Biomedical subjects
Publications and source records attributed to F Bonnaud.
The theophyllinemia variations depend upon some factors: -observance of treatment, time of blood swab posology, laboratory technic, concomitant drugs, method of adaptation selected and the mean of administration. The theophylline title is a very important biologic parameter, necessary to the asthma treatment survey through such drug. Daily posology may be adapted to this titrate.
The author does a general survey on this subject. Having evoked the EAA history, he describes the clinical syndrome with 3 forms (sharp to chronic). He relates in a first part, the main forms linked with rural occupation, from farmer's lung disease, the most frequent, to illnesses dues to cereals, woods exposition, then the one in touch with industry as coffee workers disease, and breeders of silkworms. At last, the ones in connection with urban activities as air-conditioner disease. These descriptions ended with EAA caused by a drug. Having evoked the complementary investigations necessary for diagnosis, he insists on the alveolitis washing and biochemicals studies. In conclusion, the author insists on the interest of steroids treatment in attacks.
Adverse reactions in anesthesia are more and more frequent. The favoring factors are multiple but the physiopathology of these reactions are not right known: non specific histamine-release, complement activation is anaphylaxis can occur. Skin tests are an very important data for the diagnosis of these accidents. Forty patients and ten healthy subjects were tested with systematic research of a cross-reactivity for curare family; myorelaxants, fluid gelatin, dextran are the tests the most frequently positive. Cross reactivity for curare family is sure and sensibilization by some medicine is possible. Then the behavior of the data is looked at; the research of the favoring factors, the non utilization of some substances and prophylactic treatment are recommended.
The domiciliary treatment of severe chronic respiratory failure (I.R.C.) by oxygen or assisted ventilation was accomplished by members of a recently created national organisation (ANTA-DIR, 1980). This work reports the results of a survey carried out in Nice on 19 patients (12 men and 7 women) followed for more than a year. A questionnaire was filled in at the home of each patient, primarily to assess the functional outcome and the level of compliance of the therapy prescribed. We noticed and 86% drop in the number of days spent in hospital over a 2 year period. An analysis of the diary cards on the use of respiratory equipment, as well as oxygen consumption compared to the therapy initially prescribed, allowed an analysis of the degree of patient compliance. This was very good in only 3 out of 19 subjects and on average the prescribed therapy was followed for only two thirds of the time. However, a functional evaluation using simple clinical criteria showed a discernible improvement in 11 patients, who had a better quality of life and a greater autonomy since coming under supervision.
A patient with primary pulmonary artery hypertension diagnosed by pulmonary arterial catheterisation, angiography and lung biopsy was the subject of several therapeutic trials of vasodilators. The short term and long term results over the next four years were on the whole disappointing. The type of study protocole used is discussed, as are the risks and cost.
The authors report 3 cases of endobronchial metastases of visceral carcinomas (kidney, breast, pancreas). With the aid of a review of the 144 cases found in the literature, they analyse the characteristics of this special type of secondary neoplasm and their diagnostic, physiopathological and therapeutic aspects.
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The therapeutical use of bronchial fibroscopy is very promising. Already today it is much used in postsurgery atelectasies by obstruction or in suppurative atelectasies related to important infectious foci. It considerably improves the bronchial clearing previously done by blind aspiration or bronchoscopy. The coupling of this aspiration to a perfusion-lavage in severe suppurative bacterial pneumopathies yielded interesting results.
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The authors have developed a technique of sampling and analysis of capillary blood which they describe here. Applied to 34 patients, it gives excellent correlations, both for PO2-PCO2 and pH. The advantages of capillary methods and their disadvantages are discussed.
The authors report a case of benign tumour of the pleura in a 74 year old woman. This is a pediculated tumour of the right base posteriorly above the diaphragm, the pleural nature of which was recognised before surgery and which, microscopically, proved to be a localized, benign mesothelioma of fibroblastic type. Benigh tumours of the pleura are rare but raise two interesting problems: that of their precise origin which is debated, and their prognosis; the possibility of relapse should be borne in mind.
The authors report two cases of carcinoma of the ampulla of Vater with numerous pulmonary metastases. This carcinoma is a malignant tumour with a very poor short-term prognosis. This tumour develops at the expense of the ampulla of Vater and may give rise to numerous pulmonary metastases and carcinomato,s lymphangitis. Authors are not unanimous concerning the course and prognosis of these tumours. In fact, one may note two tendencies, one optimistic, which seems to us erroneous, the other pessimistic, which we share.
The validity of measurement of bronchial air flow, using Wright's air flow meter, was studied comparing the maximum air flow thus obtained with the maximum expiratory volume in one second, used as unit of reference. During a first stage, the reproducibility of the test was determined this was excellent, 3.26% for the maximal flow rate and 2.48% for the maximum volume expired in one second. During a second stage were drawn up correlations between the two tests which were very narrow: O.971 in healthy sbjects, 0.919 in sick patients. The Wright flow meter is a strong, reliable and inexpensive instrument and will thus be very useful in the daily assessment of bronchiolar constriction at the bed side, and in the routine detection of obstructive syndromes.
Idiopathic pulmonary hemosiderosis gives rise to anemia, due to repeated intra-alveolar hemorrhage, the reabsorption of which leads to hemosiderin deposits in the lung parenchyma. The authors report a case in a young woman aged 24 years whose illness started with anemia, then two months later, with hemoptysis and a broncho-pulmonary syndrome with a low grade fever. On the 6th month, there occurred a hazy infiltrate of both lung bases which was fleeting, mobile and recurrent. In the light of this triad of anemia, hemoptysis and infiltrates, the diagnosis of idiopathic pulmonary hemosiderosis was made and confirmed by three examinations:--Lung biopsy: siderophages were found in the sub-mucosa,--Radio-isotope examination, using Fe 59 which revealed iron deposits in the lung,--A surgical lung biopsy which showed a congestive area and a fibrous area. The congestive area was the site of recent hemorrhage, the alveolar limits were filled with siderophages. The fibrous area was the site of chronic repair of older hemorrhage. It was mutilating. The course was complicated by massive bleeding which led to acute recovering respiratory failure. The patient is at present stabilised by corticosteroids. Three hundred cases of idiopathic pulmonary hemosiderosis have been reported in the world literature. Although the main characteristic is intra-alveolar hemorrhage, its course has not yet been determined. It seems however, to be due to an immunologic process as shown by the relationship between this curious disease and Goodpasture's syndrome.