Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia.

In the non-AIDS group, several underlying conditions and immune defects could lead to different PCP presentations. This study compared PCP presentation and outcome according to the underlying disease. A secondary analysis of a previously published prospective observational study including 544 PCP patients was done.

Health-Related Quality of Life Is Severely Affected in Primary Orthostatic Tremor.

Background: Primary orthostatic tremor (POT) is a movement disorder characterized by unsteadiness upon standing still due to a tremor affecting the legs. It is a gradually progressive condition with limited treatment options. Impairments in health-related quality of life (HQoL) seem to far exceed the physical disability associated with the condition.

Management of Severe Bleeding in Patients Treated with Direct Oral Anticoagulants: An Observational Registry Analysis.

Background: The use of prothrombin complex concentrates and the role of plasma concentration of anticoagulants in the management of bleeding in patients treated with direct oral anticoagulants are still debated. Our aim was to describe management strategies and outcomes of severe bleeding events in patients treated with direct oral anticoagulants.

Methods: We performed a prospective cohort study of 732 patients treated with dabigatran, rivaroxaban, or apixaban hospitalized for severe bleeding, included prospectively in the registry from June 2013 to November 2015.

Posterior reversible encephalopathy syndrome (PRES) and hypomagnesemia: A frequent association?

Posterior reversible encephalopathy syndrome (PRES) is a serious neurological condition encountered in various medical fields. Pathophysiological factor(s) common to PRES cases of apparently unrelated etiologies are yet to be found. Based on the hypothesis that hypomagnesemia might participate in the cascade leading to PRES, our study sought to verify whether hypomagnesemia is frequently associated with PRES regardless of etiology.

Immediate versus deferred chemotherapy after radical cystectomy in patients with pT3-pT4 or N+ M0 urothelial carcinoma of the bladder (EORTC 30994): an intergroup, open-label, randomised phase 3 trial.

Background: Patients with muscle-invasive urothelial carcinoma of the bladder have poor survival after cystectomy. The EORTC 30994 trial aimed to compare immediate versus deferred cisplatin-based combination chemotherapy after radical cystectomy in patients with pT3-pT4 or N+ M0 urothelial carcinoma of the bladder.

Methods: This intergroup, open-label, randomised, phase 3 trial recruited patients from hospitals across Europe and Canada.

Dexamethasone-induced apoptosis of mouse thymocytes: prevention by native 7alpha-hydroxysteroids.

Dehydroepiandrosterone (DHEA) has been shown to decrease the dexamethasone (DEX)-induced apoptosis of thymocytes and to be one of the native 3beta-hydroxysteroids extensively 7alpha-hydroxylated in thymus. This led us to question whether DHEA or 7alpha-hydroxy-DHEA is responsible for the decrease in DEX-induced apoptosis of thymocytes and whether this property is shared with other native 3beta-hydroxysteroids and their 7alpha-hydroxylated metabolites. Treatment of mice with DHEA or 7alpha-hydroxy-DHEA prior to DEX led to a smaller decrease in thymus weight than with DEX alone and to a disappearance of the DEX-induced changes in thymocyte phenotypes.

[Spontaneous colonic ischemia].

Spontaneous ischemic colitis is a frequent disease, affecting mostly elderly people and predominantly localised on the left and sigmoid colon. It is due to alterations of small vessels of the colon and/or modifications of the splanchnic blood flow. Spontaneous evolution is generally favorable with restitution ad integrum of the disease colon.

[Analysis of the drainage fluid after cephalic duodenopancreatectomy: a reliable clinical criterion].

The authors have retrospectively analysed the drainage fluid of 39 patients undergoing Whipple's operation over a 18-year period. The aim of the study was to assess whether the volume and amylase concentration of the drainage fluid were good criteria of healing of the pancreatico-jejunal anastomosis. The patients have been divided into two groups: Group I (30 patients) with no complications at the pancreatico-jejunostomy--Group II (9 patients) with a pancreatic leak.

Haemodynamic assessment of hypovolaemia under general anaesthesia in pigs submitted to graded haemorrhage and retransfusion.

We have compared the value of different variables used in the assessment of blood loss during progressive hypovolaemia and resuscitation under general anaesthesia in anaesthetized pigs. We measured mean arterial pressure (MAP), pulmonary capillary wedge pressure (PCWP), the negative component of the systolic arterial pressure variation (delta Down) and left ventricular end-diastolic area (LVEDa) using echocardiography. Blood was progressively withdrawn (up to 35 ml kg-1 in seven steps) and then reinfused after the same pattern.

[Resistance to penicillin G and Streptococcus pneumoniae infection at the Hôpital Foch, Paris, France, in 1995].

Unlabelled: Decreased susceptibility to penicillin G of pneumococcal strains is continuously increasing in France.

Objective: We assessed effect of resistance to penicillin on therapeutic management and mortality in adults with pneumococcal pneumonia in our hospital.

Methods: This one-year retrospective study (1995) included patients with proven pneumococcal infection (positive blood culture, pleural fluid, or specimens from the lower respiratory tract).

