Elevation of cardiac troponin I during non-exertional heat-related illnesses in the context of a heatwave.

Introduction: The prognostic value of cardiac troponin I (cTnI) in patients having a heat-related illness during a heat wave has been poorly documented.

Methods: In a post hoc analysis, we evaluated 514 patients admitted to emergency departments during the August 2003 heat wave in Paris, having a core temperature >38.5 degrees C and who had analysis of cTnI levels.

Analysis of emergency department interpretation of electrocardiograms.

The objective of the study was to determine the concordance of emergency physicians' and cardiologists' interpretations of emergency department (ED) electrocardiograms (ECG), to evaluate the impact of ECG misinterpretation on patient management, and to determine error rates as a function of the level of physician training and the specific ECG diagnoses. ECG interpretations were registered prospectively using a programmed-response data sheet. A second blinded interpretation by a staff cardiologist was assumed to be correct.

Gastric leiomyosarcoma. Comparative value of barium examinations, ultrasonography and CT scans.

The authors discuss four cases of gastric leiomyosarcoma explored by various imaging techniques (barium examinations, ultrasound, CT scans). Barium examinations were normal in two cases, abnormal but insufficient for diagnosis in one, and sufficient to allow topographic diagnosis in one. Ultrasonography gave abnormal findings insufficient for diagnosis in two cases and allowed topographic diagnosis in the other two cases.

[Spontaneous pneumothorax: drainage by catheter or chest tube?].

One hundred and fourteen spontaneous pneumothorax, idiopathic or with chest disease, were retrospectively analysed in order to compare the efficacy of suction drainage by small lumen IV catheter and by chest tube. Age, importance and tolerance of spontaneous pneumothorax were similar in both groups. Frequency of recidive and failure as well as duration of drainage were also not different.

Temocillin treatment of serious infections due to gram-negative bacilli in an intensive care unit.

In a group of 27 severely ill patients in an intensive care unit, 40 infections caused by Gram-negative bacilli were treated with temocillin 2g twice daily by the direct intravenous route. The patients (17 men and 10 women) were aged from 35 to 93 years (mean 65.7 years) and 22 had severe underlying diseases.

[Lung diseases complicating acute poisoning with psychotropic drugs].

474 patients admitted in ICU between 1976 and 1981 were retrospectively analysed. Pneumonia (P) was assessed by condensation on chest X ray. P developed in 14,3%.

Pattern of respiration in patients recovering from barbiturate overdose.

Ventilation has been recorded in seven patients who were unconscious following self-poisoning. Measurements were obtained on admission to the hospital and repeated daily until the patients regained consciousness. On admission, recordings were characterized by a low minute ventilation as a result of a low tidal volume in spite of a high frequency of respiration.

Phospholipase and prophospholipase activities in bronchoalveolar lavage fluid in severe acute pulmonary disease with or without ARDS.

Bronchoalveolar lavages were performed in 21 patients undergoing mechanical ventilation: Group I: coma due to sedative overdose (11 cases), without pulmonary impairment, serving as control group; Group II: severe acute pulmonary disease without ARDS (5 cases); Group III: patients with ARDS (5 cases). In the recovered fluid we measured: total proteins (P) and phospholipids (PL), phospholipasic (PLase) and prophospholipasic (PPLase) activities. In ARDS group, considerable increase of P, (p less than 0.

[Cell-mediated immunity study by skin testing in 129 critically ill patients (author's transl)].

Delayed hypersensitivity skin testing was performed in 129 critically ill patients. Six intradermal antigens were used: tuberculin, candidin, varidase, epidermophytin, trichophytin and CCB (a polyvalent microbial vaccine from the Pasteur Institute). The response was judged as positive when one test or more were positive.

[Alcoholic ketoacidosis. One case (author's transl)].

Severe ketoacidosis sometimes develops in chronic alcoholics after increased alcohol intake associated with dietary restriction. This particular case was unusual from two standpoints: a considerable, prolonged and unexplained increase in serum free fatty acid, and discordance between the degree of ketonaemia and an abundant liver glycogen load.