Presse Med
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Several thousands of deaths were attributed to heat stroke during August 2003 in France. To date, only a very few studies have analyzed the prognosis in the intensive care unit (ICU) of the most severely hyperthermic patients. ⋯ The August 2003 heat wave resulted in an elevation of the hospital and ICU death rates in the Lariboisière hospital in Paris. Despite adequate cooling and supportive therapies, the mortality of patients admitted to the ICU for heat stroke remained elevated and the neurological after effects severe. These preliminary results should be confirmed by larger cohort studies.
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To measure the impact of an infectious disease consultation on the morbidity and mortality in patients aged over 75 presenting with fever and respiratory signs and treated with antibiotics in an intensive care unit. ⋯ The over-zealous diagnoses of infection are the primary cause of over-prescription of antibiotics. Despite the population studied, considered as fragile, the 50% reduction in antibiotics is without any negative prognostic impact.
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THE TREATMENT OF DM AND PM: Among primary inflammatory muscle diseases, there are three principle subsets depending on immuno-histochemical and clinical aspects: dermatomyositis (DM), polymyositis (PM) and inclusion body myositis (IBM). Despite their physiopathogenic differences, the treatment of PM and DM is very similar. It relies on principally on oral corticosteroid therapy, occasionally initiated via the intravenous route and which is active in 50 to 70% of cases. In patient with primary or secondary resistance, intolerance or dependence regarding corticosteroids, a second treatment line with immunosuppressive agents or intravenous immunoglobulin should be added.