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J Arnal

Publications and source records attributed to J Arnal.

17 recordsLinked to original sources
PubMed1991

Efficacy of octreotide in the management of chronic diarrhoea in AIDS.

Patients with HIV infection were studied to assess the efficacy of octreotide, a somatostatin analogue, in the long-term management of refractory diarrhoea. Dosage of subcutaneous octreotide was increased progressively at 48 h intervals from 150 to 300, 750 and 1500 micrograms/day according to response. Twenty-nine patients, 21 with Cryptosporidium enteritis, one with Isospora belli enteritis and seven with no identifiable pathogen were selected for the study; four of these were excluded from the study because of death during the first month (two cases), abdominal pain and acute pancreatitis (one case each). Twenty-five patients were evaluable for response. Ten patients (four with Cryptosporidium enteritis, five without an identifiable pathogen and one with I. belli enteritis) achieved a complete response (40%) and nine cases (all with cryptosporidial enteritis) had a partial response (36%). Patients with higher weight and Karnofsky performance status and non-cryptosporidial enteritis had a better response to treatment. Mean durations of treatment and response were 4.2 +/- 4.2 and 4.4 +/- 4.5 months, respectively. In the absence of specific agents for cryptosporidial enteritis and HIV enteropathy, octreotide was found to be useful in the management of chronic diarrhoea in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Development of resistance to antibiotic therapy at a polyvalent intensive care unit during 3 years].

The antibiotherapy resistance evolution and the appearance of new enterobacter in our ICU's flora have been studied. A total of 638 bacterial samples were studied. The most frequent isolated pathogens were: Pseudomonas aeruginosa (182 strands), Escherichia coli (108 strands), Staphylococcus epidermidis (99 strands) and Staphylococcus aureus (41 strands). These four types of bacteria have been used to evaluate the antibiotic resistance variations over a period of time, which have only been significant for Pseudomonas with an increased number of amikamicine's resistant strands after the second year (p less than 0.001) and the of one multiresistant strand to piperaciline and amikamicine this second year, and four (8%) the year after. There are not significant differences in the resistance of E. Coli, Staphylococcus aureus and Staphylococcus epidermidis over this period of time. We have not observed new enterobacter strands over the time this study was performed although a higher incidence of Serratia (p less than 0.05) and Enterobacter (p less than 0.05) have been detected between the first and the third year, respectively.

Bacterial Infections↗
PubMed1989

[Nosocomial legionellosis: study of 51 cases].

We report the features of 51 cases of hospital-acquired Legionella pneumophila pneumonia (HLP), diagnosed in our hospital during a period of about 5 years. Mean age was 64.6 years, and the male:female ratio 1.6. 29% of HLP involved patients who were not admitted to the hospital at the time of diagnosis. The monthly distribution showed a maximal incidence in July and August. Only 6% of cases involved patients without underlying diseases. The most common underlying diseases were chronic obstructive lung disease (COLD) (37%), heart disease (29%) and immunosuppressant therapy (29%). 21% of the patients with renal transplant had HLP. The only constant clinical feature was fever of 37.8 degrees C or higher. During the first 24-48 hours of illness, respiratory symptoms were not present in 41% of cases, and thoracic abnormalities in the physical examination were not present in 31%. The laboratory abnormalities were nonspecific and with incidence rates lower than 50%. In 41% of patients there was hypoxemia (60 mmHg or lower) with FiO2 of 0.21. The most common radiological finding was the initial unilateral and unilobar involvement. Pleural effusion and cavitation developed in 20% and 4%, respectively. Overall mortality rate was 12%. In the 43 patients treated early with intravenous erythromycin, mortality rate was 7%. We think that the relatively low incidence of severe underlying immunosuppression and the inclusion of hospital-acquired pneumonia in our institution influenced the low mortality rate of the present study, in contrast with other series of hospital-acquired legionellosis.

Adult↗
PubMed1966

[Diarrhea].

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Diarrhea↗
PubMed1966

[Constipation].

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Constipation↗
PubMedDate not supplied

Relapsing systemic infection due to Rhodococcus equi in a drug abuser seropositive for human immunodeficiency virus.

A case of recurrent multisystemic infection due to Rhodococcus equi in a patient with antibody to the human immunodeficiency virus (HIV) but without AIDS is reported. This case, which occurred in a woman with a history of alcohol and drug abuse, is, to our knowledge, the first such case described. The infection involved the lungs, kidneys, brain, and bloodstream. Despite several courses of therapy with antibiotics to which her isolates of R. equi were susceptible in vitro, the patient experienced multiple relapses before her death. On the basis of this case and a few others reported in HIV-infected patients, we recommend an initial antibiotic course at least 6-8 weeks in duration, and we suggest that combination antibiotic treatment be considered. We also suggest that infection with R. equi be included in the diagnostic criteria for AIDS.

Actinomycetales Infections↗
PubMedDate not supplied

[Obesity].

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Nursing↗