Cerebral microbleeds and acute myocardial infarction: Screening and disease progression.

Introduction: Cerebral microbleeds (CMB) are associated with intracerebral haemorrhage. Therefore they may represent a concern if anticoagulant and/or antiplatelet therapy is needed. The aim of this study was to determine the prevalence of CMB in patients with acute myocardial infarction (AMI), and to follow their progression at 3 months under dual antiplatelet therapy (DAPT).

Bilateral vocal cord paralysis after endoscopic placement of fully covered self-expandable metal stent for palliative treatment of malignant proximal esophageal obstruction: two case reports.

Background: Oesophageal stents have several well-known respiratory complications, including aspiration pneumonia, fistula and airway compression. However, bilateral vocal cord paralysis has rarely been described.

Methods: We describe two patients who presented with refractory dysphagia due to malignant proximal oesophageal strictures.

A leukocyte score to improve clinical outcome predictions in bacteremic pneumococcal pneumonia in adults.

Background: Bacteremic pneumococcal pneumonia (BPP) is associated with high and early mortality. A simple procedure to predict mortality is crucial.

Methods: All adult patients with BPP admitted from 2005 through 2013 to the University Hospital of Dijon, France, were enrolled to study 30-day mortality and associated factors, particularly leukocyte counts.

Impact of pooling powdered infant formula samples on bacterial evolution and Cronobacter detection.

Enterobacter sakazakii has been identified as the causative agent of serious neonatal infections, associated with high mortality rates. In most cases, powdered infant formula (PIF) has been identified as the source of infection. Recently, strains commonly referred to as E.

Evaluating noninvasive ventilation using a monitoring system coupled to a ventilator: a bench-to-bedside study.

Empirically determined noninvasive ventilation (NIV) settings may not achieve optimal ventilatory support. Some ventilators include monitoring modules to assess ventilatory quality. We conducted a bench-to-bedside study to assess the ventilatory quality of the VPAPIII-ResLink (ResMed, North Ryde, Australia).

[Difficult weaning due to tracheal compression by an esophageal bezoar].

Introduction: Bezoars result from the aggregation of ingested materials (food, drugs, hair) that accumulate at a certain anatomic level in the gastrointestinal tract. It is a rare condition, which is favoured by a reduction in intestinal motility, or by a primary abnormality reducing the patency of gastrointestinal tract.

Case Report: We present a case when acute respiratory symptoms revealed an oesophageal bezoar.

[CT angiography of the neck: technical considerations].

Examination of acute stroke by CT angiography is an alternative to MRI. Technological improvement of multidetector CT scanners allows neuroimaging of stroke in a multimodal protocol including plain CT, cerebral CT perfusion and CT angiography of the cervical and intracranial arteries. CT angiography is a reliable non invasive technique for the evaluation both extracranial and intracranial vessels that may be used as an alternative to MR angiography.

Amiodarone-related acute respiratory distress syndrome following sudden withdrawal of steroids.

Acute lung toxicity is a rare but classical complication of amiodarone therapy. We report the case of a patient who developed an optic neuropathy after 15 years of amiodarone administration, and who was treated for 2 weeks with steroids. Following withdrawal of steroids, the patient rapidly developed an acute respiratory distress syndrome.

Hypoxaemia associated with an enlarged aortic root: a new syndrome?

Objective: To assess the mechanisms through which an enlarged aortic root may facilitate right to left shunting through a patent foramen ovale.

Patients: 19 patients with the platypnoea-orthodeoxia syndrome (POS) were compared with 30 control patients without platypnoea.

Interventions: Multiplane transoesophageal echocardiography.

Cardiovascular characteristics and cerebral CT findings in elderly subjects with psychomotor disadaptation syndrome.

Background And Aims: In previous studies, we described a clinical picture typically observed in frail old people, called "Psychomotor Disadaptation Syndrome" (PDS), but we have never studied etiopathogenic data. The aim of this study was to complete the clinical picture, record cardiovascular risk factors and provide cerebral CT scan findings in patients with PDS.

Methods: 73 patients with PDS were recruited in the Geriatric Medicine departments of the University Hospitals of Dijon (Burgundy, France) and Strasbourg (Alsace, France); this group included prospectively all hospitalized patients showing postural and gait abnormalities according to the following criteria: trend towards backward falling and gait pattern alteration characterized by hesitancy in initiation, small steps, and increase in the double support durations.

[Acute respiratory failure in obesity].

Obstructive sleep apnea, obesity-related hypoventilation - a hypoventilation which is independent of apneas and increased by sleep -, and hypoxemia related to local ventilation-perfusion disorders are the main mechanisms of respiratory failure occurring during acute respiratory decompensation following an often minimal triggering event. Non-invasive ventilation has been found to be an effective treatment, particularly with a ventilator capable of maintaining positive expiratory and pressure. The level of the expiratory positive airway pressure must be adapted to cure episodes of obstructive apnea or hypopnea.

[Pulmonary edema and tocolysis with beta-agonists].

It is not unusual for respiratory specialists to be called to deal with respiratory problems in pregnancy. However, some conditions, such as tocolysis-induced pulmonary edema, although common, are largely unknown to our specialty. We report on the cases of three pregnant women, who developed pulmonary edema in the context of tocolysis with the intra-venous infusion of B-agonists.

