Biomedical subjects

H Lecour

Publications and source records attributed to H Lecour.

25 records · Page 2Linked to original sources

PubMed1984

Treatment of 160 cases of acute bacterial meningitis with cefotaxime.

One hundred and sixty cases of acute bacterial meningitis were treated with cefotaxime. Patients were between 9 days and 79 years old: 7 new borns, 37 infants, 43 children, 19 adolescents and 54 adults. Fifty-eight patients (36%) were in coma when admitted. Aetiology was determined in 110 patients (68.8%): Neisseria meningitidis in 42, Streptococcus pneumoniae in 36, Haemophilus influenzae in 16, Salmonella spp. in 7, Staphylococcus aureus in 2, Enterobacter spp. in 2 and Haemophilus parainfluenzae, pseudomonas aeruginosa, Escherichia coli, Citrobacter freundii and Klebsiella pneumoniae in one patient each. All isolates were sensitive to cefotaxime, with MIC's for 26 strains ranging from 0.01 to 0.50 mg/l. One hundred and fifty-six of the 160 patients were treated with cefotaxime alone and the four others with cefotaxime in association with an aminoglycoside in three and rifampicin in one. Cefotaxime was administered by intravenous infusion, in a daily dose 100 to 300 mg/kg. Duration of treatment ranged from 8 days to 6 weeks, with a mean of 15 days. One hundred and forty-nine patients (93.1%) were cured, two after a relapse. Three patients had sequelae. Most (88.5%) had sterile CSF within 72 h after starting treatment. Eleven patients (6.9%) died, eight within the first 48 h. The only side-effects observed were mild transient eosinophilia in some patients and rash and leukopenia in 2 each. The study demonstrates that cefotaxime is effective in the treatment of acute bacterial meningitis.

Acute Disease↗

PubMed1984

Prevalence of viral hepatitis markers in the population of Portugal.

The prevalence of viral hepatitis markers in apparently healthy individuals of both sexes, born and living in both urban and rural areas of all the Portuguese provinces, was studied by radioimmunoassay.The anti-HAV prevalence was determined in 1770 individuals, 1-84 years old, divided into 8 age groups. The HBsAg prevalence was determined in 1440 individuals, 15-84 years old, divided into 5 age groups, while the anti-HBs prevalence was determined in 1980 individuals, 1-84 years old, divided into 8 age groups. The data were standardized for the Portuguese population.The anti-HAV results were similar for both sexes and showed a general prevalence of 84.9%. No significant difference in the prevalences between urban and rural areas was found. Age-group prevalences of anti-HAV were: 1-4 years, 23.9%; 5-9 years, 61.3%; 10-14 years, 76.4%; 15-19 years, 93.4%; and over 30 years, 99%.The HBsAg results showed a general prevalence of 1.25% for persons over 15 years old (2.04% for males and 0.78% for females). The anti-HBs results were similar for both sexes and showed a general prevalence of 24.3%. The northern provinces tended to have a higher anti-HBs prevalence than the southern ones, except for Lisbon province which had the highest figure. Age-group prevalences of anti-HBs were: 1-4 years, 7.6%; 5-9 years, 12.6%; 10-14 years, 8.7%; 15-19 years, 23.5%; 20-29 years, 28.4%; and over 30 years, between 30.0% and 34.3%.Only 5.3% of the anti-HAV-positive individuals, 11.2% of the HBsAg carriers, and 9.2% of the anti-HBs-positive individuals had a history of acute hepatitis.These results show that Portugal may be considered an endemic area for viral hepatitis infections.

Adolescent↗

PubMedDate not supplied

Human leptospirosis--a review of 50 cases.

Epidemiological and clinical aspects of 50 consecutive patients, 47 adults and three children, hospitalized between 1977 and 1987 for human leptospirosis, were reviewed. 45 (90%) of the patients were from rural regions. 32 (64%) cases occurred in individuals at occupational risk for the infection. 35 (70%) cases were registered in the warm season. The source of infection was known in 34 (68%) cases. Weil's disease was diagnosed in 31 (62%) patients, aseptic meningitis in 12 (24%) and acute unexplained fever in seven (14%). Haemodialysis was required for 11 (35%) patients with Weil's disease. Three (6%) patients died. Cause of death was massive gastrointestinal haemorrhage in two and renal failure in one. Leptospira icterohaemorrhagiae was responsible for 39 (78%) cases, Leptospira canicola for six (12%), Leptospira grippotyphosa for two (4%), and Leptospira australis, Leptospira ballum and Leptospira sejroe, for one case each. A muscle biopsy was performed in six patients and a renal biopsy in three. Focal necrotic muscular changes, with mild mononuclear infiltrate, were found. Pigmented casts in distal convoluted tubules, mild interstitial inflammatory infiltrate and mesangial enlargement of some glomeruli were observed in kidney biopsies. A good knowledge of the protean clinical manifestations of leptospirosis and an accurate laboratory study are required for a correct diagnosis.

