Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jul 1993
Case Reports[Acute respiratory failure in tropical malaria during pregnancy. Successful treatment using extracorporeal CO2 elimination].
A 32-year-old woman in the 26th week of pregnancy became ill, 6 days after returning from a trip to Indonesia, with a fever up to 42 degrees C, haemolytic anaemia (haemoglobin 7.6 g/dl) and thrombocytopenia (7,000/microliters). She had not been on any malaria prophylaxis. Chloroquine, quinine and pyrimethamine, administered after macrogametocytes of Plasmodium falciparum had been found in the blood smear, eliminated the parasites from the peripheral blood, but respiratory failure and treatment-resistant pneumonia occurred, leading to the adult respiratory distress syndrome (Morel stage 4). ⋯ The extracorporeal CO2 elimination was discontinued after twelve days, because artificial ventilation could now be adequately controlled. The woman was gradually weaned from the ventilator and discharged home without symptoms after a total of 11 weeks in hospital. Her child has not shown any neurological symptoms.
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Dtsch. Med. Wochenschr. · May 1993
Case Reports[Color-coded Doppler sonography in iatrogenic spurious aneurysms in the groin].
Pseudoaneurysm of the femoral artery occurred in five patients (aged between 61 and 82 years) after catheterization of the artery, four times after percutaneous transluminal angioplasty of the leg arteries and once after left-heart catheterization. The pseudoaneurysms were correctly diagnosed by colour-coded duplex Doppler sonography by demonstrating turbulence within the aneurysm and a connection to the femoral artery with bidirectional shunting. ⋯ After 30-35 min flow into the aneurysm had ceased even when the compression was released. Re-examination up to 11 months later (mean of 7.6 months) indicated that the treatment had been successful in all.
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Dtsch. Med. Wochenschr. · Apr 1993
Comparative Study[Endoscopic ultrasound in the demonstration and staging of non-Hodgkin's lymphomas of the stomach].
Nine patients (five women, four men, mean age 64.2 [49-77] years) with histologically confirmed gastric non-Hodgkin lymphoma (NHL) were investigated before starting therapy and during follow up, using endoscopic ultrasound, computer-assisted tomography and conventional ultrasound. Of ten gastric NHL infiltrations, nine were demonstrable using endoscopic ultrasound, three by computed tomography and two with conventional ultrasound. Accurate assessment of the primary tumour stage was possible in six out of eight cases using endoscopic ultrasound, but in none using tomography or conventional ultrasound. ⋯ False positive results were obtained in two cases using endoscopic ultrasound and computed tomography. Regression of the tumour and of paragastric lymph nodes on radio-chemotherapy was demonstrable in two cases, and progression in one using endoscopic ultrasound; the other techniques showed progression of extragastric lymphoma involvement in only one case. Endoscopic ultrasound is an efficient method for demonstration and local staging of gastric non-Hodgkin lymphomas.