Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2012
Case Reports[Extensive mesenteric ischemia related to naratriptan overuse associated with grapefruit juice absorption].
We reported the case of a 61-year-old woman, who has been hospitalized in ICU because of an extensive mesenteric ischaemia, involving the small bowel, secondary to a naratriptan overuse. This mesenteric ischaemia was complicated by multiple organ failure and was responsible for extensive small bowel resection and left colectomy. A concomitant abundant absorption of grapefruit juice, a well-known P450 inhibitor, may have enhanced this naratriptan toxicity. This case underscore that an abdominal pain occurring in the context of headache treatment may be related to a mesenteric ischaemia.
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Ann Fr Anesth Reanim · May 2012
Case Reports[Two cases of autoimmune encephalitis with antibodies to N-methyl-D-aspartate receptor in intensive care].
We report here two cases of autoimmune encephalitis associated with antibodies against the N-methyl-D-aspartate receptor. The primary cause was an ovarian teratoma in one case. The outcomes were good. ⋯ The second case was early treated in the course of the disease, due to the experience related to the previous case. In case of unexplained acute or subacute encephalitis or psychiatric-like disorders without prior medical history, the determination of the level of expression of antibodies against the N-methyl-D-aspartate receptors and other antineuroreceptors antibodies can help to identify this diagnosis. The initial picture of the disease, its variability and the unawareness of the recent reports on this encephalitis may lead to a wrong diagnosis and inappropriate management.
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New technologies have become available to minimize the adverse events of extracorporeal devices. Link to these technological improvements ECMO in lung transplantation is currently essential. ⋯ Its use as hemodynamic and respiratory support during the lung transplant surgery can replace conventional Cardiopulmonary bypass. And finally, ECMO is sometimes the only alternative in the most severe forms of primary graft failure.