RESUMEN
Cannabis is a widely spread drug which chronic abuse may cause diverse adverse effects on the body, in the short and long term. Among these effects, we can cite digestive disorders, mainly characterized by the onset of cyclical vomiting illness. Vomiting symptoms can be temporarily relieved by hot water showers. As a matter of fact, many patients adopt a compulsive bathing behavior characterized by the irrepressible need of having showers or baths at a high temperature. We describe the case of two patients (22 and 23 years-old) who consume cannabis on a regular basis. They were admitted several times to hospital emergency rooms for complaints about uncontrollable vomiting with recurring abdominal pain. Multiple investigations and hospitalizations did not determine a precise diagnosis explaining the symptomatology. The final diagnosis is the vomiting syndrome caused by the consumption of cannabis.
Le cannabis est une drogue très répandue dont l'utilisation chronique entraîne des effets indésirables sur l'organisme à court et à long terme. Parmi ceux-ci, nous retrouvons des symptômes digestifs, principalement caractérisés par la survenue de vomissements cycliques. Ces derniers peuvent être temporairement soulagés par la prise de douches chaudes. Ainsi, de nombreux patients adoptent un comportement compulsif caractérisé par le besoin irrépressible de prendre des douches ou bains à haute température. Nous décrivons le cas de deux patients de 22 et 23 ans consommateurs réguliers de cannabis qui se sont présentés aux urgences à plusieurs reprises pour des plaintes de vomissements incoercibles accompagnés de douleurs abdominales récurrentes. Les multiples investigations et les hospitalisations n'ont pas permis de déterminer un diagnostic précis expliquant la symptomatologie. Le diagnostic final est celui du syndrome de vomissements sur prise de cannabis.
RESUMEN
After a brief history of Emergency Departments in Belgium, the evolution of the clinical activity and the main research topics developed in Erasme Hospital are developed, including the management of the department and of patients flows, and acute clinical toxicology.
Asunto(s)
Servicio de Urgencia en Hospital , Bélgica , Investigación Biomédica , Hospitales Universitarios , HumanosRESUMEN
Rib fractures and flail chest could be fatal if gas exchange is impaired. Efficient pain relief with continuous thoracic epidural analgesia allows a good physiotherapy management without central sedation and impairment of cough reflex, this prevents pulmonary atelectasis and infection. Eighteen patients/19 were treated with success in spite of flail chest, chronic obstructive pulmonary disease and minor pulmonary contusion. Intermittent positive pressure ventilation must be reserved to severe pulmonary contusion and other crushing injuries of the chest as bronchial or great vessels ruptures.
Asunto(s)
Anestesia Epidural/métodos , Tórax Paradójico/terapia , Dolor/tratamiento farmacológico , Fracturas de las Costillas/terapia , Traumatismos Torácicos/terapia , Adulto , Anciano , Bupivacaína/administración & dosificación , Humanos , Masculino , Persona de Mediana EdadRESUMEN
In response to ischaemic or vasoconstrictor stimuli the kidney reacts by synthesising prostaglandins (PG) which modify local vascular tone. They induce a compensatory vasodilatation and direct the blood flow towards the internal cortex. It is thus not necessary to attribute a systemic role to PG in order to understand their haemodynamic action. This explains the natriuresis following the injection of PG both in the animal and in man. Nevertheless the direct effet of PG upon the tubular reabsorption of sodium remains controversial since very different experimental models lead to contradictory conclusions. Despite these disparate data, it is probable that PG are intimately involved in the pathogenesis of hypertension. A lack of PG or a deficiency in their metabolism may be responsible in essential hypertension.