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Biomedical subjects

D Patte

Publications and source records attributed to D Patte.

At least 37 records · Page 2Linked to original sources
PubMed1985

Shigella septicemia: prevalence, presentation, risk factors, and outcome.

The prevalence, presentation, and outcome of bacteremia due to Shigella and other gram-negative bacteria were determined by review of records of 2,018 inpatients with shigellosis who had their blood cultured in a Bangladeshi hospital in 1976-1983. Shigella bacteremia occurred in 82 (4.1%) patients; other bacteremia occurred in 102 (5.1%) patients. Patients with shigella sepsis more frequently (P less than .02) manifested severe dehydration, abdominal tenderness or ileus, agitation or lethargy, and leukocytosis than did nonbacteremic controls; they developed more frequently (P less than .05) renal failure (26%), leukemoid reaction (22%), thrombocytopenia (20%), and hemolytic-uremic syndrome (6%). The prevalence of all bacteremia was highest in the first year of life. Protein-energy malnutrition was a strong risk factor for shigella sepsis (P less than .01). The fatality rate in shigella bacteremia (21%) was higher (P less than .005) than in nonbacteremic shigellosis (10%) but lower (P less than .001) than in other bacteremia (51%). At highest risk of death from shigella bacteremia (P less than .01) were patients less than one year old, non-breast-fed, malnourished, and afebrile.

Adolescent↗
PubMed1985

Carbon-PGLA prostheses for ligament reconstruction. Experimental basis and short-term results in man.

The efficiency of a pure carbon prosthesis to reconstruct intra-articular ligamentous loss of substance was evaluated on 14 sheep with an 18-month follow-up study of recent and old ACL experimental injuries. Functional results showed a correlation between a tightened implant, the stability of the knee, and the absence of severe arthritis. The rupture strength of the newly formed ligament amounts to about 300 Newtons (N). That of the normal ACL amounts to 250-550 N. The structure gives a viscoelastic behavior to the prosthesis. This tissue was made of collagen fibers surrounding the carbon fibers and running generally in the direction of the ligament. In the osseous tunnels, the newly formed lamellar bone invaded and surrounded the implant. Carbon fiber fragmentation occurred, and fibers were found in the synovia and in the homolateral, inguinal, and paraaortic lymph nodes. No degeneration, necrosis of tissue, or cellular toxicity was found. On these bases, the carbon prosthesis was modified by adding a resorbable copolymer of polyglycollic (PGA) and polylactic acid (PLA) around the fibers and a resorbable sheath of the same polymer. This carbon-PGA/PLA prosthesis was used in 23 patients with a three- to 12-month follow-up period. Patients were evaluated by clinical tests and by functional control of the ligament. The indications for prosthetic replacement were: recent mop-end tears of the ACL, cruciate ligament reconstruction in chronic knee instability, and wide rotator cuff loss of substance. Five complications occurred because of hematomas and/or sepsis and prosthesis breakage. Eighteen of 23 patients had good clinical results with good function in five. The conclusions are that PGA/PLA produces a clean and flexible ligament, thus eliminating carbon fiber articular deposits and allowing a normal function. Inflammatory postoperative reactions seem to be more frequent than with other procedures and call for operative and clinical care in order to eliminate hematoma and sepsis. The efficiency of a rehabitable carbon-PGA/PLA prosthesis in intra-articular ligamentous defects in man will be confirmed only by controlled long-term clinical observations.

Adult↗
PubMed1985

[Aneurysm of the abdominal aorta, retroperitoneal fibrosis and extramembranous glomerulitis].

The authors report a case of a 58 year old male presenting with bilateral ureteral compression by peri-aneurysmal retroperitoneal fibrosis. A ureterolysis and prosthetic replacement of the abdominal aorta gave good results. Eighteen months postoperatively, proteinuria and an edema of the lower limbs revealed an extramembranous glomerulitis, for which no cause could be found. Was this rare association fortuitous, or does it result from the action of some unknown antigen?

