Biomedical subjects
Publications and source records attributed to G Laplatte.
Methanol, a highly toxic substance, is used as an industrial solvent and in automobile antifreeze. Acute methanol poisoning produces severe metabolic acidosis and serious neurologic sequelae. We describe a 50-year-old woman with accidental methanol intoxication who was in a vegetative state. MRI showed haemorrhagic necrosis of the putamina and oedema in the deep white matter.
Bacteremia occurs frequently among critically ill patients. The aim of this study carried out in Eastern France was to describe the epidemiology of nosocomial bacteremia and to assess the methicillin-resistance of Staphylococcus aureus (SA). Data were collected during a 4 months prospective survey (09/96-12/96) carried out among 44 hospitals. We counted 2633 episodes of bacteremia classified as contamination (684), nosocomial bacteremia (970) and community bacteremia (979). Incidence rate of nosocomial bacteremia was 30.7 per 100 beds in the intensive care units. When documented, the origin of the nosocomial bacteremia was the most often catheter blood related infection or urinary tract infection. Gram positif cocci were predominant among nosocomial bacteremia (53.8%). Among Gram negative bacteria (enterobacteria) (31.6%), Escherichia coli was the most frequently isolated. SA was methicillin-resistant in 18.3% of community bacteremia and in 26.5% of nosocomial bacteremia. Coagulase negative Staphylococcus were methicillin-resistant in 25.4% of community bacteremia and in 60.1% of nosocomial bacteremia. Measures to prevent catheter blood related infections and urinary tract infections may be started.
Four female and four male adults, with acute adrenocortical insufficiency were admitted to a medical intensive care unit over a period of five years (1975-1980). Three of them were under treatment for Addison's disease. The clinical picture combines fever with signs of shock and dehydration. Increased pigmentation of the skin and laboratory data suggest the diagnosis, which is established by the serum cortisol assay. The etiology was tuberculosis in four patients. Cortical retraction was found in three others. One case followed interruption of non-substitutive corticotherapy. After 48 hours of adéquate therapy, all patients had recovered.
A young soldier with familial ichthyosis vulgaris developed malignant hyperthermia after an intensive exercise. Ichythyosis was considered as a predisposing factor, but the finding of a low muscular carnitine level raises the problem of a relationship between exercised-induced malignant hyperthermia and lipid metabolism disorders.
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