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Publications (14)15.07 Total impact

  • Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2009; 26(5):567-567.
  • Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2008; 25(7):905-905.
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    ABSTRACT: Co-infection with Pneumocystis jiroveci and Mycobacterium tuberculosis is rarely reported in patients without HIV infection. We report the case of a 30 year old woman admitted to hospital for respiratory distress associated with a diffuse infiltrative pneumopathy. Corticosteroid therapy had been started two months earlier for suspected pulmonary sarcoidosis. Fibreoptic bronchoscopy and broncho-alveolar lavage produced evidence of Mycobacterium tuberculosis and cysts of Pneumocystis jiroveci. HIV serology was negative. Clinical progress was satisfactory following anti-tuberculous and anti-fungal therapy. Pneumocystis pneumonia is rare in subjects without HIV infection and is most often associated with a pathology or treatment leading to depression of cellular immunity. Corticosteroid treatment, even of short duration, presents the greatest risk. Systematic antibiotic prophylaxis should be considered in relation to the immune status of the patient. Co-infection with the tubercle bacillus as reported here is exceptionally rare.
    Revue des Maladies Respiratoires 03/2006; 23(1 Pt 1):83-7. · 0.50 Impact Factor
  • Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2006; 23(2):200-200.
  • Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2006; 23(4):399-399.
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    ABSTRACT: Introduction Co-infection with Pneumocystis jiroveci and Mycobacterium tuberculosis is rarely reported in patients without HIV infection. Case report We report the case of a 30 year old woman admitted to hospital for respiratory distress associated with a diffuse infiltrative pneumopathy. Corticosteroid therapy had been started two months earlier for suspected pulmonary sarcoidosis. Fibreoptic bronchoscopy and broncho-alveolar lavage produced evidence of Mycobacterium tuberculosis and cysts of Pneumocystis jiroveci. HIV serology was negative. Clinical progress was satisfactory following anti-tuberculous and anti-fungal therapy. Conclusion Pneumocystis pneumonia is rare in subjects without HIV infection and is most often associated with a pathology or treatment leading to depression of cellular immunity. Corticosteroid treatment, even of short duration, presents the greatest risk. Systematic antibiotic prophylaxis should be considered in relation to the immune status of the patient. Co-infection with the tubercle bacillus as reported here is exceptionally rare.
    Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2006; 23(1):83-87.
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    ABSTRACT: Pneumoperitoneum is known to be a rare complication of invasive mechanical ventilation. However it has not previously been described as a consequence of non-invasive ventilation. The authors report a case of pneumoperitoneum associated with pneumomediastinum occurring in a 64-year-old patient treated for 3 years with bilevel ventilation via a nasal mask (expiratory pressure = 9 cm H2O, inspiratory pressure = 15 cm H2O) for obesity hypoventilation syndrome. Respiratory and gastroenterological investigations did not demonstrate a cause for this complication which resolved spontaneously following the cessation of ventilation. Nine months later, clinical deterioration and a worsening of blood gas parameters led to a recommencement of non-invasive mechanical ventilation at the same levels as previously. Over two years of follow up there have been no clinical or radiological signs of a recurrence of pneumomediastinum or pneumoperitoneum. In the absence of any other explanation, barotrauma due to nasal ventilation appears to be the most likely explanation for this complication.
    Revue des Maladies Respiratoires 03/2005; 22(1 Pt 1):147-50. · 0.50 Impact Factor
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    ABSTRACT: Introduction Pneumoperitoneum is known to be a rare complication of invasive mechanical ventilation. However it has not previously been described as a consequence of non-invasive ventilation. Case report The authors report a case of pneumoperitoneum associated with pneumomediastinum occurring in a 64-year-old patient treated for 3 years with bilevel ventilation via a nasal mask (expiratory pressure = 9 cm H2O, inspiratory pressure = 15 cm H2O) for obesity hypoventilation syndrome. Respiratory and gastroenterological investigations did not demonstrate a cause for this complication which resolved spontaneously following the cessation of ventilation. Nine months later, clinical deterioration and a worsening of blood gas parameters led to a recommencement of non-invasive mechanical ventilation at the same levels as previously. Over two years of follow up there have been no clinical or radiological signs of a recurrence of pneumomediastinum or pneumoperitoneum. Conclusion In the absence of any other explanation, barotrauma due to nasal ventilation appears to be the most likely explanation for this complication.
    Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2005; 22(1):147-150.
