Revue médicale de Bruxelles
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Curability in children suffering from malignant solid tumor is 50%. Thus, high dose chemotherapy with or without total body irradiation followed by autologous bone marrow transplantation (ABMT) has been proposed to patients suffering from cancer either at initial diagnosis (poor prognosis tumor) or at relapse. ⋯ It remains to be determined if: 1. high dose chemotherapy protocols with ABMT are superior to new aggressive chemotherapeutic protocol without ABMT. 2. ABMT increases the curability of high risk patients.
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In cancer patients, respiratory distress may be due to cancer directly, to cancer complications, to cancer treatment complications or unrelated diseases. Based on the identification of the mechanism and cause of the dyspnea, therapy that will be given in a critical care unit, will be both etiological and supportive. It will take into account the prognosis of the underlying neoplastic disease.
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Clinical concepts about the acquired immunodeficiency syndrome, are evolving constantly. Laboratory tests are used to prove the infection virologically and serologically, to quantify the importance of immunodeficiency and to give a tentative prognosis. We discuss three classification systems (CDC, Haverkos, Walter Reed). ⋯ They may indicate the status of the disease, from seroconversion up to opportunistic infections and secondary cancers. Then we compare those different systems of classification, their advantages and disadvantages. These classification systems may change with evolving concepts about the syndrome.
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Origin, symptomatology, seriousness and mechanism of carbon monoxide toxicity have been reviewed as are the diagnosis based on clinical or analytical data upon which the physician may rely to search out a CO intoxication. Treatments are discussed and the best therapy is proposed in case of mild or severe poisonings.