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Biomedical subjects

F Goupil

Publications and source records attributed to F Goupil.

8 recordsLinked to original sources
PubMed1999

[Pulmonary malacoplakia caused by Rhodococcus equi in AIDS: a case report].

We describe the observation of a right upper lobe consolidation with cavitation produced by Rhodococcus equi in a patient suffering from AIDS. The inefficacy of a prolonged antimicrobial therapy adapted against R. equi led to a right upper lobectomy. The histopathology showed a pseudotumoral mass, with dense infiltration of macrophages containing Michaelis-Gutmann bodies, which was positive for the culture of R. equi. Pulmonary malacoplakia with Rhodococcus equi was diagnosed. This pathology should be evoked when a R. equi pneumonia persists despite a right management of treatment for several months. The features of pneumonia with Rhodococcus equi and of pulmonary malacoplakia are taken from a literature review.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Severe pneumonia with a pneumococcal aspect during an ornithosis outbreak].

OBJECTIVES: To describe the clinical, radiological and biological features of Chlamydia psittaci pneumonia. METHODS: A pneumonia outbreak occurred in a healthy middle-aged population working in a poultry slaughterhouse. Systematic serology (2 samples at 5 weeks intervals) provided the diagnosis of Chlamydia psittaci pneumonia in 6 patients. Patient files were analyzed retrospectively. RESULTS: The clinical presentations in this series of pneumonia were particularly homogeneous with a pneumococcal profile in all 6 cases: sudden onset, temperature above 39 degrees C, lobar alveolar involvement, hypoxemia, hyperleukocytosis and liver dysfunction. One case of hallucinatory delirium was observed. The patients were given spiramycin (9 million units per day for 3 weeks) and all recovered rapidly with no complications. CONCLUSION: The unusual virulence of the Chlamydia psittaci and very important inoculum were probably involved in this outbreak because of the severity of the pulmonary features and the short exposure of some patients to the bacteria. These cases suggest that the prevention of ornithosis in poultry slaughterhouses should be reinforced.

Abattoirs↗
PubMed1981

Antepartum fetal heart rate monitoring. A semi-quantitative evaluation of the 'non-stressed' fetal heart rate.

1964 recordings (from 246 patients were analysed on the basis of a semi-quantitative evaluation of base-line heart rate variability. All the tracings were obtained in the antepartum period, between the 20th wk of pregnancy and prior to the onset of labour. None of the recordings were made during labour or after induction of uterine activity so that a 'non-stressed' fetal heart rate test was obtained in every case. The percentage of flat tracing in each recording and the presence of sinusoidal patterns were compared with the neonatal outcome. When the tracings included a more than 50% flat pattern, 81.8% of the babies were distressed at birth. When a less than 50% flat recording was present only 11.4% of the neonates were distressed. Sinusoidal patterns were more frequently associated with abnormal tracings including those with more than 50% flat recordings. The presence of sinusoidal features did not significantly influence the neonatal outcome for tracings with a less than 50% anomaly: conversely sinusoidal patterns superimposed on a more than 50% flat tracing were predictive of fetal compromise and neonatal distress in 100% of the cases. These results allow to advocate the use of 'non-stressed' antepartum fetal heart rate monitoring, as a reliable test in the management of high risk pregnancies.

Female↗
PubMed1981

Antepartum fetal heart rate monitoring. II. Deceleration patterns.

Fetal heart rate was studied during the antepartum period in 246 patients, yielding a total of 1964 recordings. The following parameters were evaluated and correlated: --the semi-quantitative assessment of fetal heart rate instability (as expressed by the percentage of duration of flat traces); --the presence of decelerations and their relationship to the presence or absence of uterine contractions; --the neonatal condition. Overall, 50% of the patients exhibited uterine contractions while 30% contained decelerations patterns either occurring spontaneously or in association with uterine contractions. A definite relationship was observed between the presence of severe decelerations (irrespective of the time relationship with any uterine contraction) and poor neonatal outcome. A relationship does exist between the presence of severe decelerations and flattening in the recording, which, as demonstrated in the previous part of the paper also exhibited a strong positive relationship with the neonatal outcome. When one considers the different degrees of flattening, it appears that a further correlation between decelerations and neonatal state is demonstrable only in the case of a 10--50% flat recording. Here the probability of a distressed baby is 20% in the absence of decelerations, but 43.4% in the presence of decelerations. In other cases (i.e., less than a 10% or more than a 50% flat recording) the pronostic significance of the instability of the record is not significantly modified by he presence or absence of decelerations. These results indicate that consideration of decelerations is only advisable in these cases where instability is moderately affected (flattening in 10-50% of the record) and that the use of the oxytocin challenge test OCT may be reserved for such cases, when these are neither spontaneous contractions nor decelerations and not contraindications present.

Apgar Score↗
PubMed1981

Antepartum fetal heart rate monitoring. III. Fetal movements and accelerations in fetal heart rate.

This third part of the paper deals with the study of the relationships between fetal movements, fetal heart rate accelerations associated with such movements, fetal heart rate instability and neonatal outcome. No correlations has been found between absence of fetal movements and neonatal distress. A correlation has been found between the lack of fetal heart rate accelerations, the flatness of the record and poor neonatal outcome. In extreme situations (i.e. flatness in less than 10% of the record or in more than 80%) the presence or absence of accelerations does not add further useful information. Such information, however, is gained in the intermediary situations (the 'combined' recordings) and particularly when the record is between 51 and 80% flat where there appears to be an 85.6% risk to the fetus. Consequently, when trying to analyse an antenatal record it seems advisable to take primarily into account the percentage of flat recordings (providing the records are numerous enough and of sufficient length). Then, in records between 10 and 50% flat, the presence or the lack of spontaneous decelerations requires consideration whereas, when the record is between 51 and 80% flat, it is the presence or absence of fetal heart rate accelerations which is important.

Apgar Score↗
PubMed1976

Nonstressed fetal heart rate monitoring in the antepartum period.

The role of nonstressed monitoring of the fetal heart rate (HR) in determining fetal well-being during the antepartum period was assessed in 125 high-risk patients. Observations on HR, variability, and HR response to fetal movement (FM) and uterine contractions (UC) over a 30 minute period were made with an external microphone and tocotransducer. A total of 625 tests were performed; the earliest gestation tested was 28 weeks, and the latest was 46 weeks. A reactive pattern (variability greater than 6 b.p.m. and accelerations with FM) appears to be a reliable indicator of fetal well-being. All the 51 fetuses exhibiting this pattern survived. This group also had the lowest incidence of neonatal complications. On the other hand, of the babies who failed to show variability greater than 6 b.p.m. or accelerations with FM (nonreactive pattern), 40% died in the perinatal period. Thirty-five patients showed features of both a reactive and nonreactive pattern (combined pattern). Poor outcome in this group was confined to those in whom the majority of the pattern was nonreactive. An undulating HR pattern with virtually absent variability (sinusoidal pattern) was found in 20 Rh-sensitized fetuses, 50% of whom died in the perinatal period. Bradycardia and tachycardia were not found to be reliable signs of fetal distress antepartum. Of the 12 fetuses who died during observation, six showed late decelerations with spontaneous UC but all showed diminished variability. The close correlation between nonstressed patterns and neonatal outcome demonstrated by this preliminary study warrants further use of this technique for fetal evaluation.

Female↗