[Work of the resuscitation center of the Toxicology Clinic during the year 1967].
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Biomedical subjects
Publications and source records attributed to B Christoforov.
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The authors report five cases of gastric amyloidosis in addition of the fourty three published cases. These cases was polyvisceral forms, 4 times primitive and 1 time secondary to a psoriasic rheumatism. Three times only the patients had complaints of digestive tract. Four times non specific radiologic and endoscopic signs lead to a biopsy which permits diagnosis. The biopsy of gastric mucosa must take place beside the rectal biopsy; more difficult to do, it might be more successfull because the stomach is more often infiltrated by amyloidosis than the colon.
The authors presents 1 129 liver biopsies done during 7 years in a service of general medicine. Three accidents has been encountered representing a 0,17% mortality. Histologically, 50% of patients presented alterations due to ethylism, 25% presented a normal liver picture, which can be a diagnosis argument; 20% presented various lesions, of which tuberculosis is predominant, as well as acute, parasitary or hematological livers. Only 5% of the histological pictures are ininterpretable. The liver biopsy done very early in the evolution of a disease is sometimes a diagnosis argument which superior to others, allowing the rapid installation of the necessary treatment.
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The authors report a new case of lactic-acidosis in a diabetic patient receiving metformin. This patient, after urography developed an acute renal failure and a fatal lactic acidosis. Risks of urography in diabetic patients and guidelines for use of metformin are recalled; careful assessment of risk versus benefit for every proposed urography in diabetic patients never use metformin if creatinin is over 140 micromoles/liter, if an urography must be undergone, metformin must be stopped 3 days before urography and resumed only 3 days after it, if renal function allows it.
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Two case of Primary Sclerosing Cholangitis (PSC) associated with inflammatory bowel disease are reported. In one of these cases, inflammatory bowel disease was asymptomatic and discovered only by performing colonoscopy. Endoscopic retrograde cholangiography is of particular value, showing the specific lesions of PSC. Treatment is only symptomatic.
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