Presse Med
-
Spinal analgesia, a new method for relieving refractory cancer pain, was tested in 19 patients. A catheter was installed in the subarachnoid (17 cases) or peridural (2 cases) space and connected to a subcutaneous site of injection. ⋯ In 11 patients pain was relieved throughout the course of the malignant disease, with doses that did not exceed 6 mg in 7 patients and 10 mg in the remaining 4 patients. The most severe complications were leakage of the cerebrospinal fluid in 1 case, meningitis after 18 months of injection in 1 case and displacement of the catheter in 3 cases.
-
The intracranial pressure of 31 patients with bacterial meningitis, in a comatose state and with a score lower than 6 on Glasgow's scale, was monitored by means of an extradural captor in order to detect intracranial hypertension and optimize its treatment. All patients had intracranial hypertension during the first 48 hours. ⋯ Twenty (64%) of the patient survived, 15 of them without sequelae. Monitoring intracranial pressure in patients with bacterial meningitis and coma makes it possible to optimize treatment and shows that a less than 50 mmHg brain perfusion pressure is associated with a 100% death rate.
-
Spontaneous dissection of the extracranial internal carotid artery is uncommon and has been first described in 1959. Since then, 250 cases have been published. The authors report on 5 recent cases and on that occasion, they review the literature and discuss the different therapeutic possibilities. ⋯ The spontaneous course of such a dissection most often (80%) leads to an almost complete resolution of clinical and angiographic signs. Treatment, therefore, should essentially be based on anticoagulant and antiaggregant therapy, so as to prevent ischemic attacks or carotid thrombosis. Surgical indications should remain exceptional.
-
Twelve patients were treated with op'DDD over a 9-year period. All presented with mild neurological symptoms, and half of them had major complications. There was no relation between the occurrence of these symptoms and the dose or duration of op'DDD therapy. The mechanisms of this neurological toxicity, both central and peripheral, are not well known, but they appear to be similar to those of certain op'DDD-related chemicals used in industry.
-
Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
[Treatment of acute alcoholic hepatitis with prednisolone. 45 patients].
Whether or not prednisolone (or prednisone) should be used to treat alcoholic hepatitis remains controversial. This new controlled study performed on 45 patients with steatosis, fibrosis or cirrhosis of the liver suggests that prednisolone is not effective: after a 3-month follow-up clinical course, biochemical alterations, anatomical lesions and portal hypertension were the same in patients treated with prednisolone and in those who did not receive that drug.