Biomedical subjects
Publications and source records attributed to A Moinet.
The rupture of the rudimentary horn of a pseudo-unicorn uterus is a rare accident. The case reported here is very similar to most of those published. It is usually during the fifth month of a pregnancy, normal until then, that a state of shock appear suddenly, requiring a surgical procedure and disclosing this exceptional diagnosis.
UNLABELLED: 5 cases of aorto-iliac aneurysms which fistulised into the inferior vena cava are described. They illustrate the problems encountered in this condition. - DIAGNOSIS: although a classical diagnosis, it is only recognised in 27 p. 100 of cases because the clinical presentation can be very variable. A pulsating, expansive, abdominal mass very suggestive of an aneurysm of the abdominal aorta should alert to the possibility of a fistula within the inferior vena cava when the patient has unexplained cardiac failure, shock, lower limb deep vein thrombosis, urinary or psychological problems. In the absence of a continuous abdominal murmur, the diagnosis may be confirmed by complementary investigations; the investigations of choice are non-invasive. Abdominal ultrasonography showing an aneurysm of the abdominal aorta associated with dilatation of the inferior vena cava is very suggestive of the diagnosis. - The only treatment is surgery. The operative risk depends on the presence of absence of associated retroperitoneal rupture of the aneurysm, the respective mortalities being 83 p. 100 and 15 p. 100. - The principal causes of death are pulmonary embolism and renal failure which necessitate special prophylactic measures (surgical and anaesthetic).
A controlled study on a pragmatic type was performed on 30 patients of both sex, all having recurrent depressions. The efficacy of Clomipramine plus Lithium Carbonate was compared to that of Clomipramine plus placebo. The control consisted in a double-blind study with random sampling of patients. Results were recorded by an independant observer using a rating scale and were analysed statistically. In spite of the bias which was observed it seems possible to conclude. The association of Clomipramine plus Lithium Carbonate has no greater global antidepressive efficacy as compared with Clomipramine plus placebo which means that Lithium does not potentialize nor antagonize the anti depressant effect of Clomipramine. In respect of the number of patients : bipolar depressions (10 cases) unipolar (20 cases) it has not been possible to study the results in these 2 sub groups.
Even within a unique setting with high-powered and board-spectrum therapeutic tools, acute agitation can pose a serious problem. In this communication we review the cases of five schizophrenic adolescents whose agitation created a threat to themselves and the therapeutic community. The institute tried a variety of psychotherapeutic and chemotherapeutic approaches to no avail and only as last resort we used Haldol in very high doses. Since research centers which specialise in the study of schizophrenic persons and their families rarely publish about chemotherapy in high doses, it seems worthwhile relating our findings.