La Revue de médecine interne
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Review Comparative Study
[Buerger's disease or thromboangiitis obliterans].
To review clinical data, pathophysiology and treatment of thromboangiitis (Buerger's disease). ⋯ If pathophysiology is still poorly understood, spontaneous evolution can be avoided by stopping tobacco and prostacyclin.
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A right-to-left shunting across a patent foramen ovale is a rare cause of acute respiratory failure after pneumonectomy. ⋯ A platypnea-orthodeoxia (dyspnea induced by the upright position with arterial deoxygenation relieved by recumbency) should lead to the diagnosis which is confirmed by echography or cardiac catheterization. The prognosis is good after surgical closure of the patent foramen ovale. The physiopathologic mechanism is poorly understood. We report two cases of platypnea-orthodeoxia.
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Review Case Reports
[Acute pancreatitis in rheumatoid purpura. Apropos of 2 cases].
Abdominal pain observed in Henoch-Schönlein purpura (HSP) is usually attributed to digestive tract involvement. Pancreatic involvement is a rare and benign complication. The authors report two cases of acute pancreatitis as a complication of HSP. ⋯ Abdominal pain can be explained by a digestive tract involvement but also by an acute pancreatitis. This later occurrence is not as exceptional as reported in the literature. Thus, serum amylase levels should be evaluated in patients with HSP who have intense epigastric or abdominal pain, in order to recognize a pancreatic involvement.
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To assess the accuracy of diagnostic strategy of pulmonary embolism (PE) based on clinical examination, lung scan and venous duplex US findings. ⋯ Pulmonary angiography seems theoretically necessary in less than 26% of the patients with suspected PE when they have undergone lung scan and venous duplex US. In this case, and when these strategies are not very decisive, it would be important to assess the diagnostic value of spiral CT scanning.