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Biomedical subjects

C Michon

Publications and source records attributed to C Michon.

36 records · Page 2Linked to original sources
PubMed1989

Prevention of Pneumocystis carinii pneumonia relapse by pentamidine aerosol in zidovudine-treated AIDS patients.

To examine the efficacy and tolerance of pentamidine aerosol in the prevention of Pneumocystis carinii pneumonia (PCP) relapse in patients with the acquired immunodeficiency syndrome (AIDS) being treated with zidovudine, 51 patients who had had an episode of PCP in the previous 5 months were enrolled in a randomised controlled study. 25 patients (group I) received pentamidine mesylate aerosol (4 mg/kg every 2 weeks for the first month then monthly) and zidovudine, and 26 patients (group II) zidovudine alone. 3 group I patients withdrew from pentamidine therapy prematurely and were excluded from the analysis of efficacy. Relapses of PCP occurred in 2 out of 22 (9%) group I patients and in 16 out of 26 (61%) group II patients after a mean follow-up of 10 and 8.7 months, respectively. The two groups differed significantly (p less than 0.0001) in proportions without relapse. They did not differ in proportions surviving. Bronchial intolerance was common (47%); no systemic side-effects of pentamidine were observed. Pentamidine aerosol thus seems to be effective in preventing PCP relapses in AIDS patients on zidovudine. The early termination of the trial prevented assessment of the long-term efficacy and safety of pentamidine given by aerosol.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Intestinal infections in patients with acquired immunodeficiency syndrome. A prospective study in 132 patients.

We studied prospectively 132 patients with acquired immunodeficiency syndrome to define the spectrum of enteric pathogens during this disease, with special reference to the correlation between the lesions, the infections, and the symptoms. Forty-four percent of the patients harbored at least one enteric pathogen: the most frequently recovered were Cryptosporidium (28), cytomegalovirus (16), Entamoeba histolytica (13), Giardia lamblia (9), and Mycobacterium avium intracellulare (7). Patients harboring pathogens were more likely to be diarrheics (69%) than patients without a pathogen (38%; P = 0.01) and more likely to have endoscopic lesions (29%) than patients without a pathogen (4%; P less than 0.001). The most common pathogen associated with diarrhea was Cryptosporidium. Cytomegalovirus, Entamoeba histolytica, and Salmonella typhimurium were each significantly associated with endoscopic lesions. Patients with cytomegalovirus infection tended to have a greater incidence of ulcer than patients without cytomegalovirus infection. Stool analysis diagnosed 61% of the infections, while endoscopy diagnosed 44%. Seven percent were recognized by stool analysis and endoscopy. When considering the 24 patients in whom accurate diagnosis warranted endoscopic biopsies, stool examination alone would have given an incomplete diagnosis in 14 patients (due to the presence of polyinfection). The frequency of inaccurate diagnosis of infection by stool determination alone, plus the development of new antiviral agents that suppress cytomegalovirus, may favor the earlier application of endoscopic evaluation in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Divided-dose kinetics of mefloquine in man.

The kinetics of mefloquine was investigated following oral divided-doses in 10 healthy Caucasian volunteers. They received 500 or 750 mg followed by 500 mg 8 h later. Unchanged mefloquine (M) and its carboxylic acid metabolite (MM) were measured in whole blood and plasma for 50 days by h.p.l.c. Maximum blood and plasma M concentrations of 1872 +/- 362 ng ml-1 (mean +/- s.d.) and 1900 +/- 434 ng ml-1, respectively, were found within 6-10 h after the second dose. The terminal plasma elimination half-life was 20.1 +/- 3.7 days (mean +/- s.d.) and the oral clearance was 22.3 +/- 6.7 ml h-1 kg-1 (mean +/- s.d.). Plasma concentrations of MM exceeded those of M by 2-3 fold within 2 days. The whole blood concentration of MM was lower than that in plasma but also exceeded the whole blood concentration of M.

Adult↗
PubMed1988

Effects of zidovudine in 365 consecutive patients with AIDS or AIDS-related complex.

Zidovudine (AZT) is of some benefit for selected patients with AIDS-related complex (ARC) or AIDS treated for up to 24 weeks. The activity and toxicity of oral AZT, 200 mg 4-hourly when possible, was evaluated in 365 consecutive patients with ARC (80) or AIDS (285) followed up for a mean of 31 weeks (range 2-52). A transient increase in body weight, Karnofsky index, and CD4 cell count was observed during the first months of therapy. However, by 6 months, these values had returned to their pretreatment levels and several opportunistic infections, malignancies, and deaths occurred. These disappointing results were partly related to the haematological toxicity of the drug, which led to interruption of treatment in many patients. Thus the benefits of AZT are limited to a few months for ARC and AIDS patients. At least for the most severely affected patients, reduced dosage of AZT may increase the therapeutic index.

AIDS-Related Complex↗
PubMed1988

[Retrospective bacteriological study of mycobacterial infections in patients with acquired immunodeficiency syndrome].

