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Biomedical subjects

J Beytout

Publications and source records attributed to J Beytout.

At least 19 recordsLinked to original sources
PubMed1998

Threonine and methionine are limiting amino acids for protein synthesis in patients with AIDS.

This study was conducted to identify the most rate-limiting amino acids for whole-body protein synthesis in acquired immunodeficiency syndrome (AIDS) patients. We postulated that an essential amino acid that would be rate limiting in AIDS should have a low basal plasma concentration and should remain at a low level during amino acid infusion. Seven male AIDS patients (median age 37 y, CD4 cell count: 76 mm-3) without any clinically active opportunistic infection during the month before the experiment were infused intravenously with a complete amino acid-glucose mixture for 2.5 h. Eight healthy volunteers were used as controls. Before the infusion, the concentrations of most free essential amino acids (methionine, threonine, histidine, isoleucine, leucine and tryptophan) were significantly lower (P < 0.05) in AIDS patients than in controls. Most plasma free essential amino acids increased significantly during infusion. However, the absolute increase above basal levels for threonine, valine, lysine, (P < 0.05) and methionine (P < 0.073) was smaller in AIDS patients than in control subjects. Thus, threonine and possibly methionine may be rate limiting for whole-body protein synthesis in AIDS patients, suggesting that there are selective amino acid requirements in patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Empirical therapy for nonhospitalized patients with community-acquired pneumonia. Study Group of General Practitioners.

A prospective survey involving a group of 95 general practitioners (GPs) in France was conducted to describe antibiotic therapy prescribed for out-patients with community-acquired pneumonia (CAP). A total of 173 cases of CAP, defined by the association of fever and pulmonary focal crackles and/or radiological changes consistent with a pulmonary infection, were reported between February 1993 and March 1994: 84 males and 89 females (mean age: 48 yrs) of whom 45% had no underlying disease. Nineteen (11%) were immediately hospitalized and the remaining 154 out-patients were treated without microbiological investigation. First-line antibiotic therapy was amoxicillin or amoxicillin-clavulanic acid combination (57%), a first or second generation cephalosporin (12%), ceftriaxone (8%), oral broad-spectrum cephalosporin (3%), a macrolide (16%), a tetracycline (1%) and a fluoroquinolone (2%). A total of 120 (78%) patients recovered with no change in treatment and 34 (22%) patients failed to improve: 18 were hospitalized and 16 had a second-line therapy, mainly a macrolide or a quinolone. Five patients died at hospital. The overall mortality was 3%, and 14% in hospitalized patients. Empirical therapy using a betalactam to target a presumed pneumococcal infection, in agreement with European guidelines, is appropriate for out-patients with mild lobar community-acquired pneumonia.

Adolescent↗
PubMed1997

Outbreak of trichinosis in France associated with eating horse meat.

The investigation of a trichinosis outbreak in Auvergne, France identified 23 cases in 12 households living in two cities-Clermont-Ferrand and Montluçon-between 15 February and 7 March 1991. One patient required intensive care, 15 had major symptoms, and seven had minor or no symptoms. Two case control studies demonstrated a significant (p < 0.01) association between eating horse meat and acute trichinosis. Veterinary services found that three supermarkets where the patients had bought horse meat during the suspected period had been supplied by a single wholesaler. The analysis of the wholesaler's records revealed that the implicated horse meat had been imported from a slaughterhouse in the United States. This outbreak occurred despite a requirement in France for all meat from horses slaughtered in France and in countries exporting meat to France to be examined systematically for trichinella.

Adult↗
PubMed1996

[Seroprevalence of markers of viral hepatitis A, B and C in hospital personnel at the Clermont-Ferrand University Hospital Center].

OBJECTIVES: Evaluate risk of hepatitis A, B and C infection and anti HBV vaccination policy in hospital personnel. METHODS: A sample of 440 health care workers (7.5% of the personnel at the Clermont-Ferrand University Hospital) representing 74.5% people directly involved in health care and 25.5% other workers were selected at random and stratified by work classification and age. A questionnaire was used to establish personal data on viral hepatitis status and blood samples were drawn for serological tests. RESULTS: Seroprevalence for hepatitis A was 52% with no significant difference between health care and other workers. For hepatitis B, 88.3% of the population had been vaccinated and anti-HBs titre was > or = 10 mIU/ml for 91.6% and > or = 50 mIU/ml for 86.1%. Seroprevalence for anti-HBc was 7% and none of the subjects were positive for HBs antigen. Anti-hepatic C antibodies were found in 2 health care workers (0.7%). CONCLUSION: These findings emphasize the need to persue further preventive actions against hepatitis A, B and C and the requirement for continued efforts in elementary hygiene.

