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PubMed1981

[Plasma exchanges (author's transl)].

Therapeutic plasma exchanges (PE) represent a new approach to the management of numerous immune diseases and are in full development. In practice, however, they require sophisticated equipment, heavy investments and fully trained staff, and they are not as free from dangers as was initially assumed. A rational appraisal of the results therefore is desirable, but prospective comparative studies are scarce, and the present indication all too often rest upon non-scientific criteria, such as the need to slow down the course of an allegedly severe disease or the subjective impressions of the therapeutic team. In spite of these uncertainties, it would seem that PE deserves a major place in the treatment of diseases due to auto-antibodies or circulating immune complexes, as well as in that of malignant monoclonal gammapathies with hyperviscosity of the blood, some acute or chronic metabolic disorders and occasional intoxications with substances highly bound to serum proteins, which constitute the usual indications. The indications proposed in this review paper are based on the most representative publications in this particular field and on the own experience of the authors, who have performed 1200 PEs between 1978 and 1980.

Autoimmune Diseases↗
PubMed1982

[Hodgkin's disease in childhood: long term results].

Between 1965 and 1976, 83 previously untreated children aged 15 years and under, with biopsy-proven Hodgkin's disease (HD) were evaluated, treated and followed at Hospital Saint Louis, Paris. Clinical stages were IA-IIA for 59 patients, IB-IIB for 19 patients and III-IV for 5 patients. Two main kinds of treatment were used: monochemotherapy-radiotherapy (MCT-RT) for 26 patients who have received mantle field irradiation followed by a monthly Vinblastine injection during 3 years; 57 patients have received a combination of MOPP and radiotherapy (MOPP-RT). The MOPP-RT treated patients have a significantly better survival and relapse free survival than the MCT-RT treated patients (86.9% vrs 76.1% and 83.5% vs 65.4%). Thirteen relapses were observed after a median complete remission of 30 months: 6 patients are now free from disease and one is still under treatment. Ten patients are dead after a 55 months median survival: 7 died from H.D. and 3 from treatment toxicity. No 2nd cancer or leukemia were observed until now. The main long term complications of therapy were sterility in male patients, growth defects and disturbances of thyroid functions.

Adolescent↗
PubMed1982

Inadequate skin preparation as a cause of intravenous catheter-related infection in the dog.

Eight-eight dogs admitted to the intensive care unit of the University of Pennsylvania School of Veterinary Medicine were studied to determine the frequency of intravenous catheter-related infection. Dogs were randomly assigned to 1 of 2 groups. In group 2, the skin was scrubbed with an iodine soap before final rinsing with alcohol and tincture of iodine. After withdrawal of each catheter, its tip was examined by bacteriologic culture, and the limb was examined for signs of phlebitis. Bacteria were isolated from 24 (48.9%) catheter tips in group 1 and from 6 (15.4%) in group 2 (P less than 0.005). Phlebitis was evident in 6 dogs in group 1, and in 1 dog in group 2. One death occurred in group 1, from causes possibly associated with catheter infection. These data suggest that catheter-related infection may be wide-spread in the dog and that it can be reduced by meticulous skin preparation.

Animals↗
PubMed1982

[Cholesteatoma].

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Cholesteatoma↗
PubMed1995

Noninfectious complications of blood transfusion.

The noninfectious complications of blood transfusion consist of a diverse group of immune-mediated transfusion reactions that range from immediate life-threatening to subclinical reactions. Each reaction involves the recognition and interaction of the both the humoral and cellular immune systems. In the past, many of the noninfectious complications of transfusion were attributed solely to antigen-antibody interactions. Today, an emerging body of evidence suggests that cytokines and cytokine inhibitors play a central role in the pathophysiology of immune-mediated transfusion reactions and account for the broad diversity of clinical presentations.

Allergens↗