PubMed HealthSearch

Biomedical subjects

O Kourilsky

Publications and source records attributed to O Kourilsky.

At least 19 recordsLinked to original sources

Efficacy and tolerance of cefodizime in the treatment of acute pyelonephritis.

The efficacy and tolerance of cefodizime in the treatment of acute pyelonephritis were evaluated in an open, international, multicentre study. In total, 128 patients were treated with 1 g cefodizime bd iv or im for a mean of 8.3 days. Underlying urinary tract abnormalities were present in 35% of cases. The most frequently isolated bacteria were Escherichia coli (79/97 evaluable cases) and Proteus mirabilis (8/97 evaluable cases). The overall clinical and bacteriological success rate was 89.7% (87/97). The drug was well tolerated, with only a few mild and transitory adverse events. Tolerance at the site of injection was good in 97.5% (78/80) of those treated iv, and 79% (38/48) of those treated im. Three patients had skin reactions which were probably related to cefodizime. Alterations of laboratory parameters were seen transiently in five patients (3.9%). Cefodizime is effective and well tolerated in the treatment of acute pyelonephritis.

Acute Disease

Circulating immune complexes and C3d in human parasitosis.

Using the Raji cell radioimmune assay, we found low levels of circulating immune complexes (IC) in a small percentage of patients with schistosomiasis and filariasis. C3d levels, measured by immunoprecipitation, were elevated in a large number of these patients, whereas complement levels were within normal limits. Proteinuria was not found in any of the 55 patients studied. Circulating IC or elevated C3d levels were not found in any of the 19 patients with hydatidosis. The increased C3d levels, apparently not related to circulating IC, may be due to direct complement activation by parasite antigens or to sequestered IC. The latter hypothesis appears more attractive because the highest levels of C3d were found in schistosomiasis whereas schistosome antigens were unable to activate complement in vitro.

Antigen-Antibody Complex

[Utilisation of pipemidic acid as antibiotic in patients with renal failure insufficiency. Kinetics of serum and urinary concentrations (author's transl)].

In 23 chronic renal patients serum and urinary concentrations of pipemidic acid were studied, the drug being given orally for 3 to 105 days. In 13 non-dialyzed patients, whose GFR varied from 4.5 to 36 ml/mn the dosage was 11.2 to 30 mg/kg/day. Maximum serum concentrations were comprised between 6 and 29 micrograms/ml. In 2 patients minor clinical side-effects indicated a maximum tolerance level of 25 micrograms/ml. Urinary concentrations remained elevated in spite of severe renal failure. In 10 hemodialyzed patients maximum predialysis levels varied from 5.6 to 28 micrograms/ml. No side-effects were noticed. The dialysance of pipemidic acid was high, due to a low molecular weight and to a binding to proteins which seems to be lower in uremics than in normal subjects. We conclude that pipemidic acid can be utilized in chronic renal patients, in taking advantage of low GFR's for obtaining serum bactericidal concentrations on susceptible organisms.

Administration, Oral

Renal transplantation and viral infections. III. Clinical and virological correlations.

Studies of the serological development after 26 renal transplants confirm the high frequency of antibody rises not only against the herpes virus group, but also against other virus groups such as measles, Coxsackie B viruses. These antibody rises correlate with febrile episodes and hepatic dysfunction in which CMV is the most often involved. However, the frequency of antibody rises against various viral antigens without any clinical event to suggest viral etiology; the lack of concomitant virus isolation (except the herpes group), as well as the ocurrence of simultaneous antibody rises against several viruses, all suggest that some of these various antibody rises observed may be related to immunological dysfunction rather than to virus infection.

Antibodies, Viral

Renal transplantation and immunological abnormalities in thrombotic microangiopathy of adults: report of 5 cases.

Renal transplantation was performed in five adult patients with thrombotic microangiopathy, three of whom had had a bilateral nephrectomy prior to transplantation. The graft remained functional in three patients 72, 18, and 12 months after transplantation. One patient developed a thrombosis of the renal artery and one patient died from infection. There was no clinical or histological evidence of recurrence of thrombotic microangiopathy in the five patients after transplantation. Immunological investigations were performed in four of five patients before transplantation: C3 and C1q levels were low in two patients; serum C3-splitting activity and circulating immune complexes were present in all four patients and remained unchanged on haemodialysis and/or after bilateral nephrectomy. Complement abnormalities and immune complexes were not detected in the three patients with successful renal transplantation.

Acute Kidney Injury

Acute renal failure of glomerular origin during visceral abscesses.

We studied 11 patients who had visceral abscesses and in whom acute renal failure developed. All renal biopsies showed a diffuse proliferative and crescentig glomerulonephritis. In seven patients blood cultures were repeatedly negative. Endocarditis could be ruled out in six patients. Seven patients had circulating cryoglobulins; serum complement levels were normal in seven and decreased in four; circulating immune complexes were found in the three patients studied. The evolution of the glomerulonephritis, documented by serial biopsies, closely paralleled the course of the infection. A complete recovery of renal function occurred in four cases in which a rapid and complete cure of the infection was obtained. Of five patients in whom the infection was not cured, four died, and chronic renal failure developed in one. In two patients in whom therapy was delayed, chronic renal failure also developed. Deep suppuration, even in the absence of bacteremia, may be responsible for a severe but possibly reversible glomerulonephritis with circulating immune complexes.

Abscess