Swiss medical weekly
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In a 26-year-old patient admitted to the emergency ward with acute abdomen, all the symptoms--nausea, vomiting, indeterminate abdominal pain, constipation, renal failure, polyuria and polydipsia--could be explained by calcium intoxication syndrome. Investigation revealed generalized sarcoidosis. Under medical treatment with prednisone all the pathologic findings rapidly regressed. The pathogenesis of hypercalcemia in sarcoidosis, and particularly the disorder of vitamin D metabolism with raised levels of 1,25-dihydroxycholecalciferol, are discussed.
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Paroxysmal phenomena are rare but relatively typical, and occasionally initial, clinical symptoms of multiple sclerosis. They should be recognized since they can serve as clinical indicators of the disease and can be treated efficiently with carbamazepine. Such shortlived clinical symptoms and signs are probably caused by ephaptic transmission due to myelinoaxonal dissociation within the demyelinated plaque. The clinical picture, pathophysiology and treatment of these disorders are discussed.
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Swiss medical weekly · Jul 1985
[Transcutaneous bilirubin determination: correlation in white premature infants weighing less than 1500 gm].
The transcutaneous bilirubinometer (TcB) was evaluated in 24 preterm infants of less than 34 weeks gestation and weight less than 1500 g. A close correlation between the TcB index and serum bilirubin values was obtained with 50 measurements at sternum (R = 0.858, p less than 0.001). From these resultant ratios it is concluded that the TcB-meter is a valuable tool in screening healthy preterm infants less than 34 weeks gestation for hyperbilirubinemia.
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Swiss medical weekly · May 1985
[Severe symptomatic valve defects in elderly patients. Spontaneous prognosis and surgical results].
Between 1970 and 1982 125 patients aged, 65 to 79 years with severe symptomatic valvular heart disease. Aortic valve disease (72 with aortic stenosis) was encountered in 76 cases, mitral valve disease (22 with mitral regurgitation) in 32 and combined aortic and mitral lesions in 17. Additional severe coronary artery disease (narrowing greater than 70%) was present in 25% of the patients. 80% of the patients were in NYHA class III and IV, and 42% had experienced an episode of congestive heart failure. 28 patients did not undergo surgery; 10 died before surgery and 18 were not accepted or refused the operation. ⋯ In the elderly patient with severe symptomatic valvular heart disease surgery can be performed with acceptable operative risk and good late results. Surgical treatment is particularly indicated in aortic stenosis, due to the poor spontaneous prognosis. Coronary artery disease is frequent in this age group but is not a contraindication for surgery, in view of the good postoperative results of additional aorto-coronary bypass grafting.