Pathologie-biologie
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Nine cases of rheumatic fever were seen from 1982 to 1996. The diagnosis was based on Jones criteria. Four of eight children had carditis characterized by mitral regurgitation with or without aortic regurgitation and/or atrioventricular conduction disturbances. ⋯ In France, the standard of care is to prescribe antimicrobial therapy to all patients with pharyngitis or tonsillitis without performing tests to identify the causative agent. The introduction of tests for the rapid recognition in routine clinical practice of BHAS, which account for only 20 to 30% of all cases of pharyngitis and tonsillitis, should allow a more rational approach to the treatment of these infections. Reserving antimicrobial therapy to those patients with BHAS should not result in an increase in the incidence or rheumatic fever.
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Pathologie-biologie · Dec 1998
Review[Tumor antigens recognized by T-lymphocytes in human cancers. New advances and therapeutic perspectives].
The melanoma antigen coded by the MAGE-1 gene was the first tumor antigen described in human cancer. Genetic, biochemical, and "candidate peptide" strategies have been used to identify antigenic peptides presented to T-cells by class I major histocompatibility complex antigens. Antigens have now been characterized in a wide variety of tumor types. ⋯ Among the tumor antigens produced as a result of intratumoral mutations, some are of special interest because of their potentially oncogenic effects. These new data can be expected to lead to the development of novel anticancer treatments based on specific immunotherapy. Pilot clinical studies are ongoing.
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Pathologie-biologie · Dec 1998
[Specific features of nosocomial infections in the elderly at a general hospital center. 5 surveys of annual prevalence].
Specific features of nosocomial infections in patients aged 70 years or older admitted to a short-term care medical department in a 400-bed general hospital were studied to assist in designing nosocomial infection control programs for this population. Data from five annual prevalence surveys were evaluated retrospectively. The 517 patients aged 70 years or older were compared to the 1093 patients younger than 70 years. ⋯ These results indicate that urinary tract infection should be the main target of programs aimed at minimizing nosocomial infection in elderly patients admitted to short-term care facilities. Faultless technique is essential during urinary catheter insertion. High-quality nursing care contributes substantially to the prevention of urinary tract infection in noncatheterized patients with urinary incontinence or neurologic disorders.
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Pathologie-biologie · Dec 1998
[Epidemiology of sinusitis seen in hospitalized patients. Apropos of 77 episodes of sinusitis among 72 patients between 1993 and 1996].
The 77 cases of sinusitis seen in 72 patients admitted to the Briançon Hospital between January 1, 1993, and June 30, 1996, were studied. One or both maxillary sinuses were involved in 96.8% of cases. Sinus aspiration was done in 95 cases. ⋯ Nosocomial cases in the intensive care unit were associated with well-known risk factors, namely tracheal intubation with ventilation and presence of a nasogastric tube. Other study criteria included the type of organism recovered by culture and whether patients ventilated via a tracheal tube had the same organism in their sinus and tracheal tube aspirates. Some nonintensive care patients had none of the known risk factors for sinusitis; prompt diagnosis and treatment of these cases of sinusitis is important to avoid infectious complications, which are, however, less common than in intensive care patients.
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Infections associated with central catheters are a significant source of morbidity in cancer patients. The first evaluation done as part of a continuous catheter surveillance program included the 913 central catheters inserted in 1995. Three of these catheters are still in place. ⋯ Catheter-related infection was defined as an infection at the catheter site or as septicemia retrospectively shown to be related to the catheter. The risk of catheter-related infection was expressed as the number of cases per 1000 days of catheterization. Reasons for catheter removal were distributed in table I.