PubMed Health⌕ Search

Biomedical subjects

E Denes

Publications and source records attributed to E Denes.

12 recordsLinked to original sources
PubMed2006

[Antibiotherapy for acute CAP in adults].

Community acquired pneumonia is one of the most frequent infections. With time, bacterial epidemiology and bacterial resistance evolve and new antibiotics become available. So an up-date on adequate antibiotic use is necessary. We reviewed the epidemiology of pneumonia and the evolution of bacterial resistance. We also collected data on new antibiotics which can be used for this infection such as levofloxacin, moxifloxacin, telithromycin, and pristinamycin. All these drugs are effective on bacteria involved in pneumonia. At this time, only few Streptococcus pneumoniae strains have developed resistance to these drugs. However, resistance to fluoroquinolones is not easily detected with common laboratory techniques. There is no effectiveness difference between the 2 new fluoroquinolones (levofloxacin, moxifloxacin) in clinical studies. However, in bacteriological and pharmacological studies, moxifloxacin seems to be more effective than levofloxacin (500 mg/day). For the treatment of pneumonia due to Legionella pneumophila, fluoroquinolones are now widely recommended. For Streptococcus pneumonia, amoxicillin remain the drug of choice, even for bacteria with a decreased susceptibility to penicillin. The importance of treating atypical pathogens remains to be documented.

Anti-Bacterial Agents↗
PubMed2006

[Do HIV patients know their treatment?].

UNLABELLED: Optimal adherence to antiretroviral therapy (ART) in HIV disease is one of the key factors for its efficacy. OBJECTIVE: The authors had for aim to assess HIV infected patients' knowing of their ART and the correlation with a controlled HIV viral load. DESIGN: We conducted a transversal study. Outpatients were asked at the beginning of a consultation to give the name, the dosage, and the color of their medication. RESULTS: 93 patients were included with a mean age of 45.6 years. 25.8% were AIDS patients and 82.8% had an HIV viral load under 50 copies/ml. The mean duration of treatment was 6.23 years and the latest treatment had been given for 2.26 years. They took an average of 2.6 different drugs and 5.4 pills per day. 22.6% used a pillbox. 90.3% of the patients bought their treatment by themselves and 86% prepared it. The name of all the drugs was known in 68.8%, doses in 90.3%, and colors in 83.9%. In univariate as in multivariate analysis, the use of a pillbox improves the knowledge of the dose (P = 0.01). AIDS patients know the names better (P = 0.02). In univariate and multivariate analysis, knowledge of dosage was correlated to a controlled viral load (P = 0.04). CONCLUSIONS: HIV patients know their treatment well and the knowledge of the dose could be a marker of adherence to ART as it is associated with a controlled viral load.

Acquired Immunodeficiency Syndrome↗
PubMed2006

[Post-menopausal endometrial tuberculosis].

A 69-year-old menopaused woman, presented a 2-month history of metrorrhagia. We suspected a malignant disease, but, the histopathologic examination of biopsies, found an endometrial inflammation without malignant cells. Culture for mycobacteria showed a Mycobacterium tuberculosis. A course of four-drug antituberculous therapy was started and the patient recovered. Tuberculosis remains a common disease, but genital infection is infrequent. Usually, it concerns young infertile women from non-industrial countries. More attention should be paid to this disease. Women, irrespective of their age, should be investigated for silent or subclinical genital symptoms, with mycobacterial examination.

Aged↗
PubMed2005

[Salmonella of Indian origin: pseudo-susceptibility to fluoroquinolones].

We report the case of a patient presenting with typhoid fever after returning from a stay in India. This infection was not cured with a course of ciprofloxacin, due to a reduced susceptibility of the bacteria to the drug. This decreased susceptibility to fluoroquinolones was not detected by the antibiogram, but the MIC for nalidixic acid was greater than 32 mg/l. This case suggests using a third generation cephalosporin instead of a quinolone, for people coming from a high-risk zone. It also suggests that the MIC for nalidixic acid and for norfloxacin can be used as the first clue for a reduced susceptibility to fluoroquinolones.

