole. Only one relapse occurred during maintenance treatment with low-dose fluconazole (100 mg/day). No adverse effects of fluconazole treatment were observed. One of the patients on amphotericin B developed acute renal impairment requiring drug withdrawal. These results suggest that first-line fluconazole therapy is effective and well tolerated in patients with AIDS-associated non meningeal cryptococcosis.

AIDS-Related Opportunistic Infections↗
PubMed1996

Cytomegalovirus-induced alveolar hemorrhage in patients with AIDS: a new clinical entity?

We report five cases of alveolar hemorrhage associated with intravascular hemolysis in patients with AIDS. Cytomegalovirus was the only pathogen recovered from the lungs of these patients. There was evidence of multivisceral spread of the virus in all patients, and all had viremia. All had clinical, biological, and pathological features of pulmonary vasculitis, and the conditions of four improved with specific anti-cytomegalovirus therapy.

AIDS-Related Opportunistic Infections↗
PubMed1996

Diffuse panbronchiolitis in an Asian immigrant.

Diffuse panbronchiolitis (DPB) is a disease with chronic inflammation exclusively located in the region of the respiratory bronchiole. It is largely restricted geographically to the Far East, and cases in Western countries are exceptional, even among Asian immigrants. A patient of Asian origin with DPB who had been living in France for 10 years is described. Only re-examination of the initial open lung biopsy specimen after an eight year period allowed this rare disease to be diagnosed correctly. The known efficacy of low dose erythromycin in DPB was again confirmed after failure of long term high dose corticosteroid therapy administered before an accurate diagnosis had been made.

Adult↗
PubMed1996

[Current aspects of pulmonary nocardiosis].

The nocardioses are most often due to Nocardia asteroides. Other types of Nocardia may be implicated. These infections may occur in immunocompetent patients and in that situation are most often cutaneous. They occur most frequently in patients whose immunity is depressed by cytotoxic therapy or in the group with AIDS (SIDA). The clinical presentation in these two latter groups are most often pulmonary. Haematological or lymphatic dissemination is seen in approximately one case out of two with preferential involvement of the central nervous system. Currently a recrudescence of these infections is noted. It is important to emphasise that these infections are curable with antibiotic therapy and that the prognosis depends on the rapidity of the diagnosis and the earliness of treatment.

AIDS-Related Opportunistic Infections↗
PubMed1996

[Drug-induced pneumopathies accompanied by acute respiratory insufficiency].

Drug induced pneumonias accompanying acute respiratory failure are defined by a delay in presentation of less two months and severe hypoxaemia (PaO2 < 60 mmHg in ambient air). They are poorly indexed, often poorly understood by the clinician and pose difficult problems both of diagnosis and treatment. This general review touches successively on hypoxaemic drug induced pneumonia observed in oncology and haematology then those observed outside this very specific context. In each of the two groups five questions are posed: 1) Which patients? 2) Which clinical patterns? 3) What initial diagnostic discussion? 4) Which successful elements support the drug induced hypothesis? 5) What outcome? The replies obtained were compared to case reports from the literature (188 references) or from recent general reviews concerned more specifically with the hypoxaemic forms.

Acute Disease↗
PubMed1995

Pulmonary cryptococcosis: localized and disseminated infections in 27 patients with AIDS.

We reviewed the records of 85 patients infected with both human immunodeficiency virus and Cryptococcus neoformans. Twenty-seven patients (32%) had pulmonary cryptococcosis. C. neoformans was cultured from bronchoalveolar lavage (BAL) or pleural fluid in 25 cases; the remaining two patients had cryptococcal antigen (CA) detected in BAL fluid and C. neoformans cultured from other sites. All but one of the 27 patients had detectable CA in serum. The CD4+ lymphocyte count was low in all cases (median, 24/mm3). Clinical manifestations of pulmonary cryptococcosis included fever (94%), cough (71%), dyspnea (7%), expectoration (4%), chest pain (2%), and hemoptysis (1%). Diffuse interstitial opacities (70.5%), focal interstitial abnormalities, alveolar opacities, adenopathies, cavitary lesions, and pleural effusions were evident. Outcome was poor (mean survival time, 23 weeks) despite treatment. Patients with localized pulmonary cryptococcosis appeared to have a higher CD4+ lymphocyte count, an earlier diagnosis, lower serum CA titers, fewer previous or concomitant infections, and a better prognosis than patients with disseminated cryptococcosis.

AIDS-Related Opportunistic Infections↗