[Refractory thrombotic thrombocytopenic purpura revealing an epiglotis neoplasia].

Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy with neurological disorder which incidence is relatively rare. Since the discovery of the ADAMTS 13 in 1996 and the changes in the treatment (plasma exchanges and rituximab), the prognosis of the TTP has considerably improved. We report the case of a 60-year-old man with a refractory TTP.

[Disseminated strongyloidiasis with parasitemia in a patient under corticosteroid-treatment].

We report a case of disseminated strongyloidiasis with parasitemia in a 53-year-old man under corticosteroid therapy. It occurred more than 16years after contamination and led to severe sepsis and acute respiratory failure with P. aeruginosa pneumonia.

[A mixed acid-base disorder revealing a cystic dystrophy of aberrant pancreatic tissue].

We report about a patient presenting with a mixed acid-base disorder. His blood gas analysis showed a metabolic acidosis caused by renal failure and lactic acidosis combined with a hypochloraemic alkalosis. The underlying pathology was a cystic dystrophy of aberrant pancreatic tissue leading to excessive vomiting, extracellular dehydration with a renal failure and hypochloraemia.

Nadroparin in the prevention of deep vein thrombosis in acute decompensated COPD. The Association of Non-University Affiliated Intensive Care Specialist Physicians of France.

Low molecular weight heparins are as effective as unfractionated heparin in deep-vein thrombosis (DVT) prophylaxis for major surgery. However, there is no evidence nor consensus for prophylaxis in medical patients. We compared the efficacy and safety of nadroparin calcium (nadroparin) with placebo in medical patients at high risk of DVT.

[Intracranial hypertension in severe diabetic ketoacidosis with coma. Two cases].

We observed two cases of severe diabetic ketoacidosis with coma and shock. In one case, coma was present at admission and in the second occurred within 15 hours. In both cases, intracranial hypertension was confirmed with an extradural captor.

[Candidal bezoar of the urinary tract during Candida albicans septicemia].

We report a case of an obstructing fungus ball of the urinary tract. Typical predisposing factors were present, i.e.

[Non-cardiogenic pulmonary edema after transfusion of plasma containing an anti-HLA-B21 antibody].

A patient with a von Willebrand factor deficiency received three units of fresh frozen plasma during a postoperative period. During the last unit transfusion she developed a severe respiratory distress and non cardiac pulmonary edema was diagnosed based upon the clinical, radiological and hemodynamic findings. Reintubation and mechanical ventilation with end-expiratory pressure were instituted leading to a complete and rapid recovery within 48 h.

[Pseudomonas cepacia septicemias: therapeutic difficulties].

From Summer 1983 to Summer 1986, 34 cases of septicemia due to Pseudomonas cepacia could be detected in several intensive care units in the university hospital in Clermont-Ferrand (France). Intravascular catheters can be involved in the inoculation of this bacterial agent: a previous respiratory tract infection or a drained abscess can be the portal of entry of the bacteremia. Three patients died from the septicemia and the overall prognosis of the intensive care patients looks significatively worsened.

[Diagnosis of amniotic embolism by bronchoalveolar lavage].

A broncho-alveolar lavage performed in a patient who developed pulmonary oedema a few hours after a caesarian section, produced foetal squamae which led to the diagnosis of amniotic fluid embolism.

[A simplified severity index in resuscitation. Validation by a prospective study (280 cases)].

The index studied (simplified acute physiology score, or SAPS) is calculated from 14 measurable clinical and laboratory data obtained during the first 24 hours from admission. It was tested in a prospective study involving 280 consecutive patients treated in a 16-bed intensive care unit. Good correlations were found between SAPS and mortality rate and between SAPS and the two most widely used scoring systems: the Knaus index or APS (acute physiology score) and the Cullen index or TISS (therapeutic intervention scoring system), both evaluating therapeutic effectiveness.

[Fatal poisoning by alcohol-free aniseed aperitif].

A case of chronic poisoning with alcohol-free "pastis" leading to the death of a 32 year old alcoholic patient is reported. The mean daily amount of ingested glycyrrhizinic acid was 0.35 g.

[Diagnosis of trismus, excluding tetanus and local causes].

The most frequent causes of trismus are tetanus and local lesions. This report discusses other etiologies. Trismus is usually only a secondary sign of a rich clinical picture, but may be of diagnostic value in some cases.