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Fortin J, Bodson L, Fontaine M, Depil-Duval A, Paulin P, Bitar M, Ravat F, Macher J, Hall A. Utilisation d’une solution polyamphotère lors de lésions et brûlures chimiques oculaires cutanées et buccales. effet sur la douleur de la diphotérine®. Ann Burns Fire Disasters 2017; 30:286-291. [PMID: 29983684 PMCID: PMC6033482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 10/24/2017] [Indexed: 06/08/2023]
Abstract
Polyamphoteric washing solutions (PWS) have been used for several years, mainly in industries, for cases of chemical ocular or cutaneous splashes by acid or alkali. We collected 37 cases reporting the use of PWS for ocular and cutaneous chemical splashes from several centres. Among the 37 cases, 55.26% resulted from occupational exposure. Among ocular exposures, initial clinical symptoms included pain (20 cases), blepharospasm (4 cases), hyperaemia (15 cases), palpebral oedema (2 cases) and blurred vision (7 cases). Among cutaneous exposures, 2 injuries were classified as deep, and 11 as superficial. Mean (SD) pain (VAS) before PWS was 6,29 +/- 2,74; mean (SD) pain after PWS was 1,47 +/- 1,73. Early application of PWS to the eye or skin reduces the intensity of pain that is associated with chemical damage. Early application of amphoteric solution appears to reduce the incidence of sequelae, provided its pre-hospital and hospital use is early. However, further studies are needed.
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Affiliation(s)
- J.L. Fortin
- Service de médecine de prévention, Saint-Etienne, France
| | - L. Bodson
- Service des urgences, Centre Hospitalier Universitaire de Liège, Belgique
| | | | - A. Depil-Duval
- Service d’accueil des urgences, Centre Hospitalier Eure-Seine, Évreux, France
| | - P. Paulin
- Service médical statutaire et de contrôle, Police Nationale, Dijon, France
| | - M.P. Bitar
- Service d’accueil des urgences, Hôpital Nord Franche-Comté, Trévenans, France
| | | | - J.M. Macher
- Service d’accueil des urgences, Saint-Dié-des-Vosges, France
| | - A. Hall
- Colorado School of Public Health, Denver, Colorado, USA
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Vazquez FJ, Paulin P, Poodts D, Gándara E. Preferred Management of Primary Deep Arm Vein Thrombosis. Eur J Vasc Endovasc Surg 2017; 53:744-751. [PMID: 28342731 DOI: 10.1016/j.ejvs.2016.11.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 11/14/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Given its rarity, the management of primary upper extremity deep vein thrombosis is controversial. Although anticoagulation alone is commonly advocated for its treatment, it is unclear if this will reduce the risk of developing post-thrombotic syndrome (PTS). The aim of this "Evidence Driven" Clinical Scenario is to evaluate whether more aggressive treatments (including catheter directed thrombolysis or surgery) might help reduce the risk of PTS or recurrent venous thromboembolism in patients with primary upper extremity deep vein thrombosis (DVT). METHODS An electronic systematic review of Ovid MEDLINE and Embase was conducted. Randomised controlled trials and observational studies were eligible. The primary outcome was PTS. RESULTS The initial search identified 146 articles, and 36 more were identified during a secondary search. In total, 25 studies, reporting the outcome of 1271 patients, were included. None of the studies included was a randomised controlled trial and the large majority of studies were retrospective cohorts. The use of anticoagulation alone was associated with a significant risk of PTS. In patients treated with surgery with or without thrombolysis the incidence of PTS was significantly reduced. CONCLUSION Current evidence, albeit with some methodological limitations, suggests that anticoagulation may not be sufficient to prevent PTS in patients with primary upper extremity DVT and that surgery with or without thrombolysis to repair the anatomical defects is needed.
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Affiliation(s)
- F J Vazquez
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - P Paulin
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - D Poodts
- Department of Internal Medicine, Hospital Italiano de Buenos Aires, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - E Gándara
- Department of Medicine, University of Ottawa-Ottawa Hospital, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada; Department of Internal Medicine, Hospital Privado de Comunidad, Mar del Plata, Argentina.
