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A Boissonnas

Publications and source records attributed to A Boissonnas.

At least 37 records · Page 2Linked to original sources
PubMed1990

Genitourinary tumors and HIV1 infection.

4 patients with solid genitourinary tumors and HIV1 infection have been treated in our institution over the last 2 years. Two patients had seminoma, 1 renal adenocarcinoma and 1 renal angiosarcoma. All had deeply impaired immunity with a low CD4 level. 3 had or developed a true AIDS syndrome according to the WHO and CDC criterias of 1988. The remaining patient was seropositive and died less than 3 months following the diagnosis of renal angiosarcoma. He is the first reported case of renal sarcoma in a patient infected with HIV1. 2 patients were homosexuals, and the 2 others were drug addicts. Along with other reported cases, our cases underline the association between the depression of immunity due to HIV and the onset of solid genitourinary tumors.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[2 cases of testicular seminoma associated with HIV infection. Analysis of treatment tolerance].

Two homosexuals with advanced HIV infection and testicular seminoma stage IIb and IIc were treated with irradiation associated with chemotherapy in one patient. Subdiaphragmatic irradiation was followed by moderate diarrhoea. Initial chemotherapy consisted of cisplatinum, vinblastine, bleomycin replaced by cyclophosphamide after radiotherapy. The use of cyclophosphamide was discontinued after 2 courses due to neutropenia (less than 1500/mm3). Complete tumor remission was achieved in both patients without infection in spite of an aggravation of the CD4 deficit (5/mm3, 52/mm3). The patients died of opportunistic infections 14 and 12 months after terminating treatment. We conclude that cytotoxic and radiation treatment can be administered safely if carefully monitored in these severely immunodepressed patients.

Adult↗
PubMed1989

[Urogenital tumors and HIV-1 infection].

Four patients with solid genito-urinary tumors and HIV 1 infection have been treated in our institution over the last 2 years, including 2 with seminoma, 1 with renal adenocarcinoma and 1 with renal angiosarcoma. All had severely impaired immunity with a low CD4 level. Three had or developed a true AIDS syndrome according to the WHO and CDC criteria (1988). The remaining patient was seropositive and died less than 3 months following the diagnosis of renal angiosarcoma, he is the first reported case of renal sarcoma in a patient infected with HIV 1. Two patients were homosexuals and the other 2 were drug addicts. Along with other reported cases, our cases may underline the association between depression of immunity due to HIV and onset of solid genito-urinary tumors.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Acute sphenoid sinusitis in adults].

Seven cases of acute sphenoid sinusitis were reviewed. Two happened after deep sea diving. Headache of variable location and fever were the most predominant presenting symptoms (5/7). Purulent discharge in the cavum was present in three. Correct diagnosis was delayed from six to twenty-four days after beginning of symptoms, when a neurologic deficit became apparent : mainly paralysis of the sixth and third cranial nerves. Computed axial tomography was the most useful radiologic procedure for demonstrating sinus opacification in every patient. Two patients died, three had complete recovery, one had persistent epileptic focus after brain abscess. Last patient had paraparesis and incontinence of urine after study of cerebrospinal fluid (C. S. F.) flow with methylene blue. Cannulation of the sphenoid sinus was performed in two patients and surgical drainage in three. Gram negative microorganisms and Staphylococcus aureus were isolated from the sphenoid sinus of only three patients. Blood cultures were negatives in every cases and C. S. F. in six. First choice antibiotics was an association of aminoglucosides and broad-spectrum penicillin in six cases. It always had to be changed.

Adult↗
PubMed1986

[Septic arthritis caused by Campylobacter fetus].

The ten published cases of septic arthritis due to Campylobacter fetus and two more recent cases, one of which was a delayed septic complication of a total hip replacement, are discussed. In 83% of cases, febrile monoarthritis occurred which in 7 out of the 12 cases involved an already diseased joint in a subject over 70 years of age (half of the patients), who was frequently alcoholic and presented either cancer or hepatic cirrhosis and/or diabetes. Hyperleukocytosis of the blood was variable (55% of cases). The joint fluid, which contained a high level of deteriorated polynuclear cells, was routinely cultured on an enriched medium in an anaerobic or microerophilic atmosphere and in 10 out of 12 cases Campylobacter fetus was isolated within 15 days, even in the absence of previous antibiotic therapy. The arthritis, which showed little sign radiographically of destructiveness, was cured, leaving no sequellae in most cases. Treatment usually involved ampicillin or the tetracyclines, either alone or in association with the aminoglycosides.

Aged↗
PubMed1985

[Septicemia in cirrhotic patients].

