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Biomedical subjects

M Lariviere

Publications and source records attributed to M Lariviere.

At least 19 recordsLinked to original sources
PubMed1992

Toxoplasmosis in bone marrow-transplant recipients: report of seven cases and review.

We report seven cases of cerebral or disseminated toxoplasmosis that occurred following bone marrow transplantation (BMT) and review the other 24 cases described in the literature. For all the cases, toxoplasmosis occurred within 6 months of BMT, with the highest incidence in the second and third months. Twenty-four of 26 recipients tested serologically before BMT were positive for Toxoplasma gondii, a finding that supports the view that such cases result from reactivation of latent infection. At the onset of clinical symptoms, IgG antibody titers were unchanged or decreased in 23 of 25 documented cases, and IgM antibodies were detected in two cases. Antemortem diagnosis was made in 16 cases and was based on the response to specific therapy in six cases and/or the demonstration of the parasite in body fluids or tissues in 10 cases. Autopsy was performed in 19 cases and revealed that infection was not restricted to the brain but either involved lung or heart tissue or was disseminated in 14 cases.

Adult↗
PubMed1991

[Techniques applicable to broncho-alveolar lavage fluid in hospital laboratory for the diagnosis of parasitic and fungal pneumopathies in immunosuppressed patients].

Parasitic and fungal organisms which are likely to cause pulmonary infections in immunosuppressed patients can be detected in broncho-alveolar fluid (BAL fluid). Single and standard methods, such as direct examination of the pellet, eosine-methylene blue fast (RAL 555), cultures in usual mediums of mycology must be systematically applied to this sample and may help detect these organisms without further exploration. If the results are negative, more recent techniques can be used if they present a real asset: an easier reading and mostly an improved sensitivity. Such is the case of immuno-fluorescence assay with monoclonal antibodies for detection of Pneumocystis carinii, and inoculation of MRC5 fibroblast cell line in tissue culture for isolation of Toxoplasma. Fungal pulmonary infections diagnosis has not yet succeeded in benefiting from modern findings: latex tests proposed for the detection of circulating antigens are nor sensitive nor specific, except the "Crypto LA test". Considering the relatively frequent association with other infectious agents, the detection of a parasitic or fungal organism in the BAL fluid should not interrupt investigation of this sample; neither should it lead to hasty conclusions regarding the responsibility of this agent in acute pneumopathy. This role will have to be evaluated according to criteria which are different for each isolated organism.

Bronchoalveolar Lavage Fluid↗
PubMed1989

Laboratory diagnosis of pulmonary toxoplasmosis in patients with acquired immunodeficiency syndrome.

In four cases of pulmonary toxoplasmosis occurring in patients with acquired immunodeficiency syndrome, Toxoplasma sp. was discovered in bronchoalveolar-lavage fluid (three cases) and in lung biopsy specimen (one case) by using the following methods: direct examination of smears stained with eosine-methylene blue fast stain, indirect immunofluorescence assay, and inoculation of MRC5 fibroblast cell line in tissue culture.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Effects of diethylcarbamazine and ivermectin on the mobilization of microfilariae of Onchocerca volvulus].

Microfilaria of Onchocerca volvulus are localized in superficial dermis. However, they are sometimes noticed in the blood and urines, when there is an important infestation. Diethylcarbamazine (DEC) bring on an increase of microfilaria, successively in the blood and after, in the urines. This study of 30 patients, treated in double blind by placebo, DEC and ivermectin, a new molecule with spectacular action on this filariasis, allowed to compare effect of each one on apparition of microfilariae in the blood and urines. Ivermectin bring on very important increase of microfilaremia without microfilaruria, unlike diethylcarbamazine. This establishment bring to discuss very different physiologic mechanisms between them. It should have an incidence on diagnosis and treatment of this dangerous parasite.

Adult↗
PubMed1987

Toxoplasma antibody titers in renal transplant recipients. Pretransplant evaluation and posttransplant follow-up of 73 patients.

