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Biomedical subjects

G Rémy

Publications and source records attributed to G Rémy.

15 recordsLinked to original sources

Population pharmacokinetics of pyrimethamine and sulfadoxine in children with congenital toxoplasmosis.

AIMS: To develop a population pharmacokinetic model for pyrimethamine (PYR) and sulfadoxine (SDX) in children with congenital toxoplasmosis. METHODS: Children were treated with PYR (1.25 mg kg(-1)) and SDX (25 mg kg(-1)) (Fansidar) plus folinic acid (Lederfoline) 5 mg). Plasma concentrations, available from a therapeutic drug monitoring database, were determined by high-performance liquid chromatography. Population pharmacokinetic analysis was performed using a nonlinear mixed effects model. RESULTS: Eighty-nine children, aged 1 week to 14 years and weighing 2.9-59 kg, were available for evaluation. Both PYR and SDX concentration-time profiles were best described by a one-compartment open model. Volume of plasma distribution (V) and clearance (CL) were significantly related to body weight (BW) using an allometric function. Typical CL and V estimates (95% confidence interval), for a child weighing 11 kg were 5.50 (5.28, 5.73) l day(-1) and 36 (33, 39) l for PYR and 0.26 (0.25, 0.27) l day(-1) and 2.1 (1.9, 2.3) l for SDX. For BW between 3.5 and 60 kg, plasma half-lives were predicted to vary from 4.0 to 5.2 days for PYR, and from 5.0 to 7.5 days for SDX. CONCLUSION: This study indicated that body weight influences PYR and SDX pharmacokinetics in children. To optimize PYR/SDX combination treatment in congenital toxoplasmosis, short dosing intervals in very young low-wight children are probably appropriate.

Adolescent↗

[Should NSAID/corticoids be considered when treating erysipelas?].

Using non-steroidal anti-inflammatory drugs (NSAID) in association with a suitable antibiotherapy in the treatment of erysipelas, is still being largely discussed in medical publications. When compared to other fields of medicine, here their use might be justified by their ability to reduce local inflammation processes, to relieve patients more quickly, and to prevent potential sequels due to an inflammatory process. Numerous reports have suggested an association between the use of NSAID and the progression of an invasive streptococcal infection, particularly necrotizing fasciitis. The exact mechanism is still unclear. No controlled survey (NSAID versus placebo) checking the efficiency and the safety of these treatments is currently available. Only one comparative study showed a gain of one single day for prednisolone The prednisolone-treated patients had a shorter median length of hospital stay (5 days vs. 6) than the placebo-treated ones. The median treatment time with intravenous antibiotics, in the placebo group, was 1 day longer than in the prednisolone group. The occurrence of side effects was not higher in the prednisolone group. If this currently available data is not sufficient to establish a relationship between severe infectious complications and the use of NSAID, one should be cautious when using them to treat erysipelas, since their efficiency has not been positively proved.

Adrenal Cortex Hormones↗

Isolation and envelope sequence of a highly divergent HIV-1 isolate: definition of a new HIV-1 group.

We report here the isolation and envelope sequence of a divergent HIV-1 isolate from a French woman with AIDS. This virus, HIV-1VAU, is closely related to the recently described Cameroonian viral isolates HIV-1ANT70 and HIV-1MVP5180, until now designated HIV-1 subtype O. Phylogenetic analysis reveals that the three viruses are equidistant from one another and that their mutual divergence is similar to what has been reported between the more conventional HIV-1 subtypes. Therefore, these three viruses could be included in a new viral group, HIV-1 group O (outgroup), distinct from the cluster of other HIV-1 isolates, which we will refer to as group M (Major group). The HIV-1 group O is currently emerging in western central Africa but its spread in Europe has already started.

Acquired Immunodeficiency Syndrome↗

[Cervical pathology and immunodepression].

The Human Papilloma Virus is often involved in the pathogenesis of cervical lesions. A local or systemic immunodeficiency allows neoplasia outbreaks. We do not know if immunodepression only allows the virus to persist, or if the HPV induces a local immunodeficiency. Large warts are often associated with pregnancy, but cervical cancers are not increased in pregnant women. Induced immunodeficiency (among transplanted patients), or AIDS increase the rate of CIN and cervical cancers. The more serious the immunodeficiency is, the more multifocal and recurrent the lesions are. We have to look for an immunodepression and for AIDS when we observe multifocal or recurrent lesions of the cervix, specially when the lesions do not regress under correct treatment. Immunodeficient women would benefit from closer care of their cervix. We think that combine therapy (e.g. laser and local interferon) would be more efficient in case of immunodeficiency.

Female↗