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Biomedical subjects

J M Korach

Publications and source records attributed to J M Korach.

27 records · Page 2Linked to original sources
PubMed1994

[Campylobacter fetus subspecies fetus endoaortitis on a Bentall tube prosthesis. Apropos of a case].

Campylobacter fetus is a rare cause of endocarditis and endoaortitis: the authors believe this to be the second reported case of infection of an intracardiac prosthesis. The patient was a man who had already undergone replacement of the aortic valve and ascending aorta, and a gastrectomy, which were predisposing factors. The portal of entry was not found. The diagnosis was confirmed by positive blood cultures and transoesophageal echocardiography. The outcome was rapidly fatal despite antibiotic therapy and surgery, because of the seriousness of the lesions (pseudo-aneurysm of the aorta ruptured into the right atrium), the precarity of the terrain and surgical difficulties.

Aorta↗
PubMed1994

[Microangiopathic hemolytic anemia associated with cancers. Symptomatic treatment by plasma exchange].

OBJECTIVE: To determine the interest of plasmapheresis in the management of cancer-associated microangiopathic haemolytic anaemia (MHA) not due to cancer treatment. MATERIAL AND METHODS: [corrected] National retrospective study using the file of the French Hemapheresis Society. RESULTS: We isolated 6 patients (5 men and a woman aged 32 to 69-year-old) who had prostatic (4 cases) or breast carcinomas or Hodgkin's disease. Diagnosis of cancer preceeded MHA in 3 patients (from 2 to 4 years). Bone or bone marrow metastases were demonstrated in 5 patients. The clinical presentation included anuria (4 cases), bleeding (4 cases), and laboratory findings were consistent with microangiopathic haemolysis and thrombopenia in all cases and intravascular coagulation (2 cases) and/or renal failure (4 cases). MHA symptomatic treatment included 4 to 10 courses of plasmapheresis, extra-renal epuration (4 patients), anticoagulation (4 patients) and/or antiagregant (3 cases), haemodialysis (4 cases) and vincristine (2 cases). Cancer treatment consisted of antitumoural chemotherapy (2 cases) and/or hormonotherapy (5 cases). In all cases, haemolysis, thrombopenia and intravascular coagulation were controlled within 30 days. MHA treatment was effective alone in 3 patients. No relapse were observed in 3 patients whereas the course of cancer continued in 2 patients. Two patients relapsed and died from MHA after 4 and 36 months. Two patients relapsed and died from MHA within a few months and 1 was lost to follow-up. CONCLUSION: Symptomatic treatment of cancer-associated MHA including plasmapheresis may be useful while waiting for an aetiologic management of the tumour.

Adenocarcinoma↗
PubMed1993

1991 registry of the French Society of Hemapheresis (SFH): preliminary results for the first year of the on-line computer access file. The Registry Study Group.

From 1985 to 1990, the French Society of Hemapheresis (SFH) managed a National Registry of Plasma Exchange (PE) which included a data collection service, computer data input and statistical analysis of the total operation. The management of this registry did, however, encounter some problems. In 1991, an on-line computer access file was created, permitting French centers to input their data in Minitel Registry System. As a result, analysis on a national scale has proven more time-effective and data collection errors have been noticeably reduced. In January 1991, 43 centers were connected to the Minitel System. Only 17 centers, representing 4706 PEs, entered their data directly to the Minitel System during 1991 and, during the first term of 1992, a further 11 centers, representing 3258 PEs, communicated their data on paper in batch mode. The final total for 1990 was: 26 centers representing 860 patients and 7991 PEs. It is likely that some small imperfections have already developed during processing of the 1991 data, but these will be corrected as they are entered into the system. With the implementation of the Minitel System the French PE Registry represents a more accurate picture of plasmapheresis activity in France.

Evaluation Studies as Topic↗
PubMed1991

[Severe methotrexate poisoning].

Methotrexate toxicity is rare but extremely severe. When complete, it consists of ulcerations of the gastrointestinal mucosae responsible for necrotizing enteritis, erythroderma, bone marrow aplasia, interstitial pneumonia, hepatitis and organic renal failure with diuresis. Toxicity is facilitated by pre-existing renal impairment, third sector and abstention or underdosage of foliculinic acid prescribed as antagonist. The diagnosis rests on serum assays, the results of which must be interpreted taking into account the assay method and the time elapsed between the injection of methotrexate and its assay in serum. The multivisceral pathology observed may totally regress, as in the case reported here. Treatment is based on symptomatic measures, starting with maintenance of an abundant and alkaline diuresis, and on the parenteral administration of folinic acid in doses that vary with the authors.

Acute Kidney Injury↗
PubMed1991

Acute carbon monoxide intoxication and hyperbaric oxygen in pregnancy.

Modalities of oxygen therapy for pregnant women intoxicated with carbon monoxide (CO) are ill defined. Hyperbaric oxygen (HBO) is presumed to be hazardous to the pregnancy. On the other hand CO entails anoxic injuries in the mother and fetus. We have entered 44 pregnant women who sustained an acute carbon monoxide poisoning at home, into a prospective study in order to assess HBO tolerance. They were treated within 5.3 +/- 3.7 h (range: 1-12) of the intoxication with a combination of 2 h of HBO at a pressure of 2 atmospheres absolute (ATA) and 4 h of normobaric oxygen, irrespective of the clinical severity of the intoxication and of the age of pregnancy. Six patients were lost to obstetric follow-up. Only 2 patients sustained a spontaneous abortion: 1 within 12 h and 1 within 15 days of the intoxication. Thirty-four women gave birth to normal newborns. Finally 1 elected to undergo abortion for reasons unrelated to the intoxication and 1 gave birth to a baby with Down's syndrome. There is no evidence that HBO was involved with either abortion of our study. We conclude that HBO may be carried out in pregnant women acutely intoxicated with carbon monoxide.

Acute Disease↗
PubMedDate not supplied

Incidence and causes of carbon monoxide intoxication: results of an epidemiologic survey in a French department.

The purpose of this study was to estimate the incidence, mortality, and causes of carbon monoxide intoxications in France. A survey was conducted in the department of the Hauts-de-Seine, which is representative of the French population. Data were collected through a headquarters that had direct contact with all department emergency organizations and to a technical laboratory. During the 3-y study, 735 cases that were related to 291 events were reported. Thirty-six patients died. The average incidence of carbon monoxide intoxications was 17.5 per 100,000 inhabitants. Poisoning was caused by fires in 36 events and by car exhausts in 12. For the remaining events, causes were determined as follows for 196: water heaters (57%), boiler (20.5%), coal stove (9%), brazier (4%), cooker (2%), heating device (1.5%), and miscellaneous (6%). The main mechanisms of intoxication were a defective device, poor ventilation, or poor evacuation of combustion gases. Carbon monoxide intoxication occurs frequently in France, and preventive actions are warranted.

Animals↗