Biomedical subjects
Publications and source records attributed to J Mingat.
Four patients in status asthmaticus and with alveolar hypoventilation were given a helium-oxygen (He-O2) mixture to breathe during 4 hours. Clinical improvement and return to normal of arterial blood gas levels were rapid and dramatic in all patients. The He-O2 mixture, which is a low density gas, causes a reduction in pulmonary resistance and an improvement in overall alveolar ventilation.
In a prospective study 128 community acquired pneumoniae were treated with a macrolide (josamycin) by oral route. Patients improved in 94 p. 100 (113). Complications were as following: 2 deaths, 2 sequels, 3 failures. Authors discuss macrolides effectiveness in acute pneumoniae, particularly pneumococcal ones. They conclude macrolides are a good choice in first intention in acute pneumoniae of adults.
Angioimmunoblastic lymphadenopathy occurred in a 46-year-old man 16 months after an episode of infectious mononucleosis induced by Epstein-Barr (EB) virus. The features of infectious mononucleosis included fever, pharyngitis, lymph gland enlargement, hepatosplenomegaly, hyperbasophilic mononuclear cells, and IgM antibodies to EB virus, although heterophile antibodies were not detected. The illness was severe and prolonged and included an asymptomatic measles virus infection. Over a year later massive enlargement of the lymph nodes led to a biopsy, which showed a diffuse infiltration with lymphoid cells and a proliferation of arborising small vessels typical of angioimmunoblastic lymphadenopathy. In spite of corticosteroids, levamisole, chlorambucil, and radiotherapy, no remission occurred, and serious infections led to death 18 months after the onset. Viral infections with EB virus and measles virus associated with pre-existing or subsequent immunological changes probably resulted in the appearance of angioimmunoblastic lymphadenopathy.
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An unusual observation of Bouveret syndrome is reported. It occurred in a male patient, under the usual age for this disorder, with no history of cholelithiasis. Diagnosis was only established during the surgical procedure. There were neither radio-opaque stones nor air in the common biliary duct. Attempts to opacify the fistula failed. Gastro-entero-anastomosis, which is sometimes proposed because of the patient's poor general condition, is often necessary because of the local lesions. This procedure allows to wait until the local condition improves before undertaking the complete cure during the second procedure, with considerably lesser risk.