Richard Morisset

Clindamycin with primaquine for pneumocystis carinii pneumonia

Combined therapy with clindamycin and primaquine was used in twenty-eight episodes of Pneumocystis carinii pneumonia in 25 patients, of whom 17 had been unresponsive or intolerant to conventional treatment and 8 were being treated for the first time. The treatment was effective in all but two episodes, the main adverse reaction being a generalised maculopapular rash.

Sexual dysfunction among HIV-positive gay males

Abstract This study examines the psychosexual characteristics of 88 HIV-positive gay males ranging in age from 23 to 62 (M = 35.1). Subjects were recruited through hospitals, private clinics and social networking. An anonymous self-report measure of psychosexual tendencies and sexual dysfunction was used with the following result: 50 (56.8%) were classified as sexually dysfunctional, of whom 25 (28.4%) subjectively felt they had a problem. Statistical analysis revealed that the sexually dysfunctional males experience more fear of sexual relations, more sexual depression, and that they are less sexually assertive, have a lower degree of positive esteem about their sexuality compared to the non-dysfunctional and the non-problematic homosexual males. Fear of sexuality was identified as the principal predictor of sexual dysfunction. Clinical implications are discussed.

Prevalence of and risk factors for sexually-transmitted infections in hidden female sex workers.

OBJECTIVES We wanted to determine the age-specific prevalence of selected sexually transmitted infections while assessing the risk factors among hidden female sex workers (HFSW). METHODS One hundred HFSW over 15 years of age were recruited in an impoverished area of Antananarivo, Madagascar. After oral informed consent, blood and endocervical swabs were tested for specific antigens, antibodies, and pathogens using molecular, serologic, and microscopic examinations. A risk factor analysis was conducted with odds ratios and 95% confidence intervals. RESULTS Thirty-two percent, 27, 12, and 7% of HFSW were infected respectively with Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis. Specific antibodies against, syphilis were detected in 11%. None were HIV-positive. The main factors associated with STI were: young age, being married, lower education level, early age for first intercourse, and a history of genital infection.

No detectable XMRV in subjects with chronic fatigue syndrome from Quebec

We investigated the presence of XMRV in a cohort of Quebec patients with chronic fatigue syndrome (CFS). DNA was purified from activated peripheral blood mononuclear cells (PBMCs) and PCR was used to detect XMRV gag and env in 72 patients. Anti-XMRV antibodies were searched in sera of 62 patients by Western blot analysis. Attempts to detect XMRV antigens was made, using immunofluorescence with Gag anti-p30 antiserum on activated PBMC from 50 patients. Plasma viremia was measured by RT-PCR on 9 subjects. Finally, detection of infectious virus in 113 CFS subjects was made by co-culture of PHA+IL-2 activated PBMC with human LNCaP carcinoma cells, and by infecting the same susceptible cells with plasma, using a reverse transcriptase (RT) assay as a readout in both experiments. No detection of XMRV footprints nor infectious virus was detected with any of the approaches, in any of the tested individuals.

Virus load correlates inversely with the expression of cytotoxic T lymphocyte activation markers in HIV‐1‐infected/AIDS patients showing MHC‐unrestricted CTL‐mediated lysis

Cytotoxic T lymphocytes (CTL) are key players to suppress viral load (VL) but CTL responses become compromised with progression of HIV‐infection/AIDS. Some progressors develop MHC‐unrestricted CTL with anti‐CD4+ cytocidal activity. Immune activation status of these CTL and its significance in disease progression are unknown. To determine the relationship between VL and T cell activation, a cross‐sectional study was carried out using blood samples from 13 HIV‐1‐infected/AIDS patients at various stages of progression and seven age‐matched seronegative controls. We examined expression of HLA‐DR and CD38 activation markers on purified CTL. MHC‐unrestricted killing by these CTL was also evaluated against uninfected, allogeneic CD4+ T cells as well as several human cell lines. The expression of activation markers correlated inversely (rs = − 0·91, P < 0·0001) with VL of the subjects. CTL effectors of these patients killed targets expressing or lacking CD4+, independently of MHC class I recognition. Interestingly, the patients with higher VL showed an increased number of γδTCR‐bearing CTL in blood and their MHC‐unrestricted killing activity was blocked significantly (P < 0·01) by γδTCR‐specific monoclonal antibody. CD3+ T counts of these patients were also consistently subnormal. Inverse correlation between VL and CD8+ T cell activation markers seems to be an indicator of CTL‐associated immunopathogenesis in HIV patients with elevated γδCTL in the peripheral blood.

In vitro antagonism between N-formimidoyl thienamycin and aztreonam, ticarcillin and ticarcillin/clavulanic acid.

One-hundred eighty-seven bacterial strains were tested by the two-disk-agar diffusion method for the interaction between N-formimidoyl thienamycin and aztreonam, ticarcillin and ticarcillin-clavulanic acid. An antagonism between N-formimidoyl thienamycin and the other 3 beta-lactams was noted in half of the evaluable tests, especially against Pseudomonas, Escherichia coli and Morganella.

Effect of aminoglycosides on the disposition of thyroid hormones and thyroglobulin

Our study was designed to confirm the potential effects of three aminoglycosides on the disposition of thyroid hormones. Twenty‐seven patients diagnosed with either cellulitis (n = 19), chronic osteitis (n = 4), or an abscess (n = 4) were selected. Thirteen patients received tobramycin, 60 to 100 mg iv q. 8 h., plus cloxacillin, 1 gm iv q. 4 h.; seven patients received netilmicin, 40 to 120 mg iv q. 8 h., plus cloxacillin, 1 gm iv q. 4 h.; and seven patients received either cloxacillin, 1.5 gm iv q. 4 h., or cefoperazone, 2 to 4 gm iv q. 12 h. for at least 7 days. Another group of six normal subjects received neomycin, 0.5 gm po q. 6 h. for 7 days. All these subjects had normal thyroid function before antibiotic dosing and none had thyroid function abnormalities. Tobramycin and cloxacillin/cefoperazone did not influence thyroid function. Netilmicin decreased the total serum concentrations of triiodothyronine (T3) from 114 ± 9 to 75 ± 7 ng/dl (P < 0.01), probably because of increased clearance, as the T3 free fraction increased from 0.43% ± 0.02% to 0.49% ± 0.02% (P < 0.05). Thyroxine (T4) and reverse T3 (rT3) levels were not affected. Neomycin decreased T3 levels from 104 ± 8 to 92 ± 7 ng/dl (P < 0.05) and the serum concentrations of thyroglobulin from 17.3 ± 2.0 to 11.7 ± 2.0 ng/ml (P < 0.001). Because T4 and rT3 levels did not change, our results suggest that neomycin may have directly affected the gland. We conclude that some aminoglycosides can alter the disposition of thyroid hormones.

Aztreonam: correlation between disk diffusion and agar plate dilutions susceptibility tests.

Regression lines and error rate-bounded analyses were performed for correlating inhibitory zone diameters with the 30-micrograms aztreonam disk and aztreonam minimal inhibitory concentration for gram-negative aerobic clinical isolates. A correlation coefficient of -0.81 was found for the regression line. Preliminary proposed criteria to distinguish susceptible isolates from resistant ones are: susceptible greater than or equal to 22 mm (MIC less than or equal to 8 micrograms/ml), intermediate 16-21 mm (MIC = 16 micrograms/ml) and resistant less than or equal to 15 mm (MIC greater than or equal to 32 micrograms/ml). Using these criteria, the rates for false-susceptible and false-resistant isolates were zero.