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Paulin P, Fortin JL, Fortin L, Cuny B, Montagnon L, Nicod F, Lagre FX. Épidémiologie du dépistage urinaire des stupéfiants lors des visites médicales de recrutement chez les sapeurs-pompiers volontaires du Doubs : relevé expérimental. Toxicologie Analytique et Clinique 2014. [DOI: 10.1016/j.toxac.2014.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fortin J, Paulin P, Coste S, Savio C, Payre J, Ravat F, Bodson L. Utilisation d’une solution polyamphotère lors d’accidents chimiques oculaires et cutanés : à propos de 11 utilisations. Toxicologie Analytique et Clinique 2014. [DOI: 10.1016/j.toxac.2014.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sarre A, Paulin P, Dupuy C. Projet d’amélioration des non-conformités des prélèvements sanguins pour groupage et RAI en obstétrique, centre hospitalier de Roanne. Transfus Clin Biol 2010. [DOI: 10.1016/j.tracli.2010.09.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Odent-Malaure H, Benamara H, Conductier R, Dumontier P, Mompeyssin C, Paulin P, Chavarin P, Garraud O. IBTT de l’ensemble de la base de donnée e-fit jusqu’en 2009 à l’EFS Auvergne-Loire. Transfus Clin Biol 2010. [DOI: 10.1016/j.tracli.2010.09.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Courbil R, Fabrigli P, Benamara H, Chavarin P, Bregeon M, Ruyer-Dumontier P, Goure D, Paulin P, Froget A, Taibi K, Rigal E, Garraud O. Expérience de régionalisation du conseil transfusionnel. Transfus Clin Biol 2009; 16:4-11. [DOI: 10.1016/j.tracli.2009.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Accepted: 01/09/2009] [Indexed: 11/28/2022]
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Salomon OD, Sinagra A, Nevot MC, Barberian G, Paulin P, Estevez JO, Riarte A, Estevez J. First visceral leishmaniasis focus in Argentina. Mem Inst Oswaldo Cruz 2008; 103:109-11. [DOI: 10.1590/s0074-02762008000100018] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Accepted: 02/11/2008] [Indexed: 11/22/2022] Open
Affiliation(s)
- OD Salomon
- Ministerio de Salud de la Nación, Argentina
| | - A Sinagra
- Ministerio de Salud de la Nación, Argentina
| | - MC Nevot
- Veterinaria del Oeste, Argentina
| | - G Barberian
- Hospital de Pediatría Dr J.P.Garrahan, Argentina
| | - P Paulin
- Hospital de Pediatría Dr J.P.Garrahan, Argentina
| | | | | | - J Estevez
- Ministerio de Salud Publica, Argentina
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Abstract
HISTORICAL ASPECTS Chronic delusion occurring late in life has essentially been studied by European psychiatrists. "Late-onset schizophrenia" was first described and defined by Manfred Bleuler in 1943, as a form of schizophrenia which occurs after the age of 40. Later, British psychiatrists often used the term "Late-onset paraphrenia" interchangeably with "Late-onset schizophrenia" to designate this disorder. However, late-onset paraphrenia is a British concept which includes all delusional disorders starting after age 60. American psychiatrists had little interest in this patient group, so it is only within the DSM III-R that a separate category was created for patients who developed schizophrenia after age 44. There is now no longer a "late-onset" category for schizophrenia within the DSM IV, nor age criterion for the diagnosis of schizophrenia. In the French nosography, schizophrenia is excluded when a non-affective, non-organic psychosis begins after the age of 40. These chronic delusion syndromes fall into a specific French category: "Psychose Hallucinatoire Chronique" (chronic hallucinatory psychosis). LITERATURE FINDINGS Basing themselves on the analysis of many studies, the authors endeavor to define the characteristics of late-onset schizophrenia. The exact prevalence is not known, but is considered lower than 1%. There is a preponderance of women over men in this form of disease, that could be explained by the relative excess of dopamine type 2 (D2) receptors in young men (compared with young women), and by a protective role played by estrogens until the menopause, among women predisposed to schizophrenia. Studies of families reveal a lower lifetime risk of schizophrenia in first degree relatives of patients with late-onset schizophrenia, than those with an early onset. Most of these patients have been or are married, and had worked for a long time. Generally at the onset of the illness they are isolated and unemployed. Paranoid and schizoid abnormal premorbid personality traits are frequently noted with the diagnosis of late-onset schizophrenia. An association between late-onset schizophrenia and sensory impairment (visual and auditory) is frequently observed and appear to be in link with auditory and visual hallucinations. The analysis of clinical features reveal that the later the schizophrenia breaks out, the more the patient shows delusion and hallucinatory symptoms, which remain limited to his surroundings, whereas in younger patients, delusion has no limit. Moreover, late-onset schizophrenic patients have a lower prevalence of looseness of associations and negative symptoms than those with an earlier onset. The authors note from the few studies on the treatment, that a number of patients responded well to low dose of antipsychotic agents. The use of "atypical" anti-psychotic drugs is recommended, in order to reduce the adverse effects, notably the extrapyramidal symptoms which are frequent in elderly people. CONCLUSION Finally, they conclude that patients with late-onset schizophrenia have symptoms very similar to those of patients with early-onset schizophrenia. But, when taking the different forms of schizophrenia - even the late onset ones - into account, raises the question of the role of trigger factors that could guide research on predictive factors and early diagnosis. This may be one explanation for the survival of the French entity "Psychose Hallucinatoire Chonique".
