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J Rochemaure

Publications and source records attributed to J Rochemaure.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Thoracic actinomycoses. General illustrated review of 4 surgical cases].

Actinomycosis of the lung is rare and difficult to diagnose. Its good prognosis after medical treatment contrasts with the high frequency of surgical excision, due to the fact that pre-operative diagnosis is exceptional. Following a review of the recent bacteriological, radiological and therapeutic data available in the literature, 4 personal cases are presented. In all 4 cases actinomycosis was diagnosed post-operatively on the presence of yellow grains in the histological specimens. In 2 cases surgical excision proved impossible, but an almost complete radiological recovery could be obtained after prolonged treatment with co-trimoxazole. This shows how important it is to be aware of the disease, to improve its diagnostic approach and to remember its sensitivity to antibacterial agents, even in well organized forms.

Actinomycetales Infections↗
PubMed1986

[Intravenous theophylline: adaptation of dosage to blood theophylline levels at admission and to clearance].

Intravenous infusions of aminophylline expose the patient to the risk of overdosage related to the narrow safety margin of the therapeutic concentrations and to the great individual variability of its excretion. The aim of this study was to evaluate a simplified protocol designed to determine the optimal dose of theophylline based on total body clearance. Forty-four patients (average age: 63 years) admitted with decompensation of chronic respiratory failure (N = 33) or with status asthmaticus (N = 11) were studied. Theophylline was administered initially at a constant rate R0 (mg/kg/h) depending on serum theophylline concentrations on admission T0 (mg/l): R0 = 0.75 - 0.75 T0/20. Serum theophylline concentrations were measured at the 6th and 12th hours (T6 and T12) for calculation of clearance (Chiou et al. J. Pharmacokinet. Biopharm., 1978, 6, 135-151) and for adjusting dosage R. After 48 hours of treatment at this infusion rate, serum theophylline was again measured (T48) to check the adjustment of the dosage and recalculate clearance. In 11 patients T0 was greater than 15 mg/l (max = 44) and T12 was 10.5 +/- 6.4 mg/l. Theophylline was withdrawn in 6 patients with initial clearances less than 5 ml/kg/h (zero in 5 cases). T48 was within therapeutic values (10-20 mg/l) in 55 p. 100 of cases (21/38). Twelve patients had T48 less than 10 mg/l due to an increase in theophylline clearance (+ 80 p. 100 on average) related to improved right ventricular function in 7 cases. In 5 patients T48 was greater than 20 mg/l (max = 27.5) due to a fall in clearance (average -47 p. 100) which could have been caused by administration of erythromycin in 1 case and by dose-dependent kinetics in 2 cases. This protocol which is simple to carry out in practice allows early adjustment of dosage to give effective serum theophylline concentrations in over 50 p. 100 of cases. No serious cases of overdosage were observed, even in patients with high T0 and/or low initial clearances. Under-dosage and overdosage are related to large individual variations in theophylline clearance.

Aged↗
PubMed1985

Pulmonary polymorphic centroblastic type malignant lymphoma in a patient with lymphomatoid granulomatosis, Sjögren syndrome and other manifestations of a dysimmune state.

A case of lymphomatoid granulomatosis arising in a patient with a long history of dysimmunity is reported. The autopsy reviewed the final evolution into a high grade malignant lymphoma with IgM K immunoglobulin production and discovered in deep lymph nodes modifications similar to angio-immunoblastic lymphadenopathy.

Adult↗
PubMed1985

[Value of alveolar lavage and transbronchial biopsy in the diagnosis of isolated sarcoid uveitis].

The diagnosis of sarcoidosis is established by biopsy of sarcoid tissues demonstrating non-caseating granuloma, but difficulties arise when extra pulmonary organs are involved separately. Positive histologic signs can however be found in the lung even when there are no radiologic features. Bronchoalveolar lavage and biopsies were performed in 19 patients presenting severe, strictly isolated uveitis (5 cases of anterior uveitis, 3 cases of posterior uveitis and 11 cases of panuveitis). Criteria of positivity were non-caseating granuloma and lymphocytosis. Positive signs were obtained in 6 cases (31,5%); 1 case of posterior uveitis and 5 of panuveitis. There was no case of false positive results but one false negative result. There was a lack of correlation between results of these investigations and angiotensin converting enzyme blood levels. These investigations are non-invasive in experienced hands.

Adult↗
PubMed1985

[Chemotherapy of bronchopulmonary and pleural adenocarcinoma. Apropos of 31 cases].

Between January 1978 and June 1983, 31 patients aged between 35 and 73 years, with an adenocarcinoma of the respiratory system (25 lung cancers and 6 pleural cancers) were treated by chemotherapy, either exclusively or following failure of surgery. In 21 patients, the treatment consisted of a combination of cyclo-phosphamide (600 mg/m2), adriamycin (40 mg/m2) and 5-fluoro-uracil (600 mg/m2) by intravenous injection, every four weeks. The other 10 patients received different treatments, but platinum salts were administered in only 2 cases. The treatment was fairly well tolerated (only 1 death due to toxicity), but the effectiveness remained disappointing: only 1 complete response (alive after 48 months), 2 partial responses and 4 stabilisations. The overall median survival was 9 months, with a mean survival of 11.6 months. The mean survival of the responder and stabilised patients was more than 21 months. These results lead us to recommend that, apart from randomised trials, chemotherapy should be stopped after the second course in the absence of at least a stabilisation of the disease, in which prolonged survivals are sometimes observed when treatment is limited to purely symptomatic measures.

Adenocarcinoma↗
PubMed1985

[Bronchial localization of a T-cell immunoblastic lymphoma. Transformation from mycosis fungoides].

