Isolated bulb lesion following mild Plasmodium falciparum malaria diagnosed by magnetic resonance imaging.
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Biomedical subjects
Publications and source records attributed to B Pats.
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The available supply of blood products determines the resuscitation capabilities after natural disasters or armed conflicts. Air flight reduces transport delay. The purpose of the present study was to assess the quality of red blood cell concentrates (RCC) immediately after air transport (j0) and after preservation (j30). We exposed RCC to a real air flight (P) or to low pressure (V) corresponding to an air transport in experimental conditions. The quality of RCC was altered immediately after only the real air flight (hemolysis P = 0.11% versus 0.04% for witness (T)). These alterations were not observed immediately after the simulated flight (hemolysis V = 0.02%). After preservation, the RCC was altered both for those exposed to an air flight or to a low pressure (hemolysis: P = 1.09%, V = 0.78%, T = 0.25%). Other biological alterations (pH, K+, hemoglobin level) suggested that pressure variations are not the only one responsible constraint. Other studies are necessary to point the mechanism and the optimal life of conservation after flight. Exposure of preserved red blood cells to air transport alters their therapeutic properties during aging. However, the therapeutic use of RCC thus transported is not questioned.
We study physical compulsions of packed red cells during air transport. We found important variations of pressure and temperatures in blood transport box. These variations explain the biological alterations found in the first part. New rules for blood air transport are proposed.
Two cases of severe complications due to injection of hydrogen peroxide under pressure into areas of muscular attrition in war wounds are reported. In both cases the administration of hydrogen peroxide was associated with tachypnoea, with major arterial desaturation and a precordial "mill-wheel" murmur was heard. In one case, these symptoms were followed by hemiplegia caused by paradoxical arterial gas embolism, and in the other case by a pulmonary oedema confirmed by computerized tomography. Both patients recovered under hyperbaric oxygen therapy. The release of gaseous oxygen under the effect of tissue catalase and the membrane peroxydasic activity of hydrogen peroxide initiate such complications. The injection of hydrogen peroxide under pressure into a closed or partially closed cavity should therefore be strictly prohibited.
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A case is reported of a 23 year old man who sustained a central anticholinergic syndrome after undergoing upper limb surgery under regional anaesthesia and sedation with 2 mg midazolam and 75 micrograms fentanyl. The disturbances consisted of excitation and inhibition. On the 4th postoperative day, he developed progressive coma, quickly and totally reversed with 2 mg physostigmine. Chronic benzodiazepine therapy seems to be a facilitating factor of central anticholinergic syndrome. The low rate of this postoperative complication seems to proceed from failure to recognize it. Differential diagnosis and place of physostigmine therapy are discussed.
Five-hundred-thirteen regional intravenous guanethidine blocks were carried out in 125 cases of algodystrophy (118 adults), after failure of other treatments in 120 cases (Group I) and without previous treatments in 5 (Group II). A positive result occurred in 85 cases of Group I (71%) and in the 5 cases of Group II, after 4.5 +/- 1.7 blocks. In Group I the results did not differ significantly between upper (33 cases) and lower (87 cases) limb or in regard to sex, age, duration of disease, nature of previous treatments. The presence of psychic disorders was accompanied by less frequent (p less than 0.02) positive results. The tolerance was satisfactory in 85.6% of cases: 22 moderate side effects authorized a continuation of the blocks, 22 serious ones indicated interruption, especially one case of thrombophlebitis and another one of very transitory acute ischaemia. The risk of intolerance was significantly raised (p less than 0.02) by age. The regional guanethidine blocks seemed to be a good treatment for algodystrophy after failure of other treatments.
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Esophagus cancer surgery often becomes complicated with fistulas and above all with infections. In 50 cases, the authors relate 7 fistulas and 60 nosocomial infections among which pneumonia takes the first place. The pneumonia diagnosis has been established on the criteria of the "National Nosocomial Infection Study" and on bacteriologic samples. Those mostly isolate Gram-bacilli and streptococci. The diagnosis and etiologic factors leading to prophylactic measures are studied.
In a preliminary retrospective study, 418 regional sympathetic blocks with guanethidine administered as treatment of 103 cases of algodystrophy gave 70 p. cent of positive results versus 55 p. cent in case of psychic disorders. The tolerance was correct in 85 p. cent but was decreased by old age.
Twenty-six young men with no previous medical history all ingested mushroom soup, exclusively made with Cortinarius orellanus. They were hospitalized 10-12 days after the incident. On admission, 12 patients presented with acute tubulointerstitial nephritis with acute renal failure; 8 required haemodialysis. In addition to symptomatic treatment, 9 patients were given corticosteroids. In this group of 12 patients, 8 recovered rapidly, and the other 4 suffered from chronic renal failure for several months. In the other group of 14 patients, initial leukocyturia was observed in 12 cases, although renal function remained normal during a one-year follow-up. Hepatic acetylation and hydroxylation tests performed after 6 months in 22 patients did not provide any explanation for the strong individual sensitivity to the renal toxicity of this fungus.
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