Comparative study of RT23 and Merieux tuberculin tested among healthy volunteers.

SETTING: Several studies have indicated considerable variability in the biological results of different tuberculin preparations in different geographical areas or even within a single region. OBJECTIVE: To compare the biological potency of two different tuberculins. DESIGN: We performed simultaneous testing with RT23 and Merieux tuberculin in a group of 546 Police Academy students in Athens to compare reactions to both tuberculins. The students were divided into three groups according to their year of training; the participants in each group were tested using the Mantoux method simultaneously with the two tuberculins in different concentrations. RESULTS: Using a 10 mm cut-off point for a positive tuberculin skin test, positive reactions to RT23 and Merieux were highly correlated. No statistically significant difference was established. The results indicated significant superiority of the size of the reaction with RT23 tuberculin (P = 0.014). CONCLUSIONS: Both tuberculins appear to have equivalent potency, with RT23 more frequently producing reactions of larger sizes.

Prolonged coma due to cerebral fat embolism: report of two cases.

Fat embolism syndrome remains a rare, but potentially life threatening complication of long bone fractures. The true incidence is difficult to assess as many cases remain undiagnosed. Cerebral involvement varies from confusion to encephalopathy with coma and seizures. Clinical symptoms and computed tomography are not always diagnostic, while magnetic resonance imaging is more sensitive in the detection of a suspected brain embolism. Two cases of post-traumatic cerebral fat embolism, manifested by prolonged coma and diffuse cerebral oedema, are presented. The clinical course of the disease as well as the intensive care unit management are discussed.

Management of severe and complicated malaria in the intensive care unit.

Malaria remains today one of the major health problems in the tropics with increased morbidity and mortality. The most serious complications are caused by Plasmodium falciparum, which, in contrast to the benign malarias, may progress to a life-threatening multi-system disease. Our case concerns a young woman in the 14th week of pregnancy, admitted to the ICU in a coma, with pulmonary oedema, haemolytic anaemia, renal failure and thrombocytopenia as complications of P. falciparum malaria. The case is discussed and possible explanations for the clinical picture and complications of P. falciparum malaria are given in the light of experiences from the literature.