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Biomedical subjects

R Garnier

Publications and source records attributed to R Garnier.

At least 37 records · Page 2Linked to original sources
PubMed1996

Allergy to complex platinum salts: A historical prospective cohort study.

OBJECTIVE: To assess the incidence of allergy to complex platinum salts in a platinum refinery. METHODS: A historical prospective cohort study was carried out on 77 workers (67 men) who started work between 1 January 1979 and 31 December 1991 and who were not atopic on skin prick tests to three common allergens at the time of recruitment. Skin prick tests with complex platinum salts were carried out and diagnosis of allergy to complex platinum salts made by the company's doctor. Skin tests and medical examinations were carried out routinely every six months. Follow up was until 30 September 1992 or until leaving refinery work. RESULTS: 18 workers developed a positive result on skin tests and 23 developed symptoms, including all 18 subjects with positive skin tests; the probability of surviving (95% confidence interval (95% CI)) for 72 months after joining the company, with negative skin test results was 0.67 (0.51-0.79) or with no symptoms was 0.63 (0.49-0.75). The incidence of positive skin tests and symptoms was highest during the first two years of work. Symptoms occurred more frequently in September and October than during the other months of the year. The exclusion of atopic subjects did not seem to have resulted in a lower incidence of sensitisation. Smoking was a significant predictive factor for both positive skin tests (estimated relative risk 5.53) and symptoms (4.70). CONCLUSION: The findings confirm that smoking is and that atopy may not be a high risk factor for the development of allergy to complex platinum salts. The high incidence of sensitisation and the available data on the clinical course of sensitised workers show that sensitised workers must be promptly and completely removed from exposure.

Adolescent↗
PubMed1996

Coin-operated dry cleaning machines may be responsible for acute tetrachloroethylene poisoning: report of 26 cases including one death.

BACKGROUND: Incorrect operations by customers are not uncommon in coin-operated dry cleaning establishments; dry cleaning machines may also be poorly maintained. This may result in retention of large amounts of the cleaning solvent in dry cleaned items. CASE REPORT: A 2-year-old boy was found dead in his bed, with a strong odor of solvent in the room. Toxicological analysis demonstrated tetrachloroethylene poisoning. The solvent had been retained in the double curtains of the bedroom which had been dry cleaned in a coin-operated establishment the same day. A retrospective study at the Paris Poison Center revealed 25 additional cases, all with a favorable outcome. Analysis of the circumstances of these accidents showed that the main causes of tetrachloroethylene retention in clothes are overloading of the machine and dry cleaning of bulky items. However, failure of the dry cleaning machine may also be involved. CONCLUSIONS: To immediately reduce the health risks, consumers were informed both via the mass media and by warnings in coin-operated dry cleaning shops. A second batch of preventive measures is in preparation including modifications of the machines to limit solvent exposure and a specific regulation concerning their inspection and maintenance.

Adult↗
PubMed1996

Four cases of amitraz poisoning in humans.

Only 7 cases of human poisoning with amitraz have been previously published and most of them are poorly documented. Four additional cases are now reported. The symptoms observed were remarkably similar in all cases: all patients experienced drowsiness; 3 presented with bradycardia, miosis and/or hyperglycemia; 2 developed hypotension and/or vomiting. These symptoms are compared to those observed in previous human or animal poisoning. Alpha 2-adrenoceptor stimulation could explain the clinical and laboratory features in most cases.

Adult↗
PubMed1994

HLA class II alleles in isocyanate-induced asthma.

Studying genetic factors that control human immune responsiveness may further our understanding of specific types of asthma in which the role of immune factors is uncertain to date. HLA Class II gene products are involved in the control of immune responses. Therefore, we investigated whether HLA Class II genetic markers contribute to susceptibility or resistance to isocyanate-induced asthma (IAA) in exposed workers. We collected venous blood samples from two groups of unrelated white adults: (1) patients with isocyanate-induced asthma documented by a positive inhalation challenge; and (2) exposed individuals with no history of IAA. The second exon of DQA1, DQB1, DPB1, and DRB genes was selectively amplified by the polymerase chain reaction (PCR) method. HLA typing was carried out by the PCR-RFLP method, which allowed discrimination of most HLA DQA1, DQB1, DPB1, and DRB alleles. No significant difference was found in the distribution of DPB1 alleles between patients and control subjects. Allele DQB1*0503 and allelic combination DQB1*0201/0301 were associated with susceptibility to the disease. Conversely, allele DQB1*0501 and the DQA1*0101-DQB1*0501-DR1 haplotype conferred significant protection to exposed healthy control subjects. Our results are consistent with the hypothesis that immune mechanisms are involved in isocyanate-induced asthma and that specific genetic factors may increase or decrease the risk of developing IAA in exposed workers.

