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Biomedical subjects

S Houacine

Publications and source records attributed to S Houacine.

8 recordsLinked to original sources

[Acute drug-induced lung diseases with hypoxemia, cytotoxic drugs excluded].

Drug-induced acute lung diseases constitute a chapter of pneumology and intensive care that is now in full mutation. In practice, these diseases are still inadequately indexed and little known, the only exception being those caused by cytotoxic drugs observed in onco-haematology. They create for clinicians difficult diagnostic and therapeutic problems. From the cases reported in the literature, recent review papers and 10 personal cases, the authors ask five successive questions concerning hypoxic pneumopathies: 1) which patients?; 2) which clinical features?; 3) which initial diagnostic discussion?; 4) which are the elements likely to support the drug-induced hypothesis?; 5) which outcome?

Acute Disease↗

[Epidemiology of micro-organisms responsible for community-acquired pneumonia].

Pneumonias occupy a prominent situation among lower respiratory tract infections where they are remarkable for their potential mortality and for our relative knowledge of the responsible micro-organisms. Analysis and synthesis of each series published must answer several questions, such as: what are the lung diseases considered? which investigations have been performed? which criteria of imputability have been used? in which patients has the study been carried out? in which place, which period and which structure? In spite of methodological lacunae and of the inhomogeneous answers to the questions asked, there is some concordance between the series found in the literature. Thus, more than 90% of community-acquired pneumonias with microbiological identification are caused by Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Legionella pneumophila, Chlamydia psittaci (or pneumoniae), or Influenza A virus.

Adolescent↗

[Respiratory involvement in AIDS].

This review paper is divided into three parts. The first two parts are devoted to an analytical description of the clinical, diagnostic, prognostic and therapeutic aspects of the various bronchopulmonary and pleural lesions observed in AIDS. The third part presents an overall view of the main diagnostic and therapeutic approaches in the main clinical situations covering all respiratory disorders.

Acquired Immunodeficiency Syndrome↗

[Recurrent pneumothorax in asthma attacks].

The clinical disturbances associated with attacks of asthma may be aggravated and maintained by the occurrence of pneumothorax. In such cases preventing recurrences is part of the management of asthma. We report the cases of 2 young patients who presented with 3 successive episodes of pneumothorax during asthmatic attacks. Pleural drainage was performed on 2 occasions prior to having recourse, during the second episode, to surgical fixation, i.e. visceral pleurectomy. It seems to us that surgical treatment in such patients should be carried out as early as the first recurrence of pneumothorax.

Adolescent↗

[Legionnaires' disease: 21 cases observed over 2.5 years in a Parisian respiratory intensive care unit].

The incidence of Legionnaire's disease is probably underestimated in France. Its clinical presentation is very suggestive, especially after the failure of a 48 hour therapeutic trial of beta-lactams, when a pneumococcal infection is initially suspected. This one sign is sufficient to orient the diagnostic survey and constitutes an indication for a therapeutic trial of macrolides for at least 72 hours. In fact, the delay in the diagnosis appears to be the determinant factor in the fatal outcome of the disease.

Adolescent↗

[Treatment of an asthmatic crisis by acupuncture. Probable role in the onset of pneumothorax with development to status asthmaticus].

The onset of pneumothorax during acupuncture treatment has been reported since 1973. Usually unilateral, it occurs in patients free from any bronchopulmonary disease, and its consequences are therefore relatively benign. However, rare cases of bilateral pneumothorax have been reported since 1978, as well as a pneumothorax developing in asthmatic patients, with often dramatic consequences. A 15-year-old girl with a severe attack of asthma was treated by implantation of needles, and this coincided with the onset of a pneumothorax, and a subsequent state of status asthmaticus. A fatal outcome was only just avoided. The question is raised as to the technical quality of the implantations practised, as well as the validity and dangers of acupuncture in asthmatics, particularly during the acute attack.

Acupuncture Therapy↗

[Acute respiratory failure disclosing bilateral diaphragmatic paralysis].

In the case of three patients an acute respiratory failure with alveolar hypoventilation is related to bilateral diaphragmatic paralysis apparently isolated from any other neurologic abnormalities. The current initial diagnosis of pulmonary embolism leading to admission in an intensive respiratory care unit, because of the severity of the acute respiratory failure, has to be rectified then. Bilateral diaphragmatic paralysis is suspected on account of the absence of any patent etiology, on increasing dyspnea in supine position and paradoxic movements of the upper abdomen (whether spontaneously or in attempted weaning of ventilation support). Bilateral diaphragmatic paralysis is asserted by electromyogram with measurement of nerve conduction velocities of the two phrenic nerves. In the first case, it appears early in the course of an amyotrophic lateral sclerosis; in the second case, it occurs before the presence of a herpes-zoster becomes patent. In the third case, paralysis seems to be idiopathic. Evolution is promising in the last two cases, owing to the reversibility of the lesions. The difficulty of diagnosis, the varying nature of etiology and prognosis encountered in these three cases are also apparent in the 15 cases published in medical literature. The small number of cases published up to now, contrasting with the cases we have witnessed over the last 3 years, leads us to think that this disease must exist more often and may remain unknown to us.

Adult↗