Presse Med
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Letter Case Reports
[Hyperkalemia under treatment with high-dose trimethoprim-sulfamethoxazole].
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A retrospective study of patients with electrical burns was conducted to choose criteria for initial dispatching and establish a treatment protocol for out patient management. ⋯ Information on prevention of electrical burns should be intensified.
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In the past twenty years, the increased number of organ transplant recipients and better immunosuppressive regims have enhanced transplant survival, and several transplant recipients may conceive pregnancy or paternity after the graft. There is no French registry of posttransplant pregnancies, but analysis of the international literature reports 2300 pregnancies after kidney transplantation, 100 pregnancies after heart and 3 after heart-lung transplantation, 90 pregnancies after liver transplantation. ⋯ Outcome is generally excellent for the mother and the baby. However, transplant recipients with either high blood pressure, diabetes, serum creatinine above 160 mumol/l or within less than 1 year after the graft should be considered at too high risk to conceive a pregnancy with no deleterious effect on the mother and/or on the foetus.
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Sedation is a technique widely used in intensive care unit patients. The main objective is to ensure a proper level of analgesia and the best physical and psychical comfort possible. ⋯ Drugs used for sedation are combinations of opioids (fentanyl or sufentanil), benzodiazepines (midazolam) and hypnotic drugs such as propofol. In combination with the pharmacological approach, a psychological approach is of greater interest in conscious patients.
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It is currently accepted that the consequences of sepsis are highly dependent on host response, largely controlled by the inflammatory reaction. Inflammation in response to infection is a continuous process from simple local reaction which regresses rapidly to systemic reaction leading to multiple organ failure. Septic shock is a specific aspect of severe infection dominated by persistent hypotension despite vascular filling. ⋯ Much progress has been made in the methodology in large clinical trials. It is clear that a posteriori analysis of subgroups must be abandoned and that research must continue in this high-mortality pathology. The upcoming clinical trials will benefit from acquired experience.