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1.
Int J Tuberc Lung Dis ; 3(1): 68-73, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10094172

RESUMO

SETTING: Department of Seine-Saint-Denis, France. OBJECTIVE: To compare the presentation and outcome of Mycobacterium kansasii infections according to human immunodeficiency virus (HIV) status. DESIGN: Retrospective analysis of all the medical charts of adults meeting the diagnostic criteria of the American Thoracic Society for M. kansasii infection between 1991 and 1995. RESULTS: Between 1991 and 1995, 35 cases (23 HIV-[6%] and 12 HIV+ [34%]) were found, giving an annual incidence of 0.5/100000. The following particularities were common to both groups: 1) frequency and prominence of respiratory and general symptoms, 2) rarity of clinically apparent extra-thoracic involvement, 3) bacteriological confirmation mostly obtained with respiratory tract specimens, 4) favourable bacteriological outcome, and 5) low mortality attributable to the mycobacterial infection. The most striking differences concerned chest radiography: HIV- patients had apical cavitated and nodular lesions, while HIV+ patients exhibited a variety of other patterns, including alveolar infiltrates, miliary lesions and/or thoracic lymphadenopathy. CONCLUSION: Apart from pulmonary radiographic differences, presentation and short-term outcome of M. kansasii infections were similar in HIV+ and HIV-patients.


Assuntos
Infecções por HIV/complicações , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium kansasii , Adulto , Idoso , Feminino , França , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/diagnóstico por imagem , Radiografia , Estudos Retrospectivos
2.
Eur J Surg ; 165(12): 1175-81, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10636553

RESUMO

OBJECTIVE: To develop a new graft and to verify its technical feasibility, viability, and ability to reduce the risk of infection by interposition of an aortic segment between the airway and the prosthetic component of the graft. DESIGN: Experimental study. SETTING: Multicentre study, France. ANIMALS: 38 New Zealand rabbits. INTRODUCTION: A 1 cm aortic segment was obtained from the thoracic aorta of a rabbit and cryopreserved or stored at +4 degrees C. The aortic segment, surrounded by a ringed expanded polytetrafluoroethylene (ePTFE) prosthesis was used to replace 1 cm of cervical trachea in two groups of rabbits, either with cryopreserved or fresh aorta. MAIN OUTCOME MEASURES: Macroscopic, microbiological, and histological studies four months later. RESULTS: 12/20 animals in the cryopreserved group survived and 13/18 in those had had fresh aorta inserted. Partial or total necrosis of the aortic muscular layer was replaced by connective tissue, which was a guide for epithelialisation from the anastomoses. CONCLUSION: This new graft is worthy of further investigation, as it is technically feasible and easy to insert.


Assuntos
Aorta Torácica/transplante , Prótese Vascular , Traqueia/cirurgia , Animais , Aorta Torácica/patologia , Criopreservação , Rejeição de Enxerto/patologia , Necrose , Politetrafluoretileno , Complicações Pós-Operatórias , Coelhos , Traqueia/patologia , Transplante Heterotópico/efeitos adversos
3.
Ann Med Interne (Paris) ; 150(7): 582-4, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10637675

RESUMO

Nocardia farcinica is an increasingly common cause of human infection in Europe. We observed an isolated nodular subcutaneous abscess due to N. farcinica in the forearm of a young patient with overlap syndrome between systemic sclerosis and polymyositis. Despite in vitro resistance to trimethoprim-sulfamethoxazole, this oral combination completely resolved the lesion within 3 weeks and was maintained for 6 months. The spectrum of cutaneous nocardiosis in the immunocompromised host is discussed.


Assuntos
Abscesso/complicações , Nocardiose/complicações , Polimiosite/complicações , Escleroderma Sistêmico/complicações , Dermatopatias Bacterianas/complicações , Adulto , Feminino , Humanos , Síndrome
6.
Antimicrob Agents Chemother ; 40(4): 1027-9, 1996 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8849221

RESUMO

Crude extracts from 115 extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolates were analyzed biochemically. The TEM-3 type was encountered 108 times, SHV types were encountered 7 times, and the TEM-26 type was encountered only once. For the last one, the gene was identified; an adenine was detected at position 925, as in blaTEM-26B not in blaTEM-26.


Assuntos
Klebsiella pneumoniae/metabolismo , beta-Lactamases/metabolismo , beta-Lactamas/metabolismo , França , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/genética , Resistência beta-Lactâmica , beta-Lactamases/genética , beta-Lactamas/farmacologia
7.
Kidney Int ; 35(2): 696-703, 1989 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2651759

RESUMO

Fifty-five cases of primary (that is, without urinary tract abnormalities), acute pyelonephritis (PN) were studied by computed tomodensitometry (CT). There were 48 women and 7 men. All were febrile and 16 had positive blood cultures. In 7 cases, (4 diabetics and 3 malnourished alcoholics) PN was painless, diagnosis was delayed and lesions were severe. Two diabetics underwent emergency nephrectomy for sepsis. Conventional radiological techniques (IVP and ultrasonography) were poorly informative. In contrast, initial CT abnormalities were visible in 44 patients. They consisted of triangular or round hypodense images, diffuse hypodensity in a grossly swollen kidney, and/or abscesses. Hypodense images were presumably due to acute focal ischemia. Renal histology was available in five patients. It showed acute interstitial nephritis with leukocyte infiltrates, edema and hemorrhagic streaks. Pyelonephritis was due to E. coli in 48 cases (87.5%). In 27 cases E. coli isolates were studied by genotypic assays which detect the three most frequent (pap, afa and sfa) of the four operons known to encode adhesin. In all cases, at least one of these genotypic markers of uropathogenicity was found. In 27 cases, repeat CT was done shortly after treatment. It showed healing in only 12. Early cortical scar formation was visible in 2. Final evaluation in 27 cases with adequate follow-up showed that (in addition to the 2 patients who had been nephrectomized), in only 17 of 27 (63%) had the kidneys recovered a normal appearance. In two cases one kidney had undergone atrophy; renal biopsy showed subacute-chronic interstitial nephritis.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Infecções por Escherichia coli/patologia , Córtex Renal/patologia , Pielonefrite/patologia , Doença Aguda , Adulto , Idoso , Atrofia , Infecções por Escherichia coli/diagnóstico por imagem , Feminino , Humanos , Rim/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pielonefrite/diagnóstico por imagem , Fatores de Risco , Tomografia Computadorizada por Raios X
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