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Biomedical subjects

E Guerot

Publications and source records attributed to E Guerot.

7 recordsLinked to original sources

Carbamazepine-associated severe left ventricular dysfunction.

INTRODUCTION: The cardiovascular effects of carbamazepine are well-known but left ventricular dysfunction is rarely reported. CASE REPORT: We describe 2 cases of severe carbamazepine-associated left ventricular dysfunction during massive self intoxications in young patients without preexistent cardiac disease. We compare our cases to the available literature and discuss the mechanisms implied in the development of left ventricular dysfunction following carbamazepine overdose. Bedside echocardiography was useful in both diagnosis and treatment.

Adult↗

Acute benzodiazepine withdrawal delirium after a short course of flunitrazepam in an intensive care patient.

Acute benzodiazepine and opioid withdrawal syndromes are increasingly described in intensive care unit patients. There is often some difficulty in distinguishing between the respective responsibilities of the sedative and analgesic agents. We report a case of acute benzodiazepine withdrawal delirium after a short course of flunitrazepam in an intensive care patient. Flunitrazepam was administered because of institution of mechanical ventilation. Recent data on the incidence and risk factors of the syndrome in intensive care unit patients are presented. Criteria for diagnosis and therapeutic guidelines are discussed.

Acute Disease↗

[Use of the helium-oxygen mixture in pneumology practice].

Therapeutic use of the helium-oxygen mixture (heliox) was first reported in 1934. Medical use was further restricted to physiological studies. Density and viscosity of Heliox are very different from those of air or oxygen. This can explain how Heliox can induce modifications in the airway flow. In diseases of the main or small airways (upper airway obstruction, chronic obstructive pulmonary disease, asthma), such modifications could induce a diminution in the resistive component of the work of breathing and therefore protect against the risk of developing a respiratory failure. This explains a renewed interest of clinicians for Heliox since the beginning of the eighties. To date, the good tolerance of heliox seems to be well established. Inversely, scientific validation of the therapeutic indications of the mixture in airway diseases are lacking. Moreover, potential therapeutic indications of the mixture are not restricted to airway diseases. Various applications, such as adult respiratory distress syndrome, pneumothorax, fiberoptic bronchoscopy, and mechanical ventilation, are suggested by preliminary reports. Obtaining a synthetic vision of older and more recent studies is the purpose of this review.

Adult↗

Toxoplasma pericarditis in acquired immunodeficiency syndrome.

Large pericardial effusions are now a well-known complication of the acquired immunodeficiency syndrome, mainly caused by mycobacterial disease. However, other etiologies can be found. We report a case of toxoplasma pericarditis without other parasitic localizations. Pericarditis is a very uncommon clinical feature during toxoplasmosis. Its diagnosis is often difficult to establish, particularly in immunocompromised patients. Nevertheless, its possible evolution to constriction or tamponade requires its consideration. New methods of rapid tissue cultures may be helpful and allow early specific treatment.

AIDS-Related Opportunistic Infections↗

Investigation of hospital-acquired infections due to Alcaligenes denitrificans subsp. xylosoxydans by DNA restriction fragment length polymorphism.

We demonstrate that DNA restriction fragment length polymorphism determined by pulsed-field gel electrophoresis is very useful in the investigation of the epidemiology of hospital-acquired infections caused by Alcaligenes denitrificans subsp. xylosoxydans. This approach showed that hospital-acquired infections caused by this opportunistic pathogen over a 6-month period in 10 patients hospitalized in an intensive care unit and a surgical unit were not a true outbreak. In addition, this molecular typing method established that the respiratory therapy equipment was the source of the contamination of two patients.

Adult↗

[Long-term course of conduction disorders in 97 patients with an HV interval superior or equal to 70 milliseconds].

The natural history of disorders of conduction is imperfectly known. The presence of an HV interval of 70 milliseconds or more, which is regarded as pathological, usually results in pacemaker implantation. In this study the course of symptoms and disorders of conduction was investigated in 97 patients with an HV interval of 70 ms or more, and therefore equipped with a pacemaker, followed up for a mean period of 26.5 +/- 19.5 months. Among these 97 patients, 65 had presented with one or several syncopes, 14 had experienced feelings of faintness and 18 were asymptomatic. Among patients with symptoms, these totally disappeared in 63 and became milder in the remaining 12 patients. Complete and permanent AV block was observed in 11 patients. The actuarial incidence of complete permanent AV block was about 5 p. 100 per annum until 4 years. The only predictive parameter for such a course was the occurrence of a second degree type 2 or a third degree paroxysmal block prior to pacemaker implantation (significantly associated with the absence of symptoms).

Adult↗