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Biomedical subjects

P Sauder

Publications and source records attributed to P Sauder.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Immunoallergic intravascular hemolysis and tubulointerstitial nephritis due to penicillin G].

A 51-year old woman treated with high doses of penicillin G developed acute intravascular haemolysis and tubulointerstitial nephritis. Immunological investigations showed circulating immune complexes, decreased C3 and C4 components of complement, IgG deposits in the renal interstitium, positive direct Coombs test with anti-IgG sera and complement and circulating anti-penicillin antibodies demonstrated by indirect antiglobulin tests and IgG RAST. Plasma haemoglobin and anti-penicillin antibodies could be removed by an early exsanguino-transfusion. These findings suggest that the nephritis was due to immune complexes and the haemolysis, to a combined hapten-type and immune complex mechanism.

Anemia, Hemolytic, Autoimmune↗
PubMed1983

Haemodynamic studies in eight cases of acute colchicine poisoning.

1 The authors performed haemodynamic studies in 8 cases of colchicine poisoning. The doses absorbed ranged between 9 and 160 mg (mean dose 39 mg). THe haemodynamic study was performed between the 6th and 72nd h after intoxication, before and after plasma infusion (370 ml over a period of 20 minutes). 2 Four patients had severe shock with decreased cardiac index (CI) and increased sytsemic vascular resistance (SVR). Four patients had a hyperkinetic state with increased CI and decreased SVR. The four patients with cardiac failure died, the others recovered. 3 Haemodynamic study of acute colchicine poisoning is of therapeutic and prognostic interest. Hypovolaemia is always present. An initial decrease of cardiac performance is an index of severity with a lethal outcome.

Adolescent↗
PubMed1983

Acute voluntary intoxication by ricin.

1 A 21-year-old student ingested thirty ricin seeds in a suicidal attempt, some of which were masticated. Three hours later he developed severe diarrhoea with vomiting and abdominal cramps, followed by extracellular dehydration and circulatory collapse. 2 Biological changes included haemoconcentration. He recovered following symptomatic treatment by infusion of saline and glucose solutions. 3 Ricin was quantified by a radioimmunologic method using Iodine 125, and showed that only a small part of the ricin contained in the seeds was absorbed.

Adult↗
PubMed1983

[Pulmonary edema caused by heroin. Hemodynamic study of 2 cases].

The authors report two cases of heroin induced pulmonary edema. In both cases the severity of respiratory failure, attested by a deep hypoxemia (paO2 28 and 32 mmHg) and a metabolic and respiratory acidosis (pH 7.07 and 7.14) imposed an artificial ventilation with positive end expiratory pressure (PEEP). Hemodynamic study revealed a noncardiogenic edema. In both cases, a cardiac insufficiency was also present : in the first case it's etiology remained unclear, in the second it was a complication of hyperkalemia.

Acidosis↗
PubMed1983

[Acute poisoning by inhalation of metallic vapors].

Seven cases of acute intoxications by inhalation of metallic vapors are reported. The metals involved were zinc in three cases, tin in one case and mercury in three cases. The severity of the respiratory symptoms was dependent from the inhalated metal. The inhalation of zinc or tin vapors produced an acute limited pneumonitis. A lesional pulmonary oedema and acute interstitial fibrosis with lethal outcome was observed in two cases of intoxication by mercury vapors. The treatment by dimercaptopropanol used in mercury intoxications, increased urinary mercury excretion, but did not improve the pulmonary symptoms.

Adult↗
PubMed1982

[Acute nadoxolol poisoning. A multicentric study of 35 cases].

Between 1976 and 1980, 35 cases of nadoxolol poisoning were collected from french antipoison centers. Acute intoxication was voluntary (50%) or accidental (50%). The ingested dose ranged between 0,25 and 22,5 g. Clinical symptoms appeared three hours after ingestion and consisted of cardio-vascular disorders which were present in 10 patients: bradycardia (7 cases), cardiogenic shock (6 cases), intraventricular block (5 cases), increase of P.R. interval (4 cases) and Q.T. interval (3 cases). The toxic dose in otherwise healthy adults was 5 g. The treatment consisted of gastric lavage and correction of cardiovascular disorders with sodium lactate (4 cases) or dopamine (1 case). All the patients recovered.

Acute Disease↗
PubMed1981

[Acute voluntary or accidental disopyramide poisoning. A multicentric study of 106 cases (author's transl)].

Between 1972 and 1978, 106 case-records of disopyramide poisoning were collected from French anti-poison center. Acute intoxication was voluntary in 90% of the cases and occurred in young adults. Clinical symptoms appeared early and consisted mostly of cardiovascular disorders, which were present in 60 patients: cardiogenic shock (24 cases), circulatory arrest (17 cases), atrio-ventricular block (21 cases), intraventricular block (24 cases) and severe ventricular arrhythmia (12 cases). The toxic dose in otherwise healthy adults was 1,5 g and the mortality rate was high (12,2%). An analysis of therapeutic measures and outcome indicated that the best treatment consists of early gastric lavage, cardiorespiratory manoeuvres, electric heart stimulation, administration of sodium lactate in cases with intraventricular conduction disturbances and isoprenaline in cases with cardiogenic shock.

Acute Disease↗
PubMed1978

[Early surgical treatment of a septal perforation complicating a posterior infarct. Value of the diaphragmatic left ventricular approach].

