Presse Med
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Necrotizing fasciitis is a rare and severe infectious disease with infectious necrosis often extending in depth to the subcutaneous tissue in the absence of rapid medical-surgical treatment. We report two cases of necrotizing fasciitis of the thigh, which underline the principle clinical and therapeutic characteristics of this often underrated disease. ⋯ This disease corresponds to infectious necrosis of the subcutaneous tissue and is essentially characterized by its rapid, occasionally violent, progression. It represents a surgical emergency and requires early and extensive incision in order to avoid severe functional after effects, or even death of the patient. Only enhanced education of the physicians leading to rapid clinical diagnosis will improve the prognosis which still remains fearsome.
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During acute sodium arsenite intoxication, absorption is usually oral and rarely respiratory. We report the first case of acute intoxication by intravenous administration, with pharmacokinetic modelling. ⋯ During this acute intravenous induced arsenic poisoning, the symptomatology was comparable to that following oral intoxication. The chelating treatment, although rapidly suspended, obviously contributed to survival. The eventual occurrence of other cases should permit the adaptation of therapeutic protocols to these types of intoxication.
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Determine the level of knowledge of the general practitioners on the early phase of Lyme borreliosis in an endemic area and notably to define the attention paid to the use and interpretation of serologic investigations for the treatment of patients with erythema migrans. ⋯ Fifty percent of the general practitioners working in endemic areas for Lyme borreliosis still believe that seropositivity against Borrelia burgdorferi is required to diagnose erythema migrans, which is untrue. However, this study shows that a specific education on Lyme borreliosis would significantly improve this score.
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REQUIREMENT: Information given to the patient is a topic which is especially of current interest, and which has been taken into account in the recent law of March 4, 2002 on patient's rights. But what about non-steroidal anti-inflammatory agents, that is, one of the most widely prescribed classes of medicinal products worldwide and which induce the highest number of sometimes fatal adverse effects (adverse drug reactions)?
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To determine the reasons for refusing admission to an intensive care unit and the immediate outcome of the patients refused. ⋯ Some refusals could have been avoided if the downstream networks (short-hospitalisation, re-habilitation centres.) had been able to accommodate the patients proposed. Moreover, by abandoning the strategy of wide admission to intensive care to the benefit of a selective triage of the patients proposed, a certain number of refusals would probably have been avoided. Nevertheless, there are obvious difficulties in the application of the latter method.