Herpes simplex virus type 1 hepatitis due to primary infection in a pancreas-kidney transplant recipient.

Herpes simplex Virus (HSV) hepatitis is a rare complication of HSV-1 primary infection, with a delayed diagnosis, affecting mainly immunocompromised patients. We describe a case of HSV-1 hepatitis after primary infection occurring in the postoperative days after a pancreas-kidney transplantation. The patient presented with an unusual evolution of a persistent severe hepatitis associated with a persistent viremia (Quantitative Polymerase Chain Reaction) despite an adequate intravenous (iv) antiviral treatment.

[Massive rhabdomyolysis: an uncommon complication of cholesterol embolization syndrome].

A 79-year-old man with atherosclerosis presented blue toes and livedo reticularis. The patient had eroded aortic atheromatous plaques, and cholesterol embolization syndrome was suspected. An endovascular technique to exclude sources of cholesterol emboli was however performed.

[Value of skin tests for the choice of a neuromuscular blocking agent after an anaphylactic reaction].

We report a grade III allergic hypersensitivity reaction occurring in a 72-year-old patient immediately after anaesthesia induction. Anaphylaxis to cisatracurium was diagnosed on clinical symptoms, biological tests and positivity of the cutaneous tests to this neuromuscular blocking agent. Five days after this allergological assessment, rocuronium, a muscle relaxant for which skin tests appeared negative was used during surgery without adverse effects.

[Metformin-associated lactic acidosis precipitated by acute renal failure].

In type II diabetes treated with metformin, lactic acidosis is a rare but severe complication. Commonly patients with lactic acidosis show signs of shock, tissue hypoxia, acute hepatic or renal failure and the link between metformin therapy and lactic acidosis may be coincidental, associated or causal. Excessive plasma metformin concentrations show that lactic acidosis is due to a toxicological mechanism.

[Ischemia of a transplanted kidney and hyperlactatemia].

The authors report four cases of patients presenting with hyperlactatemia following renal transplantation. The post-transplantation course of three patients who underwent renal transplantation was complicated by occult haemorrhage. Excessive blood loss was not evident, the patients were haemodynamically stable and their blood pressure, pulse rare and filling pressure (central venous pressure) were unremarkable.

[Failure to recover after anesthesia attributed to a transient dissociative state].

Failure of a patient to recover rapidly after anaesthesia is a rare event, due to various causes, including medication related effects, metabolic disturbances or neurologic insults. We report a case in a middle aged physically healthy woman who failed to recover promptly after intravenous anaesthesia. Propofol was administered for 20 minutes.

Assessment of deep vein thrombosis prophylaxis in surgical patients: a study conducted at Nancy University Hospital, France.

Objective: This retrospective evaluation aimed to assess the adequacy of prophylaxis against thromboembolism prescribed to surgical patients at the authors' institution, and to compare it with generally accepted published guidelines. Aspects considered were indications for prophylaxis, regimens used and monitoring.

Methods: Eleven units (nine surgical and two surgical intensive care) took part in the survey on a voluntary basis.

[Renal harvesting from donors in cardiac arrest: report of 3 cases and surgical technique].

During periods of transplant organ shortage, techniques designed to "salvage" transplants must be developed. The authors report three cases of renal harvesting from donors in cardiac arrest, in which the use of in situ perfusion-cooling with transfemoral introduction of Gillot's catheter resulted in six good quality transplants. The indications, surgical technique, alternatives and results are discussed.

Relationship between blood pressure and renin, angiotensin II and atrial natriuretic factor after renal transplantation.

The objective of the study was to assess the evolution of renin, angiotensin II, atrial natriuretic factor (ANF) and blood pressure (BP) in the first trimester following renal transplantation in man Thirty-two recipients were investigated for 3 months post-transplantation. Twenty had a history of hypertension with moderate cardiac hypertrophy. Thirty-one retained their native kidneys.

Extracorporeal shock wave lithotripsy in a patient with complete atrioventricular heart block.

Extracorporeal shock wave lithotripsy using a spark gap generator is contraindicated in patients with complete atrioventricular heart block. A case of a patient with such a heart block, who successfully underwent renal lithotripsy, without cardiac pacemaker, is reported.

Computer-controlled monitoring of bladder pressure in the prevention of 'TUR syndrome': a randomized study of 53 cases.

Objective: To evaluate the performance of a computer-controlled monitor of bladder pressure in the prevention of transurethral resection (TUR) syndrome.

Patients And Methods: The in vitro pressure loss in catheters and endoscopes of different size was measured for irrigant flow rates of 0-500 mL/min to calibrate them before surgery. The calibrations were used in a computerized monitoring system designed to control bladder pressure during TUR of the prostate (TURP).

[Effects of propofol on blood concentration of cyclosporine].

Objective: This study was designed to assess whether propofol modifies the blood concentrations of cyclosporine and lipoproteins, which bind cyclosporine.

Study Design: Prospective open study.

Patients: Fifteen consecutive grafted patients, scheduled for surgery allowing them to resume their oral treatment postoperatively.

[Management of intraoperative erection by penile block].

Erection during endoscopic or penile surgery is a troublesome event. In this case report, the erection was first treated with intracavernous injection of etilefrine (8 mg) and detumescence was obtained rapidly. However, one hour later, the erection occurred again.

[Effects of anesthesia on postoperative micturition and urinary retention].

Postoperative micturition difficulties, considered as minor complications, have a high incidence. Acute urinary retention can follow all types of anaesthetics or operations. Surgical trauma to the pelvic nerves or to the bladder, postoperative oedema around the bladder neck, and pain-induced reflex spasm of the external and internal urethral sphincters may play a role in the development of urinary retention.

[Penile block in adults].

A block of the penile nerves provides a sensory blockade of the penis. In adults, surgery can thus be carried out on the foreskin, glans, corpus cavernosum, corpus spongiosum or penile urethra. The two dorsal nerves of the penis can be blocked by two different routes.