The authors report the case of a man aged 59 years, with primary hyperparathyroidism; removal of a first adenoma, did not lead to recovery. Later, an egg-shell calcification was found together with a second large cervico-mediastinal parathyroid adenoma, the removal of which caused all the symptoms to disappear. After a review of other cases in the world literature with calcification of the parathyroid glands, the authors consider, before using more complicated techniques for preoperative localisation of parathyroid adenomas, one should carry out careful radiological examination of the cervical and mediastinal region. Under these conditions, one may detect significant calcifications which have escaped routine examination and may contribute to the topographic diagnosis of the parathyroid lesion sought.

Adenoma↗

PubMedDate not supplied

[Intravenous nitroglycerin as vasodilator therapy in acute myocardial infarction (author's transl)].

Thirteen patients with left ventricular failure complicating acute myocardial infarction were treated with intravenous nitroglycerin. The hemodynamic criterium for admission to this study was a pulmonary capillary wedge pressure greater than 15 mm Hg. All patients received intravenous nitroglycerin at infusion rates sufficient to lower pulmonary capillary wedge pressure by an average of 15 mm Hg, corresponding to the optimal left ventricular filling pressure in acute myocardial infarction. During this study, heart rate did not vary significantly; pulmonary capillary wedge pressure decreased from 24 +/- 0,7 to 15 +/- 0,8 mm Hg (p less than 0,001), mean arterial pressure from 95 +/- 5 to 80 +/- 4 mm Hg (p less than 0,005), mean right atrium pressure from 8,7 +/- 1 to 4,6 +/- 0,8 mm Hg (p less than 0,001), systemic vascular resistance index from 36,4 +/- 2 to 29,6 +/- 2 mm Hg/mm-1/l/m2 (p less than 0,005). Cardiac index increased from 2,5 +/- 0,2 to 2,7 +/- 0,1 l/mn/m2 (p less than 0,025) and stroke work index did not vary significantly. These data indicate that nitroglycerin provides a significant improvement of cardiac performance, more through reduction of preload than through reduction of afterload, the later being however significant. This study points out that intravenous nitroglycerin is a most efficient drug in patients with left ventricular failure complicating acute myocardial infarction.

Acute Disease↗

PubMedDate not supplied

[Acute nephritis and allergic vasculitis due to phenindione (author's transl)].

The authors report a case of acute nephritis which appears during a treatment with phenindione. The nephropathy described after this medication are now well known. Their manifestations are either a proteinuria associated or not with a nephrotic syndrome or an interstitial nephritis whose pronostic is reserved. In this observation the mechanism is different : the lesion is glomerular and complicates an allergic vasculitis which was secondary to the phenindione's therapy. The pronostic was good.

Acute Disease↗

PubMedDate not supplied