[Prognostic factors of pneumococcal meningitis. Retrospective study of 31 cases]

Our aim was to study the susceptibility of Streptococcus pneumoniae to antibiotics in patients with pneumococcal meningitis and to search for the prognosis factors in those patients. We have studied retrospectively 31 cases of pneumococcal meningitis. Comparisons were performed with univariate analysis. The mean age was 36,7 +/- 20,5 years [ranged: 9 and 78 years]. The sex ratio was 3,4. The susceptibility of Streptococcus pneumoniae to penicillin G was affected in 10 cases [33% of isolated pneumococcus. The MIC to penicillin G was >/= 2 in only one case. The hospital mortality was 26% [8/31]. With univariate analysis, factors associated with death were: age >/= 55 years [Ss p= 0,006, OR: 17.2; IC[95%]: 2.3-134], albuminorachie >/= 7g/l [p= 0,002, OR: 22; IC[95%]: 1,9-251], shock [p= 0,031, OR: 6.7; IC[95%],: 1.05-42] and Glasgow Coma Score [GCS] /= 7g/l shock and Glasgow Coma Score

Complications de l'intubation endo-tracheale et de la tracheotomie Etude retrospective de 797 cas

A retrospective study of complications of endotracheal intubation and tracheostomy is realized on 797 patients admitted in the center of intensive care and emergency medecine [CAMU] of Tunis upon a period of 5 years between 1988 and 1992. During this period 14 cases of laryngotracheal stenosis are identified; 8 cases following endotracheal intubation and 6 cases following tracheostomy. The evolution of these stenosis, in spite of treatment is caracterized by a high mortality [42,8%]. The determinants of laryngotracheal stenosis with P values 11 days, a frequency of self extubation >/= 2, a frequency of reintubation >/= 3, the existence of a nosocomial comial pulmonary infection and/or a shock of reventilation. These findings confirm the complexity of mechanisms of laryngotracheal injury and underline the importance of their prevention. So the authors recommend the pratice of tracheostomy before 10 days of intubation to prevent the complications of prolonged endotracheal intubation

Les saignements uterins dysfonctionnels chez l'adolescente [a propos de 63 observations]

The pubertary uterine hemorrhage are always functional. 63 cases were observed in three years. The importance of the hemorrhagia is responsable in 17.4% of the hospitalisations. The etiology was searched in all cases. The hormonal treatment is prescribed in the first intention in 58.7% of cases