Adrenal Cortex Hormones↗
PubMed1984

[Reversible paraplegia following intrathecal injection of high doses of human gammaglobulins in the treatment of low-grade tetanus. 4 cases].

Intrathecal serotherapy appears to be effective in the treatment of tetanus, and it has been claimed that human immune globulins are innocuous. In the 4 cases reported here reversible paraplegia developed a few hours after intrathecal injection of 1500 to 2000 UI of human immune globulins prepared by the French Blood Transfusion Centre. We believe that paraplegia was related to the high doses administered. The fact that intrathecal serotherapy is normally used in severely ill patients whose impaired consciousness precludes motricity and sensitivity testing may explain why this complication has not previously been reported. The need for high doses of intrathecal immune globulins is discussed. It has recently been suggested that high doses are superior to low doses. We consider that this form of treatment is justified, even in the least severe forms of tetanus, but we feel that doses higher than 1000 IU are not without danger.

Aged↗
PubMed1984

[Hypokalemic paralysis after prolonged absorption of a non-alcoholic pastis in a diabetic].

A typical case of glycyrrhizin-induced hypokalemic paralysis in a diabetic patient is presented. Hypokalemia was responsible for a generalized muscle weakness with a rise in serum muscular enzymes and cardiovascular disorders, which improved under potassium supplementation and spironolactone therapy. The pseudoaldosteronism syndrome with low plasma renin activity and aldosteron suggested aldosteron -like liquorice intoxication. Patient's interrogation revealed regular consumption of a common aperitive drink: a non-alcoholic pastis containing small amounts of glycyrrhizin. The discrepancy between the severity of clinical manifestations and the ingested amounts of glycyrrhizin is explained by the diabetic state.

Beverages↗
PubMed1983

[Thyrotoxicosis, then hypothyroidism caused by iodine overload (amiodarone) associated with neuropathy. Failure of plasma exchange].

A 54-year-old woman, with no previously documented thyroid disease, treated with amiodarone (200 mg/day, five days a week for 33 months) for paroxysmal tachyarrhythmia complicating mitral stenosis, suddenly developed extremely severe thyrotoxicosis. After therapeutic failures with carbimazole and propylthyrouracil (PTU) associated with beta-blockers, she was transferred to intensive care for plasma exchange (PE). Two PE were performed, temporarily aggravating the cardiovascular status of the patient, with no secondary improvement. The quantity of T3 removed was very small, about 1,000 ng per exchange. On the 14th day PTU had to be discontinued (toxic thrombopenia) and only symptomatic treatment was maintained (assisted ventilation, digitalis, hyperalimentation). In the 4th month, while the patient had a high total serum iodine, hypothyroidism developed due to partial block of the organification of the iodine with high TSH and fixation; this state also lasted 4 months. Spontaneous recovery was observed after 8 months. In addition a severe peripheral neuropathy was observed during the hyperthyroid phase confirmed by electromyography, distinct from the signs of thyrotoxic myopathy. This gradually regressed over 7 months and may be attributed to amiodarone therapy. The association of these two successive types of thyroid disorder due to amiodarone is an exceptionally rare phenomenon. Severe thyrotoxicosis generally requires long-term symptomatic therapy, its natural course being towards spontaneous regression. PE are ineffective on the circulating hormonal levels and were dangerous because of the underlying cardiac disease. The development of hypothyroidism at the 4th month is explained by the persistent iodine overload, and therefore prolonged surveillance after withdrawal of therapy is advised. The neurological complication of amiodarone was quite distinct from the hyperthyroid myopathy.

Amiodarone↗
PubMed1983

[Thymic seminoma].

A 27-year-old man presented with signs of a thymic seminoma. This rare tumor is difficult to diagnose on histologic examination, and pre-operative diagnosis is important because of its marked radiosensitivity (which justifies limited excision only).

Adult↗