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Biomedical subjects

T Lambert

Publications and source records attributed to T Lambert.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Acquired immunodeficiency syndrome and related syndromes in hemophiliacs: status throughout the world].

The occurrence during the last 2 years of 29 cases of AIDS in hemophiliacs (21 in USA and 8 in Europe) suggests possible transmission of this disease by blood products. All these patients had received Factor VIII or IX concentrates and developed pneumocystis carinii pneumonia or other opportunistic infections. Kaposi's sarcoma was not observed in any patient. Recent studies have focused on the frequency of AIDS-related complex in hemophiliacs, which may arise as a crucial problem. However this does not justify at the moment any reduction in the substitutive treatment of hemophiliac patients unless new clues to the understanding of these disorders are provided. Therefore, it is mostly important to clearly define, through research programs and precise follow-up of patients, blood products which can be used safely in hemophiliacs.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Incidence of immune responses following 102 infusions of autoplex in 18 hemophilic patients with antibody to factor VIII.

An activated prothrombin complex concentrate (Autoplex) was infused for the treatment of 102 bleeding episodes in 18 hemophilia A patients with antibody to factor VIII who were previously known as high responders. Among 95 bleeding episodes treated with a single infusion of the concentrate [43-107 factor VIII correcting units (FECU)/kg], only 1 anamnestic response was observed. On the contrary, a significant rise in antibody titer occurred following 2 of 4 double (at 8-12 hr interval) and all 3 multiple (over 3-10 days) infusions of Autoplex. The occurrence of immune responses may be explained by the presence of factor VIII coagulant antigen (VIII:CAg) in the 26 batches of Autoplex tested by two-site immunoradiometric assay (10-36 U/vial). The anamnestic response was not correlated to the batch used nor to the amount (0.6-7.8 U/kg/day) of VIII:CAg infused per day. However, exposure to the concentrate over several days appeared to be the major predisposing factor for an immune response.

Adolescent↗
PubMed1983

Measurement of progabide and its deaminated metabolite in plasma by high-performance liquid chromatography and electrochemical detection.

Progabide (4- [[(4-chlorophenyl-5-fluoro-2-hydroxyphenol)-methylene] amino] butanamide) and its deaminated metabolite were measured simultaneously in plasma by high-performance liquid chromatography. Both compounds were extracted from plasma and the molecules were stabilized at the methylene--amino double bond with sodium borohydride reduction. Oxidative electrochemical detection was used for final quantitation. The method was used to measure progabide and progabide acid in plasma from a healthy volunteer who received a single 1200-mg dose of progabide orally. Lower limits of detection for progabide and progabide acid were 30 and 15 ng/ml, respectively. Coefficient of variation was less than 5% for both compounds.

Chromatography, High Pressure Liquid↗
PubMed1982

False reactions in radioimmunoassay for viral hepatitis B markers in patients suffering from coagulation disorders.

Simultaneous occurrence of hepatitis B surface antigen (HBsAg) and antibodies to HBsAg (anti-HBs) has been frequently described in hemophiliac patients. During our working procedures, this phenomenon was also observed. Interference of coagulation disorders with radioimmunoassay (RIA) used in the detection of viral hepatitis B markers was studied. It was shown that, in vivo or in vitro, correction of coagulation disorders led to the disappearance of false positive reactions and, thus, simultaneous presence of HBsAg and anti-HBs never occurred. Confirmatory tests which are usually recommended to control RIA were reviewed and it found that only a completed coagulation of serum by thrombin addition, before performing the test, gave specific results.

Antibodies, Viral↗
PubMed1982

[Hemophilus influenzae osteomyelitis and joint infection (author's transl)].

Diagnostic and therapeutic problems of Hemophilus influenzae arthritis can be solved by epidemiology, pharmacokinetics and counter immunoelectrophoresis. Counter immunoelectrophoretic study of the joint fluid is especially helpful when culture of the joint fluid fails to yield the organism. Identifying the rare cases with beta-lactamase-producing organisms is an essential step in the selection of the best antibiotic treatment.

Ampicillin↗
PubMedDate not supplied

Risperidone versus haloperidol: I. Meta-analysis of efficacy and safety.

Haloperidol is widely considered a reference standard in antipsychotic therapy and is commonly used in comparative studies of the efficacy and safety of antipsychotic medication. Comparative clinical trials have shown that the novel antipsychotic agent risperidone tends to have greater efficacy (i.e., clinical response defined as a > or = 20% reduction in total scores on the Positive and Negative Syndrome Scale) than haloperidol in patients with chronic schizophrenia and poses less risk of extrapyramidal symptoms (EPS). We used DerSimonian and Laird's random-effects model to analyze pooled patient data from available randomized, double-masked, comparative trials of risperidone and haloperidol in patients with schizophrenia treated for at least 4 weeks at recommended doses. The purpose of the analysis was to determine whether there are significant overall differences in the rates of patient clinical response, prescription of anticholinergic agents, and treatment dropout. Six of the nine trials revealed in a literature search met all criteria for inclusion in the meta-analysis. The meta-analysis showed that in patients with chronic schizophrenia, risperidone therapy is associated with significantly higher response rates, significantly less prescribing of anticholinergic medication, and significantly lower treatment dropout rates than haloperidol. These results demonstrate the greater treatment efficacy associated with risperidone compared with haloperidol and suggest both a lower incidence of EPS and improved treatment compliance.

