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Biomedical subjects

R Husson

Publications and source records attributed to R Husson.

13 recordsLinked to original sources

Bacterial infections in human immunodeficiency virus type 1-infected children: the impact of central venous catheters and antiretroviral agents.

We conducted a retrospective study to analyze the impact of central venous catheters (CVCs) and antiretroviral therapy on the frequency and the patterns of bacterial infections in children infected with human immunodeficiency virus during a 3-year period. Among 204 bacterial infections other than otitis media reviewed, soft tissue infection (n = 69), bacteremia (n = 57), pneumonia (n = 27) and sinusitis (n = 27) were encountered most frequently. Catheter-related staphylococcal infection was the most common infection in children with CVCs, particularly in those who were less than 6 years old. In children without CVCs, Streptococcus pneumoniae was the most frequent organism. Younger children had more CVC-related infections whereas children with lower CD4 counts had more CVC-related and CVC-unrelated infections. A lower frequency of CVC-unrelated infections was detected in patients who received antiretroviral therapy, especially those receiving a continuous infusion of zidovudine. These data suggest that increased frequency and altered patterns of bacterial infections are associated with the use of CVCs in these patients, but antiretroviral therapy may reduce the frequency of CVC-unrelated infections.

Adolescent

Dideoxycytidine alone and in an alternating schedule with zidovudine in children with symptomatic human immunodeficiency virus infection.

OBJECTIVE: To determine whether a short course of 2',3'-dideoxycytidine (ddC) could provide safe antiretroviral activity in children with symptomatic human immunodeficiency virus infection and whether it could be used with azidothymidine (AZT, zidovudine). The goal was to maintain uninterrupted antiretroviral therapy while sparing AZT-related myelosuppression and ddC-related neuropathy. METHODS: In a pilot study, we evaluated four dosage levels of ddC--0.015, 0.02, 0.03, and 0.04 mg/kg, given orally every 6 hours--in 15 children between 6 months and 13 years of age with Centers for Disease Control P2 (i.e., symptomatic) human immunodeficiency virus infection. Thirteen patients had not had any prior antiretroviral therapy; two patients had received and benefited from AZT, but dose-limiting neutropenia had developed. At each dosage level, ddC was given for 8 consecutive weeks and then stopped. After a 30-day rest, a schedule of ddC for 1 week was followed by 3 weeks of AZT therapy (180 mg/m2 every 6 hours); this alternating schedule was repeated for as long as tolerated. Age-appropriate psychometric testing was performed before the start of ddC therapy and after 8 weeks. RESULTS: During the 8 weeks of therapy with ddC alone, no neutropenia or anemia was observed; 6 of 9 patients had decreases in p24 antigen levels, and 8 of 15 had an increased CD4 cell count. At the 0.04 mg/kg level, a rash developed in three patients; mild mouth sores developed in 9 of 15 patients. On the alternating ddC/AZT schedule, no neuropathy was observed. CONCLUSIONS: 2',3'-Dideoxycytidine has antiretroviral activity in some children and appears to be safe for short intervals. Longer courses of ddC at lower dosage levels, and schedules integrating ddC into combination regimens, deserve to be explored.

Acquired Immunodeficiency Syndrome

[Drug-induced complications and professional responsibility].

The authors collated the drug-induced side effects reported by subscribers to the malpractice insurance company, Sou Medical. The figures give an idea of the frequency of such events but their reflection of reality should not be overestimated. These presumed incidents represent only 9% of the reports filed (approximately 300 in 20 yr), thus showing their relative rarity. Radiological dyes and general anesthetics comprise two separate groups, as do the exceptional reactions to vaccines. Antibiotics, neuroleptics, non-steroidal anti-inflammatory drugs and corticoids are most frequently implicated, while anticoagulants are rarely cited. These findings underline the rarity of litigation for drug-induced side effects.

Adrenal Cortex Hormones

Radiologist's responsibility in France when using contrast media.

French physicians must obtain their patient's consent before carrying out an action that interferes with the patient's corporal integrity. The doctor must use simple, approximate, intelligent, and honest words that help the patient to reach the indispensable decision. Proof of lack of consent lies with the patient. Three lawsuits dealing with contrast media use illustrate the application of the French general principles of medical responsibility and compliance with present standards of information for the patient.

Contrast Media

Human T cell clones recognize two abundant Mycobacterium tuberculosis protein antigens expressed in Escherichia coli.

Human T cells reactive to Mycobacterium tuberculosis were cloned from peripheral blood mononuclear cells (PBMC) of four tuberculosis patients by using whole irradiated bacilli as the in vitro stimulatory agent. Twenty-two T cell clones (CD4+) were tested for their reactivity to 12 different mycobacterial species and showed a distribution from limited to broad cross-reactivity. These T cell clones were also tested for their reactivity to three abundant M. tuberculosis proteins of 65, 19, and 14 kD, each expressed from recombinant DNA in Escherichia coli. The three proteins were expressed from DNA clones that were previously isolated from a lambda gt11 genomic DNA library of M. tuberculosis by using monoclonal antibodies directed against this pathogen. A T cell clone from one patient was stimulated by an E. coli lysate containing the 65 kD antigen, and a T cell clone from a second patient was stimulated by an E. coli lysate containing the 19 kD antigen in an in vitro proliferation assay. Both T cell clones showed very limited cross-reactivity when tested against other mycobacteria. We conclude that some patients with tuberculosis exhibit a T cell response to the 65 and 19 kD M. tuberculosis proteins defined by these isolated genes.

Antigens, Bacterial

[Dentin pins: risk evaluation and precautions].

When large restorations are necessary, self screw-cutting dentinal pits are very useful auxiliaries. The main risks encountered during their utilization are: --perforation through periodontium--pulpal wound--dentinal cracks--weakness of mechanical properties of restorative material--corrosion--breakdown of the drill--pulpal warning up--unesthetical front restorations. The way to prevent those difficulties are: --precise clinical and radiological examinations--insertion point--direction--number--composition--choice of pits.

Corrosion