Papers by Stephane Rudnicki
The Lancet Respiratory Medicine
Journal de Gynécologie Obstétrique et Biologie de la Reproduction
Bien que le placenta percreta reste une pathologie rare, sa fréquence tend à augmenter avec celle... more Bien que le placenta percreta reste une pathologie rare, sa fréquence tend à augmenter avec celle des césariennes. Ce sont donc des situations auxquelles les obstétriciens vont être de plus en plus souvent confrontés or il peut entraîner un risque vital ou au minimum fonctionnel. Nous rapportons le cas d'une patiente qui présentait un placenta percreta avec envahissement vésical et les modalités de sa prise en charge ainsi que la revue de la littérature. Le traitement conservateur, au moins dans un premier temps, est fortement recommandé pour limiter les conséquences. Il se fera au moyen de ligatures vasculaires, d'embolisation et/ou d'un traitement médical par Méthotréxate. La prise en charge peut être prévue grâce aux moyens de détection échographiques qui doivent être disponibles dans les populations à risque.
![Research paper thumbnail of [Severe hypofibrinegenemia after rattlesnake envenomation in France]](https://a.academia-assets.com/images/blank-paper.jpg)
Annales de biologie clinique
A 22-year-old man, who maintains illegally numerous exotic snakes at home (suburbs of Paris), was... more A 22-year-old man, who maintains illegally numerous exotic snakes at home (suburbs of Paris), was bitten by one of his Bresilian rattlesnakes, the lance-headed viper Bothrops moojeni, with grade III envenomation. The fibrinogen was less than 0,5 g/L, the prothombin time was 22%, the activated partial thromboplastin time was 94 seconds. The authors discuss the biological and clinical management of this defibrination, due to defibrinogenating proteases (thrombin-like enzymes), present in Bothrops moojeni venom. The patient received 7 vials of an antivenom directed to another crotal, Bothrops lanceolatus. Despite the importance of defibrinogenation, there was only a few clinical evidence of bleeding, according to the literature. The normalization of coagulation studies occured only after day 11. This case-report outlines the danger of the increase of exotic snakes maintained as pet in France and the difficulties to obtain specific antivenoms.
New England Journal of Medicine
Annales Françaises d Anesthésie et de Réanimation
Annales francaises d'anesthesie et de reanimation
Envenomation from bite of exotic snakes is rare in France and represent a serious therapeutic pro... more Envenomation from bite of exotic snakes is rare in France and represent a serious therapeutic problem: only an adapted antivenom is effective and obtaining such a treatment is a real difficulty. The authors report two clinical cases of envenomation with defibrination after bite by pit vipers from South America. The two patients were treated with nonspecific antivenom therapy with divergent results. The use of the paraspecific effects of antivenom can allow an effective treatment in the absence of specific antivenom, but requires to be known better.
Annales francaises d'anesthesie et de reanimation
Progrès en Urologie, 2012
Annales francaises d'anesthesie et de reanimation
Since March 2003, military operations in Iraq "Operation Iraqi Freedom" (OIF) and in Af... more Since March 2003, military operations in Iraq "Operation Iraqi Freedom" (OIF) and in Afghanistan "Operation Enduring Freedom" (OEF), have made many wounded and killed in action (KIA). This article proposes to highlight the specific epidemiology of combat casualties, met in these both non-conventional and asymmetric conflicts. Personal protective equipments, Kevlar helmet and body armor, proved their efficiency in changing features of war injuries. Health Force Services organized trauma care system in different levels, with three main objectives: immediate basic medical care in battalion aid station, forward surgery and early aeromedical evacuation. The Joint Theater Trauma Registry (JTTR), a war injury registry, provides medical data, analyzed from the combat theater to the military hospital in United States. This analysis concluded that during modern conflicts, most injuries are caused by explosive devices; injuries are more severe and interestingly more specifi...
La Revue de Médecine Interne, 2006
Réanimation, 2010
ABSTRACT The treatment of shock states often requires fluid replacement. Hypertonic saline is an ... more ABSTRACT The treatment of shock states often requires fluid replacement. Hypertonic saline is an alternative to conventional solutions, isotonic crystalloids or colloids. The concept of low-volume resuscitation has grown over the last 30 years mainly in the areas of hemorrhagic shock and brain osmotherapy. More recently, hypertonic saline has been evaluated in other types of shock, of cardiogenic and septic origin. Improvement of the hemodynamic failure is due to the combination of increased preload, increased contractility and improvement of the microcirculation. Other properties such as immunomodulation or anti-edematous effects are interesting in many types of shocks. Data mainly issued from animal models argue for clinical trials in different diseases.
Presse médicale (Paris, France : 1983), 2012
![Research paper thumbnail of [Antitoxin treatments for necrotizing pneumonia due to Panton-Valentine leukocidin-secreting Staphylococcus aureus]](https://attachments.academia-assets.com/41222842/thumbnails/1.jpg)
Médecine et maladies infectieuses, 2009
Staphylococcus aureus is responsible for two main clinical presentations in humans: suppurative i... more Staphylococcus aureus is responsible for two main clinical presentations in humans: suppurative infections and toxigenic diseases. A small percentage of S. aureus strains secrete Panton-Valentine leukocidin (PVL). This toxin is implicated in skin infections, furunculosis, osteoarticular infections, and particularly, in serious pulmonary infections known as necrotizing pneumonia, which affect immunocompetent patients with no comorbidity. A clear outline of the clinical presentation was described recently. Necrotizing pneumonia caused by PVL-secreting S. aureus strains is characterized by a combination of fever, hemoptysis, multilobar alveolar infiltrations, and leukopenia. The disease usually progresses to toxic shock or refractory hypoxemia. A number of interesting therapies targeting leukocidin have been proposed over the past few years based on in vitro data. This review focuses on the physiopathological basis and on the therapeutic relevance of various drugs.
La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne, 2009
We report a 69-year-old man admitted in intensive care unit for aseptic meningoencephalitis. Init... more We report a 69-year-old man admitted in intensive care unit for aseptic meningoencephalitis. Initially, suspicion of an infectious etiology led to introduce an anti-infectious treatment. Behçet's disease was diagnosed during hospitalization incited to screen for noninfectious etiologies. A high dose steroid therapy was rapidly effective. The diagnosis of neuro-Behçet's disease was entertained.
La Revue Sage-Femme, 2006
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Papers by Stephane Rudnicki