[Hypothermia after intrathecal morphine for caesarean delivery: Another case report]. / Hypothermie profonde après rachianesthésie et morphine intrathécale après césarienne: un nouveau cas clinique.

After an uneventful caesarean delivery under spinal anaesthesia (hyperbaric bupivacaine 10mg, sufentanil 5µg and morphine 50µg), hypothermia (nadir 34°C) was recorded in a ASA 1 patient. Partial recovery was rapidly obtained with 400µg of naloxone but full recovery was obtained after seven hours of active rewarming with a forced-air warming blanket. Suggested pathophysiology and incidence of this hypothermia are described.

[Fatal toxic hepatitis in pregnancy. A discussion of the role of methyldopa]. / Hépatite toxique mortelle au cours de la grossesse. Discussion du rôle de la méthyldopa.

The authors report a case of toxic hepatitis in a woman of 22 years of age in the third trimester of her first pregnancy treated by methyldopa for hypertension of pregnancy which was diagnosed at 33 weeks of amenorrhoea. The prodromal symptoms were mild and consisted of nausea, vomiting and rise in temperature and this phase was associated with febrile jaundice without pruritus and it was only associated with coagulation disorders in the third stage of labour. This was a case of mixed cytolytic hepatitis (ASAT x 3N) and cholestasis (x 1.5N). The outcome was fatal. The patient died three days after delivery following haematemesis and renal failure as well as hepatic encephalopathy. The main diagnostic feature was acute hepatic stasis in spite of the absence of pruritus and the presence of a raised temperature after hematolytic, viral and obstructive causes had been eliminated. Histology confirmed that there was toxic hepatitis. This aetiology was suggested by the timing of the symptoms after MD (methyldopa) had been taken. Elkington described methyldopa hepato-toxicity in 1969. Fatal cases in the literature were in patients who were over 40 years of age. Methyldopa is used in pregnant women because of its safety as far as the fetus is concerned. Mechanism by which it causes toxic hepatitis is a combination of abnormal metabolism (the cytochrome P450 chain produces an antigen) and an immune reaction in response to this antigen and these explain why such severe and potentially fatal forms of the condition exist.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship between the intra-erythrocyte sodium composition and the membrane lipoprotein composition among different mammal species.

Internal sodium and lipoprotein composition of RBCs of nine mammalian species are measured. A significant correlation can be demonstrated between the erythrocyte mean sodium value of studied species and the membrane protein/lipid ratio (r = 0.80, alpha less than 0.01). Erythrocyte internal sodium can be correlated with membrane-free cholesterol but not with the phospholipid fractions.