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T Lambert

Publications and source records attributed to T Lambert.

At least 55 records · Page 3Linked to original sources
PubMed1997

Epidemiological survey of Neisseria meningitidis susceptibility to penicillin G in France.

The susceptibility of 82 strains of Neisseria meningitidis to penicillin G and amoxicillin was evaluated with two media "gonococci-meningococci" medium (G medium) derived from Mueller Hinton and chocolate agar. Among these 82 strains 52 were isolated from CSF and/or blood and 30 from miscellaneous isolates. G medium was compared with chocolate agar using the correlation between diameters and MIC and the E-test. Routinely standardised antibiogram is still used but the authors added the following techniques 1) MIC of penicillin G is tested (0.06; 0.125; 0.250; 0.50 mg/l); 2) use of oxacillin disc charged with 5 micrograms. Penicillinase producing meningococci were not found. Standardised antibiogram on 4192 strains resulted in a modal distribution of diameters between 18 to 40 mm. Moderate meningococci susceptible strains to penicillin G are increasing in France: 1994: 4%; 1995: 11%; 1996: 18%.

Amoxicillin↗
PubMed1996

Is lidocaine-prilocaine cream (EMLA) always useful for venous puncture in preoperative autologous blood donation?

PURPOSE: The goal of the present study was to evaluate in adults the benefit of the Eutectic Mixture of Local Anesthetics (EMLA) for preoperative autologous blood donation. METHODS: Twenty-six adult patients requiring three blood samples were studied. The pain of venipuncture was assessed by the patient using a 100 mm Visual Analogue Scale (VAS) and a four-category Verbal Rating Scale (VRS). The first puncture was performed without anaesthesia, as a "reference puncture". The second and third punctures were performed with EMLA and placebo in a double-blind cross-over randomization. For statistical analysis, the patients were allocated to two groups according to the VAS scores of the reference puncture: (Group 1) VASref < 20 mm; (Group 2) VASref > or = 20 mm. RESULTS: For the whole 26 patients, the VAS and the VRS pain scores were lower for EMLA puncture than for both the placebo and reference punctures (P < 0.05). Twenty patients had a VASref < 20 mm and six patients a VASref > or = 20 mm. In Group 1, there was no difference between EMLA and placebo for both the VAS and VRS scores. In contrast, in Group 2, the VAS score was lower for EMLA than for both the placebo and the reference punctures (respectively 11 +/- 7.1, 28.9 +/- 7.9, 29.1 +/- 6.4; P < 0.01); the VRS score was also lower for EMLA puncture than for placebo puncture (P < 0.05). CONCLUSION: In adults requiring repeated venous punctures, pain from cannulation may be evaluated at the first puncture with a Visual Analogue Scale, thus indicating or not the need for EMLA.

Adult↗
PubMed1996

Fatal intravascular autoimmune hemolytic anemia after fludarabine treatment for chronic lymphocytic leukemia.

We report the case of a patient with chronic lymphocytic leukemia (CLL) who developed fatal intravascular autoimmune hemolytic anemia (AIHA) after fludarabine treatment. He had previously received several treatments including two courses of fludarabine. The direct antiglobulin test (DAT) was negative at diagnosis but was found to be positive with anti-IgG after the first fludarabine treatment. When the patient was treated again with fludarabine nine months later, the DAT became positive with anti-IgG and anti-C3d antiglobulins after the second course of treatment. Abrupt, fatal intravascular hemolysis occurred after the third course. The occurrence of severe AIHA in CLL patients treated with fludarabine has been reported by several authors. Physicians should be aware of the risk of severe AIHA in CLL patients with a history of AIHA or positivation of the DAT during previous fludarabine administration, or in case of secondary fixation of complement to the red cell membrane occurring during fludarabine treatment.

Aged↗
PubMed1995

Kinetics of drug delivery to the arterial wall via polyurethane-coated removable nitinol stent: comparative study of two drugs.