Antipsychotic Agents↗
PubMedDate not supplied

Risperidone versus haloperidol: II. Cost-effectiveness.

Australia and Canada are currently the only Western nations with government guidelines for analyzing the cost-effectiveness of drugs. We used guidelines issued by the Australian Pharmaceutical Benefits Advisory Committee to construct a model for comparing the cost-effectiveness of risperidone and haloperidol over a 2-year period in patients with chronic schizophrenia. Use of clozapine was also included in the analysis as an alternative treatment given to patients who proved unresponsive to therapy with haloperidol or risperidone. Results are expressed in Australian dollars. Cost-effectiveness was determined by using decision-analytic modeling to compare clinical outcomes and costs. The analytic model contained a decision tree for each of the compared agents that tracked the distribution of patients between treatment outcome pathways (i.e., scenarios). Distributions were based on probabilities derived from our meta-analysis results reported elsewhere and from other sources. Each scenario had an associated monetary cost that included all significant direct costs (i.e., hospital costs; outpatient costs; and the cost of drugs, the services of health care professionals, and government-subsidized hostel accommodation). The cost for a given outcome was the sum of costs for all scenarios leading to that outcome. Cost-effectiveness was expressed as the total cost per favorable outcome. The definition of a favorable outcome was one in which the patient was in a response phase at the end of the 2-year period. The probability of a patient experiencing a favorable outcome at the end of 2 years was 78.9% for risperidone versus 58.9% for haloperidol. The total cost of treatment for 2 years was $15,549.00 for risperidone versus $18,332.00 for haloperidol. The expected cost per favorable outcome was $19,709.00 for risperidone and $31,104.00 for haloperidol. Risperidone was more cost-effective than haloperidol and therefore was "dominant" in pharmacoeconomic terms because it produced a higher proportion of favorable outcomes at lower cost. Sensitivity analysis showed that the difference in clinical response rate was a key determinant of cost-effectiveness.

Antipsychotic Agents↗
PubMedDate not supplied

Structural relationship between the genes encoding 3'-aminoglycoside phosphotransferases in Campylobacter and in gram-positive cocci.

Campylobacter coli strain BM2509 resistant to ampicillin, chloramphenicol, erythromycin, kanamycin, spectinomycin, streptomycin and tetracycline was isolated from a patient with hospital-acquired diarrhoea. Resistance to kanamycin has not been thus far described in Campylobacter. Phosphocellulose paper-binding assay indicated that resistance to kanamycin and structurally related antibiotics in strain BM2509 was due to synthesis of a 3'-aminoglycoside phosphotransferase of type III (APH(3')-III), an enzyme so far confined to Gram-positive cocci. The kanamycin and tetracycline resistances were transferable en bloc by conjugation to C. fetus but not to Escherichia coli. Analysis by agarose gel electrophoresis of crude bacterial lysates revealed the presence, in BM2509 and in the transconjugants, of a plasmid, pIP1433, with a size of 47.2 kilobases (Kb). Strain BM2509 also harboured a 4.5-Kb cryptic plasmid. DNA annealing studies indicated a close structural relationship between the kanamycin resistance gene of C. coli BM2509 and that representative of this type of resistance determinant in Gram-positive cocci. These results indicate that emergence of resistance to kanamycin in Campylobacter is due to acquisition in vivo of a gene or a plasmid from Gram-positive bacteria.

Aminoglycosides↗
PubMedDate not supplied

[The role of integrons in dissemination of antibiotic resistance].

Bacteria can transfer genetic information to get protection against most antibiotics. The acquisition of resistance genes involves genetic mobile elements such as plasmids and transposons. Another genetic structures, named integrons, have been described and contain one or more gene cassettes located at a specific site. Integrons contain an intI gene encoding a site-specific recombinase belonging to the integrase family and a recombination site attI. A gene cassette includes an open reading frame and, at the 3'-end, a recombination site attC. Integration or excision of cassettes occurs by a site-specific recombination mechanism catalyzed by the integrase. However, insertion can rarely occur, at non-specific sites leading to a stable situation for the cassette. Cassettes are transcribed from a common promoter located in the 5'-conserved segment and expression of distal genes is reduced by the presence of upstream cassettes. Most gene cassettes encode antibiotic resistant determinants but antiseptic resistant genes have also been described. Integrons seem to have a major role in the spread of multidrug resistance in Gram-negative bacteria but integrons in Gram-positive bacteria have been recently described. Moreover, the finding of super-integrons with gene cassettes coding for other determinants (biochemical functions, virulence factors) in different Gram negative bacteria suggests that integrons are probably implied in bacterial genome evolution.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Beating-heart myocardial revascularization without extracorporeal circulation. Indications, technique and 1st results of a series of 98 cases].

The authors present a series of 98 aorta-coronary bypass procedures without the help of Extracorporeal Circulation. Indications and technique are detailed. There was no hospital mortality and short-term results are satisfactory. This technique, feasible in about 10% of all cases, should be considered especially in old patients, in case of chronic renal insufficiency and in redo surgery.

Adult↗
PubMedDate not supplied

Khat chewing as a cause of psychosis.

It is well established that psychosis may arise in the context of abuse of certain illicit drugs (e.g. amphetamine). This article reviews the effects of chewing the plant khat and outlines the pharmacological aspects, the dependence issue and a comparative study between previously reported cases and four cases reported here to highlight the epidemiology, clinical features and prognosis of khat-induced psychosis.

Adult↗