Renal replacement therapy in patients with severe precapillary pulmonary hypertension with acute right heart failure.

Background: Renal replacement therapy has been suggested as a therapeutic option in the setting of acute right ventricular failure in patients with severe precapillary pulmonary hypertension. However, there are few data supporting this strategy.

Objectives: To describe the clinical course and the prognosis of pulmonary hypertensive patients undergoing renal replacement therapy in the setting of acute right heart failure.

Carboplatin: a new cause of severe type B lactic acidosis secondary to mitochondrial DNA damage.

In adults, type B lactic acidosis is rare and generally associated with a toxin, particularly metformin or antiretroviral nucleosides analogues. We report a case of lactic acidosis caused by carboplatin in a 50-year-old woman suffering from primary peritoneal carcinoma. She was admitted for severe lactic acidosis (pH 6.

Obstetrical Complications and Outcome in Two Families with Hereditary Angioedema due to Mutation in the F12 Gene.

Backgroud. Hereditary angioedema (HAE) is characterized by recurrent swelling of the skin, the abdomen (causing severe acute pain), and the airways. A recently discovered type caused by mutations in the factor XII gene (designated as HAE type III) occurs mainly in women.

Bronchoalveolar lavage cytological alveolar damage in patients with severe pneumonia.

Introduction: Histological examination of lung specimens from patients with pneumonia shows the presence of desquamated pneumocytes and erythrophages. We hypothesized that these modifications should also be present in bronchoalveolar lavage fluid (BAL) from patients with hospital-acquired pneumonia.

Methods: We conducted a prospective study in mechanically ventilated patients with clinical suspicion of pneumonia.

Accuracy of clinical presentation for differentiating bacterial from viral meningitis in adults: a multivariate approach.

Objective: To determine whether bacterial (BM) and viral (VM) meningitis can be differentiated based on initial clinical presentation.

Design And Setting: Retrospective cohort study in a medical emergency department and intensive care unit in a university hospital.

Patients: 144 adults, including 90 with confirmed BM and 54 unpretreated VM.

Usefulness of abdominal CT scan in severe peritoneal sepsis linked to primary peritonitis.

We report 2 cases of primary group A streptococcal peritonitis in which emergency abdominal CT scan ruled out a hollow viscus perforation, or necrosis, avoiding unnecessary laparotomy. These cases highlight the usefulness of abdominal CT scan and suggest that blind surgical exploration has no advantages.

Biventricular assist device for scombroid poisoning with refractory myocardial dysfunction: a bridge to recovery.

Unlabelled: We report the usefulness of biventricular mechanical circulatory support in a 36-yr-old woman with refractory myocardial dysfunction resulting from scombroid poisoning.

Design: Case report.

Setting: Medical and surgical university care units.

Increased diffusion of soluble adhesion molecules in meningitis, severe sepsis and systemic inflammatory response without neurological infection is associated with intrathecal shedding in cases of meningitis.

Objective: Sepsis and systemic inflammatory response syndrome (SIRS) result in the release in plasma of inflammatory cytokines and soluble forms of adhesion molecules in relation to endothelial activation. This study was designed to compare cerebrospinal fluid (CSF) concentrations of adhesion molecules in meningitis and SIRS without neurological infection and to evaluate in meningitis whether they originate from passive diffusion through damaged blood-CSF barrier or from local production.

Design: Prospective observational study.