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Biomedical subjects

P Marcel

Publications and source records attributed to P Marcel.

9 recordsLinked to original sources
PubMed1992

Ocular toxoplasmosis in human immunodeficiency virus-infected patients.

The files of 45 human immunodeficiency virus-infected patients with ocular toxoplasmosis were reviewed, with a median follow-up of eight months. The condition was unilateral in 37 of the 45 patients (82%) and was bilateral in eight (18%). Inflammation of the anterior chamber and the vitreous was present in 32 of 53 eyes (60%) and 38 of 53 eyes (72%), respectively. Cytomegalovirus retinitis developed during the follow-up period in nine patients (20%). Cerebral toxoplasmosis was concurrently diagnosed with the ocular toxoplasmosis in 13 patients (29%). The efficacy of the combination of pyrimethamine and sulfadiazine or clindamycin was assessed in 42 patients for the induction therapy and in 38 patients for the maintenance therapy. Induction therapy was always effective within a median period of six weeks. During maintenance treatment, the 24-month relapse rates were 0.20 and 0.18 for the 50-mg/day and 25-mg/day dosage of pyrimethamine, respectively. The overall 12-month survival rate was 0.72. Our results suggested that ocular toxoplasmosis has a better ocular prognosis than cytomegalovirus retinitis, but that it requires appropriate treatment because life-threatening cerebral involvement is often associated.

Adult↗
PubMed1991

Efficacy and tolerance of intravitreal ganciclovir in cytomegalovirus retinitis in acquired immune deficiency syndrome.

Forty-four patients with acquired immune deficiency syndrome with cytomegalovirus (CMV) retinitis (64 eyes) intolerant of or refusing systemic antiviral therapy received 710 intravitreal injections of ganciclovir at the dosage of 400 micrograms per injection. The patients were followed for a mean period of 9 weeks. Induction therapy consisted of two injections a week until healing. Maintenance therapy consisted of one injection a week until relapse. All but 1 of 53 induction courses led to cicatrization, after a mean of 6.6 injections. In 54 maintenance courses, the 8-week relapse rate was 53%. During intravitreal therapy, involvement of the fellow eye occurred in 11% of the patients and CMV infection developed in a nonocular site in 16% of the patients. Five retinal detachments and two intravitreal hemorrhages occurred. No endophthalmitis or cataract was noted. Intravitreal ganciclovir appears to be a safe and effective alternative in patients intolerant of intravenous anti-CMV drugs.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Cotton-wool spots and AIDS related complex.

Twenty-nine patients with the AIDS Related Complex (ARC) were studied retrospectively. Cotton-wool spots (CWSs) were the main ophthalmological finding, present in 9 patients (31%) at this stage of the disease. The CWSs were asymptomatic and were therefore discovered during a routine examination. The proportion of patients with significant weight loss was greater among ARC patients with CWSs than among those with normal fundi. Leukocyte counts were found to be significantly lower (p = 0.03, odds ratio 10.0 [1.24 to 80.4]) among ARC patients with CWSs. Lymphocyte counts and the CD4/CD8 ratio were also found to be diminished in these patients. Among the nine patients with CWSs during ARC, seven developed major opportunistic infections or HIV (Human Immunodeficiency Virus) related neoplasias during the following months (3.8 +/- 3.5 months). These findings are consistent with a poorer prognosis for HIV infected patients who have CWSs.

AIDS-Related Complex↗
PubMed1989

Foscarnet in the treatment of cytomegalovirus retinitis in acquired immune deficiency syndrome.

Cytomegalovirus (CMV) retinitis is the major cause of visual loss in acquired immune deficiency syndrome (AIDS). Thirty-one patients with active CMV retinitis were treated with the new antiviral drug, Foscarnet (trisodium phosphonoformate). After a 3-week course of induction therapy, the retinitis improved in 29 of 31 patients (93.5%). Complete resolution of the retinitis was seen in 19 cases (61.3%). Ten patients had partial resolution (32.2%) and two (6.5%) failed to respond. After induction therapy, six patients were put on a low-dose maintenance regimen. All patients without maintenance therapy relapsed within 3 weeks after discontinuation of Foscarnet. The rate of relapse on maintenance therapy was 50% (3/6) within the first 5 weeks. The three other patients of Foscarnet maintenance did not relapse after a follow-up period of 12 weeks. In contrast to ganciclovir, Foscarnet did not induce neutropenia but it produced kidney toxicity that led to reversible renal insufficiency in three cases. Thus, Foscarnet appears to be a useful alternative to ganciclovir, particularly when combined with bone marrow toxic drugs, such as zidovudine (azidothymidine).

