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Antoine de Torrenté

Publications and source records attributed to Antoine de Torrenté.

4 recordsLinked to original sources

Candida glabrata spinal osteomyelitis involving two contiguous lumbar vertebrae: a case report and review of the literature.

Due to the increase of the immunocompromised population, mucosal and systemic infections caused by Candida glabrata, formerly known as Torulopsis glabrata, have shown a recent significant increase. We present a case of C. glabrata vertebral osteomyelitis which required repeated surgical therapy, a complete L2 and L3 corporectomy and more than one year of hospitalisation to complete healing. We compare this case to eight previously reported cases outlining the features of C. glabrata spinal osteomyelitis, including symptoms, diagnosis, treatment, evolution and outcome. According to the case presented and in review of the literature, we believe that in the absence of abscess and neurologic symptoms, medical treatment should be initiated with close clinical, laboratory and radiologic follow-up. An unfavorable evolution of these parameters should be an indication for aggressive and, if necessary, repeated surgical intervention in association with an antifungal treatment.

Amphotericin B↗

Quality of life of Do-Not-Resuscitate (DNR) patients: how good are physicians in assessing DNR patients' quality of life?

QUESTIONS UNDER STUDY: To assess 1) the impact of quality of life evaluation on the implementation of Do-Not-Resuscitate (DNR) orders by physicians, 2) the accuracy of physicians' estimation of DNR patients' quality of life. METHODS: A 10-month prospective clinical study in a community hospital including 255 DNR patients and 9 physicians in postgraduate training. Outcomes of interest were the influence of quality of life on the DNR decision and the assessment from patients and physicians of five different components related directly or indirectly to quality of life: mental (the Mini Mental State Examination), physical (the Activities of Daily Living) and social (Framingham Disability), degree of pain (visual analogical scale of pain) and of depression (Geriatric Depression Scale). RESULTS: Quality of life intervened in more than 70% of the DNR decisions. However, physicians underestimated quality of life components of DNR patients (Kappa <0.4 for each functionality). Severe depression, social isolation and physical dependence influenced negatively patients' perception of their quality of life (p <0.01). CONCLUSION: Physicians often (71%) rely on the assumed quality of life of their patients in their DNR decision but unfortunately tend to underestimate it. Greater involvement of patients in the DNR decision could improve quality of care.

Decision Making↗