Saudi Med J
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Comparative Study Clinical Trial
Intravesical immunotherapy for superficial bladder cancer.
To compare and evaluate the efficacy and tolerance of intravesical instillation of Bacillus Calmette-Guerin (BCG) and interferon alpha-2b immunotherapy for superficial transitional cell carcinoma (TCC) of the urinary bladder. ⋯ Bacillus Calmette-Guerin was confirmed as a more effective intravesical immunotherapy for superficial TCC of the urinary bladder as compared to interferon alpha-2b. Both agents' treatments are well tolerated.
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Traumatic fat embolism syndrome occurs most often following fractures of long bones sustained in road traffic accidents and is a common cause of medical consultation from the orthopedic surgery department. The sub-clinical presentation is subtle and expresses itself by the presence of hypoxemia, while the full clinical syndrome compromises respiratory insufficiency, an altered consciousness and a characteristic petechial rash. Recognition is simple once the patient is viewed in the context of his or her clinical setting. ⋯ We report a patient with traumatic fat embolism syndrome who developed the syndromes classical symptoms and signs following fracture of the long bones of his left lower leg. Admission to an intensive care unit, mechanical ventilatory support with positive end-expiratory pressure and corticosteroid therapy lead to his improvement and allowed eventual open reduction and internal fixation and discharge of our patient. Modern therapy offers a relatively good prognosis for patients with traumatic fat embolism syndrome; the optimal dose and timing of corticosteroid therapy in prophylaxis and treatment however, remain the subject of intense debate.