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Biomedical subjects

I Pin

Publications and source records attributed to I Pin.

65 records · Page 4Linked to original sources

[Effect of nebulized salbutamol in 26 patients hospitalized for asthma attack].

Twenty-six asthmatic patients who were hospitalised following an acute asthmatic attack and who had a peak expiratory flow of less than 50% predicted, without hypercapnia, received 5 mg. of salbutamol delivered by a micronebulizer LSA on admission (HO). At H1, 10 mg of additional salbutamol were nebulised in cases where there had been an increase of less than 20% of the PEF. At H2, all the subjects received steroid therapy. Group 1 in which success was defined by an increase of 20% of peak flow judged at H1 and H2, and group II where the increase in peak flow was less than 20%. Group II benefited at H2 by treatment with theophylline or salbutamol intravenously given in a randomised fashion. At H8 the 2 treatments were associated in group II in cases of failures. 15 men, and 11 women aged 40 +/- 17 suffering from severe asthma (65% of Charpin Stage IV) were included. The mean peak flow at HO was 32 +/- 9% of the predicted PEF. 21 subjects, or 81% improved their peak flow by more than 20% at H2. The toleration for salbutamol was very good from the cardiovascular point of view. At HO there was no clinical criteria nor peak flow assessment which would enable one to predict the failures from nebulized salbutamol for a given subject. Nevertheless a level of dyspnoea of greater than 5 on Borg's scale and a peak flow of less than 150 l/min made failure likely.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Meningo-encephalomyelitis in Lyme disease].

A case of isolated central nervous system involvement in Lyme disease is described. A 13 year-old boy developed progressive spastic quadraparesis, chronic lymphocytic meningitis with a low CSF glucose concentration and demyelinating lesions of the white matter on MRI. The diagnosis was proved serologically by high antibody titers against Borrelia burgdorferi (BB) in the serum (1:5, 120) and CSF (1:1,280). There was evidence of specific intrathecal immune response against the BB antigen. The patient was treated with penicillin G and then ceftriaxone. The CSF abnormalities quickly improved but improvement of the neurologic symptoms was gradual and to date still incomplete.

Adolescent↗

[A fatal respiratory form of type C Niemann-Pick disease].

An unusual case of Niemann-Pick disease type C is reported. The disease was first manifested in utero with hepatomegaly and ascitis. At the age of 3 months, respiratory signs were noted due to diffuse alveolar and interstitial pneumonia. Both bronchoalveolar lavage and blood serologic studies revealed respiratory infection by respiratory syncitial virus and Chlamydia trachomatis. These concomitant infections delayed the diagnosis of Niemann-Pick disease which was finally made by the electronic microscopic studies of liver biopsy and bone marrow specimens. Type C was identified by biochemical characterization of lipid accumulation in hepatocytes and by lipid enzyme profiles obtained from cutaneous fibroblast cultures. The child died at the age of 6 months from respiratory failure. Post mortem examination of the lung showed the presence of numerous overloaded alveolar macrophages in the alveolar spaces and walls. The severity of the lung issue disease is unusual in type C Niemann-Pick disease, in which neurologic involvement is usually the main prognosis factor.

Chlamydia Infections↗

[Chronologic relationship between gastroesophageal reflux and asthma. Simultaneous study of the measured pH and respiratory function].

UNLABELLED: The aim of the study was: 1) to define the frequency of gastroesophageal reflux (GER) in asthmatics; 2) to study a possible relationship between episodes of GER and changes in airflow obstruction while maintaining as far as possible physiological conditions. Nineteen consecutive patients (aged 40.3 +/- 19 years) presenting with severe asthma requiring continuous treatment, were studied in a stable period. All treatments were stopped for 12 hours before the examination, except corticosteroids and sustained theophylline. Esophageal pH was measured continuously one hour before and three hours after a standardized meal. Respiratory function was measured every 30 minutes using a miniaturized spirometer which enabled the measurement of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1-VC ratio: 1) the frequency of pathological GER was defined by a Kaye's score greater than 90 and was 32%; 2) there was no significant correlation between the individual changes in FEV1 and different variables for the pH measured in the 30 mn before the measurement of bronchial obstruction (number of GER episodes, duration of GER, duration of the last GER episode, time of the last GER); 3) we have found no significant difference between the variation of FEV1 above or below 10% of the best FEV1 of each patient in relation to the quality (intensity, duration, delay) of GER episodes recorded 10 minutes before the spirometry. IN CONCLUSION: in severe asthmatics these results: 1) confirm the high frequency of pathological GER; 2) do not allow the establishment of a direct causal relationship between GER episodes and occurrence of a bronchial obstruction.

