Revue des maladies respiratoires
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We describe the development of severe and recurrent alveolar hemorrhage in a 30 year old man. The patient had presented with frank hemoptysis, that recurred after an interval of 4 weeks, associated with dyspnea and severe anemia requiring transfusion. The chest x-ray and CT scan showed bilateral diffuse ground glass shadows. Fibreoptic bronchoscopy confirmed bilateral diffuse bleeding. Investigations for the common causes of diffuse alveolar hemorrhage (immunological, infective) proved to be negative on two occasions. Toxicological examination of the urine during the relapse revealed a significant level of cannabis and a trace of cocaine. The patient repeatedly denied the use of illicit drugs. ⋯ This clinical observation emphasises that the inhalation of cocaine is a cause of diffuse alveolar hemorrhage particularly in young adults.
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Review Comparative Study
[Allergy to non steroidal anti-inflammatory drugs].
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Intensivists are increasingly implementing end-of-life decisions in patients who remain dependent on life sustaining therapies without hope for recovery. ⋯ Intensivists should improve their ability to meet the needs of dying patients and their family members. Each situation, patient, family and caregiver is unique, and therefore needs a specific approach. Introducing palliative care and multidisciplinary teams into the ICU might provide an additional opportunity for patients and families to be informed and listened to.