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Biomedical subjects

A Bourdais

Publications and source records attributed to A Bourdais.

33 records · Page 2Linked to original sources
PubMedDate not supplied

[Respiratory complications of leptospirosis. Apropos of 6 cases, 3 of which show hemodynamic studies].

Six cases of leptospirosis with pulmonary complications are reported. Three cases were accompanying an hepato-nephritis due to L. icterohaemorrhagiae. The first patient died with massive hemoptysis. The second, presenting a bilateral pneumopathy predominant on the left side, recovered after plasma exchange and hemofiltration. The third case concerned a pulmonary edema complicating a vascular refilling in a shock syndrome it simply recovered. The three other cases were observed in an anicteric leptospirosis: in two cases, L. Australis was responsible; in the last, L. icterohaemorrhagiae was involved. The first patient had a radiologic picture simulating miliary tuberculosis. The second had pulmonary edema complicating a vascular refilling in a shock syndrome. The last was an acute respiratory distress syndrome, treated with artificial ventilation with penicillin therapy and corticotherapy. All these 3 patients recovered. The diagnostic, physiopathologic and therapeutic problems of these pulmonary complications of leptospirosis are discussed. The lesional nature of the pulmonary edema is proved by the low pulmonary wedge pressures observed with the Swan-Ganz Catheter.

Adult↗
PubMedDate not supplied

[Acute renal insufficiency caused by Plasmodium falciparum malaria in the last period of pregnancy (2 cases) (author's transl)].

A report of 2 cases of acute renal insufficiency in african women, 8 months pregnant and suffering of malignant malaria. In both cases labor has been induced by artificial breaking of the membranes and use of oxytocin. One of the children was still-born and the other died 3 days later. Delivery has been followed by a resumption of the urinary flow, facilitated by high dosages of furosemide. This diuretic drug when associated with hypoprotidic diet, hypercaloric intravenous infusions of glucose hypertonic solutions supplemented with amino-acids gives a good chance of recovery without extra-renal dialysis.

Acute Kidney Injury↗
PubMedDate not supplied

[Shock during necrotic amoebic colitis (author's transl)].

Two varieties of conditions of shock may be isolated during necrotic amoebic colitis (13 cases). Eight patients present a simple hypovolemic shock secondary to wastage by diarrhea and perilesional oedema with globular, protein, alcaline and potassic deficiency. Its prognosis is relatively good, after vascular infilling and corrections of metabolic disorders. Five other patients present real toxi-infectious shock resulting from widespread tissue necrosis with auto-intoxication associated with septicemic complications. Its prognosis is frankly bad. The treatment is far more difficult. The use of cardiovascular analeptics, such as dopamine, after an infilling failure, is not always sufficient to re-establish the situation. The exeresis of necrotic tissues is an indispensable condition to remove the cause of the shock before septicaemic generalisation.

Adult↗
PubMedDate not supplied

[Shock in abruptio placentae (author's transl)].

In sixty abruptions of the placenta observed during eighteen months, a severe condition of shock was observed in thirty per cent of patients. This shock state is seen during the abruption or after delivery. It's essentially a question of hemorrhagic shock, the importance of hemorrhagy being often underestimated, if the drop of blood pressure and blood losses are only estimated. The measurement of central venous pressure and the research of metabolic acidosis are better indexes of shock. This shock is associated with hypofibrinogenaemia and with other symptoms of disseminated intra-vascular coagulation. Fibrinolysis is rarely observed (3 times). Presence of fibrin degradation products is frequent. Renal complications are observed only in 1/6 of cases, but are frequently severe (one case of renal cortical necrosis). Heparinotherapy does not confirm the hope be suscited and seems to be a frequent source of ehmorrhagic complications in African women. Perfusion of fibrinogen, if useful, can be another source of complications. Rapid transfusion is the more effective treatment of abruption placenta and probably the less dangerous with strict control of the central venous pressure.

Abruptio Placentae↗
PubMedDate not supplied

[Surgical approach to the so-called infectious perforations of the small intestine in Africa south of the Sahara (author's transl)].

Non traumatic perforations are frequent in Africa South of the Sahara and most often due to salmonellosis. From 50 cases recorded in Dakar, the authors study the main problems raised by diagnosis (specially in non reactive peritonitis requiring iterative controls), surgical tactic and procedure, and intensive care. In 86 p. 100 of the case they report on, the authors performed a suture completed by passive drainage. However, and in spite of the risk of leaking, resection had to be done either immediately or because suture failure. As patients were presented generaly in very bad condition, intensive cares were complex but essential. Death rate ranged between 25 p. 100 and 50 p. 100.

Bacterial Infections↗
PubMedDate not supplied

[Necrotizing amoebic colitis (a propos of 12 cases observed in Dakar)].

Twelve cases of necrotizing amoebic colitis recorded in Dakar Hospital Principal are studied. The authors draw basis rules for an early surgical indication giving opportunity to detect not too extensive lesions and implement intensive care which may prove effective. Prognosis is still unfavourable with a death rate of two thirds.

Adolescent↗
PubMedDate not supplied

[Acute hyperkalemia disclosing an intraperitoneal rupture of an amebic liver abscess. Value of preoperative peritoneal dialysis].

In a patient with shock and hyperkalemia , a peritoneal dialysis, started to treat an hyperkalemia , showed the presence of chocolate-like pus in the peritoneal cavity, and confirmed the intraperitoneal rupture of an amoebic liver abscess . Peritoneal dialysis led to the correction of the metabolic disorders and of the shock and restored the diuresis, ensuring favourable conditions to surgical intervention. Surgical drainage of the abscesses and ornidazole treatment led to complete recovery.

Adult↗