Adult↗

[A case of pleuropneumopathy due to Eikenella corrodens].

We report the observation of a pleuropneumonia due to Eikenella corrodens in a man of 39 years old suffering from diffuse dilatation of the bronchi. This small micro-aerophilic Gram negative bacillus has rarely been implicated as a cause of pneumonia. It appears that it may often be associated with streptococcal infections and that it becomes a pathogen when the immunity is lowered. Its sensitivity to antibiotics is excellent, particularly vis-à-vis bêta-lactams.

Adult↗

[Treatment of asthma crises in children with nebulized salbutamol].

Thirty-two children were treated with nebulized salbutamol for acute asthma. Seventy-five per cent of the treatments were efficient, either after a first nebulization at 0.15 mg/kg (47% = group I), or after a second nebulization 45 min later, at 0.05 mg/kg (27% = group II). Twenty-five per cent of the treatments (group III) were inefficient or only partly efficient. The clinical tolerance was good except in two children. Group I and II presented differences only for the auscultation score. Children from group I and II were older and had less severe asthma than those from group III. On the basis of this study, nebulized salbutamol appears to be an affective and safe treatment for acute asthma. The repeated administration of low doses, shortly after the first nebulization increases the quality of the response.

Adolescent↗

[Sleep apnea syndrome combined with an anatomical obstruction of the upper airways].

In patients with sleep apnoea syndrome abnormalities of the upper airways may play a major role in the genesis of apnoea. Three cases are presented which illustrate the part played by hypertrophy of the tonsils in a child and by stenosis of the pharynx in an adult and of the larynx in another adult. All three patients were cured by surgical correction of these abnormalities. The physiopathology of alveolar hypoventilation, present in one of the three patients, is discussed in relation to the effects of pure oxygen inhalation on the patient's ventilation.

Adult↗

[Primary alveolar hypoventilation. Clinical aspects and diagnostic problems. Apropos of a case].

Primary alveolar hypoventilation is a rare syndrome of unknown origin, characterized by a dysfunction of the automatic respiratory pattern in spite of normal lungs and in the absence of mechanical ventilatory defects. A reduction of the ventilatory response to CO2 is regularly found, and cardiac failure is common. The differential diagnosis mainly concerns the sleep apnoea syndrome. The usual treatments have little effectiveness.

Blood Gas Analysis↗

[Immediate hypersensitivity to quinine].

Systemic anaphylactic reaction with shock was observed after ingestion of an antipyretic combination product containing quinine. That quinine was responsible for the reaction was proven by immediate skin tests and by oral challenge tests. The demonstration of specific IgE's by a radioallergosorbent test (RAST) provided evidence for an immediate hypersensitivity mechanism.

Adult↗

[Diffuse familial interstitial pulmonary fibrosis. Study of a family].

A study of the genealogy of a 53 year old lady (A.M...) suffering from diffuse interstitial pulmonary fibrosis (FID) has revealed several cases of FID in her forbears and relations. Two brothers of A.M... died of histologically proven FID; FID was also discovered in one of their daughters. A sister died young of some unclassified respiratory problem. Two cousins died likewise at a young age of acute FID proven histologically. The level of spontaneous pneumothorax was particularly elevated in this family which represented a clinical peculiarity when compared to sporadic FID. The most probable mode of transmission of familial FID is autosomal dominant with variable penetrance. The HLA group seen in A.M... showed the A2 and B12 alleles. The B12 allele was also present in the niece of A.M...

Bronchi↗