[Surgical treatment of tuberculous mediastinal adenopathies in childhood (author's transl)].
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Biomedical subjects
Publications and source records attributed to F Magnin.
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The authors report a new case of acute renal insufficiency with Rifampicin. They evoke the clinical background which is characteristic of these anuric tubular nephritis. They recall the different complications with Rifampicin to which they can be associated and the different mechanisms which can be at the origin of this affection as well as the difficulties to reveal them. Then, they insist on the prevention of renal accidents within the frame of our present knowledge.
Through a routine examination a Castleman tumour of left hilary topography was discovered in a 30 years old man. No recurrence followed exeresis. With regard to this case, the authors underlined the infrequency of these tumours with no preferential mediastinal topography and its occurrence at any age. Diagnosis is often reached after surgery by histological analysis of the tumour which enabled the distinction in two types according to Flendrig: type I plasmocytic with inflammatory signs; type II hyalino-vascular without any inflammatory signs. Surgery usually advised is not without any drawbacks because of the vascularization of the tumour and its adherence to neighbouring organs. But Castleman tumours still set nosological problems and the debate remains opened on the question of a nodal origin or a true neo-formation.
Gastrostomy can have both a preventive and curative effect for patients particularly exposed to food inhaling, especially the heavy casualties with loss of initial consciousness and prolonged intubation or tracheotomy. In these patients stopping the forcible feeding led to frequent mishaps and to recurrent pulmonary complications. Gastrostomy prevents them while enabling the seriously injured patients to receive 2.500 calories daily. These cases showed the different circumstances where gastrostomy done rapidly under L. A. and with assisted ventilation gave good results.
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The authors report 93 observations during which OCB were performed under local anesthesia. They insist on the validity of the method which can be used on fragile patients or on those with respiratory insufficiency for whom an exploring thoracotomy would be contra-indicated. Incidents were minor and momentary (pneumothorax, pleural reaction). It is mostly in diffuse lesions of miliary and fibrotic nature that this technique was used to identify various lesions : silicosis, sarcoidosis, tuberculosis, histiocytosis, etc... In a third of the cases, lesions were not specific and could not be definitely identified in parieto-alveolar fibrosis or inflammatory alveolitis.
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