In 73 consecutive kidney transplant recipients, anti-Toxoplasma antibodies were determined before transplantation and during a 3-year follow-up after transplantation. In 9 patients, antibody titers increased significantly after transplantation. Antibody titers to various viral antigens determined in parallel remained unchanged, suggesting that the anti-Toxoplasma antibody increase was not due to polyclonal nonspecific stimulation. In 2 of the 24 pretransplant seronegative patients, acquired toxoplasmosis was diagnosed serologically after transplantation, with the observation of a strong IgM and IgG antibody response. The incidence of toxoplasmosis in this group of patients was not found to be significantly different from that in a normal population, suggesting that transmission of Toxoplasma from the transplanted kidney may not be a significant mode of contamination. Among the 49 patients who were seropositive before transplantation, reactivation of toxoplasmosis was suspected in 7 cases on the basis of a significant increase in IgG antibodies. Reactivation occurred more frequently in patients treated with azathioprine and antithymocyte globulin, and a direct relationship between administration of steroids and antibody increase was demonstrated in three patients. Although toxoplasmosis has occasionally been reported as a major infectious problem in kidney transplant recipients, our clinical and serological data show that the potential risk of developing Toxoplasma infection is low since none of the patients with either acquired or reactivated toxoplasmosis developed clinical disease.

Adolescent↗
PubMed1986

A double-blind comparison of the efficacy and safety of ivermectin and diethylcarbamazine in a placebo controlled study of Senegalese patients with onchocerciasis.

Ivermectin (MK-933) has been compared with diethylcarbamazine (DEC) and placebo in a double-blind study in 30 adult male Senegalese patients with Onchocerca volvulus infection. 10 patients were randomly assigned to each treatment group. Ivermectin was administered as a single oral dose of 12 mg and DEC as 50 mg daily for two days and 100 mg twice daily for the following six days, total 1.3 g in eight days. Skin O. volvulus microfilaria densities remained near pre-study values in the placebo patients, but decreased rapidly with both active drugs to mean values about 2% of pretreatment (Day 8) and then increased slowly, reaching in 12 months about 4% of pre-treatment (ivermectin) and 18% (DEC). This difference is statistically significant. Clinical adverse reactions were recorded in four ivermectin, ten DEC and three placebo patients. One ivermectin and six DEC patients received steroid treatment for relief of these reactions. Serious adverse ocular changes were not seen in any patients, possibly because of the steroid therapy in the DEC patients. Adult O. volvulus from onchocercal nodules one and six months after treatment showed no effect of either drug on viability. Intra-uterine developing forms of the microfilariae appeared normal in all three treatment groups at the one month examination but deformed and degenerated forms were evident at six months in the ivermectin group but not in the DEC and placebo patients. Ivermectin as a single oral dose appears to be a safer and more effective microfilaricidal drug in human onchocerciasis than DEC in the standard multi-dose regimen.

Adolescent↗
PubMed1986

Toxoplasma infection after human allogeneic bone marrow transplantation: clinical and serological study of 80 patients.

Systematic clinical and serological studies to evaluate the frequency of toxoplasmosis in bone marrow transplant recipients were performed in 80 consecutive patients. Antitoxoplasma antibody titres were measured in donors and recipients before transplant and subsequently post-transplant. Before bone marrow transplant, 54 recipients were seropositive and 26 were seronegative, whereas 35 donors were seropositive and 45 were seronegative. After bone marrow transplant, the frequency of clinical and serological manifestations of toxoplasmosis appeared closely related to the recipient's serological status before transplant. In the seronegative group of patients before transplant the incidence of toxoplasmosis was low: only two patients experienced seroconversion 3 months after bone marrow transplant and one developed clinical symptoms consistent with toxoplasmosis but without cerebral involvement. Clinical toxoplasmosis or secondary elevation of antibody titres was mostly observed in pre-bone marrow transplant seropositive patients; in this group, cerebral toxoplasmosis occurred in four patients and a significant secondary rise of antibody titres was observed in 16 patients. It thus appears that toxoplasmosis is most often related to a reactivation of latent cysts. Prophylactic treatment may be useful in patients presenting serological evidence of past or latent infection before bone marrow transplant.