Polymer-coated removable stents were used to deliver 14C-labeled etretinate and 3H-labeled forskolin to the vessel wall in 31 New Zealand White rabbits to study their kinetics. Stents loaded with etretinate (n = 8) and forskolin (n = 14) were implanted in the rabbit carotid arteries, and the animals were euthanized at different time intervals. Drug levels were measured in the media and adventitia of the stented segment, in distant tissues, and in blood. In four rabbits, forskolin-loaded stents were percutaneously retrieved 2 hr after implantation in the carotid artery, and the tissue and blood levels were determined 2 and 24 hr after retrieval. In seven rabbits etretinate-loaded stents were retrieved 72 hr after implantation in abdominal aorta, and drug levels were measured in the tissues and blood immediately after and at 1 and 4 days after retrieval. Levels of etretinate in the vessel wall peaked at 24 hr (250 ng/mg) and remained high up to 72 hr (185 ng/mg) after stent placement. Levels of forskolin peaked within 2 hr of stent placement (135 ng/mg) and rapidly declined to 4.9 ng/mg at 24 hr with the stent in situ. About 50% (1.4 mg) of the original etretinate remained in the stent at 72 hr compared to about 5% (0.08 mg) of forskolin at 24 hr. Ratio of peak drug levels in the vessel wall to those in the blood was 6,000 for etretinate and 780 for forskolin. (ABSTRACT TRUNCATED AT 250 WORDS)

Alloys↗
PubMed1995

Spontaneous loss of HBeAg and development of anti-HBe during long-term follow-up of blood donors found to be HBsAg-positive.

Since 1980, at North London Blood Transfusion Centre 61 (14%) of a total of 442 hepatitis B surface antigen (HBsAg) positive carriers have been hepatitis B e antigen (HBeAg) positive by radioimmunoassay at the time of detection, with 353 (80%) anti-HBe positive. We have undertaken long-term follow-up of infectivity markers in 285 of these 442 HBsAg carriers detected by routine screening. Donors undergoing acute HBV infection were excluded from the analysis. The donor follow-up times ranged from 1.2 to 13.5 years. Regular follow-up samples were obtained and examined for HBsAg, HBeAg, anti-HBe, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Thirty-five (12.3%) of the 285 carriers were HBeAg-positive when first detected. Eight of these 35 developed anti-HBe during follow-up. At no time did any carrier revert from anti-HBe to HBeAg. When these data were subjected to a Kaplan--Meier analysis an estimated lower quartile time to seroconversion of 3.83 years, and a median seroconversion time of 8.25 years were predicted. This corresponds to a mean rate of 6.5% per annum for the first 25% to seroconvert, and 5.7 for the next 25%.

Blood Donors↗
PubMed1994

Characterization of the aac(6')-Ik gene of Acinetobacter sp. 6.

The aac(6')-Ik gene which confers resistance to aminoglycosides in Acinetobacter sp. 6 CIP A165 was characterized. The resistance gene was identified as a coding sequence of 438 bases pairs corresponding to a protein with a calculated mass of 16627 Da. Alignment of aac(6')-Ik with aac(6')-Ig from Acinetobacter haemolyticus indicated 83% identity. Like aac(6')-Ig of A. haemolyticus and aac(6')-Ij of Acinetobacter sp. 13, the aac(6')-Ik gene was apparently located in the chromosome and was species specific. The high degree of identity between aac(6')-Ig and -Ik, compared with genomic DNA relationships between the host species, indicated that these genes have diverged from a common ancestor in a parental Acinetobacter species.

Acetyltransferases↗
PubMed1994

Outcome of ABO-incompatible liver transplantation in children with no specific alloantibodies at the time of transplantation.