[Long-term results of surgical pharyngectomy (uvulo-palato-pharyngoplasty) versus office CO2 laser (L.A.U.P.) for the treatment of uncomplicated snoring].

Two treatments are habitually proposed for snoring without obstructive sleep apnea syndrome: the surgical pharyngotomy, and the treatment by laser done in the office. Our study analyses retrospectively, by telephone questionnaire, a group of 168 snorers, without obstructive sleep apnea syndrome, treated by pharyngotomy (n = 71) or CO2 laser (n = 97) between 1989 and 1993. Results after a mean follow-up of 5 years, with a minimal of 3 years, show for the two procedures the same efficacity, and an equivalent prevalence of side effects.

[Surgical replacement of the aortic arch].

Deep hypothermia with circulatory arrest is the usual method of cerebral protection during replacement of the aortic arch. However, this technique only gives the surgeon a limited period of time to carry out aortic repair. It also requires that cardiopulmonary bypass be prolonged to rewarm the patient which may cause many complications.

[Current treatment of acute dissections of the ascending aorta].

In 1977, the authors introduced the gelatin resorsin formol glue for emergency surgery of dissection of the ascending aorta (Stanford Type A). This special issue devoted to surgery of the thoracic aorta gives them the opportunity of summarising the different techniques of replacing the ascending aorta, underlying the procedures available for reinforcing the sutures. The value of the gelatin resorcin formol glue extensively described and the authors then analyse the principles and methods of treating aortic insufficiency and of the extension of replacement of the aorta to the aortic arch.

Urethral recurrence of transitional cell carcinoma of the bladder. Predictive value of preoperative latero-montanal biopsies and urethral frozen sections during prostatocystectomy.

Objective: The management of the male urethra after cystectomy for bladder cancer continues to be a dilemma. Patients who undergo a cystectomy require either urinary diversion or bladder substitution. Therefore, the use of the urethra to ensure voiding is important.

Radionuclide cisternography in spontaneous intracranial hypotension.

We report a case of spontaneous intracranial hypotension (SIH) that was investigated using cranial MRI and radionuclide cisternography. Radionuclide imaging was remarkable, showing direct signs of diffuse asymmetric leakage and indirect signs of cerebrospinal fluid (CSF) hypotension consisting of slow CSF circulation to the convexity and rapid appearance of urinary bladder activity. The MRI appearance was also suggestive of SIH, with diffuse meningeal enhancement.

The effects of inhaled nitric oxide and its combination with intravenous almitrine on Pao2 during one-lung ventilation in patients undergoing thoracoscopic procedures.

Unlabelled: The aim of this study was to assess whether hypoxemia during one-lung ventilation (OLV) can be prevented by inhaled nitric oxide (NO) (Part I) or by its combination with intravenous (IV) almitrine (Part II) in 40 patients undergoing thoracoscopic procedures. In Part I, 20 patients were divided into two groups: one received O2 (Group 1) and one received O2/NO (Group 2). In Part II, 20 patients were divided into two groups: one received O2 (Group 3) and one received O2/NO/almitrine (Group 4).

Ureteroileal implantation in orthotopic neobladder with the Le Duc-Camey mucosal-through technique: risk of stenosis and long-term follow-up.

Purpose: We determined the postoperative risk of nonneoplastic ureteroileal implantation stenosis using the Le Duc-Camey technique, and assessed the extent to which followup is mandatory.

Materials And Methods: Between October 1980 and October 1989, after a cystoprostatectomy, 158 consecutive men underwent lower urinary tract reconstruction by means of a U-shaped orthotopic ileal neobladder. Of these cases 109 were tubularized and 49 were detubularized.

[Tremors].

In this general review of tremors, one must distinguish the parkinsonian rest tremor, which concerns relaxed muscles, from other tremors that accompany muscle activities, such as maintaining a posture or executing a movement. Among various postural and action tremors, essential tremor occupies first place, in terms of its prevalence. The diagnosis of essential tremor is based on precise criteria.

[Bilateral malignant mesothelioma of the tunica vaginalis testis. Apropos of a case].

The authors report the first case of synchronous bilateral malignant mesothelioma of the tunica vaginalis. Despite bilateral radical orchidectomy completed by unilateral inguinal radiotherapy, the patient developed an uncontrolled recurrence three years after initial treatment of the second tumour. The prognosis of malignant mesothelioma is very poor with a median survival of 28 months reported in the literature.

[Tissue expansion. Presentation of a model of external filling valve].

Based on their experience of facial tissue expansion, the authors present a model of an external filling valve and illustrate its advantages in 9 cases in which 13 external valve were used: painful injection, absence of leakage, fast and confortable filling. The indications are sequelae of facial burns, face scars, treatment of orbito-temporal neurofibromatosis. The major advantage is rapid tissue expansion which reduces the problems of infection and skin loss.

[Antibiotic prophylaxis in urology].

There is little reason why the organism could benefit from the presence of micro-organisms in the urine. In the case of severe infection, the consequences can be devastating, both for the health of the individual and for the overall effect in terms of health care costs. There is thus a clear need for a reduction in the number and severity of urinary tract infections by a strictly controlled, well-planned, antibiotic prophylaxy.