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Biomedical subjects

G Ginies

Publications and source records attributed to G Ginies.

At least 19 recordsLinked to original sources
PubMed1999

[Weber-Rendu-Osler disease: pulmonary arterio-venous malformation with shunt disclosed after 5 occurrences of purulent meningococcal encephalitis].

Hereditary hemorrhagic telangectasis or Weber-Rendu-Osler disease is associated with the presence of capillary malformations with pulmonary visceral shunts. These shunts are the cause of recurrent infections of the nervous system by loss of the anti-infectious lung filter. Hereditary hemorrhagic telangiectasis was diagnosed in a 68-year-old woman with a history of epistaxis, cutaneous telangectasis, purulent and pyogenic brain abscesses and meningitis. Outcome was favorable with antibiotic therapy. Ventilation as well as chest x-ray, brain scan and liver ultrasongraphy were normal. Blood gases showed a PO2 at 63 mmHg in ambient air and 62 mmHg with FiO2 = 1. There was no dyspnea or cyanosis nor any apparent polycythemia. Pulmonary angiography showed and arteriovenous malformation in the lower right lobe. Endovascular embolization was achieved with coils and N-butyl-cyano-acrylate glue which enabled angiographic occlusion and normalization of gas exchange: on ambient air the PaO2 = 71 mmHg and on FiO2 = 1, PaO2 was 359 mmHg. A true shunt was suspected on account of the association of hereditary hemorrhagic telangiectasis and recurrent meningitis. The diagnosis was suspected on blood gases alone.

Aged↗
PubMed1996

[Legionnaires' disease with acute respiratory insufficiency. Clinical and biological characteristics, comparison with pneumococcal pneumonia].

OBJECTIVES: Legionnaires' disease is one of the main etiologies of bacterial pneumonias because of its frequency as well as its potential severity. The therapeutic choice implies the need to look for distinctive clinical, biological or radiological signs, due to the unreliability of rapid immunological criteria. Pneumococcus is the first cause of bacterial pneumopathy. Thus, identifying the distinctive signs between these two etiologies may be necessary. METHODS: In our restrospective study, nine Legionnaires' disease-related pneumonias were compared with nine pneumococcus-related pneumonias with acute respiratory failure and comparable level of severity. Patients were recruited over a two year period in a medical intensive care unit. RESULTS: Four criteria were found more frequently in pneumonia related to Legionnaires' disease: high-grade fever at the time of admission, elevated transminases, presence of Miller's criteria (converging clinical and biological signs) and increasing creatine kinase. CONCLUSION: In patients with severe pneumonia, both Pneumococcus and Legionella should be entertained as possible diagnoses before starting treatment. A prospective analysis of precise diagnostic criteria is needed to distinguish between these two bacterial diseases.

Acute Disease↗
PubMed1989

[Malaria, pregnancy and prophylaxis].

We present two case histories. The first is a case of congenital malaria in a newborn whose Laotian mother immigrated into France 2 years ago. The other is a case of very severe malaria with fetal death in a 28 year old woman who was 8 months pregnant and who had come back to France from Gabon where she had lived for 2 years. The authors wish to draw attention to malaria brought into the country and how serious it can be, and suggest prophylactic measures to be applied for pregnant women and their newborn babies.

Adult↗
PubMed1988

[Onset of convulsive crises with theophylline therapy at therapeutic doses].

Six patients treated with theophylline, including five with advanced chronic obstructive pulmonary disease, developed generalized seizures with serum theophylline concentrations ranging from 7 to 21 mg/l. Cerebral computed tomographic scans showed a small sylvian infarction in one patient. In the other five patients nothing, except theophylline, could account for the seizures. There were no clinical signs of theophylline toxicity prior to the failures, all of which had a favourable outcome. Patients with acute exacerbations of chronic obstructive pulmonary disease seem to be prone to develop generalized seizures when treated with theophylline.

Aged↗
PubMed1986

[Hypercapnic status asthmaticus. Rapid reversibility of hypercapnia under medical treatment].

Fifty-four episodes of hypercapnic status asthmaticus (Pa CO2 50 mmHg or more) were treated with intravenous theophylline (6 mg/kg over 30 minutes, then 1 mg/kg/hour), intravenous hydrocortisone hemisuccinate (1 g then 500 mg 4-hourly) rehydration and oxygen therapy at a sufficient rate to obtain a Pa O2 of 80 mmHg or more. As a rule, improvement was rapid with a significant decrease of mean Pa CO2 values from 61 +/- 14 to 44.5 +/- 11.5 mmHg (P less than 0.001) over 2 hours. In only 3 cases was mechanical ventilation necessary. An initially high Pa CO2 value is not an absolute indication of mechanical ventilation. This method remains exceptional and can be avoided in most patients by the emergency medical treatment outlined above.

Adolescent↗