Adult↗
PubMed1994

Acute zolpidem poisoning--analysis of 344 cases.

Zolpidem is a new short acting hypnotic agent, first launched in France in 1988. Three hundred forty-four cases of intentional acute overdoses are reviewed retrospectively. Patients were predominantly female (70%) in their third or fourth decade. Ingested doses of zolpidem ranged between 10 and 1400 mg (one pack or less in 80%). Half of the patients ingested other substances (psychotropic drugs and alcohol) concomitantly. Signs of intoxication were observed in two thirds of the population but could be attributed to zolpidem in only 105 cases: drowsiness (N = 89) occurred at doses of 140 to 440 mg; coma (N = 4) or respiratory failure (N = 1). Other symptoms were rare (excepted vomiting, N = 7). Of the rare electrocardiographic or biological abnormalities, none appeared to be directly related to zolpidem. Therapy for intoxication was usually limited to supportive measures and/or gastric lavage. Symptoms of intoxication rapidly remitted in 91% of cases. Three percent of patients with multiple drug ingestion recovered despite severe complications during intensive care. Fatalities were reported for 6% but could not be directly linked to zolpidem. Previous published reports are confirmed: zolpidem acute overdose is generally benign and requires no specific therapeutic measures.

Adolescent↗
PubMed1994

Effects of occupational lead exposure on motor and somatosensory evoked potentials.

In order to objectivate the effects of inorganic lead compounds on the nervous system, 17 men occupationally exposed have been recorded for Motor Electric Potentials (MEPs) of the abductor policis brevis muscles with transcranial, cervical root and peripheral electrical stimulations, for Somatosensory Evoked Potentials (SEPs) of median and tibial posterior nerves, and for Electromyography (EMG). Considering each subject, 16 out of the 17 lead exposed ones exhibited electrophysiological abnormalities, occurring at both peripheral and central levels for the somatosensory as well as for the motor systems. As compared to a normal control group, the lead exposed one showed decreased sensory and motor peripheral conduction velocities, increased motor central conduction time, and delayed cortical P22 SEPs component that could be interpreted as a sensory-motor cortical dysfunction. The respective contributions of MEPs and SEPs are compared to clinical, biological and EMG examinations in the evaluation of the neurotoxic effects of inorganic lead compounds.

Adult↗
PubMed1994

Paraquat poisoning by skin absorption: report of two cases.

Two cases of paraquat poisoning resulting from skin absorption are reported. One patient died from respiratory failure 26 d after deliberate application of the herbicide onto his whole body as a treatment for scabies. The other patient developed extensive dermatitis (probably a complication of pre-existing psoriasis). Only a moderate and transitory impairment of this latter patient's renal and respiratory functions were observed after repeated exposure of his damaged skin to a dilute paraquat spray.

Adult↗
PubMed1993

Evoked potentials and cerebral blood flow in solvent induced psycho-organic syndrome.

Epidemiological studies have provided evidence that neuropsychiatric symptoms are induced by long term exposure to solvents; individual diagnosis with psychometric tests, however, is not always possible (for example, when the patient has linguistic difficulties). Therefore evoked potentials and cerebral blood flow were studied in 50 patients occupationally exposed to solvents who were referred to our department and for whom a solvent induced psycho-organic syndrome was suspected. Degree of exposure was evaluated by its duration (mean 13.9, range 1 to 37 years) and its intensity (from an interview). At the group level, P22 and N35 latencies and amplitude N20-P22 of somatosensory evoked potentials were higher in cases than in controls (p < 0.05), whereas there was no difference for brainstem and visual evoked potentials, nor for hemispheric cerebral blood flow (but a higher distribution in the left occipital region was seen in patients, p < 0.05). Some parameters were linked to degree of exposure (amplitude N20-P22 of somatosensory evoked potentials, interpeak latency I-V of brainstem evoked potentials, distribution of cerebral blood flow in the internal frontal left region). At the individual level, these examinations were not of diagnostic value because sensitivity was low.