The shortage of suitable liver donors for children has motivated the use of ABO-incompatible (ABO-I) grafts for transplantation in urgent situations. However, survival after ABO-I liver grafts has been reported at about 30% as compared with 80% in cases of ABO-identical or -compatible liver grafts. This difference has been attributed to antibody-mediated, hyperacute or chronic liver rejection, due to preformed ABO antibodies (alloantibodies). In this study, we report our results with ABO-I livers in children without alloantibodies at the time of transplantation. From January 1988 to June 1993, 143 OLT were performed in 122 children. Eight children received 8 ABO-I liver grafts. Of these, 7 patients were included in the study. All 7 were alloantibody free before OLT. Five children were spontaneously alloantibody free, while in 2 children, the plasma alloantibodies were eliminated before and after transplantation using intravenous infusion of specific blood group antigens of the donor blood group (soluble antigens). Immunosuppression consisted of a triple-drug treatment combining CsA, AZA, and steroids. The follow-up period was between 10 and 48 months. One child died from a surgical complication. Six children survived, but 1 died 10 months later from intestinal obstruction. There were no graft losses and no episodes of hyperacute or chronic rejection. The graft and patient survival rate was 71%. There was a 28% incidence of rejection, but all were mild (requiring steroid boluses only). Our results suggest that the absence of ABO alloantibodies at the time of and after transplantation can protect ABO-I liver grafts against antibody-mediated rejection, whether hyperacute or chronic, and that soluble antigens are effective in eliminating alloantibodies in children.

ABO Blood-Group System↗
PubMed1994

A spontaneous point mutation in the aac(6')-Ib' gene results in altered substrate specificity of aminoglycoside 6'-N-acetyltransferase of a Pseudomonas fluorescens strain.

The aac(6')-Ib' gene from Pseudomonas fluorescens BM2687, encoding an aminoglycoside 6'-N-acetyltransferase type II which confers resistance to gentamicin but not to amikacin, was characterized. Nucleotide sequence determination indicated total identity between aac(6')-Ib' and the aac(6')-Ib gene from Pseudomonas aeruginosa BM2656 [1] with the exception of a C-to-T transition that results in a serine to leucine substitution at position 83 of the deduced polypeptide. The aac(6')-Ib gene specifies a type I enzyme which confers resistance to amikacin but not to gentamicin [2]. It thus appears that the point mutation detected is responsible for enzymic altered substrate specificity.

Acetyltransferases↗
PubMed1994

The Australian multicentre double-blind comparative study of remoxipride and thioridazine in schizophrenia.

A double-blind, randomized study of parallel group design comparing remoxipride and thioridazine (dose range 150-600 mg/day of either drug) was undertaken at 11 Australian centres. A total of 144 patients (remoxipride = 73, thioridazine = 71) with DSM-III-R schizophrenia or schizophreniform disorder commenced the study, and 89 patients (remoxipride = 45, thioridazine = 44) completed the 6 weeks of the trial. The mean daily doses at last rating were 404 mg (remoxipride) and 378 mg (thioridazine). Initial Brief Psychiatric Rating Scale scores decreased by a mean 8.7 points in both remoxipride and thioridazine groups. Equivalent treatment responses were also confirmed by Clinical Global Impression. During the study, sedatives or hypnotics were needed by 68% of the remoxipride patients and 51% of the thioridazine patients. Thioridazine was associated with more postural hypotension, drowsiness, increased sleep, headache, dizziness on rising, dry mouth, sexual dysfunction and weight gain, while remoxipride patients reported more insomnia. There were no differences between remoxipride and thioridazine on dystonia, hypokinesia, dyskinesia, rigidity and akathisia. The results indicate that remoxipride has similar antipsychotic efficacy to thioridazine but causes fewer side effects.

Adolescent↗
PubMed1994

Detection of aac(6')-I genes in amikacin-resistant Acinetobacter spp. by PCR.