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Affiliation(s)
- H Convert
- Psychiatre, Service du Docteur Gavaudan, Centre hospitalier Valvert, 78, boulevard des Libérateurs, 13391 Marseille cedex 11
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Pinna C, Paulin P, Vedie C. La « mélancolie » d'un mangeur d'opium anglais, Thomas De Quincey (1785-1859). Annales Médico-psychologiques, revue psychiatrique 2004. [DOI: 10.1016/j.amp.2004.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Garberi JC, Angel SO, Paulin P, Pszenny V, Romano L. Use of a monoclonal antibody and a DNA probe for diagnosing acute toxoplasmosis in ambiguous cases. J Clin Pathol 1994; 47:853-4. [PMID: 7962658 PMCID: PMC494946 DOI: 10.1136/jcp.47.9.853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
An unusual case of cerebral toxoplasmosis in an HIV negative 11 year old child is reported. Central nervous system disease was assessed immunohistochemically in a brain biopsy specimen with TgP8--a specific monoclonal antibody against Toxoplasma gondii antigens--thus confirming IgG and IgM serology, technetium scan findings, and clinical data. In addition, an active parasitaemia was confirmed by DNA in situ hybridisation assay in white cells using an ABGTg4 probe. The child recovered after specific T gondii treatment. Follow up six months later showed that he was immunodeficient.
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Paulin P, Cusset C, Jacquelin L, Pages JM, Chapalain JC. [Schnitzler's syndrome. A new case]. Presse Med 1992; 21:1758-61. [PMID: 1488421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A new case of Schnitzler's syndrome is reported in a 72-year old man hospitalized for severe deterioration of his general condition associated with recurrent ancient urticaria. Paraclinical examinations, which showed inflammatory syndrome, bone condensation and IgM monoclonal gammapathy, led to the diagnosis of Schnitzler's syndrome, first described in 1972. Twenty-two cases have now been published, characterized by vasculitic urticaria, osteosclerosis and IgM macroglobulinaemia. There is also severe inflammatory syndrome and the other immunological examinations are normal. Recent studies suggest the possibility of uncontrolled activity of interleukin-1 alpha. The condition is chronic and usually benign, but the fear of malignant transformation in the long term makes the therapeutic choice difficult.
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Affiliation(s)
- P Paulin
- Service de Médecine A, Centre hospitalier de Beauregard, Montbrison
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Fabiani JE, Paulin P, Simkin G, Leoni J, Palombarani S, Squiquera L. Hereditary angioedema: therapeutic effect of danazol on C4 and C1 esterase inhibitors. Ann Allergy 1990; 64:388-92. [PMID: 2108593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Hereditary angioedema (HAE) is an inherited deficiency of C1 esterase inhibitor (C1 inh). The two types of genetic C1 inh deficiency are type I, which is quantitative, and type II, which is functional. For the purpose of the present study, four HAE patients were selected. None of them had received any androgenic therapy. The group included three type I and one type II cases. All patients that entered the protocol received danazol, 400 mg/day for 14 days. The complement system was evaluated by monitoring C4, hemolytic complement 50% (CH50), circulating immune complexes (CIC), and antigenic and functional C1 inh during the study. The level of complement factors at the beginning and at the end of this period demonstrated a statistically significant increase in C4 and CH50 and the disappearance of CIC, while C1 inh remained unmodified. These results suggest that the therapeutic effect of danazol may have two mechanisms of action: (1) promotion of C4 synthesis by anabolic effect resulting in an improvement of the complement system with the disappearance of CIC and (2) a minor increase in C1 inh level primarily due to the lack of its consumption.
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Affiliation(s)
- J E Fabiani
- Institute for Allergy and Immunology, Buenos Aires, Argentina
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Fabiani JE, Paulin P, Simkin G, Leoni J, Palombarani S, Squiquera L. [Hereditary angioedema. Effect of danazol on C4 and functional C1INH]. Rev Alerg Mex (1987) 1989; 36:99-104. [PMID: 2772500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Hereditary angioedema (HAE) is an inherited deficiency of the inhibitor of C1 esterase (C1 inh). Two types of genetic C1 inh deficiency have been described, type I: quantitative, and type II: functional. For the purpose of the present study, 4 out of 51 HAE patients were selected. None of them had received any previous androgenic therapy. The group was integrated by two type I and one type II cases. All patients that entered in the protocol received 400 mg/day of danazol over 14 days. The complement system was evaluated by monitoring C4, Hemolytic complement 50% (CH50), Circulating Immune Complexes (CIC), and antigenic and functional C1 INH during the study. The level of the complement factors at the beginning and the end of this period demonstrated a statistically significant increase of C4 and CH50 and the disappearance of CIC, while C1INH remained unmodified. These results suggest that the therapeutic effect of Danazol may have two mechanisms of action: i. promotion of C4 synthesis by anabolic effect resulting in an improvement of the complement system with the disappearance of CIC, and ii, a minor increase of C1 inh level primarily due to the lack of its consumption.
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