[Acute poisoning by insecticides with anticholinesterase activity. Evaluation of the efficacy of a cholinesterase reactivator, pralidoxime]. / Intoxications aiguës par insecticides à action anticholinestérasique. Evaluation de l'efficacité d'un réactivateur des cholinestérases, le pralidoxime.

Pralidoxime is the most frequently used antidote in anticholinesterase insecticide poisoning, owing to its cholinesterase reactivating action. The efficiency of Pralidoxime has been retrospectively evaluated by comparing two groups of 31 patients, the first one treated by Pralidoxime in the most commonly used doses (1200mg/24H), the second one untreated. Age, sex and nature of poison were taken in consideration to make a matched distribution in both groups. The clinical and biological initial features were nearly the same in both groups; the other therapeutic measures were the same. There was no statistical difference between the both groups for evolutive criteria such as that mortality, duration of artificial ventilation, intubation, atropine administration, decrease in plasma cholinesterase. The results pleading against the use of Pralidoxime, at least at this dose, in anticholinesterase insecticide poisoning, warrant confirmation by prospective randomized studies. The efficiency of Pralidoxime warrants confirmation firstly in the course of poisonings by some clearly identified insecticides, to which pralidoxime is supposed to be the most effective, cater used in high doses, as recommended by some authors.

[Purpura fulminans and C7 deficiency complicated by Pneumocystis carinii pneumonia]. / Purpura fulminans et déficit en C7 compliqué d'une bronchopneumopathie à Pneumocystis carinii.

A case of meningococcal purpura fulminans is reported in a 22-year-old woman who also suffered from a congenital deficiency in the seventh component of the complement system. This was her third episode of recurrent meningitis. In the course of her treatment in intensive care, the septic shock was cured, but she developed Pneumocystis carinii pneumonia. Histological investigations revealed abnormalities in her T-cell population, with a very low T-helper (CD4) to T-suppressor (CD8) ratio. Laboratory data showed that she did not have any antibodies to HIV.