The distribution of aac(6')-I genes in 62 strains of Acinetobacter spp. resistant to amikacin, netilmicin, and tobramycin and susceptible to gentamicin, a phenotype compatible with synthesis of an AAC(6')-I enzyme, was studied by PCR and by DNA hybridization. Both methods gave similar results. Among the 51 Acinetobacter baumannii strains, aac(6')-Ib was found in 19 isolates and aac(6')-Ih was found in the remaining strains. The aac(6')-Ig gene was present in all 10 A. haemolyticus strains studied and was detected only in this species. A pair of degenerate oligonucleotides complementary to conserved regions of aac(6')-Ic, -Id, -If, -Ig, and -Ih enabled detection of these genes and also of aac(6')-Ij, recently recognized in Acinetobacter sp. strain 13.

Acinetobacter↗
PubMed1994

Characterization of transposon Tn1528, which confers amikacin resistance by synthesis of aminoglycoside 3'-O-phosphotransferase type VI.

Providencia stuartii BM2667, which was isolated from an abdominal abscess, was resistant to amikacin by synthesis of aminoglycoside 3'-O-phosphotransferase type VI. The corresponding gene, aph(3')-VIa, was carried by a 30-kb self-transferable plasmid of incompatibility group IncN. The resistance gene was cloned into pUC18, and the recombinant plasmid, pAT246, was transformed into Escherichia coli DH1 (recA) harboring pOX38Gm. The resulting clones were mixed with E. coli HB101 (recA), and transconjugants were used to transfer pAT246 by plasmid conduction to E. coli K802N (rec+). Analysis of plasmid DNAs from the transconjugants of K802N by agarose gel electrophoresis and Southern hybridization indicated the presence of a transposon, designated Tn1528, in various sites of pOX38Gm. This 5.2-kb composite element consisted of aph(3')-VIa flanked by two direct copies of IS15-delta and transposed at a frequency of 4 x 10(-5). It therefore appears that IS15-delta, an insertion sequence widely spread in gram-negative bacteria, is likely responsible for dissemination to members of the family Enterobacteriaceae of aph(3')-VIa, a gene previously confined to Acinetobacter spp.

Amikacin↗
PubMed1994

Characterization of the chromosomal aac(6')-Ij gene of Acinetobacter sp. 13 and the aac(6')-Ih plasmid gene of Acinetobacter baumannii.

The amikacin resistance genes aac(6')-Ih of Acinetobacter baumannii BM2686 and aac(6')-Ij of Acinetobacter sp. 13 BM2689 encoding aminoglycoside 6'-N-acetyltransferases were characterized. The 441-bp coding sequences predict proteins with calculated masses of 16,698 and 16,677 Da, respectively. Analysis of the deduced amino acid sequences indicated that the proteins belonged to a subfamily of 6'-aminoglycoside acetyltransferase type I enzymes from gram-negative bacteria. The aac(6')-Ih gene of BM2686 was located on a 13.7-kb nonconjugative plasmid. The aac(6')-Ij gene from BM2689 was not transferable either by conjugation to Escherichia coli or A. baumannii or by transformation to Acinetobacter calcoaceticus. Plasmid DNA from BM2689 did not hybridize with an intragenic aac(6')-Ij probe. These results suggest a chromosomal location for this gene. The aac(6')-Ij gene was detected by DNA hybridization in all 28 strains of Acinetobacter sp. 13 tested but not in other Acinetobacter strains, including A. baumannii, proteolytic genospecies 4, 6, 14, 15, 16, and 17, and ungrouped strains. The aac(6')-Ih and -Ij probes did not hybridize in dot blot assays with DNA from members of the families Enterobacteriaceae and Pseudomonadaceae that produced 6'-N-acetyltransferases. These data suggest that the genes are confined to the Acinetobacter genus and that the aac(6')-Ij gene is species specific and may be used to identify Acinetobacter sp. 13.

Acetyltransferases↗
PubMed1993

[Prosthetic duplication of the ascending aorta].

A simple implantation technique for multiple bypass of the ascending aorta with cervico-encephalic and infradiaphragmatic targets is reported. A conduit made by termino-terminal suture of two bifurcated grafts is anastomosed latero-laterally to the ascending aorta. The procedure is easy to perform and provides a suitable trajectory to the grafts.

Aged↗