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F Lacassin

Publications and source records attributed to F Lacassin.

25 records · Page 2Linked to original sources
PubMed1993

[Infectious endocarditis, risk factors, prevention. Research group for infectious endocarditis and jury of the consensus conference].

Infective endocarditis, resulting from deposition of circulating microorganisms during a period of bacteremia on damaged endothelial heart valves, remains a serious disease. Its overall incidence did not decline in recent years, 24 cases/year/million inhabitants, in France. This can be explained by a modification of the type of underlying cardiac conditions with regression of rheumatic fever and increase of degenerative heart diseases, prosthetic valves and mitral valve prolapse. The risk of bacterial seeding on a damaged valve remains difficult to evaluate, the highest risk being for patients with prosthetic valve, previous infective endocarditis and cyanotic congenital heart disease. A case-control study, done in 1991, confirmed that procedures are risk factors for infective endocarditis and that the multiplicity of procedures increases the risk. A French consensus conference on the prophylaxis of infective endocarditis has updated the recommendations for antibiotic prophylaxis. Two groups of cardiac patients were identified, based on the incidence and the severity of endocarditis occurring in patients with these conditions, 1) patients considered at risk which require specific prophylaxis, and 2) patients considered non at risk which do not require antibiotic prophylaxis. Procedures which require antibiotic prophylaxis are dental procedures and specific gastrointestinal and urologic procedures. As complex protocols are associated with poor compliance by practitioners and patients, the jury has aimed for simplicity and feasibility.

Anti-Bacterial Agents↗
PubMed1993

[Epidemiology of bacterial endocarditis in France in 1991].

In order to update our information about the incidence and demographic, microbiological and clinical characteristics of infective endocarditis (IE) in France, a 12 month long study was carried out in three regions: Ile de France, Rhône-Alpes and Lorraine. Four hundred and fifteen cases of IE were recensed: certain (32%), probable (53%) or possible (15%). The annual incidence was 24.3 per million. The average age was 56 +/- 19 years. There was no past history of cardiac disease in 34% of cases; 33% had native valvular heart disease and 22% had one or more valvular prostheses. The site of IE was mitral in 39%, aortic in 36%, tricuspid in 6% and other or multivalvular in 19% of cases. The causal microorganism was isolated in 92% of cases. It was a streptococcus in 58% of cases (S. viridans in 27%; group D streptococcus + enterococcus in 23%); a staphylococcus was isolated in 23% of cases (Staphylococcus Aureus in 18%) and another microorganism in 11% of cases. The presumed portal of entry was dental in 24%, gastro-intestinal in 13%, cutaneous in 6% and urinary in 4% of cases. Twenty patients were intravenous drug addicts. Forty-five patients had medical or surgical procedure. Twenty-four per cent of patients were operated during the first two months, 17% died during this period (15% of operated and 18% of non-operated patients). Despite the advances in antibiotic therapy and in cardiac surgical techniques, IE seems to be as common and as severe as ten years ago.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Predictive value of cytomegalovirus viraemia for the occurrence of CMV organ involvement in AIDS.

In HIV-infected patients, the presence of cytomegalovirus (CMV) viraemia is predictive of the development of acquired immunodeficiency syndrome (AIDS), but it is not known whether it predicts further occurrence of CMV organ involvement. To assess the predictive value of CMV viraemia in the occurrence of CMV organ involvement, CMV blood cultures were performed at the onset of AIDS in 71 patients. They were prospectively followed up for at least 6 months, with a mean of 16.6 +/- 7 months (6-36 months). CMV viraemia was present in 28/71 patients (39.5%) at the onset of AIDS. CMV organ involvement occurred in 18/71 patients (25.4%) after 8.7 +/- 3.3 months. Fourteen of the 28 patients (50%) with early CMV viraemia developed CMV organ involvement after 7.7 +/- 6.3 months as compared with 4/43 patients (9.3%) who were not viraemic at the onset of AIDS with a mean follow-up of 11.8 +/- 3.8 months (P less than 0.001). At the time of CMV organ involvement, CMV viraemia, however, was present in 94.4% of the cases. No differences in survival was observed between initially viraemic and non-viraemic patients. No difference has found in mean CD4 cell count between viraemic and non-viraemic patients. This high predictive value of early CMV viraemia in AIDS for the occurrence of CMV organ involvement underlines the need for repeated search for CMV organ involvement when CMV viraemia is detected, and for less toxic antiviral drugs that might be used earlier.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Pentamidine-induced acute pancreatitis in a patient with AIDS.

We report pentamidine-induced acute pancreatitis in a patient with the acquired immunodeficiency syndrome (AIDS). The course of this pancreatitis was prolonged but favorable. Pentamidine was detected in serum as late as one month after discontinuation of therapy. The special pharmacokinetics of this drug may account for the potential severity of pentamidine-induced acute pancreatitis.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Peritoneal tuberculosis simulating advanced ovarian carcinoma: a case report].

Disseminated peritoneal tuberculosis accounts for 1-3% of tuberculosis disease, represented by high frequency of lung defects in endemic countries. The authors report one case in a 43-year-old woman, the initial interpretation of which, based on pleural and peritoneal exudate, showed suspected latero-uterine mass and significant elevated serum CA 125 level, mimicking disseminated ovarian carcinoma. Only after exploring laparotomy with biopsy was disseminated peritoneal tuberculosis identified, thus correcting the diagnosis. Symptomatology, X-ray defect, and cynetic of serum CA 125 level were left in totality after 3 months of antituberculosis multidrugs. This is a diagnostic trap, which presents a new interest for such pathology as tuberculosis, which is on the increase again in the West.

Adult↗
PubMedDate not supplied

[Pneumopathies caused by Streptococcus pneumoniae in 27 HIV infected patients].

OBJECTIVES: Determine the clinical features and outcome of acute pneumonia due to Streptococcus pneumoniae in HIV infected patients compared with non-HIV infected patients. METHODS: From January 1986 to February 1992, we observed 33 episodes of pneumococcal pneumonia in 27 HIV-infected patients. Most of the patients were drug addicts (16/27), and/or originated from Central Africa or Haiti (10/27). In 9/27 (33%) patients, HIV infection was previously unknown. Eleven of the 27 patients were at the CDC stages II-III and CD4 cell count was greater than 200/mm3 and CD8 cell count was greater than 1000/mm3 in 12/23 patients and 10/20 patients respectively. RESULTS: In 10/33 episodes, respiratory symptoms were severe: bilateral pneumonia (n = 2) and/or hypoxaemia (n = 9). In 22/33 episodes, hospitalization occurred less than 24 h after the onset of symptoms and in 9/33 episodes, the initial chest X-ray was normal. Streptococcus pneumoniae was isolated in 16/33 episodes, from blood (n = 10), bronchoalveolar lavage (n = 3) or sputum (n = 3). Penicillin G or amoxicillin was used and allowed a favorable and quick response in all episodes. Recurrence occurred in 5/18 (27%) followed patients. These recurrences were not favoured by a low CD4 cell count since it was more than 200/mm3 in these five patients. However, the mean count of CD8 cells was higher in patients with recurrence than in patients without recurrence, 1990/mm3 versus 995/mm3 (p = 0.03). CONCLUSION: CD8 hyperlymphocytosis could increase the risk of recurrence and would help identify a subgroup with higher risk of pneumococcal pneumonia among HIV infected persons.

AIDS-Related Opportunistic Infections↗