We report a type 1 diabetes in an 88-year-old female patient discovered in 1938 at the age of 26. She was promptly put on insulin, which lasted 62 years so far. This patient was highly remarkable because she portrayed a historical case of insulin-treated diabetes diagnosed in 1938. The absence of microangiopathy and specially retinopathy was quite singular, all the more reason that her diabetes was ill-controlled. Environmental or genetic factors may, one day, explain this unusual favourable outcome.

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[Importance of endoscopy with biopsy in gastroduodenal amyloidosis. Apropos of 5 cases].

The authors report five cases of gastric amyloidosis in addition of the fourty three published cases. These cases was polyvisceral forms, 4 times primitive and 1 time secondary to a psoriasic rheumatism. Three times only the patients had complaints of digestive tract. Four times non specific radiologic and endoscopic signs lead to a biopsy which permits diagnosis. The biopsy of gastric mucosa must take place beside the rectal biopsy; more difficult to do, it might be more successfull because the stomach is more often infiltrated by amyloidosis than the colon.

Abdomen↗

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[Treatment of congestive heart failure: new concepts].

In the past, hemodynamic factors, in congestive heart failure were considered as being of major importance in the production of the major symptoms and signs of the disease: peripheral (increased oxygen extraction, flow redistribution) or central (Starling's law, myocardial contractility). More recently, excessive hormonal compensation has been felt to be more important such as: The renine-angiotensin-aldosterone axis, Circulating catecholamines, Arginin-vasopressin. These hormones are responsible for water and sodium retention, tachycardia and increase in peripheral resistance. Newer agents such as Captopril are effective in blocking the action of these endocrine factors.

Arginine Vasopressin↗

PubMedDate not supplied

Management of arterio-venous fistula due to unusual aorto-iliac aneurysms.

Aorto-caval fistula associated with thoraco-abdominal aneurysm or with multiple segmental aneurysms is a major challenge for the vascular surgeon. We report two patients who were managed successfully. In addition to the classical surgical techniques of aneurysm repair, we used haemodynamic monitoring with a Swan Ganz catheter, an autotransfusion device and interruption of the vena cava, thus avoiding the three main causes of death in such cases, namely, gross haemodynamic disturbances, major bleeding, and pulmonary embolism.

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PubMedDate not supplied

[Fatal hepatic wound during pleural puncture for evacuation].

Explore the source record for details and available documents.

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