[Acute renal failure and peritonitis. Diagnostic difficulties. Diagnostic orientation of paradoxic alkalosis].
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Biomedical subjects
Publications and source records attributed to B Blaive.
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Selective profile lung angiography provides a valuable contribution to the diagnosis of pulmonary embolism. Indeed, the frequent localization of emboli in the postero-basal zones which could be partially obstructed or undetectable on the frontal lung angiography supports the use of this technique. Our results are based on 50 recent cases of pulmonary embolism, divided into three groups: - non-massive pulmonary embolism explored before the 10th day (16 patients); - non-massive pulmonary embolism explored after the 10th day (24 patients); - massive pulmonary embolism (10 patients). Selective profile angiography confirmed the diagnosis in 10 patients by revealing pathognomonic pictures. Furthermore, a highly-probable diagnosis was allowed in 11 patients having very evocative pictures. Finally, selective profile lung angiography helped to determine the localization of the thrombi, the circulation in adjacent zones, and the quantification of the obstruction in 30 patients.
Two patients with severe forms of legionnaires' disease presented similar manifestations of a confusional syndrome, a major infectious syndrome resistant to cyclines, beta-lactams, and aminoglycosides, altered hepatic and renal functions, and a fulminating course with the need for assisted ventilation in one case. Indirect immunofluorescence serology gave very positive results in both patients and changes in serum levels were reported 6 and 8 months after the onset of the disease. A serotype I strain of Legionella pneumophila was isolated by direct immunofluorescence from bronchial aspiration products in the second case. These cases are discussed in relation to reports in the published literature.
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