Adult↗
PubMed2003

[Isolated neurosarcoidosis without systemic signs].

Sarcoidosis is a multisystemic disease which involves the nervous system in 5 to 15 p.cent. Neurosarcoidosis without signs of systemic disease is rare and may be difficult to diagnose. We report a case of a 61 year-old patient with a pseudotumoral neurosarcoidosis and along evolution of 25 years without systemic signs. In such cases, histological analysis is rewarding.

Adrenal Cortex Hormones↗
PubMed2000

[Cutaneous reactions or necrosis from interferon alpha: can interferon be reintroduced after healing? Six case reports].

PURPOSE: Alpha, beta or gamma interferon (INF) are cytokines produced by cells in response to antigenic stimulation. They are used to treat various hepatic, hematological, oncological and neurological diseases. Cutaneous reactions (rash, alopecia, labial herpes, erythema, or induration at the site of injection, and more rarely cutaneous necrosis) represent 5 to 12% of side-effects observed in patients receiving INF. The authors report six cases of local cutaneous reactions to alpha INF, five of which corresponded to cutaneous necrosis. This makes them question the relevance of INF reintroduction. METHODS: The study included 5 male and 1 female patients (mean age: 59.1 years; range: 42 to 74 years old). Three patients had chronic hepatitis C, while three others presented a blood disease. RESULTS: Cutaneous necrosis occurred after 1 to 10 months of treatment. The mean time to healing was 16.2 weeks. Reintroduction of the drug including injection in other sites did not lead to recurrence of necrosis in five out of the six cases. CONCLUSION: INF-induced cutaneous necrosis does not depend on the type of INF, the site of injection, the dose and may occur 2 months to 9 years after treatment implementation. The exact mechanisms involved in cutaneous necrosis remain unknown. Morbidity is due to a very long time to healing (4 to 6 months). Futhermore, healing sometimes requires prior surgery. Physicians should be aware of the potential occurrence of erythema in patients treated by INF, as it is the first sign of necrosis. The site of injection should then be modified. In case of necrosis, risk factors for thrombophilia, factors reducing microcirculation (DHE, beta-blockers, cigarette smoking) should be investigated. INF injections should be cautiously reintroduced in other sites with the help of a nurse in case of self-injections prior to the occurrence of necrosis. Regarding self-injections patients' training should be emphasized.

Adult↗
PubMed1999

[A history of diseases: apropos of idiopathic capillary hyperpermeability syndrome].

BACKGROUND: Idiopathic capillary hyperpermeability syndrome is expressed by episodes of hypovolemic shock with normal consciousness. CASE REPORT: A 61-year-old man had a history of recurrent shock. During the shock episodes, blood pressure was non-measurable and laboratory tests showed polycythemia, low serum protein and monoclonal immunoglobulinemia. The patient also developed pneumocystosis and had an infra-His block. DISCUSSION: The final diagnosis was idiopathic capillary hyperpermeability syndrome. This rare syndrome associates recurrent shock with IgG monoclonal immunoglobulinemia and, at the time of the shock episodes, increased hematocrit with paradoxical fall in serum protein.

Capillary Permeability↗
PubMedDate not supplied

[Reactive arthritis due to Clostridium difficile].

Extracolonic manifestations of Clostridium difficile infections have rarely been reported as a cause of reactive arthritis. We report the case of a monoarticular arthritis following pseudomembranous colitis. A 45 year-old man was admitted for fever and monoarthritis of the left knee, 8 days after the onset of a C. difficile enterocolitis associated with urethritis. Samples obtained from the knee, urine, and blood cultures remained sterile. Bone scintigraphy revealed a left knee and forefoot hyperfixations. The association of arthritis and urethritis led us to the diagnosis of Fiessinger-Leroy-Reiter syndrome. Antibiotics for arthritis were ineffective and stopped, but they were continued for colitis. NSAIDs were prescribed and clinical manifestations disappeared within 24 hours, the patient resumed walking after 48 hours. Four months later there was no relapse and no sequela.

Abscess↗