Adult↗
PubMed1995

[Bilateral acute retinal necrosis in a patient with acquired immunodeficiency syndrome].

A case of bilateral progressive outer retinal necrosis occurred after herpes zoster ophthalmicus in a patient with acquired immunodeficiency syndrome. This case does not correspond to the classical picture of progressive outer retinal necrosis. The disease led to blindness despite intravenous therapy with acyclovir and foscarnet. PCR could not identify any virus in the aqueous humour, but VZV is evidenced in cerebrospinal fluid. Acute retinal necrosis is now clearly defined by the American Uveitis Society, which should allow to determine its incidence and risk factors. Herpes zoster usually precedes the acute outer retinal necrosis. The infectious theory (VZV, HSV, CMV) widely prevails over the immune theory. We prefer the virus genome identification in the aqueous humor or in the vitreous by PCR to confirm diagnosis rather than the specific antibody titration. Therapy consists in acyclovir, foscarnet and ganciclovir. But whatever the treatment, the visual prognosis is poor.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Western blot as a seroepidemiologic tool for detecting foci of Mediterranean spotted fever (MSF).

We conducted a serosurvey on Mediterranean spotted fever (MSF), in a nonendemic area using western blot and microimmunofluorescence. Among 262 tested sera, 53 were positive by micro-immunofluorescence at a titer of 50. When 48 positive sera were western blot tested, 15 did not exhibited any reaction, 17 reacted against the non-specific lipopolysaccharide, and only 16 reacted against the specific protein antigens. Fourteen of the sera with a specific reaction were sampled in a village with a unique submediterranean climate. Western blot may be a more specific tool to determine the real seroprevalence of MSF.

Adult↗
PubMed1994

[Antibiotic prophylaxis in gynecologic surgery].

Hysterectomies are contaminated procedures; surgical wound related sepsis ranges from 10 to 25%. Several randomised controlled studies demonstrated a significant benefit with prophylactic antibiotics. The study results were more controversial for abdominal hysterectomies. Ureidopenicillins, cephamycins and other antibacterial agents active on Gram negative rods and anaerobes can be recommended as a preoperative flash at anaesthesia induction, followed by a second injection whenever the procedure duration exceeds 3 hours. In case of extended hysterectomy for cancer, broad spectrum antibiotic prophylaxis is usual; some recent studies demonstrated the efficacy of a short duration antibacterial agent use. Mastectomies are at low risk for postoperative infection. Antibacterial prophylaxis is common, especially in plastic surgery.

Anti-Bacterial Agents↗
PubMed1993

Comparison of western blot and microimmunofluorescence as tools for Lyme disease seroepidemiology.

Sera from a population of 212 farmers of the Puy de Dôme (Midlands of France) who are in close contact with Ixodes ricinus, the vector of Lyme disease in Europe, and sera from 100 urban blood donors from the nearly city of Clermont Ferrand were examined by microimmunofluorescence (MIF) for antibodies reacting with Borrelia burgdorferi. The results showed a higher seroprevalence of IgG > 1/100 in farmers (25%) than in blood donors (10%). Using western blot with antibody at a 1/200 dilution, and regarding sera as being positive if they contained IgG reactive with more than 5 bands, 93/212 farmers (44%) and 20% of blood donors were positive. Reactions with specific protein bands (94, 73, 30 and 21 KDa) by western blot were demonstrated in 83/212 sera from farmers (39%) and 16% of blood donors. Both methods showed a higher seroprevalence in the farmer population. Western blot is a sensitive and specific test for seroepidemiology but, in highly endemic areas, it is not diagnostic for active Lyme borrelliosis.

Adult↗
PubMed1991

Comparison of different antibiotic regimens for therapy of 32 cases of Q fever endocarditis.

