📇 Rhumatologue · LES ABYMES · (971) · Salarié

M SAMUEL MARKOWICZ

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11 articles scientifiques publiés — formation continue solide
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104 rhumatos / 100 000 hab. — département bien doté

Rhumatologue

📍 LES ABYMES (971)SalariéRPPS 10102040218

Publications actives

21 publications sur 5 ans

📊 Reconnaissance scientifique : 7/100📝 30 articles publiés🇫🇷 Publications académiques françaises (8)

✨ Génération du profil synthétique IA en cours…

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Top publications · les plus citées

Cardiovascular risk evaluation of HIV-positive patients in a case-control study: comparison of the D:A:D and Framingham equations

Journal of the International AIDS Society · 2014

📚 9 citations🔓 Open Access📄 PDF gratuit ↗

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IntroductionPatients with HIV infection are at increased risk of developing cardiovascular disease (CVD) due to complex interactions between traditional CVD risk factors, antiretroviral therapy (ART) and HIV infection itself [1]. Prevention of CVD is essential as it remains the most common serious non‐AIDS event and contributes significantly to all‐cause mortality. A cardiovascular risk‐assessment model tailored to HIV population is thus essential.Materials and MethodsWe conducted a retrospective case‐control study within the HIV cohort of the Saint‐Pierre Hospital, Brussels. Cases (n=73) presented a first CVD (ischemic heart disease or stroke) between January 2002 and December 2012. Controls (n=142) were patients without any CVD and were matched for age, race, sex and follow‐up duration. We used Wilcoxon test to identify predictors of cardiovascular risk among the data collected. We compared Framingham [2] and DAD (Data Collection on Adverse Events of anti‐HIV drugs) [3] equations calculated in all patients at time of event, two, four and six years before. We then simulated the impact on the DAD scores if different therapeutic interventions had been introduced when patient cardiovascular risk at ten years exceeded 20%.ResultsComparison of cases and controls showed that C‐reactive protein (CRP) >3 mg/L (p=0.008) and HIV viral load >50 copies/ml (p=0.007) at time of event, as well as slower increase in CD4 cell count (p=0.035), were significantly more frequent in cases. DAD and Framingham median scores in cases and controls are shown in Figure 1 and Table 1. Smoking cessation lowered the DAD score of cases at time of event from 21.6% to 18.3%, modification of ART (discontinuation of indinavir, lopinavir and abacavir) lowered it from 21.6% to 17%, while both interventions with control of blood pressure and cholesterol lowered it from 21.6% to 12.4%.ConclusionsIncreased CRP levels, uncontrolled HIV viral load at time of event and slower immunologic response were found to be associated with increased CVD risk. DAD score in cases increased more and faster over time than the Framingham score and seems therefore to be more accurate in identifying HIV‐positive patients at high risk of CVD. Different therapeutic interventions could have led to a significant reduction of the DAD score in these patients and should remain a priority in patient management.

Infectious Mononucleosis Resulting in Acute Necrotizing Mediastinitis: A Case Report and Literature Review

European journal of case reports in internal medicine · 2020

📚 5 citations🔓 Open Access

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The serological prevalence of Epstein-Barr virus (EBV) among young adults exceeds 90% worldwide. Even though EBV primary infection is usually benign, severe complications can occur in adolescents and young adults and so the disease must be promptly diagnosed. The development of an oropharyngeal abscess leading to a descending necrotizing mediastinitis (DNM) is exceptional and potentially lethal, so early diagnosis with a CT scan, appropriate antibiotics and surgery are essential. The authors present a case where DNM was associated with reactive hemophagocytic syndrome as a result of infectious mononucleosis, as well as a review of similar cases in the English literature.

Initial empirical antibiotic therapy in kidney transplant recipients with pyelonephritis: A global survey of current practice and opinions across 19 countries on six continents

Transplant infectious disease : an official journal of the Transplantation Society · 2024

📚 4 citations🎯 RCR 1.31🔓 Open Access📄 PDF gratuit ↗

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AbstractBackgroundDespite the burden of pyelonephritis after kidney transplantation, there is no consensus on initial empirical antibiotic management.MethodsWe surveyed clinicians throughout the world on their practice and opinions about the initial empirical therapy of post‐transplant pyelonephritis, using clinical vignettes. A panel of experts from 19 countries on six continents designed this survey, and invited 2145 clinicians to participate.ResultsA total of 721 clinicians completed the survey (response rate: 34%). In the hypothetical case of a kidney transplant recipient admitted with pyelonephritis but not requiring intensive care, most respondents reported initiating either a 3rd‐generation cephalosporin (37%) or piperacillin‐tazobactam (21%) monotherapy. Several patient‐level factors dictated the selection of broader‐spectrum antibiotics, including having a recent urine culture showing growth of a resistant organism (85% for extended‐spectrum ß‐lactamase‐producing organisms, 90% for carbapenemase‐producing organisms, and 94% for Pseudomonas aeruginosa). Respondents attributed high importance to the appropriateness of empirical therapy, which 87% judged important to prevent mortality. Significant practice and opinion variations were observed between and within countries.ConclusionHigh‐quality studies are needed to guide the empirical management of post‐transplant pyelonephritis. In particular, whether prior urine culture results should systematically be reviewed and considered remains to be determined. Studies are also needed to clarify the relationship between the appropriateness of initial empirical therapy and outcomes of post‐transplant pyelonephritis. image

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M SAMUEL MARKOWICZ

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Activité de recherche & publications

Publications académiques en France

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Top publications · les plus citées

Publications scientifiques (11) — classées par pathologie

Transversal6

Case report / série2

Revue générale2

Épidémiologie & registres1

Risque cardio-vasculaire1

Vraie vie / RWE1

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