[Fat embolism with lung hemorrhage].

Post-traumatic fat embolism was disclosed by a picture of alveolar hemorrhage. Acute hypoxemia associated with dense bilateral pulmonary infiltrates was observed in a 21 year-old woman, 4 days after an accident with closed tibial fracture. Cruoric pulmonary thromboembolism was ruled out, as was an acute pulmonary edema.

[MRI screening of vestibular schwannomas without gadolinium: usefulness of the turbo gradient spin echo T2-weighted pulse sequence].

The purpose of this retrospective MRI work was to evaluate the use of turbo gradient spin echo (TGSE) high resolution imaging for the detection of eighth nerve schwannomas, without injection of gadolinium. The TGSE sequence (slice thickness: 3 mm with 1.5 mm interleaving; matrix: 512) was compared with a reference sequence: T1-weighted spin echo (SE) after gadolinium injection (slice thickness: 3 mm, matrix: 256).

[Comparison of MRA and angiography in the follow-up of intracranial aneurysms treated with GDC].

Objective: Evaluation of TOF 3D MRA compared to angiography in the follow-up of intracranial aneurysms treated by Guglielmi detachable coils (GDC).

Material: and method: Prospective analysis of follow-up MRA and angiographies for 20 patients with 22 aneurysms. There were 2 MRAs for 3 aneurysms giving a total of 25 cases.

[Contribution of magnetic resonance imaging in sclerotic combined degeneration of the spinal cord due to vitamin B12 deficiency].

Subacute combined degeneration (SCD) of the spinal cord is known to present histopathologically degenerative lesions in the spinal cord, but few studies on the neuroradiological findings have so far been reported. We present the interest of initial and follow-up MR findings in three cases of SCD. In the three cases, a causal event precipitated the onset of neurological symptoms: general anesthesia for the first and the third one and folic acid treatment for the second one.

Multi-variate analysis predicts clinical outcome 30 days after middle cerebral artery infarction.

Background And Purpose: To evaluate the functional prognostic value of proton magnetic resonance spectroscopy performed within the 5 days of an infarction of the middle cerebral artery territory, compared with previously demonstrated prognostic factors.

Methods: Proton magnetic resonance spectroscopy was performed on 77 consecutive non-comatosed patients during the acute stage of middle cerebral artery infarction. The functional status was determined for each patient via the Orgogozo score.

[Lung disease due to Mycobacterium xenopi excluding AIDS. Apropos of 8 cases].

Between 1994 and early 1999, Mycobacterium xenopi was isolated in 11 HIV-negative patients seen at the Respiratory Disease Department of the Dijon University Hospital. Eight of these patients met the criteria of lung infection. Clinical and radiological features simulated pulmonary tuberculosis which delayed diagnosis until the germ was identified.

Cerebral metabolism after transient ischemic attack. A 1H MR spectroscopy study.

Metabolic changes induced by cerebral infarction or by stenosis and occlusion of the internal carotid artery have been previously described in 1H Magnetic Resonance Spectroscopy (1H MRS). These changes are essentially characterized by decreased N-acetyl-aspartate (NAA) and increased lactate concentration. Little is known about the metabolic changes observed in the three days following a transient ischemic attack (TIA), in the absence of stenosis or occlusion of the internal carotid artery, and without visible infarction on Magnetic Resonance Imaging (MRI).

Central sleep apnoea in Arnold-Chiari malformation: evidence of pathophysiological heterogeneity.

We report on the case of two young patients with type I Arnold-Chiari malformation (ACM), as revealed by a central sleep apnoea (CSA) syndrome without any other neurological defect. Case 1 was a 14-yr-old male patient, who developed severe alveolar hypoventilation and needed long-term mechanical ventilation via a tracheostomy. Case 2 was a 39-yr-old male patient, who developed features suggestive of sleep apnoea and responded to nasal continuous positive airway pressure ventilation despite the central type of apnoeas.

[Management of obesity and respiratory insufficiency. The value of dual-level pressure nasal ventilation].

Obstructive Sleep Apnea (OSA), Obesity-Linked Hypoventilation (OLH)--a hypoventilation which is independent of apneas and increased by sleep--, and COPD are mechanisms for respiratory failure in obese patients. We thought nasal bi-level positive airway pressure to be a suitable treatment: EPAP is useful to maintain upper airway patency and IPAP-EPAP difference to correct OLH and COPD hypoventilation. Our purpose is to report the results of such a therapeutic approach.

Relative survival analysis of 252 patients with COPD receiving long-term oxygen therapy.

Objectives: A survival analysis was conducted on patients with COPD receiving long-term oxygen therapy (LTOT) to compare two different statistical methods.

Methods: We used a multivariate crude (observed) survival model (Cox) and a multivariate relative survival model (Hakulinen). Only the latter is able to correct the survival by adjusting it to the normal life expectancy of the studied patients.

[Agenesis of the corpus callosum: modes of manifestation in adults].

Agenesis of corpus callosum is an uncommon brain malformation that is usually detected in childhood. In adult, focal epileptic seizure is the most frequent manifestation. Otherwise, asymptomatic patients can be detected by cerebral imagery with specific criteria.