[Hospital pathology caused by methicillin-resistant staphylococci].
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Cross Infection↗
Biomedical subjects
Y Domart
Publications and source records attributed to Y Domart.
Use of granulated sugar in treatment of open mediastinitis after cardiac surgery.
19 critically ill adults with acute mediastinitis after cardiac surgery were treated with granulated sugar, either directly (11 patients) or after failure of continuous irrigation (8 patients). Mediastinal tissue cultures were positive in 18 patients. Packing the mediastinal cavity with granulated sugar every 3 or 4 h resulted in near-complete debridement of the wound and rapid formation of granulation tissue in all patients and sterilisation of the wound after an average of 7.6 days. Dressings were easy and painless to change. 5/19 (26%) patients died before discharge, but none because of wound complications. The rest were discharged on average 54.2 days (range 29-120) after initial debridement of the wound; 11 underwent secondary surgical closure of the wound and in 3 the wound healed by granulation tissue formation alone. No recurrence of sternal infection has occurred after a mean follow-up of 8.2 months (range 3 to 17).
Adult↗
[Reversibility of severe digitoxin poisoning with antidigoxin antibodies].
We report a case of severe digitoxin poisoning treated at the stage of ventricular fibrillation by infusion of FAB antidigoxin fragments with low in vitro covering properties. There were no side effects. The possibility of rapidly reversing the prognosis will permit the use of specific FAB fragments before the onset of potentially lethal cardiac arrhythmias, when these antibodies become more generally available.
Aged↗
[Digitoxin poisoning: reversing ventricular fibrillation with Fab fragments of anti-digoxin antibody].
Purified Fab fragments of ovine anti-digoxin antibodies (Wellcome Foundation) were used to treat a patient who attempted suicide by absorbing 10 mg of digitoxin (serum concentration 265 micrograms/l). The poor prognosis, as assessed clinically and from serum potassium levels (7.5 mEq/l), seemed to warrant such a treatment. The weak (6.85%) cross-reactivity elicited in vitro between the anti-digoxin antibodies and digitoxin was compensated by increasing the doses, but improvement was observed with 3.6 g, i.e. about half the effective dosage initially considered. The criteria of effectiveness were clinical, electrocardiographic (reversal of the ventricular fibrillation), biochemical (simultaneous and opposite changes in extra- and intracellular potassium levels, suggesting that ATPase inhibition by digitalis is a reversible process) and toxicological: there was an increase in digitoxin serum levels suggesting displacement of the drug from tissue sites to plasma and other extracellular compartments where the Fab fragments are distributed, and Fab-bound digitoxin appeared fairly rapidly in the urine, which suggested shunting of the normal hepatic metabolic pathway.
Aged↗