Adolescent↗

PubMedDate not supplied

Epidemiological aspects of acute viral hepatitis in Portugal.

Epidemiological aspects of 400 consecutive in-patients with acute viral hepatitis, aged one to 81 years, were studied: 180 patients were less than 15 years old (mean age 6.9 years) and 220 were older (mean age 33.8 years). Serum hepatitis markers were detected by RIA. Hepatitis A (HA) was diagnosed in 188 patients (47.0%), ages ranging from one to 34 years (mean age 8.5 years), hepatitis B (HB) in 163 patients (40.8%), ages ranging from two to 72 years (mean age 32.7 years) and non-A, non-B hepatitis (NANBH) in 41 patients (10.2%), ages ranging from two to 81 years (mean age 35.4 years). Two patients had simultaneous HA and HB, and in six patients the etiology was not classified. In patients less than 15 years old, HA was the commonest type (91.1%), other etiologies having a low frequency; in the age group over 15 years, HB represented the most frequent type (70.0%), followed by NANBH (16.8%) and HA (10.9%). The probable source of infection was unknown in most of the cases (51%). With regard to HA, secondary contact was frequently reported and small outbreaks were registered. Parenteral exposure was the main probable source of HB and NANBH virus infections, the transmission frequently being iatrogenic. Drug abuse was a rare source of infection.

Adolescent↗

PubMedDate not supplied

Treatment of childhood bacterial meningitis.

One hundred and eighty-seven children with identified bacterial meningitis were treated with intravenous cefotaxime: 15 patients were neonates, 79 infants, and 93 were aged from 1 to 14 years. Causative organisms were: Neisseria meningitidis in 80 cases, Streptococcus pneumoniae in 41, Haemophilus influenzae in 40, enteric gram-negative bacilli in 20 and Staphylococcus spp. in six. Enteric gram-negative bacilli included: Salmonella spp. in 14 cases, Klebsiella pneumoniae in two, and Escherichia coli, Enterobacter sakazakii and Acinobacter calcoaceticus in one each; in one case the organism was not specified. Daily dose of cefotaxime was 150 to 300 mg/kg. Concomitant treatment with an aminoglycoside was used in seven cases. One hundred and seventy-two patients (92.0%) were cured. Fever persisted for a mean of five days and meningeal signs for a mean of four days. Fifteen (8.0%) patients died: most [13] of them were admitted in coma, and two in shock. Death occurred in the first 48 h in ten cases. Sterilization of CSF was achieved in the first 72 h of treatment in 155 (90.1%) of the cured patients. Cefotaxime was well tolerated. CSF penetration of cefotaxime was evaluated in seven patients: concentrations ranged from 0.499 mg/l to 2.829 mg/l. Based on this clinical study, cefotaxime is an effective and safe drug for the treatment of childhood bacterial meningitis.

Adolescent↗

PubMedDate not supplied

Update on the use of cefotaxime for pediatric meningitis in Portugal.

We treated 256 children who had identified bacterial meningitis with cefotaxime. Causative organisms were: Neisseria meningitidis in 108 cases, Streptococcus pneumoniae in 61, Haemophilus influenzae in 60, enteric Gram-negative bacilli in 21, and Staphylococcus spp. in six. Daily doses of cefotaxime were 150-200 mg/kg. A total of 240 patients (93.7%) were cured. In the cured patients, sterilization of cerebrospinal fluid was obtained in the first 72 h of treatment in 214 (80.0%). Cefotaxime is an effective and safe drug for the treatment of childhood bacterial meningitis.

Adolescent↗

PubMedDate not supplied

Zidovudine therapy and left ventricular function and mass in human immunodeficiency virus-infected patients.

Human immunodeficiency virus-infected (HIV) patients frequently present left ventricular dysfunction. Its etiology is not elucidated but zidovudine has been postulated as a possible cause factor. This study is an attempt to clarify this issue by evaluating the effect of zidovudine therapy on left ventricular function in these patients. We prospectively studied by echocardiographic examination 11 consecutive HIV-infected patients who were assigned for zidovudine therapy. We excluded patients that had a history or a physical examination suggestive of ischemic, rheumatic, congenital, or hypertensive heart disease. Patients with diabetes mellitus, excessive ethanol intake and patients on potentially cardiodepressant drugs were also excluded. Echocardiographic examination was performed immediately before the initiation of zidovudine therapy and 1 and 3 months later. Left ventricular diameters, mass and fractional shortening showed no significant difference from baseline, at 1 or 3 months after the initiation of zidovudine therapy. Our results suggest that zidovudine therapy has no effect on left ventricular diameters, mass or fractional shortening during a short term.

Adult↗