Acquired Immunodeficiency Syndrome↗
PubMed1987

A single dose of three different ophthalmic beta-blockers antagonizes the chronotropic effect of isoproterenol in healthy volunteers.

The systemic effect of three beta-blocking eyedrops was compared in a placebo-controlled, double-blind trial in 12 healthy male volunteers. Each subject received successively each treatment in random order at weekly intervals. The eyedrops administered were as follows: 0.5% timolol, 2% carteolol, 0.6% metipranolol, and placebo. We evaluated the intraocular pressure and systemic beta-blockade 3 hours after a single administration of one eyedrop in each eye. The systemic beta-blocking effect was evaluated by the isoproterenol sensitivity test, that is the dose of isoproterenol required to increase resting heart rate by 25 bpm (I25). Each beta-blocking eyedrop antagonized the chronotropic effect of isoproterenol. I25 for placebo was 3.1 +/- 0.5 micrograms, for metipranolol 5.2 +/- 0.9 micrograms (P less than 0.005), for timolol 10.9 +/- 1.9 micrograms (P less than 0.001), and for carteolol 39.6 +/- 5.4 micrograms (P less than 0.0005). Each treatment significantly decreased the intraocular pressure: metipranolol 3.6 +/- 0.4 mm Hg (P less than 0.001), timolol 2.44 +/- 0.4 mm Hg (P less than 0.01), and carteolol 2.38 +/- 0.48 mm Hg (P less than 0.01) compared with placebo. The resting heart rate and blood pressure were not influenced by the treatments. Even though the results might be different in the case of an earlier or a later time of evaluation or chronic administration, we believe that the isoproterenol sensitivity test may be used to evaluate the systemic effect of beta-blocking eyedrops.

Adrenergic beta-Antagonists↗
PubMed1987

[Role of prolactin in changes of parasitism induced by lactation].

In order to establish the role played by prolactin in lactation during the evolution of Strongyloides ratti in the female rat, the authors tried to reproduce the effects of this physiological state by treatment with sulpiride (substituted benzamide), of which the prolactinogenic effect is intense in the female rat. Low doses partially reproduced the effects of lactation on parasitism by diminishing its intensity and delaying the onset of rejection, although without preventing it. The pharmacological action of sulpiride, which acts by blocking the dopamine receptors, explains why only low doses are active and why their action is limited to the onset of parasitism. This experiment lends weight to the hypothesis that prolactin plays a fundamental role in modifications of the evolution of Strongyloides ratti during lactation.

Animals↗
PubMed1981

[Parasitism and corticosteronemy in rats during repeated infestations with Strongyloides ratti].

The greater the number of larvae, the lower the possibilities of superinfestation when rats are repeated exposed to contact with Strongyloides ratti larvae, once a week or every two days for periods of up to twenty-four days: super-infestations occurs only on the 2nd day (10,000 larvae), the 4th day (5,000 larvae) and the 9th day (1,000 larvae). However, superinfestation continues throughout the entire duration of the experiment (46 days) when contamination is very low (10 larvae). Although there is now superinfestations, each new contact with larvae produces a hypercorticosteronemia reaction. Thus, the immunity acquired, although it is rapidly capable of preventing the larvae from reaching adulthood, does not prevent the larvae from beginning their migration and triggering the reaction. Progressively and slowly, this cortico-adrenal reaction decreases. It no longer takes place after 3 weeks of weekly infection by 10,000 larvae of after 2 weeks of bi-daily infection by 10,000 or 5,000 larvae. The reactional hypercorticosteronemia which follows an infestation does not intensify after repeated infections, whatever their frequency or intensity.

Animals↗
PubMedDate not supplied

[Cytomegalovirus retinitis in AIDS. Treatment with intravitreal injections of ganciclovir].

Cytomegalovirus (CMV) retinitis is the most frequent ocular infection in AIDS, and it is responsible for blindness. Intravitreal injections of ganciclovir in doses of 400 g have been tried in patients who could not tolerate any systemic treatment. Induction therapy consists of 2 injections per week, followed by maintenance therapy with 1 injection per week. The present study involved 17 patients. Twenty-three induction courses could be evaluated; all had a favourable response with an average of 6 injections per eye. Seventeen maintenance courses were evaluated, with a mean of 5 injections per eye. There was no relapse in 10 eyes (70 percent) at 48 days. There was no evidence of toxicity from repeated intravitreal injections: no cataract, retinal detachment or endophthalmitis was observed with a total of 231 injections. Intravitreal ganciclovir appears to be an effective local treatment of CMV retinitis in AIDS patients when systemic therapy cannot be used.

Acquired Immunodeficiency Syndrome↗