A case report is presented of a patient with a pleural effusion subsequently shown to have a localised immunoblastic lymphoma of the bronchus of non-Hodgkin's type. The development of this lymphoma in a patient with mycosis fungoides underlines the potential for the transformation of a T cell epidermoid lymphoma of low grade malignancy to a lymphoma of high grade malignancy.

Bronchial Neoplasms↗
PubMed1985

[Respiratory pathology induced by inhalation of hair lacquer].

On the basis of a critical analysis of the literature, the authors review the various respiratory lesions imputed to the inhalation of hair lacquers. Pulmonary thesaurismosis is alleged to result from accumulation in the pulmonary parenchyma of non-biodegradable macro-molecules, such as PVP. Only isolated cases have been published and the true existence of this disease remains to be confirmed, in the absence of convincing epidemiological data as well as the lack of experimental reproducibility. Chronic inhalation of hair lacquers may, however, be responsible for bronchial irritative manifestations and obstruction of the small airways, in particular in hairdressers. Increase in the relative risk of bronchopulmonary carcinoma has not been proven.

Acute Disease↗
PubMed1985

[Contamination of bronchial fiberscopes by mycobacteria. Myth or reality?].

The authors report the results of a study into mycobacterial contamination of bronchial fibroscopes over a 6 year period during which 8,750 fibroscopies were performed. On 19 occasions, there were two positive results on the same day which could have led to contamination (0.07 p. 100). In 12 cases, there was heavy bacterial contamination on the first examination and at least 5 colonies on the second. Crossed transmission was not observed. The authors emphasize the role of the accessory parts and connections which are often neglected and which may lead to false positive results in the following patients; a sterilisation procedure is proposed which seems to be effective as no mycobacterial contamination has been observed since it was introduced.

Bronchoscopes↗
PubMed1985

[Is bronchial fiberscopy always indicated in hemoptysis? Apropos of 427 tests].

The authors report the results of a retrospective study of 427 fiberoptic bronchoscopies in patients with haemoptysis. The patients were classified into 4 groups according to the results: Group I: a specific diagnosis was made (cancer, tuberculosis, infection); 151 cases (35 p. 100); Group II: inflammatory mucosa, 172 cases (40 p. 100); Group III: normal bronchoscopy, 84 cases (20 p. 100); Group IV, only blood, 20 cases (5 p. 100). Of the 151 patients in Group I, 12 had a normal chest X-ray (8 p. 100); seven of them had bronchopulmonary carcinoma (7 out of 65 cases of cancer: 10.7 p. 100). These results show that bronchoscopy is essential in cases of haemoptysis even when the chest X-ray is normal.

Bronchial Neoplasms↗
PubMed1984

[Treatment of status asthmaticus. Prospective evaluation of a protocol combining aminophylline and terbutaline (44 cases)].

The treatment of status asthmaticus remains poorly defined. Even the definition of the condition is controversial. We have therefore attempted to define a therapeutic protocol consisting of a combination of terbutaline, aminophylline and hydrocortisone administered parenterally. We have conducted a prospective evaluation of the effectiveness and tolerance of this protocol. 44 consecutive patients with status asthmaticus (defined as an abnormally severe episode of asthma with early or marked alveolar hypoventilation: PaCO2 greater than or equal to 5.20 kPa) were entered into the study over a period of 56 months. The effectiveness of this combination is reflected by the rapid improvement in the clinical and blood gas parameters, the relatively rare use of mechanical ventilation (of brief duration) and the low mortality. The tolerance proved to be excellent, as the terbutaline only had to be stopped in 1 case (permanently) and the aminophylline in one other case (temporarily). These initial results encourage us to a more aggressive approach in the early treatment of status asthmaticus with particular attention to the associated metabolic acidosis.

Adult↗
PubMed1984

[Diffuse interstitial pneumopathy during treatment with gold salts].

A case of severe diffuse interstitial pneumonia is reported in a 69 year old after 5 weeks treatment with gold salts. Regression of symptoms on withdrawal of gold salts and under steroid therapy, the similarity with previously published cases, the absence of another cause lead us to incriminate the gold salts. The case is documented with optical and electronic microscopic studies of transbronchial biopsy and repeated examination of bronchoalveolar lavage fluid. A general review of the literature is included with a critical discussion of the physiopathogenic mechanisms. The results of the examination of the bronchoalveolar lavage fluid are further evidence in favour of cell-mediated hypersensitivity reaction.

Acute Disease↗
PubMed1983

[Small-cell anaplastic bronchopulmonary cancers. Prognostic and therapeutic review apropos 49 cases].

This retrospective study of 49 patients with small-cell broncho-pulmonary carcinoma showed the principal prognostic factor to be the response to chemotherapy: an initial treatment association of cyclophosphamide (800 mg/m2), adriamycin (60 mg/m2), methotrexate (40 mg/m2) and CCNU (60 mg/m2) every four weeks was used in 40 patients, out of 46 patients who underwent chemotherapy. All cases were followed up for a minimum of 6 months except 2 who were lost to follow-up; there are 9 survivors, all of whom initially had an apparent complete remission: the extension of the disease seemed to be of less prognostic significance than the response to treatment. The response rate to this protocol was 84 p. cent with 52 p. cent apparent complete remissions. The mean global survival rate was 9 months (mean survival rate of treated patients: 11.46 months). Some patients with disseminated carcinoma initially had very prolonged survival. The association of a final session of thoracic radiotherapy seemed to be useful (the 4 patients who underwent radiotherapy after 8 to 12 sessions of chemotherapy are still alive after an average of 18 months follow-up with no signs of recurrence).

Adult↗