Eighty-four patients submitted to cholecystectomy were randomly assigned in a double-blind study either to an intravenous dose of 10 mg of metopimazine, three times D-1, for two days or to an identically administered placebo. A definite superiority of metopimazine as an anti-emetic drug was demonstrated. General acceptance was excellent, but arterial pressure might be looked over closely when metopimazine was administered intravenously immediately after a general anesthesia.

Adult↗

PubMed1979

[Clinical study of massive transfusions (108 cases)].

Amongst 108 surgical patients receiving massive transfusions, 60 died. Study of the aetiology of the haemorrhage, the circumstances of the transfusion, and the role of massive transfusions in the transmission of infectious diseases, disturbances in haemostasis, immunological, respiratory and metabolic complications led to the determination of certain simple criteria of gravity which may restrict their use:age over 60 years; the number of units used, if it exceeds 30; the existence of cirrhosis, of an acute lesion as the source of bleeding, or of peroperative haemorrhage. By contrast, the transmission of hepatitis, coagulation disturbances, immediate or delayed incompatibility accidents and variations in pH, blood potassium and calcium levels and arterial pO2 had little influence on mortality.

Adolescent↗

PubMed1977

[The value of early routine radiological examination following esophagectomy for carcinoma of the lower third of the esophagus].

An early upper gastrointestinal series may be carried out on a routine basis after recovery of the postoperative ileus and makes it possible to confirm the good quality of the anastomoses or, by contrast, reveal a benign fistula. Under some circumstances, it may be carried out very early following the development of postoperative complications: pain, fever, respiratory, circulatory and renal insufficiency or in the presence of abnormal discharge from the drains. It then shows whether this complication is due to an oesophagomediastinal or pleural fistula.

Adult↗

PubMed1977

[Pulmonary complications of esophagectomy for carcinoma of the middle third of the esophagus].

The authors studied 20 patients undergoing operation for a carcinoma of the middle third of the oesophagus during the period January 1972 to April 1975. Postoperative pulmonary complications are extremely common in such patients. All the patients had pulmonary function study results which were compatible with this type of surgery. All underwent resection with oesophagogastric anastomosis via a left thoracophrenolaparotomy. Of the 20 patients, 14 suffered from one or more episodes of acute respiratory insufficiency, some related to pneumonia. On the basis of various associated clinical, radiological, biological, evolutive and histopathological criteria, five types of pulmonary complication were distinguished: 1-Shock lung; 2-Infective pneumonia; 3-Traumatic pulmonary disease; 4-Acute cor pulmonale; 5-Lung disease of undetermined origin. Twelve patients died as a result of pulmonary complications, 11 early (before the 16th day). One patient only died as a result of rupture of the oesophagogastric anastomosis.

Esophageal Neoplasms↗

PubMed1976

Chloroquine retinopathy in patients with rheumatoid arthritis.

270 consecutive patients with rheumatoid arthritis who had received chloroquine therapy were examined ophthalmologically for toxic retinal lesions. The total annual dose of chloroquine was 70-75 g. The maximum total dose given was 1330 g. The duration of treatment ranged up to 15 years. The primary material was divided into four groups according to total chloroquine dose received: greater than 100 g, 101-300 g, 301-600 g, and less than 600 g. Each dose group was arbitrarily split into two age groups, one with patients under 63 years of age and the other with patients over 63, in order to analyse the effect of age upon the ocular findings. In the present study, slight macular changes were included in the concept of maculopathy and were not thought to contra-indicate chloroquine therapy. Macular changes were found in about 25% of the patients, regardless of age in the lowest dosage group. The frequency of maculopathy increased with increasing total dose only in the older age group. It was also shown that the frequency of maculopathies and other eye diseases also increased with increasing age. This was evident even from the age of 50. The only patient with chloroquine retinopathy was an inadequately controlled 74-year-old woman. Chloroquine treatment of rheumatoid arthritis in the absence of any other disease which may cause retinopathy implies negligible risks in adult patients under 50 years of age. These patients could be less frequently checked. Older patients require regular ophthalmological checks. It is important to use the smallest effective dose possible, and never higher than 4 mg of chloroquine phosphate/kg body weight and day for 10 months annually; in elderly patients, preferably even lower doses.

Age Factors↗

PubMed1976

Psoriasis, sacro-iliitis and peripheral arthritis occurring in patients with the same HLA haplotype. A preliminary family report and a hypothetical explanation of the interaction between MHS products.

The present family investigation has shown that genes within the MHS are mainly responsible for the development of psoriasis or psoriasis-associated arthritic lesions (peripheral arthritis and sacroiliitis). We have hypothetically discussed the possibility that multiple genes, all located within the MHS, act in concert to increase the risk of developing disease to very high levels. This implies that at least two MHS linked genes act in complementary fashion for the development of disease, these genes seem to be able to operate both in the cis and in the trans position. One of these genes would be situated in the chromosomal portion of the MHS which carries the HLA-D locus. Families with a high incidence of disease would show inheritance according to the cis position of genes, when it can be shown that most of the carriers of the specific disease-associated haplotype are affected by disease, whereas in other families, complementarity between two distinct HLA haplotypes with genes acting in the trans position would result in disease.

Adolescent↗

PubMed1976

[A new criterion of hospital administration: the "security threshold" of patients].

Explore the source record for details and available documents.

France↗

PubMed1975

[Chloroquine-induced retinopathy in patients with rheumatoid arthritis].

Explore the source record for details and available documents.

Adult↗

PubMed1975

Complications of transrectal aspiration biopsy of the prostate.

Four cases of coli-sepsis, one with a fatal outcome have been observed after more than 14 000 transrectal aspiration biopsies (TAB) of the prostate performed at Karolinska Sjukhuset with Franzén's apparatus. A few cases of transient febrile reaction and urinary contamination after TAB of the prostate have also been recognised. One of the patients with sepsis and two with febrile reactions belonged to a relatively small group of patients referred from the Department of Rheumatology. These observations prompted the present study. The records of all the patients referred for TAB of the prostate from the Department of Rheumatology were reviewed. Four complications (three patients with febrile reaction and growth of E. coli in the urine and one case of sepsis) were observed after 63 biopsies in 51 patients (6.3%). The patient with sepsis and two other patients with complications belonged to a group of 32 patients with proven rheumatic disease (chronic polyarthritis): 42 biopsies had been performed in this particular group of patients, bringing the incidence of complication to 7.1%. For comparison the records of 294 patients from the Department of Urology submitted to TAB of the prostate were also reviewed. Complications in the form of transient febrile reactions were found in five cases after 508 biopsies (1.0%). In addition, three cases of coli-sepsis not belonging to the above-mentioned groups are briefly described as case reports. Patients with rheumatic disease (chronic polyarthritis) seem to run a higher risk of complications after TAB of the prostate. Sepsis from E. coli is a rare but serious complication which can develop into, often fatal, endotoxin shock. TAB of the prostate should therefore be restricted to cases with clinical suspicion of prostatic malignancy.

Adult↗

PubMedDate not supplied

[Hypoglycemia].

After vagal collapsus, hypoglycemia is the emergency most often seen in the dental office. It usually happens among the treated diabetic population; there are approximately one million diabetics in France. Its sudden appearance requires an emergency treatment with oral or IV intake of glucose, or the injection of glucagon. Hypoglycemia is defined by a drop of the blood glucose level below the normal values. Of sudden onset, the clinical signs of hypoglycemia can vary, specially the neurological and psychiatric manifestations, and they can lead to a coma. The objective diagnosis relies on the blood glucose level.

Dental Offices↗