Presse Med
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To assess morbidity and mortality in patients treated with Refludan for heparin-induced thrombocytopenia type II in comparison with controls. ⋯ The rate of thromboembolism complications, amputations and death was significantly lower in patients treated with Refludan than in controls. There was a clinically acceptable increase in episodes of bleeding with Refludan. The benefit/risk ratio was optimum for APTT between 1.5 and 3.
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INDICATIONS FOR DRUG THROMBOLYSIS: There has been much debate on the indications for drug thrombolysis in pulmonary embolism. Thrombolysis would not appear to be justified excepting in massive pulmonary embolism when clinical signs or explorations evidence poor hemodynamic tolerance. Current data would confirm its independent effect on reducing mortality in such cases. ⋯ THE PREPIC STUDY: The first controlled prospective trial on caval filters confirmed that indications for caval interruption in patients with proximal deep vein thrombosis should be limited to contraindications and failures of anticoagulant therapy. Other indications for filters, whether temporary or definitive, should be evaluated with specific controlled prospective trials. LOW-MOLECULAR WEIGHT HEPARINS: If this possibility is confirmed for the treatment of pulmonary embolism, it will provide a simple rational treatment for venous thromboembolism. 'SMALL CLOTS': Changing diagnostic strategies, particularly the use of helical CT angiography, has raised the question of therapeutic abstention when "small" clots are undetectable by this exploration.
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Clinical Trial Controlled Clinical Trial
[Efficacy of pneumococcal vaccination].
POLYVALENT VACCINE: Pneumococcal vaccination is based on the antigenic properties of polysides carried on the bacterial capsule which induce production of bactericidal serotype-specific antibodies. The 23 serotypes contained in the current vaccine cover 85 to 90% of all strains observed in pneumococcal infections in Europe.
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Severe accidental hypothermia with central temperature below 28 degrees C can result from prolonged cold exposure and lead to a fatal outcome by spontaneous or provoked ventricular fibrillation. ⋯ Prognosis is very poor in patients who experience severe accidental hypothermia (< 28 degrees C) with circulatory collapse. Death often results from major rhythm disorders. Optimal emergency rewarming and oxygenation using extracorporeal circulatory assistance can be successful.