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Biomedical subjects

P Trunet

Publications and source records attributed to P Trunet.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Penicillin-induced encephalopathy].

Five cases of encephalopathy due to intravenous penicillin treatment (penicillin G sodium in 4 cases, oxacillin in 1) are reported in 5 uraemic patients. The first abnormalities noted were decreased consciousness and myoclonic jerks (3 cases), followed by seizures and coma (2 cases). Lumbar puncture and cerebral computed tomography gave normal results. Electroencephalograms showed diffuse sharp and slow activities over the brain areas. The diagnosis was confirmed by the high blood levels of the penicillins. Three patients recovered after discontinuation of the drugs; two patients died in status epilepticus and coma resistant to all treatments.

Adult↗
PubMed1982

Diagnostic features of early high post-laparotomy fever: a prospective study of 100 patients.

To define the most important diagnostic signs, symptoms and laboratory findings related to intra-abdominal sepsis in the early post-operative period, 15 binary variables were prospectively assessed in 100 febrile (greater than 39 degrees C) post-laparotomy patients admitted to an intensive care unit. Intra-abdominal sepsis was found alone in 55 patients and in association with an extra-abdominal focus in 11 patients. Fever was related to an extra-abdominal septic focus in 23 patients and no infectious cause was found in 11. Analysis (chi 2) indicated that 6 of the 15 variables were significantly associated with an intra-abdominal focus of infection. The predictive value of each variable, indicated by relative risk, ranked the six variables in order of diagnostic importances: no bacteraemia (1.67), leucocytosis (1.60), ileus (1.50), mental disturbances (1.41), contaminated first laparotomy (1.38), abdominal tenderness (1.22). The absence of bacteraemia was the most important finding separating intra- and extra-abdominal foci of infection. In a febrile post-laparotomy patient with any evidence of sepsis, the absence of bacteraemia should not lull the physician into a false sense of security but rather alert him to the likelihood of an intra-abdominal septic focus.

Abdomen↗
PubMed1982

Computed tomography and post-laparotomy intra-abdominal abscesses.

Thirty-one patients were prospectively studied and had abdominal computed tomography for post laparotomy sepsis. Computed tomography is of particular interest in seriously ill post-operative patients, 15 of our patients were on ventilators, and it enabled diagnosis and localization of abscesses in 15 patients. Drainage could therefore be achieved via a limited surgical approach, and extensive laparotomy was avoided. Of 16 patients without abscess, the abdominal computed tomogram was negative in 14 cases and there were two false positives. The overall accuracy was 0.94 with a sensitivity of 1 and a specificity of 0.88. The ability to screen the whole abdomen and exactly localize the lesion are the advantages of this non-invasive method.

Abdomen↗
PubMed1982

Influence of age, previous health status, and severity of acute illness on outcome from intensive care.

Age, previous health status (HS), and severity of acute illness were assessed prospectively on 228 unselected patients admitted over 1 yr to the multidisciplinary ICU, to determine their influence on outcome. One hundred and fifty patients (66%) were discharged from the ICU, but the survival rate fell to 50% at 6 months, and was similar after 1 yr (49%). Over a 6-month period, there was improved HS in survivors which gradually leveled off. Compared to prior HS, the final HS was worsened in 37% of survivors. Three factors were important predictors of late survival: age under 50, good previous HS, and less than two visceral failures. We conclude that evaluation of ICU outcome should provide information on 6-month survival and HS and include important variables as age, previous HS, and severity of acute illness.

Acute Disease↗
PubMed1981

[A rare cause of acute respiratory distress syndrome in adults: acute disseminated pulmonary tuberculosis. Four cases (author's transl)].

Four cases of acute respiratory distress syndrome due to miliary tuberculosis are reported. All four patients had tuberculin anergy; three developed disseminated intravascular coagulation. All were treated early with anti-tuberculous drugs. Three patients were intubated and ventilated with positive end expiratory pressure, but they died shortly afterwards. The fourth patient was treated with continuous positive airway pressure and corticosteroids and survived. In view of such reports, the possibility of tuberculosis should be considered systematically in all adult patients with unexplained acute respiratory distress syndrome. The extremely rapid course of the disease and the inconsistent results of standard examinations for tuberculosis justify an "aggressive" diagnostic approach. Extra-pulmonary biopsies, notably of the bone marrow, are very helpful.

Acute Disease↗
PubMed1980

The role of iatrogenic disease in admissions to intensive care.

We prospectively studied all patients admitted to a multidisciplinary intensive care unit to determine how many of their diseases were iatrogenic and, of these, what number were potentially avoidable. Of 325 patients admitted in the course of one year, 41 (12.6%) were hospitalized because of iatrogenic disease. Many of these patients had concomitant serious illnesses. Nevertheless, 19 patients (46.3%) were admitted with iatrogenic disease resulting from therapeutic or technical errors that were potentially avoidable. Iatrogenic disease was fatal in eight cases, life-threatening in 13, moderate in 20.

Adolescent↗
PubMed1979

[Acute tubular necrosis in acute alcoholic hepatitis with cardiac beriberi (author's transl)].

In one case of fulminant hepatic failure by acute alcoholic hepatitis, renal failure seemed to be related to active renal vasoconstriction by systemic endotoxemia due to impaired hepatic clearance of toxins, associated with or complicated by a located intravascular coagulation with acute tubular necrosis. The associated thiamin deficiency may have accentuated this renal vasoconstriction.

Acute Disease↗
PubMed1976

[The changes of survival of patients hospitalized in a resuscitation service].

In order to define criteria of prognosis for patients hospitalized in intensive care units, 2105 cases of patients treated for an acute life threatening illness for 4 years were reviewed. According to severity of initial illness, 3 groups were defined: Ist one initial illness, presumably reversible (55,3%), IInd, several initial illnesses presumably reversible (27,7%), IIIrd, one or several initial illnesses, with at least one of them presumably irreversible (17%). Total mortality was 31,3%, significantly lower in women than in men. According to groups, mortality was 8,7% in the Ist, 42,7% in the IInd (p less than 0,0001), 88,8% in the IIIrd (p less than 0,0001). In any group prognosis was influenced by the type of initial disease (respiratory, circulatory, renal or metabolic, septic, neurologic and hepato-digestive failure). In groups I and II mortality was greater when high risk factors exist, and is more and more bad with age, but always minus that 50%. In the group III mortality was the same with or without high risk factors, was not influenced by age, and was always near 90%. For 4 years, mortality significantly lowered in the group II, from 57% to 29%. We conclude that treatment in an intensive care unit of life threatening visceral acute failure has a poor result when this later is related to an chronic or non presumably reversible disorder. In other cases high risk factor, particularly old age, is not a contre indication to treatment in an intensive care unit.

Adolescent↗