[Peculiar bilateral opacities].
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Biomedical subjects
Publications and source records attributed to M Grivaux.
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The authors report 9 cases of primary pulmonary lymphoma (PPL). With this report, together with the publication of recent and important studies and with the latest advances in immunology, the principal features of this rare entity are emerging from among other lymphoproliferative pathologies of the lung. As a rule, PPL is a histologically well-differentiated tumour with low malignancy and slow course. Treatment is surgical in localized forms. In extensive forms there is no firmly established treatment, but the absence of clinical symptoms permits therapeutic abstention.
A brief report is given of an extremely rare case of pericardial constriction in a patient with quiescent sero-negative rheumatoid arthritis. Pericardectomy was only partially completed as it was impossible to divide the bands joining the peri- and epicardium.
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A case of lithium poisoning with lithium salts in a man of 66 years is reported. Sinus node dysfunction and conduction-tissue modifications were found. The responsibility of lithium in these disoredrs is discussed. The literature and the cellular mode of action of lithium are reviewed.
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Septicemia is a complication of prolonged venous catheterisation; although rare, is at present important owing to the severity of the condition and the possibility of prevention. The severity should lead one to very careful precautions to avoid sepsis, which antibiotic therapy and emergencies often lead one to neglect. The development of research on the prophylaxis of septicemia suggests that in the future, prolonged intravenous fluid may be given less dangerously. They are usually essential during the initial stages of intensive care.
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The authors report a case of constrictive pericarditis complicating an apparently stable sero-negative rhumatoïd arthritis, a rarely described pathological association. The patient had a serious polyserositis due to an extremely marked and inflammatory pericardial constriction. The rhumatoïd origin was confirmed by pericardial effusion, histological and immunofluorescent studies. The inflammatory pericardial process rendered pericardiectomy virtually impossible and resulted in a fatal outcome.
Sixteen cases of lactic acidosis are reported: 7 phenformin treated diabetes, 5 cardiovascular diseases (2 myocardial infractions, 2 pulmonary embolisms, 1 heart failure). In 2 patients no etiology was found. Concomittant renal failure or liver diseases were found in respectively 9 and 4 cases. Patients presented the usual criteria of lactic acidosis: clinical, polypnea, severe hypotension (9/16), peripheral symptoms of shock (12/16), hypothermia (9/16), abdominal pain (9/16): biologically, acidosis (pH = 6,99 +/- 0,01, HCO3- = 5,9 +/- 1,5 mmol), hyperlactatemia (14,1 +/- 3,6 mmol/l) with hig lactate/pyruvate ratio (105 +/- 73), and anion gap (24,3 +/- 4,2 mmol/l). Sodium bicarbonate infusion was performed in all cases (2,5 to 42 mmol/kg). Few cases required volhemic expansion or furosemid induced diuresis. One patient was treated with extrarenal dialysis. 13 patients were alkalinised with less than 185% of estimated deficit measured from alkalin reserve: 12 died. 3 patients received 185% more than this deficit, associated with furosemid (1,8 to 12,5 mg/kg): only one patient died ten days after by casual disease, with lactatemia of 3,2 mmol/l. In spite of the small number of patients, these findings suggest that an early and massive alkalinisation, with large doses of furosemid, can improve the severe lactic acidosis prognosis.
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