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Biomedical subjects

D Peyramond

Publications and source records attributed to D Peyramond.

At least 19 recordsLinked to original sources
PubMed1999

[Prospective comparative study of HCV serologic status in and AIDS population].

OBJECTIVE: Study the influence of hepatitis C virus (HCV) serology on the course of HIV disease in AIDS patients. PATIENTS AND METHODS: A prospective study of survival prognosis in HIV infected patients who had reached the AIDS stage was conducted in the Saint-Etienne, Clermond-Ferrand and Lyons infectious disease centers to compare patients with positive and negative HCV serology. Data were collected using the clinico-epidemiological software DMI II. The effect of HCV ìco-infectionî defined by RIBA II or III confirmed seropositivity, was studied using Kaplan-Meier survival plots. RESULTS: Among the 1,005 HIV-infected subjects included in the study, 219 had AIDS and 43 of them (19.6%) were HCV positive. Survival curves in HIV/HCV positive patients with AIDS were not significantly different from those of HCV-negative AIDS patients (median 17.8 versus 18.6 months respectively, p = 0.93). This result was confirmed by univariate Kaplan-Meier analysis. Only 2 patients were treated with interferon and no deaths were attributed to liver disease. CONCLUSION: HCV positivity in AIDS patients does not appear to influence survival. The longer survival obtained with the new anti-retroviral treatments may have an effect on the HIV-HCV interaction.

AIDS-Related Opportunistic Infections↗
PubMed1999

Non-tuberculous mycobacterial tenosynovitis: a review.

The clinical characteristics, outcome and treatment of non-tuberculous mycobacterial tenosynovitis are reviewed. From lesions localized in the hand, 10 different species of non-tuberculous mycobacteria have been reported. The most common are Mycobacterium marinum and Mycobacterium kansasii. Other less frequent organisms are Mycobacterium avium complex, Mycobacterium szulgai, Mycobacterium terrae, Mycobacterium fortuitum, Mycobacterium chelonae, Mycobacterium abscessus, Mycobacterium malmoense and Mycobacterium xenopi. The infections appear to be the result of previous trauma, surgical procedure, corticosteroid injection or non-apparent inoculation (water contamination). Immunosuppression is sometimes associated with the infections and can be considered as a risk factor. Surgical debridement and appropriate mycobacterial cultures are critical to enable diagnosis and appropriate management. Specimens should be inoculated on a range of media and incubated at a range of temperatures in order to isolate mycobacteria with different growth characteristics (with prolonged incubation). The optimal treatment of these infections is discussed.

Hand↗
PubMed1999

Detection of Pneumocystis carinii DNA in blood specimens from human immunodeficiency virus-infected patients by nested PCR.

The detection of Pneumocystis carinii DNA in blood by PCR could be useful for studying the natural history of pneumocystosis and could also be a noninvasive diagnostic method. The results of previous studies are nevertheless conflicting. In our study, we compared three commercially available DNA extraction kits (GeneReleaser, QIAamp Tissue Kit, and ReadyAmp Genomic DNA Purification System) and proteinase K and proteinase K-phenol-chloroform treatments for the extraction of P. carinii DNA from dilutions of a P. carinii f. sp. hominis cyst suspension mixed with human whole blood. A rapid and simple nested PCR protocol which amplifies a portion of the mitochondrial large-subunit rRNA gene was applied to all the extraction products. The QIAmp Tissue Kit was the most effective kit for the isolation of amplification-ready P. carinii DNA and was used with nested PCR for the testing of whole-blood specimens from 35 immunocompetent control patients and 84 human immunodeficiency virus (HIV)-infected patients investigated for pulmonary disease and/or fever. In HIV-infected patients, P. carinii DNA was detected by nested PCR in blood samples from 3 of 14 patients with microscopically proven P. carinii pneumonia, 7 of 22 patients who were considered to be colonized with P. carinii, and 9 of 48 patients who were neither infected nor colonized with P. carinii. P. carinii DNA was not detected in blood specimens from the 35 immunocompetent patients. P. carinii DNA in blood might represent viable P. carinii organisms or DNA complexes released from pulmonary phagocytes. In conclusion, P. carinii DNA may be detected in whole blood from HIV-infected patients, but the nature and the meaning of the circulating form of P. carinii remain to be established.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Evaluation of allergic-type reactions to antibiotics and rapid immunotherapy].

Adverse effects of medications, most notably antimicrobials, are becoming increasingly common and raise difficult challenges in the area of clinical pattern definition (wide variety of symptoms, polypharmacy in many cases), diagnosis, and methodology (need for a rapid diagnosis, frequent obscurity of causative mechanisms, and less than ideal reliability of laboratory techniques). Sixty patients were treated by rush immunotherapy to one or more antimicrobials. The pretreatment evaluation included oriented history taking, skin tests, blood cell counts, IgE assays, and cell activation tests (basophils and lymphocytes). The results of this study confirm the usefulness of skin tests (intradermal, prick, or patch tests), which provided etiological orientation in 54 of the 60 cases. They also provide additional evidence of the lack of reliability of currently available in vitro tests (only 29 of the 60 tests were positive).