The authors report the case of a 53 year old patient who required operation on the 5th day after postero-inferior myocardical infarction for a poorly tolerated perforation of the ventricular septum. In discussing this case, they recall that the results for surgical repair of septal perforations complicating myocardial infarction are poorer when the infarction is posterior than when it is anterior. They suggest that this difference in prognosis is in large part due to the customary use in postero-inferior infarcts, of the right transventricular approach, which does not allow the infarct to be resected at the same time as the septum is closed. They finish by recommending the systematic use of a diaphragmatic approach to the left ventricle, including resection of the infarct, for all cases of septal perforations with posterior infarction in which surgery is necessary.

Cardiac Catheterization↗
PubMed1977

[Massive mitral insufficiency due to spontaneous and isolated rupture of a posterior papillary muscle. Echocardiographic study, treatment by assisted circulation and prosthetic valve replacement].

The authors report a case of a patient of 72 years of age in whom the sudden onset of severe left ventricular failure led to the discovery of massive mitral incompetence. The diagnosis of rupture of the posterior papillary muscle of the mitral valve, which was suggested on clinical and echocardiographic grounds, was confirmed at operation. This was carried out after 72 hours of assisted circulation by counter-pressure, and consisted of a replacement by a prosthetic valve. The authors emphasise, in the light of this case, the importance of echocardiography by ultrasound in the early diagnosis of this type of acute mitral incompetence, clarify the signs, and emphasise the part played by assisted circulation with an intra-aortic balloon in the treatment of this condition.

Aged↗
PubMedDate not supplied

Clinical features and management of poisoning due to antimalarial drugs.

The toxicities of antimalarial drugs vary because of the differences in the chemical structures of these compounds. Quinine, the oldest antimalarial, has been used for 300 years. Of the 200 to 300 compounds synthesised since the first synthetic antimalarial, primaquine in 1926, 15 to 20 are currently used for malaria treatment, most of which are quinoline derivatives. Quinoline derivatives, particularly quinine and chloroquine, are highly toxic in overdose. The toxic effects are related to their quinidine-like actions on the heart and include circulatory arrest, cardiogenic shock, conduction disturbances and ventricular arrhythmias. Additional clinical features are obnubilation, coma, convulsions, respiratory depression. Blindness is a frequent complication in quinine overdose. Hypokalaemia is consistently present, although apparently self-correcting, in severe chloroquine poisoning and is a good index of severity. Recent toxicokinetic studies of quinine and chloroquine showed good correlations between dose ingested, serum concentrations and clinical features, and confirmed the inefficacy of haemodialysis, haemoperfusion and peritoneal dialysis for enhancing drug removal. The other quinoline derivatives appear to be less toxic. Amodiaquine may induce side effects such as gastrointestinal symptoms, agranulocytosis and hepatitis. The main feature of primaquine overdose is methaemoglobinaemia. No cases of mefloquine and piperaquine overdose have been reported. Overdose with quinacrine, an acridine derivative, may result in nausea, vomiting, confusion, convulsion and acute psychosis. The dehydrofolate reductase inhibitors used in malaria treatment are sulfadoxine, dapsone, proguanil (chloroguanide), trimethoprim and pyrimethamine. Most of these drugs are given in combination. Proguanil is one of the safest antimalarials. Convulsion, coma and blindness have been reported in pyrimethamine overdose. Sulfadoxine can induce Lyell and Stevens-Johnson syndromes. The main feature of dapsone poisoning is severe methaemoglobinaemia which is related to dapsone and to its metabolites. Recent toxicokinetic studies confirmed the efficacy of oral activated charcoal, haemodialysis and haemoperfusion in enhancing removal of dapsone and its metabolites. No overdose has been reported with artemesinine, a new antimalarial tested in the People's Republic of China. The general management of antimalarial overdose include gastric lavage and symptomatic treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

Antimalarials↗
PubMedDate not supplied

Composition of phospholipid fatty acids in red blood cell membranes of patients in intensive care units: effects of different intakes of soybean oil, medium-chain triglycerides, and black-currant seed oil.

Fatty acid composition of phospholipids in red blood cell membranes was studied in 32 severely head-injured or cerebral stroke patients receiving enteral nutrition for 3 weeks. During this study the effects of three diets differing only by their lipid composition were investigated. The daily energy intake of each patient amounted to 2950 kilocalories, of which the lipid fraction represented 45.7%. Diet A contained only soybean oil, diet B consisted of a 50% soybean oil and 50% medium-chain triglycerides mixture, and diet C was an emulsion of 50% soybean oil, 42.5% medium-chain triglycerides, and 7.5% black-currant seed oil. Our results showed no biochemical signs of fatty acid deficiency in red blood cell membranes for the patients at the beginning of the study, after a comparison with a control group of 20 healthy adults. Inhibition of delta 6-desaturase activity on linoleic acid (C18:2 omega 6) after diet A was suggested by an increase of linoleic acid without a corresponding increase of dihomo-gamma-linolenic acid (C20:3 omega 6). Replacing 50% of soybean oil by with medium-chain triglycerides (diet B) prevented this enzyme inhibition. Supply of black-currant seed oil rich in gamma-linolenic (C18:3 omega 6) and stearidonic (C18:4 omega 3) acids (diet C) induced significant increases of dihomo-gamma-linolenic and eicosapentaenoic (C20:5 omega 3) acids, without influencing arachidonic acid (C20:4 omega 6) levels. This balance was evaluated through the ratio (C20:3 omega 6 + C20:5 omega 3)/C20:4 omega 6.

8,11,14-Eicosatrienoic Acid↗