Subject(s)
Bites and Stings/complications , Dogs , Sepsis/etiology , Adult , Animals , Gram-Negative Bacteria , Humans , MaleSubject(s)
Gastric Lavage , Meprobamate/poisoning , Peritoneal Dialysis , Humans , Male , Meprobamate/analysis , Middle AgedABSTRACT
Closed injury of the internal carotid artery is rare, as it represents only 4% of all the lesions affecting the carotid system. Diagnosis of this injury is difficult, the first signs often being missed as they usually occur in severely injured patients, with the neurological signs appearing later. The death rate remains high, and the sequelae very heavy. After a road traffic accident, three patients, all drivers wearing their seat-belts, presented with bone and/or abdominal lesions, a head injury and a left anterolateral flail chest. All three cases showed an unilateral mydriasis; the variations in their conscious levels led to further neurological investigations. The diagnosis was suggested in one patient by computerized axial tomography, and confirmed in all three by carotid arteriography. The results were excellent when early surgery could be performed (2 cases). However, in the absence of surgery, carotid dissection could only be a major contributing factor for the cerebral oedema associated with the previous hemispheric contusion. The mechanism of these carotid injuries would appear to involve rotation and extension or flexion movements of the neck, crushing the internal carotid artery against the transverse processes of the cervical vertebrae or the mandible: a possible part played by the seat-belt would explain the frequent association of the injury with chest trauma.
Subject(s)
Aortic Dissection/etiology , Carotid Artery Diseases/etiology , Wounds, Nonpenetrating/complications , Adult , Aortic Dissection/diagnostic imaging , Aortic Dissection/surgery , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/surgery , Carotid Artery Injuries , Carotid Artery, Internal/diagnostic imaging , Carotid Artery, Internal/surgery , Female , Humans , Male , Middle Aged , RadiographyABSTRACT
Seventy transtracheal aspirates (T.T.A.) have been achieved with patients having an acute pneumonia; 42 had a chronic respiratory failure; 25 had received a previous antibiotherapy; 49 presented negatives delayed hypersensitivity skin reactions. No major accident was noticed and the T.T.A. were positive in 87 p. cent of the cases. The results show the predominance of the Cocci Gram + especially pneumococcus. These cases are associated with Hemophilus influenzae in 19 p. cent of the cases. Negative skin tests show the frequency of this association. Infections with Bacilles Gram -- are found as well in this circumstance. The previous antibiotherapy alters microflora and leads to a B.G. -- as well predominance. At last, the evolution is not influenced by the discovery of an organism in the T.T.A. The authors compare the results with those found in previous work and conclude in the interest of that method which enable a quick identification of the organism and the starting of a well adapted antibiotherapy.
Subject(s)
Pneumonia/microbiology , Acute Disease , Adult , Aged , Biopsy, Needle , Female , Humans , Male , Middle Aged , Pneumonia/diagnosis , TracheaABSTRACT
Sixty patients were studied during non cardiac thoracic surgery. In 21,6 p. cent a culture of organism was isolated and for 53.8 p. cent of them developed a pneumonic process during postoperative period. The organism'role was confirmed by clinical correlation and an abnormal chent radiograph. The same organism was isolated in blood culture sputum or empyema. On the other side the patients with sterile cultures had always a favorable course. The results confirmed the interest of the method which would permit a prophylactic antibiotherapy.
Subject(s)
Bronchi/microbiology , Postoperative Complications/microbiology , Respiratory Tract Infections/microbiology , Thoracic Surgery , Aged , Bronchi/metabolism , Female , Humans , Male , Methods , Middle AgedABSTRACT
A right cardiac catheterism with a calculation of cardiac output by thermodilution method has been achieved on 40 chronic respiratory failure patients with acute outbreak. The results have been analysed according to the type of chronic pulmonary disease, obstructive (n = 24) or restrictive (n = 16), the number of out asphyxic outbreaks and the necessity of mechanical ventilation (VA). The mean pulmonary arterial pressure (PAP) is high (6.38 +/- 1.58 KPa) systolodiastolo gradient increases with the number of outbreaks (p less than 0.001). The cardiac index is low (2.32 +/- 0.57 1.mn(-1).m2(-1)) and the pulmonary capillary pressure (PCP) is high, specially during the obstructive syndromes. A high level of PAP during mechanical ventilation seems to be of poor prognosis. The authors compare these results to the literature.