Anti-Bacterial Agents↗
PubMed1999

[Imported dengue: study of 44 cases observed from 1994 to 1997 in 9 university hospital centers. Infectio-Sud-France group].

Imported dengue is increasingly observed in non endemic countries. We report a retrospective study of 44 cases of dengue fever diagnosed in nine french university hospitals between 1994 and 1997. The patients were aged between 13 and 67 years. Most of them were tourists and had been traveling for a few weeks, in French West Indies and French Guyana (18), South-East Asia (10), India (7) or Polynesia (4). Only, two contracted the disease in Africa. The onset of symptoms preceded the return or followed it within 7 days. The most frequent clinical presentation was a febrile and painful syndrome. Cutaneous manifestations (rash or macular exanthem) were observed in 59% of cases, digestive symptoms in 50%, pharyngitis and/or cough in 25%, microadenopathy in 20%, moderate mucous haemorrhagic manifestations in 16% and neuropsychiatric manifestations in 14%. The common biological abnormalities were thrombocytopenia (84%), leukopenia (59%), and elevated transminases (57%). The diagnosis, orientated by negativity of malaria smears, the knowledge of an epidemic in the visited country, or occurrence of similar cases in the entourage, were argued by serological results: presence of anti-DEN IgM in 25 cases, serological conversion (anti- DEN IgG) in 7 cases or very high seropositivity (anti-DEN IgG > 1/1280) in 12 cases. No virus isolation was obtained.

Adolescent↗
PubMed1999

[AIDS with inaugural Pneumocystis pneumonia pneumonia. Impact of triple antiretroviral therapy].

To evaluate the impact of the advent of triple combination therapy for AIDS on the nature of the first AIDS-definiting event, a retrospective study was conducted in the infectious diseases department of the Croix-Rousse Teaching Hospital in Lyon, France. The 280 patients entered in the AIDS registry of the department between January 1, 1994, and August 31, 1998, were studied. In 1994 and 1995, 33.05% of registry entries were for a first AIDS-defining event. After the introduction of triple combination therapy during the second half of 1996, this proportion increased significantly from 30.1% for the period between January 1, 1994, and June 30, 1996, to 56.7% for the period from July 1, 1996 to August 31, 1998 (P = 0.00003). The proportion of Pneumocystis carinii pneumonia (PCP) occurring as the first AIDS-defining event also rose significantly between these two periods, from 47.5% to 82.1% (P = 0.002). These data indicate that triple combination therapy may be associated with an increase in the proportion of first AIDS-defining events, most notably of inaugural PCP. National data support this possibility. It would be of interest to conduct early screening campaigns for AIDS in order to allow early effective therapy.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Propionibacterium acnes infectious endocarditis].

BACKGROUND: Propionibacterium acnes, a Gram positive microaerophilic bacteria is considered to have a low level of virulence. Nevertheless, it can be associated with infective endocarditis. We report 2 cases and a review of the literature. CASE REPORTS: The first man developed an acute prosthetic valve infective endocarditis and died. The second case was also a prosthetic valve infective endocarditis in a patient who developed infectious spondylitis. DISCUSSION: P. acnes is an uncommon causal agent in infective endocarditis and appears to have a predilectio for prosthetic valves. A prior history of skin infection is rare. P. acnes grow quite slowly, often requiring 7 to 14 days for identification. All isolates of P. acnes from blood or valve do not necessarily mean contamination.

Discitis↗
PubMed1998

[Prevention of infectious endocarditis].

Although prophylaxis with antibiotics cannot avoid all cases of infectious endocarditis, it remains the main approach capable of reducing the frequency of this severe disease. It consists in using an adapted antibiotic cover in situations exposing to bacteraemia in patients at-risk with known cardiopathy. In France, recommendations have been established by a consensus conference in 1992. The fact that the incidence of this infection has not decreased merits recalling these recommendations.

Anti-Bacterial Agents↗
PubMed1998

[Importance of antiproteases in the treatment of microsporidia and/or cryptosporidia infections in HIV-seropositive patients].

Diarrhea due to infection with Microsporidium (M) or Cryptosporidium (C) raises significant therapeutic challenges in HIV-infected patients. The usefulness of protease inhibitor therapy was evaluated in 20 HIV-positive patients with positive tests for M and/or C. There were 17 men and three women with a mean age of 42.5 years (range, 26-64 years). Two patients had category B disease and 18 category C disease according to the 1993 CDC classification scheme (CD4 count before therapy, 72/mm3; mean viral burden, 4.6 log). Seventeen patients had chronic diarrhea (due to M in 12 cases and to C in five), and the remaining three patients were asymptomatic M carriers. Clinical symptoms resolved after addition to the antiretroviral regimen of indinavir (n = 17) or saquinavir (n = 3). Mean weight gain was 10.5 kg. Karnofsky's index improved. Twelve patients, including one of the three who were asymptomatic at baseline, had negative follow-up stool cultures. The mean CD4 count increase was 125/mm3, and the mean viral burden decrease was 1.285 log. These data suggest that protease inhibitors may be capable of eradicating M and/or C infection refractory to other treatments. The reason for this effect may involve partial restoration of immune function due to inhibition of HIV replication.

AIDS-Related Opportunistic Infections↗