We studied 32 cases of Q fever endocarditis diagnosed in France between January 1985 and December 1989 to evaluate the efficacies of the different regimens of antibiotics used for treatment. Each patient was monitored during the treatment (range, 12 to 60 months), and clinical and biological information was computerized. Various treatments were prescribed, including doxycycline alone (9 cases) or in association with rifampin (4 cases), quinolones (16 cases), or sulfamethoxazole-trimethoprim (1 case). Two patients died before the beginning of the treatment. Nineteen patients had hemodynamic failure and subsequently underwent valve replacement. Nine valve tissue cultures were positive despite previous antibiotic treatment. In terms of their effects on mortality, the difference between doxycycline alone and doxycycline plus quinolones is statistically significant. We conclude that the addition of quinolones to doxycycline is beneficial. On the basis of clinical, serological, and valve tissue culture results, no treatment was able to cure Q fever endocarditis within 2 years, even with a combination of antibiotics. We advise a minimum duration of treatment of 3 years with therapy combining quinolones and doxycycline.

4-Quinolones↗
PubMed1990

[Hepatic alveolar echinococcosis: diagnosis and treatment].

Alveolar echinococcosis is a parasitic disease which is relatively rare in humans. It almost exclusively affects patients of rural origin living in enzootic regions (Eastern France, Auvergne) and most lesions are in the liver. Several anatomico-clinical forms have been described; the most frequent is the multilocular form, but the disease may consist of one single cyst or abscess. The liver structure is always deeply altered, with compression, inflammation or superinfection. Jaundice, liver enlargement, abdominal pain or signs of secondary localizations are manifestations that lead to the discovery of hepatic alveolar echinococcosis. The anatomical features of the lesions are demonstrated by ultrasounds and computerized tomography. The main differential diagnosis is tumoral pathology of the liver. In most cases the diagnosis of echinococcosis is confirmed by serological tests, although needle or even surgical biopsy might be necessary. Diagnosed at an early stage, alveolar echinococcosis can be amenable to surgical treatment (hepatectomy), and liver transplantation may even be performed. Medical treatment with benzimidazoles seems to be promising.

Albendazole↗
PubMed1990

[Distomatosis: diagnosis and treatment].

Distomatosis caused by Fasciola hepatica is fairly common in France. It is due to the ingestion of contaminated watercress or wild dandelions. Fever is frequent. Jaundice and liver pain are inconstant. The disease is often revealed by an isolated eosinophilia. Ultrasonography and/or computerized tomography are useful to evaluate the hepatic lesions. The diagnosis is confirmed by the finding of eggs in the stools or by serological tests. Numerous other flukes may infect people living overseas and particularly in South-East Asia. Clonorchis sinensis and other Opisthorchidae are responsible for distomatosis of the liver and digestive tract. Several types of intestinal distomatosis may also be acquired. Paragonimiasis (a pulmonary fluke) is particularly frequent in that part of the world. The diagnosis rests on the finding of eggs in the stools (digestive tract distomatosis) or in the airways (paragonimiasis) or on serological tests. The prognosis has been improved by treatment with praziquantel, a drug which in most cases stops the development of the disease within a few days.

Animals↗
PubMed1990

Chronic Q fever: diagnosis and follow-up.

Sera from 40 patients (25 men, and 15 women) with clinical features compatible with the diagnosis of chronic Q fever were received. Total or partial clinical data were available. All of them had serological evidence of chronic Q fever (IgG class anti-phase I titer greater than 800). The final diagnosis was vascular infection in four cases (with two positive cultures for Coxiella burnetii), bone infection in two patients (one positive culture), chronic hepatitis in one patient, and endocarditis in 32. The last patient had an isolated fever with a chronic Q fever serologic profile. Among the 32 with endocarditis, valve replacement was performed in 59%, and valve cultures were positive in 14/18 patients. Twenty-nine of these patients had previously known valvulopathy; 23 were exposed to cattle, sheep or goats; and four had an immunocompromised situation. Ten patients died; two before any treatment, five of cardiac failure during or a few weeks after surgery, and three during the medical treatment. For antibiotic treatment, tetracycline alone was employed in seven cases. For the other patients, combined therapy including tetracycline and another drug (rifampin, fluoroquinolones, cotrimoxazole, or erythromycin) was initiated. Three patients were considered to be completely cured.

Adolescent↗