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Biomedical subjects

F Oberling

Publications and source records attributed to F Oberling.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Piperacillin and netilmicin combination therapy for febrile episodes in neutropenic patients.

We assessed the efficacy of a piperacillin (3 x 4 g/d) and netilmicin (5 mg/kg/d) combination therapy for infections in febrile neutropenic patients. The study was conducted over a 30-month period and 203 patients were included. Bone marrow transplant recipients were not included in this study. Origin of infection was documented in 101 (50%) episodes: 33 fungal, viral or parasitic infections and 68 bacterial infections mainly composed of septicemia. Of the 169 evaluable patients with proved bacterial infections or non-documented infections, 129 (76%) recovered with the piperacillin and netilmicin combination treatment. All gram-positive bacterial infections failing first line therapy were cured after the addition of vancomycin. Piperacillin and netilmicin appeared very effective in this large monocentric prospective study. It does not seem necessary to include vancomycin in first line therapy of infections of the neutropenic patients in our institution; however, vancomycin must be added early in the case of suspected or documented staphylococcal infection failing empiric treatment.

Acute Disease↗
PubMedDate not supplied

[Hypothyroid hypertrophic myopathy following mantle irradiation for Hodgkin's disease. A case].

The authors report a case of hypothyroid hypertrophic myopathy consecutive to mantle irradiation for Hodgkin's disease. A rise in TSH level is frequent after mantle irradiation and it justifies prolonged monitoring of these patients' thyroid function, in view of the risk of patent hypothyroidism and perhaps cancer. The patient's age, the pre-irradiation lymphography and the chemotherapy associated with radiotherapy are all factors that influence the incidence of thyroid dysfunction, but there is no agreement concerning their relative importance. Hypertrophic myopathies due to hypothyroidism are rare, and their dramatic clinical presentation contrasts with an almost normal muscle histology. Alterations of energy metabolism and changes in the properties of myosin induced by hormonal deficiency account for the muscular weakness of these patients. On the other hand, the mechanism of muscle hypertrophy remains controverted, the most probable theory being and increase in the number of myotubes. Following irradiation, notably for Hodgkin's disease, the frequency of hypothyroidism requires a regular and systematic laboratory follow-up. Replacement therapy must be instituted if the basal TSH level increases, even if the T4 level is normal.

Adult↗
PubMedDate not supplied

Treatment of subdiaphragmatic Hodgkin's disease: long-term results and side effects.

To evaluate the results, prognostic factors and especially side-effects of the treatment for subdiaphragmatic Hodgkin's disease (SHD) a retrospective study was conducted in the Haematology Departments and in the Cancer Centres of Nancy and Strasbourg between 1976 and 1990; 55 patients corresponding to the IA to IIB SHD stages were analysed. The median age was 45 years. In accordance with Ann Arbor classification, we observed 12 CS IA (21.3%), 2 CS IB (3.5%), 14 CS IIA (25.4%) and 27 CS IIB (49.7%). Twenty-five patients (45.4%) underwent laparotomy with spleen involvement in 10 cases. Fifteen patients (27.3%) had exclusive radiotherapy, 10 by inverted-Y field with or without splenic field, 5 by limited field to inguinal and homolateral iliac nodes. Forty patients had prior chemotherapy, 18 by MOPP protocol, 18 by hybrid MOPP/ABVD protocol and 4 by other schemes. The total dose delivered ranged from 26 to 45 Gy. With a median follow-up of 8 years, the overall and disease specific survival rates are respectively 61% and 83% at 10 years. Nine patients relapsed (16.4%), 4 among the 15 (26.6%) treated by exclusive irradiation and 5 among the 40 (12.5%) treated by combined therapy. We observed 8.3%, 21.4% and 18.5% of relapses respectively among the clinical stages IA, IIA and IIB. Eleven patients (20%) developed a second cancer. Twenty-six long-term complications were noted, nine of which concerned the digestive system. The only significant prognostic factor is age, with 10-year specific survival rates of 96% and 66% respectively for patients younger and older than 50 years (p=0.0003). Our data confirm that the most appropriate treatment for stage IA is exclusive radiotherapy and combined therapy for all other cases. With the use of CT-scan and eventually lymphography, the laparotomy is reserved only for cases with an uncertain diagnosis. Tobacco use is also clearly a risk factor in our series for late vascular complications and second cancers.

Adolescent↗
PubMedDate not supplied

[Medullary microcirculation in human primary and secondary myeloscloroses].

There are histological and experimental evidence for bone marrow microcirculation to play a role in histogenesis of myelosclerosis. Human sternal bone marrow microcirculation was studied after death using ink injection in two cases of primary myelofibrosis, two cases of secondary meylofibrosis (Hodgkin's disease) an one case of osteomyelosclerosis. Control material consisted of 30 previously studied normal human sternums. In all cases interadipocytic sinusoidal network has completely disappeared. Medullary vascularization is anarchic with a vascular and hypervascular areas. The significance of these modifications is discussed.

