Biomedical subjects

K Breuil

Publications and source records attributed to K Breuil.

10 recordsLinked to original sources

PubMed2000

[Importance of allergologic consultation after a ++perianesthetic complication. Report on a year of activities at the Poitiers University Hospital Center].

OBJECTIVE: Patients who present an accident during general anesthesia must be tested 4 to 8 weeks later in order to determine the exact cause and prevent any further acute accidents. We report the results of a prospective study based on a 1-year period of allergology consultations after peroperative accidents in the Poitiers University Hospital. PATIENTS AND METHODS: Previous history, surgical procedure, the nature and gravity, of the reaction, risk factors and tests results were recorded. All observations were transmitted to the Regional Pharmacovigilance Center. The level of causality of the administered drug was determined from these data which were integrated into the national computer bank of side effects. RESULTS: After 2,500 general anesthesia procedures, a total of 21 patients had been referred to the allergology consultation. Eighteen were positive for at least 1 test (skin tests or laboratory tests). Among the substances administered, causality was probable for 16, possible for 4 and doubtful for 1. CONCLUSION: Our findings demonstrate the importance of allergy tests and the need for close collaboration between anesthetists, allergologists and pharmacologists.

Adjuvants, Anesthesia↗

PubMed1998

[Propacetamol and new occupational contact dermatitis].

We describe the cases of three hospital nurses who presented eczematous lesions on the hands and eyelids. They worked in surgery department or in post anaesthesia recovery room, all preparing syringes of Pro-Dafalgan (propacetamol: parenteral paracetamol form). They were not sensitive to oral paracetamol or occupational products and latex. During week-end or holidays when they stopped handling Pro-Dafalgan, the eczema recovered but relapsed on working. A few cases are described in the literature so precautions begin to be preconized for healthcare workers but they are not usually in practice. Test performed with solvent, paracetamol, latex, formol and other hospital allergen tests were negative. The only allergen would be propacetamol because all tests performed with it were strongly positive. Following the official evaluation method in pharmacovigilance, based on chronologic and semiologic criterias, considering the positivity of rechallenge and specific tests, propacetamol imputability was probable in all our cases. It is preconized to declare cases to Regional Pharmacovigilance Centers to complete information about handling risks of this very usual analgesic.

Acetaminophen↗

PubMed1995

Anaphylactic reaction to local administration of rifamycin SV.

BACKGROUND AND OBJECTIVE: Systemic reactions during anesthesia are commonly attributed to muscle relaxants, hypnotics, macromolecular solutions, latex, or parenteral antibiotics. After exclusion of these different components as causes, we were interested in the potential implication of rifamycin in the systemic reaction, which occurred during anesthesia, and in the immunologic mechanism by which it can trigger this reaction. METHODS: We report four cases of systemic reactions occurring after local administration of rifamycin. Three patients needed orthopedic surgery, and the fourth needed a urethrotomy. Severe systemic reactions occurred in all four patients when the surgeon washed the incision area with a rifamycin solution. All patients correctly responded to appropriate treatment and recovered. Skin tests were performed 2 months after the incident with the drugs used during anesthesia, latex, and rifamycin. To assess the relationship with a possible IgE-mediated mechanism, two in vitro tests were concomitantly performed to evaluate the cell reactivity to rifamycin: (1) determination of histamine release from peripheral basophils and (2) platelet cytotoxicity test, which explored the presence on platelets of specific IgE antibodies bound to the low-affinity receptor for IgE. RESULTS: Skin tests were performed with different drugs used during surgery, and results were only positive for rifamycin in the four cases, accompanied in two cases by a systemic reaction. Histamine release from basophils was positive in three of four patients. The platelet cytotoxicity test results were positive in all four cases. CONCLUSION: It appears that rifamycin, used locally during surgery, is apt to trigger severe systemic anaphylactic reactions, which are linked to an IgE-related process. This situation is worth pointing out, especially in patients who undergo repeated orthopedic operations during which, at least in Europe, rifamycin is commonly used for the prevention of local sepsis.

Administration, Topical↗

PubMed1990

[Allergy to ketamine].

A case is reported of allergy to ketamine substantiated 2 years after the accident. The female patient had ketamine for the removal of a mole. During this procedure, she developed a generalized rash and laryngospasm; the use of adrenaline was required. Since that time, although no confirmatory investigations had been carried out, she had been given a paper identifying Ketalar as being the involved drug. Investigations were carried out after she had been given a further anaesthetic (without using ketamine) 2 years after the accident. These confirmed an allergic reaction to ketamine, and not to the solvent, chlorobutanol.

Adult↗

PubMed1990

[Allergy to kiwi: an unrecognized allergy].

We reported 4 cases of an uncommon hypersensitivity: hypersensitivity to kiwi fruit. The clinical reactions, essentially buccal, occurred few minutes after ingestion of the fruit. The Radio Allergo Sorbent Test were positive in the 4 cases. The skin tests, with fresh extracts of kiwi, made in 3 cases were dramatically positive, while they are negative in controls patients. The kiwi fruit initially comes from China, but is now produced in France, and especially in Poitou-Charente. It contains a proteolytic enzyme call Actinidin with physical and chemical properties similar to those of Papain, who can perhaps explain this hypersensitivity.

Adult↗

PubMed1971