The main species of mycobacteria isolated in 62 of the 316 acquired immunodeficiency syndrome patients admitted to the Claude Bernard Hospital, Paris, between January, 1983 and October, 1986 were studied retrospectively according to their site of isolation and their pathogenic role. Mycobacterium tuberculosis was isolated in 19 cases (from pulmonary specimens in 17 cases); this species was present in 59 percent of our African patients as against 20 percent of our European patients. M. avium intracellulare was isolated in 33 cases (17 from blood, 12 from the lung and 11 from the gastrointestinal tract) and was found in 55 p. 100 of our European patients. Other species that were isolated less frequently were M. xenopi (5 cases), M. kansasii (3 cases), M. aurum, M. chelonae, M. fortuitum, M. gordonae, M. simiae and M. terrae (1 case each). Post mortem specimens obtained from 110 acquired immunodeficiency syndrome patients were cultivated during the same period. In 20 patients, at least one specimen was positive for a mycobacterium: M. tuberculosis in 2 cases, M. avium intracellulare in 18 cases. Twenty-nine of the 33 patients in whom M. avium intracellulare was isolated were considered a posteriori as being infected by this organism. The therapeutic approach varies according to the species involved. No treatment seems to be truly effective against M. avium intracellulare. Pending the results of cultures, no direct bacteriological examination can provide information on the mycobacterial species concerned; however, a conventional antituberculosis treatment may be instituted, particularly in patients from Africa or Haiti.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Abnormal free fatty acids and cortisol concentrations in the serum of AIDS patients.

The serum free fatty acid (FFA), cortisol and urinary creatinine, 17-hydzoxycorticosteroid and 17-oxosteroid concentrations of acquired immunedeficiency syndrome (AIDS-I: beginning and AIDS-II: end phase) and AIDS-related complex (ARC) patients were determined. Both groups were compared to a control group (healthy men). ARC and AIDS-I patients. The ratios of stearic (C18:0) to oleic (C18:1) acid were 75%, P less than 0.01 (ARC) and 45%, P less than 0.05 (AIDS-I) greater than normal, due to a decrease in the relative percentage of monounsaturated fatty acids by 25%, P less than 0.001 (ARC) and 20%, P less than 0.01 (AIDS-I). In contrast, the relative percentage of polyunsaturated fatty acids was 85% greater than normal (P less than 0.001) in ARC and 100% greater than normal (P less than 0.001) in AIDS-I patients. Total FFA levels did not differ from controls. Serum cortisol levels were 35% (P less than 0.01) above normal in ARC and 60% (P less than 0.001) above normal in AIDS-I patients. Urinary 17-hydroxycorticosteroids and 17-oxosteroids were very low (2-3-fold lower than normal values, P less than 0.001) in both groups of patients. Urinary creatinine did not differ from controls. In AIDS-II patients the total FFA concentration was below normal 35% (P less than 0.01) and the stearic/oleic acid ratio was 50% above normal (P less than 0.05). The relative percentages of monounsaturated and polyunsaturated fatty acids in this group were similar to those of controls. Serum cortisol concentrations were significantly higher, 50% (P less than 0.001), but the urinary 17-hydroxycorticosteroids and 17-oxosteroids were 2-fold lower (P less than 0.001) than those of controls. Urinary creatinine did not differ from controls. These significant differences from normal may be implicated in the pathophysiology of AIDS and could represent not only a good index of diagnosis and prognosis, but also indicate new therapeutic approach to the disease.

17-Hydroxycorticosteroids↗
PubMed1988

[11 cases of isosporiasis (Isospora belli) in patients with AIDS].

The study of 11 cases of isosporiasis (Isospora belli) shows that this opportunistic coccidia, alone or with Cryptosporidium, causes severe prolonged diarrhoea which worsens the prognosis and evolution of AIDS patients. A low prevalence (0.7%) is found in subjects from tropical regions. The results of treatment are disappointing. Bactrim is the only drug found to be effective but prolonged parasitological surveillance is required to detect the frequent relapses, and assess the long-time usefulness of this drug.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Digestive manifestations in acquired immunodeficiency disease].

Digestive manifestations of AIDS were studied retrospectively in 87 patients with respect to clinical, microbiological, endoscopic and histological data. Chronic or intermittent diarrhea was observed in 62 p. 100 of patients and frequently associated with major weight loss. The digestive opportunistic infections were: oesophageal candidiasis (42 p. 100), cryptosporidiosis (24 p. 100), cytomegalovirus infections (22 p. 100), isosporiasis (3.4 p. 100), atypical mycobacteriosis (2.2 p. 100), toxoplasmosis (2.2 p. 100). Thirty non-opportunistic agents were detected in 26 patients. Gastrointestinal Kaposi sarcoma occurred in 18 p. 100 of cases. The etiology of diarrhea remained unknown in 16 p. 100 of patients. The value of endoscopy is discussed: esophagogastroduodenal fibroscopy, is usually required to assess oesophageal candidiasis, colonoscopy is required to assess cytomegalovirus colitis on histological data.

Acquired Immunodeficiency Syndrome↗
PubMed1987

AIDS subacute encephalitis. Identification of HIV-infected cells.

Human immunodeficiency virus (HIV) RNA and proteins were detected in the brains of several AIDS patients with subacute encephalitis, by in situ hybridization and immunohistology. The majority of infected cells were mononucleated and bore processes. Using single and double immunohistologic procedures, the authors identified these cells as macrophages. The majority of them had the phenotype of microglial cells (Leu-M3-, CD4-), others were labeled with markers of circulating macrophages (Leu-M3+, CD4+/-). The presence of HIV RNA and proteins in CD4- cells could be explained by depressed CD4 antigen expression, as a result of infection or macrophage tissue differentiation.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Hepatic, biliary and pancreatic lesions in LAV-HTLV III infection].

We believe it is important to underscore: The frequency and variety of the lesions, mainly within the liver but also of the biliary tract and the pancreas, which may reveal an inaugural complication of AIDS. The interest of the vascular lesions, mainly of the sinusoids as well as the various associated lesions due to pathogens (bacteria, viruses, fungi) and/or to toxic drugs. The physiopathology and histogenesis of the lesions are still obscure. Both the lesions of the hepatocytes and these of the sinusoids are poorly understood, and it is reasonable to discuss the role of various pathogens, such as viruses, peculiarly Epstein Barr and moreover LAV-HTLVIII viruses.

Acquired Immunodeficiency Syndrome↗