Aged↗
PubMedDate not supplied

[Chediak-Higashi syndrome. Study of lymphocyte transformation stimulated by phytohemaglutinin (PHA)].

The reactivity to PHA stimulation of peripheral blood lymphocytes from a child with a Chediak-Higashi syndrome was studied. Lymphocyte transformation was assayed by tritiated-thymidine incorporation. Patient lymphocytes reacted to much lower concentrations of PHA than normal controls. With an optimal dose of PHA the peak of thymidine uptake occurred on day 2 of incubation instead of day 4 as observed in normals.

Chediak-Higashi Syndrome↗
PubMedDate not supplied

[A new case of hemoglobin G Georgia (author's transl)].

A new case of hemoglobin G Georgia (alpha95 Pro yields Leu) is described in a portuguese patient with lymph node tuberculosis. The patient had a slight anaemia with haemolytic crises and moderate splenomegaly. The electrophoretic mobility of this unstable, abnormal haemoglobin was slower than that of Hb S. The percentage of the major (alpha2 G beta2) and the minor (alpha2 G delta2) abnormal components was determined by DEAE-sephadex chromatography and was 18% and 1% respectively. Structural analysis showed the replacement of a proline residue in position 95 (G) in the alpha chain by a leucine residue. This residue alpha 95 interferes with the alpha 1-bêta 2 contact. Functional studies have shown an increased oxygen affinity, a reduced hem-hem interaction and a normal Bohr effect.

Anemia, Hemolytic↗
PubMedDate not supplied

[Use of plastic isolators in the prevention of infection in high risk patients with hematologic diseases].

The authors report a microbiological study of the flora of high risk adults with blood diseases isolated in hermetically sealed plastic isolater. This type of isolation is very effective in the prevention of infections due to hospital germs as such contamination occurred only twice in 292 days isolation and was found in only 0.8% on samples. The efficacy of methods of body decontamination and the incidence of infective complications in our series is also reported.

Adolescent↗
PubMedDate not supplied

[Hodgkin's disease. T lymphocyte defect in patients in complete remission (author's transl)].

11 patients with Hodgkin's disease in remission, including 7 patients with an initial stage III-IV, off treatment for at least 6 months, were tested for blood T lymphocyte functions. All were completely re-evaluated at the end of treatment to assess complete remission. The number of peripheral blood lymphocytes was below 1,200/cu mm 5/11 patients. Absolute numbers of E-rosette-forming T lymphocytes were decreased in 8 patients, whereas active rosettes were normal in 4/6. A slightly increased percentage of EAC rosettes, a marker for B lymphocytes, was found in only 2 patients. In vitro lymphocyte reactivity to a sub-optimal dose of PHA was studied in 9 patients. A statistically significant defect of lymphocyte transformation was observed in the patient group T lymphocytes. A membrane change is suggested rather than a true depletion. The persistance of such abnormalities long after treatment may raise the question of a complementary immunostimulating treatment in these patients.

Adolescent↗
PubMedDate not supplied

[Extraskeletal plasma cell tumors (author's transl)].

Extraskeletal plasmacytomas are very rare malignant plasma cell tumors. They often seem to arise from a pathologic plasma cell reaction to an antigenic stimulation and are characterized by the variety of their locations and the frequent absence of monoclonal dysproteinemia. The authors are reporting three new observations of extraskeletal plasma cell tumors. Some pathological, biological and pathogenic features of these tumors are emphasized.

Aged↗
PubMedDate not supplied

PHA dose dependent defect in lymphocyte stimulation and E-rosette-forming cells in untreated Hodgkin's disease.

14 untreated patients with Hodgkin's disease were tested for lymphocte reactivity in vitro to optimal and suboptimal doses of PHA. A PHA dose-dependent defect in lymphocyte stimulation was demonstrated in patients when compared with a group of normal individuals. No correlation between the in vitro defect and decreased absolute number of E-rosette-forming cells (T-lymphocytes) in peripheral blood was found.

Adolescent↗
PubMedDate not supplied

[Hodgkin's disease. T lymphocyte defect in patients in complete remission (author's transl)].

11 patients with Hodgkin's disease in remission, including 7 patients with an initial stage III-IV, off treatment for at least 6 months, were tested for blood T lymphocyte functions. All were completely re-evaluated at the end of treatment to assess complete remission. The number of peripheral blood lymphocytes was below 1,200/cu mm 5/11 patients. Absolute numbers of E-rosette-forming T lymphocytes were decreased in 8 patients, whereas active rosettes were normal in 4/6. A slightly increased percentage of EAC rosettes, a marker for B lymphocytes, was found in only 2 patients. In vitro lymphocyte reactivity to a sub-optimal dose of PHA was studied in 9 patients. A statistically significant defect of lymphocyte transformation was observed in the patient group T lymphocytes. A membrane change is suggested rather than a true depletion. The persistance of such abnormalities long after treatment may raise the question of a complementary immunostimulating treatment in these patients.

Adolescent↗