Acta Clin Belg
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Xenoestrogens such organochlorine pesticides are known to induce changes in reproductive development, function or behaviour in wildlife. Because these compounds are able to modify the estrogens metabolism, or to compete with estradiol for binding to the estrogen receptor, it may be possible that these products affect the risk of developing impaired fertility, precocious puberty or some kinds of cancer in man. Le plus ancien récit de lutte contre la pollution remonte à une légende indienne racontant que la divinité Sing-bonga était incommodée par les émanations des fours dans lesquels les Asuras fondaient leurs métaux (1). ⋯ Des mortalités élevées de poissons ou de coquillages ont été rapportées dans des élevages situés à proximité des zones d-épandage de pesticides organophosphorés et de carbamates. En 1991, la dispersion aérienne de fenitrothion dans le but de provoquer la démoustication en Languedoc a été à l-origine de la perte de plusieurs tonnes de crevettes japonaises. L-utilisation de trichlorfon et de dichlorvos comme antiparasitaires dans des fermes d-élevages de saumons a provoqué des épisodes de mortalité importante (9).
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Remifentanil (Ultiva) is a recently introduced esterase-metabolized potent opioid (EMO) mu-receptor agonist with a rapid onset and offset of action for use as part of general anaesthesia in association with isoflurane or propofol or with midazolam (Dormicum) and in combination with mivacurium. ⋯ A nurse from the anaesthesiology department of a hospital was found dead at home with a syringe and empty vials of Ultiva (2 mg) and of Dormicum (1 mg/mL). At autopsy several injection sites were found on her body. Usual toxicology screening operated in our laboratory revealed only the presence of benzodiazepines in blood. Regarding the case history, we decided to adapt a method specially designed for remifentanil and its inactive metabolite testing. The analytes were isolated by SPE on a Clean-Screen column. After silylation with BSTFA with 1% TMCS, the analytes were detected by GC/MS-EI operating in the SIM mode. No Remifentanil could be detected, whereas the metabolite of remifentanil GR90291 was determined in femoral blood, liver, kidney and lung. Furthermore, midazolam could be detected in femoral and cardiac blood. Hair analysis of a segment of 5 cm revealed the presence of diazepam and midazolam, whereas neither remifentanil nor its metabolite could be detected.
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Our preliminary experience with the bronchoscopic application of cryotherapy using rapid decompression of liquid nitrous oxide as cooling agent is reported. Seventeen applications through rigid bronchoscopy in twelve patients were performed. A single cryotherapy session was successful in the debulking of obstructive malignant lesions of the central airways in five patients (four non-small cell carcinoma, one renal cell cancer metastasis), and in the treatment of a capillary haemangioma (one patient). ⋯ Cryotherapy was also successful in the treatment of early bronchial cancer (carcinoma in situ) in four patients, requiring repetitive sessions in two. There were no complications or side-effects. These preliminary findings confirm the safety and efficacy of bronchoscopic cryotherapy in a variety of airway lesions.