Adult↗
PubMed1991

[Acute accidental poisoning with hospital disinfectant. 45 cases of which 13 with fatal outcome].

Airsane HP 800 is a disinfectant widely used in hospitals as a powder to be diluted in water. It mainly contains a mixture of quaternary ammonium compounds. Forty five cases of acute accidental poisoning with this product have been reported to the Paris Poison Centre. All the victims were mentally disturbed patients: 2 were young adults hospitalized in psychiatric units and the other 43 were old people hospitalized for senile dementia. All ingested the solid preparation which was left in their room by hospital workers who did not know it was dangerous. Corrosive burns of the mouth, pharynx, oesophagus and sometimes of the respiratory tract were produced in most patients. Thirteen of them died. All were old persons. Ten had inhalation pneumonitis and died of acute respiratory distress one hour to twelve days after taking the powder. Progressive deterioration was responsible for the death of the other three between the 19th and 40th days. These severe accidental poisonings could easily be prevented by a better information of hospital workers, and by storing the disinfectant and preparing the solution beyond the reach of patients.

Adolescent↗
PubMed1991

[Lead poisoning in children. Apropos of 129 cases].

One hundred and twenty nine children with chronic lead poisoning were followed from August 1985 to July 1989. Old lead paint was recognized as the contaminant source at home. Pica of paint flakes was the main mode of intoxication. Children were classified according to the Center for Disease Control 1985 as follows: class IV (39 cases), class III (45 cases), class II (30 cases), class I (15 cases). Nineteen of those in class IV had blood lead levels above 700 micrograms/l and received BAL + EDTA followed by EDTA alone for a mean of 4.6 +/- 3.5 courses. With this treatment, blood lead level decreases were 50 +/- 17%. Nine of these class IV children had an evaluation at last 3 months after the last chelation course: 5 became class I or II, and 2 class III with a negative provocative test. The remaining 20 children in class IV were given a mean of 2.7 +/- 1.4 courses of EDTA. Blood lead levels decreased by 52 +/- 15%; 11 children were evaluable at least 3 months after the last chelation course: 4 became class I, and 7 class II. Thus overall 80% of class IV moved under treatment to class I or II. Among those 45 children in class II, 30 underwent a provocative test and 24 one to three courses of EDTA: 8 were further studied: 3 became class I and 5 class II. Combination of screening, medical treatment and sociocultural approach led to avoid acute effects of severe chronic childhood lead poisoning. The efficacy of such an approach in preventing chronic effects has still to be evaluated.

Chelating Agents↗
PubMed1990

Specific anti-digoxin Fab fragments: an available antidote for proscillaridin and scilliroside poisoning?

The purpose of this study was to evaluate the capacity of specific anti-digoxin Fab fragments to bind to and neutralize scilliroside and proscillaridin in acute poisoning. Apparent affinity constants were determined with values of 2.6 10(8)M-1 for scilliroside and 3.8 10(7)M-1 for proscillaridin. These results are in accordance with a possible in-vivo neutralization of these toxins.

Antibody Affinity↗
PubMed1990

Sensory and cognitive event related potentials in workers chronically exposed to solvents.

To obtain objective measures of possible impairment due to organic solvents, auditory, visual and somatosensory evoked potentials and cognitive event related potentials were recorded in a group of 13 workers occupationally exposed to a mixture of various solvents. The patients were compared to healthy subjects and to chronic alcoholics seen during post-alcohol withdrawal. Auditory and visual evoked potentials were almost normal but somatosensory evoked potentials showed a slight decrease of peripheral conduction velocities and an increase of central conduction times more marked in the solvent exposed workers who were also alcoholics. The late "cognitive" components reflecting attention processes (N2 and P3) were normal. Solvent-exposed workers and alcoholics were both characterized by some difficulty in modulating their attentional resources according to task demands, as reflected by a tendency to responses (N1, N2 and P3) of similar amplitudes whether the stimulus was or was not the target. These findings support the presence, in solvent exposed workers, of minor dysfunction of the nervous system at both peripheral and cortical levels potentiated by alcohol as well as of mild cognitive impairments concerning attention processes.

Adult↗