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Biomedical subjects

F Biron

Publications and source records attributed to F Biron.

50 records · Page 3Linked to original sources
PubMed1991

Severe falciparum malaria (21 cases).

The incidence of severe falciparum malaria is increasing in the developed countries and mortality remains high despite progress in intensive care management and schizonticide treatment. Many authors emphasize the importance of exchange transfusion (EXT) in the most severe cases. We studied 21 cases (34 +/- 12 years, 6 females; SAPS: 8.4 +/- 3.7) of severe malaria (according to WHO criteria) consecutively admitted to ICU between 1985 and 1990: 3 patients underwent EXT. Twenty were febrile above 39 degrees C, 10 had cerebral malaria, 14 hepatic impairment, 8 acute renal failure, 5 pulmonary oedema. Nine patients required mechanical ventilation, 1 haemodialysis, 1 intracranial pressure monitoring. Mean parasitemia was 13%, 16 patients had thrombocytopenia less than 50 x 10(9)/l, 3 anemia less than 7 g/dl and 3 leucopenia less than 2.8 x 10(9)/l. Nineteen received quinine i.v., 1 mefloquine, 1 chloroquine. Sixteen patients received blood products transfusion, 3 were treated by EXT in addition. Twenty were cured and discharged from hospital without sequelae (mean stay: 14 days); 4 had nosocomial infection, 1 a splenic infarction. One patient (17-years-old; SAPS: 17; parasitemia: 7.8%) died 12 h after admission from non-cardiogenic pulmonary oedema with multi-organ failure. The literature and this study lead us to propose EXT in patients with unfavourable evolution after conventional treatment rather than in all the patients with a parasitemia above 10% at admission. A randomized study to compare conventional treatment in ICU with or without EXT is necessary.

Adolescent↗
PubMed1991

Acute silicosis due to inhalation of a domestic product.

A 20-yr-old woman with no history of pulmonary disease presented with acute dyspnea and fever. After various investigations and treatments the symptoms persisted and a lung biopsy was performed. Pathologic analysis disclosed the presence of silicotic crystals within lung tissue and mediastinal lymph nodes. The patient admitted having repeatedly inhaled a domestic scouring powder rich in silica during the preceding 6 months. This is the first report of acute pulmonary silicosis developing after exposure to a common household product.

Acute Disease↗
PubMed1991

[Ideal treatment of malaria attack: more questions than answers? Experience of a department of infectious diseases].

The number of cases of malaria imported to western Europe from tropical areas is steadily growing, due to the increased number of people traveling to endemic regions and to the spread of Plasmodium strains resistant to chemoprophylaxis. This has prompted the WHO to frequently update its guidelines concerning preventive therapy. We report on 143 consecutive cases of benign attacks of malaria in patients returning primarily from western and central Africa. Plasmodium falciparum was responsible for 80% of the cases. Forty-one percent of the patients had followed their preventive regimen correctly; mefloquine failed in 3 of them. Three early relapses were observed after curative treatment, including 2 patients who had received intravenous quinine for more than 5 days. Because P. falciparum infection is potentially lethal, we suggest that the treatment of malaria attacks be optimized, by systematically dosing serum quinine levels, in order to adjust the administered doses, and, as a first-line therapy, by prescribing a combination of drugs to patients at high risk of resistance.

Adolescent↗
PubMed1990

[Treatment of salmonellosis and shigellosis with the new quinolones].

Sixty patients with enterocolitis (36 men, 24 females), mean age thirty seven (12 to 84) have been treated with new quinolones. Two groups have been constituted. First group included patients without bacteremia despite enterocolitis. Among them, 9 patients suffered from shigellosis (8 S. flexneri, 1 S. sonnei). Twenty-two patients had a minor salmonellosis (13 S. typhimurium, 4 S. enteritidis, 1 S. blockley, 1 S. Virchow, 1 S. london, 1 S. baildon, 1 S. C2 group). Patients in the second group underwent a septicemic salmonellosis (18 S. typhi, 3 S. paratyphi, 8 other Salmonella serotypes). All patients but one received an oral treatment. Forty-seven patients received 400 mg/day ofloxacin, 8 patients 1.500 mg/day ciprofloxacin, 5 patients 800 mg/day pefloxacin. Treatment lasted an average of 10 days (5 to 31 days). Apyrexia was observed within an average of 3 days (1 to 8 days). Blood culture have always been sterile after a two days treatment duration. No more shigella or salmonella was found in feces, five days after beginning of treatment. No relapse has been observed within a 30 days mean background (1 to 180 days). Not any intolerance needed to stop treatment. Patients have been hospitalized on an average of 11 days. Therefore, new quinolones will represent an effective, well tolerated treatment for salmonellosis or shigellosis.

Adolescent↗
PubMed1988

[Severe pulmonary varicella in 7 non-immunodepressed adults].

We report seven cases of seven pulmonary varicella occurring in seven adults without any previous history of known immunological deficit. In all the cases the vesicular eruption was diffuse, occurring after contact with a child presenting with benign varicella. The respiratory signs appeared five to seven days after the cutaneous signs. On admission there was significant hypoxaemia (PaO2 = 35 to 47 mmHg on air), requiring positive pressure expiration (10 to 18 cmH2O) on mechanical ventilation (4 times) or spontaneous ventilation (3 times). The pulmonary radiographs showed diffuse nodular interstitial shadowing. Treatment consisted of Acyclovir (10 mg/kg/8 h). Five patients were cured without any sequellae five to six days after ventilation. One patient died (3 months pregnant), 1 patient presented with a superinfection with staphylococcus aureus. The occurrence of respiratory signs in an adult presenting with varicella requires hospitalisation for treatment with Acyclovir and also the prevention of superinfections.

Acyclovir↗
PubMedDate not supplied

Malignant boutonneuse fever and polymyalgia rheumatica: a coincidental association?

Mediterranean spotted fever is a tick-borne disease that is endemic in the Mediterranean basin from spring to autumn. Usually mild, the disease can be severe in some cases, especially when risk factors are encountered in patients or when treatment is delayed. The correlation between these malignant forms and patients' immunological disorders remains unclear, while the pathophysiology of the disease seems well known. A case of a malignant form of Mediterranean spotted fever is reported which occurred 2 months prior to the diagnosis of polymyalgia rheumatica. Evidence of immunological disorders consisted only in an antiphospholipid antibody associated with a transient lupus anticoagulant. No underlying risk factors other than the primary undiagnosed phase of polymyalgia rheumatica has been observed.

Aged↗