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    ABSTRACT: To compare the efficacy and tolerability of nebulized adrenaline and terbutaline in acute severe asthma. Design: Prospective pilot randomized double-blind cross-over trial. Setting: Emergency department of a university hospital. Patients: Thirty-eight patients admitted with severe acute asthma. Each patient received adrenaline (3 mg) and terbutaline (5 mg) nebulizations over 20 min in randomized order. Additional treatment comprised methylprednisolone, intravenous hydration, and oxygen. The efficacy and tolerability of the two drugs were evaluated at the end of each nebulization as well as potential synergistic effects. Eighteen patients received adrenaline first, and 20 received terbutaline first. Peak expiratory flow (PEF) improved significantly in both groups after the first nebulization (from 157 L/min +/- 111 L/min to 199 L/min +/- 134 L/min with adrenaline, P <.01; and from 142 L/min +/- 65 L/min to 193 L/min +/- 181 L/min with terbutaline, P <.01). Both drugs induced a significant decrease in respiratory frequency. The improvement in PaO2 was only significant with terbutaline. Respiratory frequency, PEF and PaO2 were not improved by the second nebulization. No adverse effects were observed. Adrenaline nebulization was as effective and as well tolerated as terbutaline in acute severe asthma. No synergistic effect between terbutaline and adrenaline was observed.
    Journal of Critical Care 06/2004; 19(2):99-102. · 2.50 Impact Factor
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    Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2004; 21(4):869-869.
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    ABSTRACT: To study lower respiratory tract colonization by anaerobic bacteria in ICU patients on prolonged mechanical ventilation using two types of protected tracheal sampling methods. Prospective clinical investigation in the intensive care unit of a university hospital. Twenty-six consecutive patients mechanically ventilated within 24 h after their admission in ICU and with expected duration of mechanical ventilation longer than 7 days. Two types of protected tracheal sampling methods were obtained without the use of bronchoscopic guidance on the day following intubation and twice a week until extubation: protected tracheal aspiration and protected tracheal specimen brush. Specific methods for anaerobic isolation were used. Early colonization was defined if colonization occurred within the first 5 days after intubation. Of the 26 patients studied 22 were colonized by at least one bacterial strain. Twenty-one patients were colonized by aerobic and 15 by anaerobic bacteria. Twenty-eight anaerobic strains were identified, with bacterial counts higher than 10(3) cfu/ml in 11 cases. Of the 15 patients colonized by anaerobes 14 were also colonized by aerobic bacteria. The use of protected specimens ruled out oropharyngeal contamination. Early onset colonization occurred in 16 of 22 patients colonized by aerobes and in 8 of 15 patients colonized by anaerobes. Five patients developed ventilatory-acquired pneumonia following colonization (by anaerobic bacteria in two cases). In eight patients colonization by anaerobic bacteria occurred despite antimicrobial therapy. These results show that anaerobic bacteria frequently colonize the lower respiratory tract of mechanically ventilated patients and underline the potential importance of the anaerobic bacteria in ventilatory acquired pneumonia.
    Intensive Care Medicine 08/2003; 29(7):1062-8. · 5.54 Impact Factor
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    ABSTRACT: OBJECTIVE: To study lower respiratory tract colonization by anaerobic bacteria in ICU patients on prolonged mechanical ventilation using two types of protected tracheal sampling methods. DESIGN AND SETTING: Prospective clinical investigation in the intensive care unit of a university hospital. PATIENTS: Twenty-six consecutive patients mechanically ventilated within 24 h after their admission in ICU and with expected duration of mechanical ventilation longer than 7 days. MEASUREMENTS AND RESULTS: Two types of protected tracheal sampling methods were obtained without the use of bronchoscopic guidance on the day following intubation and twice a week until extubation: protected tracheal aspiration and protected tracheal specimen brush. Specific methods for anaerobic isolation were used. Early colonization was defined if colonization occurred within the first 5 days after intubation. Of the 26 patients studied 22 were colonized by at least one bacterial strain. Twenty-one patients were colonized by aerobic
    Intensive Care Med. 07/2003; 29:1062-1068.
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    ABSTRACT: Cryptogenic organising pneumonitis (COP) is now a well defined clinico-pathological entity. It may be idiopathic or secondary to infection, a drug reaction or a connective tissue disorder. Corticosteroid treatment is remarkably effective. We describe a case of COP occurring during the course of an acute respiratory distress syndrome in a pregnant woman. The unusual association of blood and pulmonary eosinophilia leads us to envisage a borderline form of COP and eosinophilic pneumonitis. Other unusual features were the poor response to steroids and the rapid improvement following death of the foetus.
    Revue des Maladies Respiratoires 11/2002; 19(5 Pt 1):638-40. · 0.50 Impact Factor
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    ABSTRACT: In alcoholic patients, metabolic acidosis can be related to lactate acidosis associated with sepsis or thiamine deficiency, ketoacidosis, methanol or ethylene glycol poisoning. High resolution proton nuclear magnetic resonance (NMR) can be used to detect abnormal organic acid metabolites in urine or serum from patients with various metabolic disorders. In the present case, a 26-year-old patient was admitted for a coma associated with severe metabolic acidosis. Alcoholic ketoacidosis (AKA) was identified by urine proton NMR. Her metabolic disorders rapidly improved. Persisting associated neurological alteration was related to extrapontine myelinolysis as shown by imaging cerebral NMR.
    Intensive Care Medicine 03/2001; 27(4):785-786. · 5.54 Impact Factor