Adolescent↗
PubMed1985

Double-blind study of ivermectin and diethylcarbamazine in African onchocerciasis patients with ocular involvement.

In a randomised double-blind study, ivermectin was compared with diethylcarbamazine (DEC) and placebo in the treatment of onchocerciasis in 30 male patients from Mali with moderate to heavy Onchocerca volvulus infections and ocular involvement. 10 patients received a single oral dose of ivermectin, 12 mg, 10 received DEC daily for eight days (total dose 1.3 g), and 10 received matching placebo. Patients were examined periodically for twelve months. Punctate keratitis disappeared in 6 of 7 ivermectin patients but increased in DEC patients. Numbers of O volvulus microfilariae (mf) in the anterior chamber decreased slowly and eventually disappeared in most ivermectin patients during the six months following treatment; anterior chamber mf disappeared more rapidly in some patients after DEC, but reappeared within six months of stopping treatment. Both ivermectin and DEC caused a prompt decrease in mean skin mf density; density then increased in both groups over the twelve month observation period, reaching 9% of pretreatment values in ivermectin patients and 45% in the DEC group. Analysis of adult O volvulus from nodules excised at three and twelve months post treatment showed no effect of either drug on viability; however, there was evidence of degeneration of intra-uterine developing mf in the ivermectin group. Side-effects were less frequent and less severe in ivermectin patients than in DEC patients. Ivermectin as a single oral dose appears to be a more effective microfilaricidal drug than DEC in onchocerciasis.

Adolescent↗
PubMed1982

Efficacy and tolerance of ivermectin in human onchocerciasis.

Initial clinical studies in 32 Senegalese subjects have demonstrated the efficacy of ivermectin in Onchocerca volvulus infection (river blindness). Although O. volvulus microfilariae in skin snips were not reduced in number after single oral doses of 5 micrograms or 10 micrograms/kg body-weight, they were greatly reduced in all subjects after single oral doses of 30 micrograms or 50 micrograms/kg and were eliminated completely in 6 of th 8 subjects who received the 50 micrograms/kg dose. All subjects tolerated the drug well. Transient pruritus which did not require treatment was observed on the day the dose was given in 2 of the 8 subjects after the 30 micrograms/kg dose and in 4 of the 8 who received the 50 micrograms/kg dose. Ivermectin produced no abnormal laboratory results.

Adult↗
PubMed1981

[Binding of fluorescein-labelled lectins on trophozoites and cysts of 3 strains of Toxoplasma gondii].

The presence of carbohydrates on the surface of trophozoites and cysts of Toxoplasma gondii was investigated using 26 fluorescein labelled lectins. Three strains of parasites at different phases were tested; intra-cellular, intra-cystic and free trophozoites did not stain. However Soja hispida lectin intensly bind on cyst wall. The fluorescence could be eliminated by preincubation with certain carbohydrates, but not with trophozoite soluble antigen. These results suggest to the authors that cyst wall may be of host rather than of parasite origin.

Animals↗
PubMed1980

[ELISA in schistosomiasis. Limits. Possibility of application (author's transl)].

Sera from patients with schistosomiasis and various infections were examined by an enzyme-linked immunosorbant assay technique (ELISA) using soluble antigens prepared from adult worms and eggs of Schistosoma mansoni. Marked false positive reactions were observed in cases of certain parasitic (hydatidosis) and non parasitic diseases (liver cirrhosis). Equivalent results with the techniques of immunofluorescence and immunoenzymology (done on adult sections) were obtained with adult worm antigen read at a higher optic-density limit. At present, this technique might be useful in seroepidemiological surveys; however, further purification of the antigen will increase its sensibility and specificity.

Echinococcosis↗