[Late perfusion with N-acetylcysteine in a case of paracetamol poisoning seen at the stage of fulminant hepatitis].
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Biomedical subjects
Publications and source records attributed to B Tardy.
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The torsades de pointes with bepridil are serious side-effects, known right from 1982, and for which definite therapeutic recommendations were decreed in 1984 then in 1991. The observations of 7 new cases drove us to discuss about the respect for these recommendations. From the study of these 7 middle-aged patients (+/- esm) 76.9 +/- 2.4, we have noticed that they all combined 3 risk-factors at least with an average (+/- esm) 3.71 +/- 0.29 (range 3-5). The non-respect for the methods of prescription of bepridil leads to serious trouble in the rate of heartbeat and can threaten vital prognosis. So, it is advisable for the practicians to be warmly and precisely informed and prescribe another anti-angina-pectoris treatment in high risk-patients.
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Neurologic manifestations occur in over 90% of patients with thrombotic thrombocytopenic purpura. Neuropathologically, thrombi produce occlusion of terminal arterioles and capillaries resulting in diffuse small infarcts. In the great majority of surviving patients, brain CT does not disclose any abnormalities. The authors report a case of thrombotic thrombocytopenic purpura in which brain MR examination showed multiple punctate lesions in the white matter.
OBJECTIVES: Heparin-induced thrombocytopenia is a relatively common and potentially serious adverse complication of heparin treatment. After heparin withdrawal initiation of an alternative anticoagulant is often indicated. Org 10172 or Orgaran is a mixture of several non-heparin low molecular weight glycosaminoglycans with proven antithrombotic efficacy. Unlike low molecular weight heparins, Org 10172 has a low cross reaction rate (about 10%) with the heparin-dependent antibody. METHODS: We present nine patients with heparin induced thrombocytopenia. Org 10172 was prescribed to treat or to prevent a thromboembolic event. RESULTS: Seven patients required further parenteral anticoagulant at diagnosis of heparin-induced thrombocytopenia. Org 10172 was given at prophylactic doses for three patients with a high thrombosis risk and at therapeutic doses for four patients who presented either a venous or an arterial thrombosis related to thrombocytopenia. Two patients presented heparin-induced thrombocytopenia four to six years earlier and needed a parenteral anticoagulation treatment in a post-operative period. CONCLUSION: For the nine patients, Org 10172 was a safe and effective antithrombotic treatment. However, strict monotoring of the platelet count is absolutely mandatory during Org 10172 therapy.