Chirurgie; mémoires de l'Académie de chirurgie
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Thyroid carcinoma and familial intestinal polyposis are not accidentally associated. A new case is described which, along with the other 32 cases already published, reveals an incidence of thyroid carcinoma 100 times higher in patients with polyposis than in the general population, and 160 times higher in female patients under 35 years of age. Several features of these thyroid carcinomas can be pointed out: greatest incidence in women, occurrence at a young age, existence of a papillary tumor appearing independently from the evolution of the polyposis, and probably familial disease. It is therefore necessary to systematically examine the thyroid body in all subjects with familial intestinal polyposis.
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The initial management of multiple trauma must achieve a triple aim: performing the actions required by a vital emergency, preventing as well as possible the complications associated with the initial lesions, and, most importantly, bringing the injured person into hospital in the best possible conditions for emergency surgery. Achieving these aims requires a perfect coordination of medical and nonmedical rescue. A rough initial categorization is important to decide whether additional medical staff is desirable, choose the type of transport planned (by ambulance, helicopter...) as well as the department or hospital due to receive the patient. ⋯ The indications of ventilatory support must be very wide whenever coma or signs of respiratory distress are noted, more so with an associated shock. The indications of aspiration of a gaseous or fluid pleural effusion must also be discussed. Maximal suppression of pain must be kept in mind throughout all these operations.(ABSTRACT TRUNCATED AT 250 WORDS)