The clinical features of 22 patients with cirrhosis of the liver complicated by septicaemia were studied retrospectively and compared with a control group of 52 patients with septicaemia without cirrhosis. The incidence of septicaemia was higher in the cirrhotic group (4.25 p. 100) than in the control group (0.64 p. 100). The overall incidence of cirrhosis in patients with septicaemia was 19 p. 100. Nine of the 22 cirrhotic patients and 16 patients in the control group died. Prognostic factor common to both groups of patients were: shock, coma, delayed apyrexia and the isolation of more than one infecting organism on blood culture. Poor prognostic factors specific to the cirrhotic patients were the presence of ascites, especially if infected, and signs of hepatocellular failure.

Aged↗
PubMed1985

[Osteoarthritis caused by dematiaceous fungi. Apropos of 3 cases].

Three cases of osteoarthritis due to dematiaceous fungi are reported. The first case, a Drechslera longirostrata spondylitis complicating prosthetic valve fungal endocarditis responded only to the association of Amphotericin B and Ketoconazole. The second patient had chronic osteoarthritis of the knee due to Phialophora parasitica resistant to medical and surgical treatment after renal transplantation. These two cases are the first and the second known reports of clinical infection with these fungi. The third patient had osteoarthritis of the patella complicating a skin infection by a thorn prick. This was cured by surgical excision and 3 months' medical treatment. These cases of infections osteoarthritis of the knee followed subcutaneous abscesses. Deep tissue infections with dematiaceous fungi with osteoarthritic involvement are very rare (6 cases of Drechslera and 8 cases of Phialophora have been reported). These fungi are opportunist saprophytes of plants in subtropical regions. They are characterised on culture by their brown and black pigmentation and microscopy shows septated filaments. Cutaneous effraction is the usual portal of entry in man; patients commonly have depression of their immune systems. Osteoarthritis is generally due to local extension of a subcutaneous abscess. The functional sequellae can be very serious. Treatment comprises surgical excision of the infected tissues with antifungal drugs which may have to be given in association.

Adult↗
PubMed1985

[Attacks of gout and thromboembolic disease: role of heparin therapy].

The authors report 4 cases of acute gout in the lower limb occurring soon after starting heparin therapy for venous thromboembolic disease. As none of the usual factors which induce gout were present, the possible roles of the venous thrombosis and the heparin therapy were examined. Intra-articular thermic and acid-base changes secondary to the thrombosis could have explained the site of the attacks of gout in 3 of our 4 patients; the fourth patient had normal phlebography; the relationship between the attack and the start of heparin therapy suggested that the heparin may have induced the gout, possibly by an interaction with the synovial proteoglycans leading to the precipitation of urate crystals in the joint. In the absence of references in the literature, these hypotheses need further confirmation.

Acute Disease↗
PubMed1984

[Sea-blue histiocyte syndrome. Review of the literature apropos of a case of idiopathic splenomegaly in the adult].

A case of idiopathic splenomegaly with ceroid histiocytosis--the so-called sea-blue histiocytosis--is reported with reference to the literature. The histological, histochemical and ultrastructural features of stained sea-blue and ceroid-containing macrophages are described and their physiopathological significance is discussed. Attention is drawn to the distinctions, between idiopathic and secondary or associated forms, and the practical value of the pathological diagnosis is emphasized.

Ceroid↗
PubMed1984

[Sarcoidosis at the Cochin University Hospital Center from 1975 to 1982].

An analysis of 80 cases of sarcoidosis admitted to the departments of respiratory medicine (36), rheumatology (19) and internal medicine (25) over a 7 year period, revealed a wide range of clinical presentations; there was a higher incidence of associated disease and a greater number of localisations of the disease in patients admitted to the department of internal medicine than in those admitted to the other two departments. On the other hand, bronchial biopsy was more commonly positive in patients admitted to the department of respiratory medicine whose respiratory function was more disturbed than the patients in the other two departments. The patients referred to the departments of rheumatology and internal medicine without radiological respiratory involvement had respiratory function tests and positive alveolar lavages. The prognosis was the same in all three departments; 50 p. 100 were treated with steroids. The recruitment of the patients in this series allows a different evaluation of the disease compared to series reported from more specialised departments.

Adolescent↗
PubMed1984

[Tuberculous meningitis in adults. Diagnostic elements: analysis of 32 cases].

The aim of this study was to determine the value of paraclinical investigations in the diagnosis of 32 adults with TB meningitis. Mycobacterium tuberculosis was found in spinal fluid cultures of 21 patients (66 p. 100). But only two had positive smears. In five with positive cultures the sampling was performed between one and 13 days after the beginning of chemotherapy. In 7 patients with negative spinal fluid cultures, mycobacterium tuberculosis was found in gastric contents aspiration (3); urine (2); bone marrow (1) and abscess (1). Cytochemical analysis of first spinal fluid samples showed an elevation of protein from 0.5 to 7 g/l in all patients (mean 2.1 +/- 1.6 g/l); sugar was low in 26 (mean 0.30 +/- 0.26 g/l); cell count was less than 500/mm3 in 26, with a mononuclear response in 24. 20 patients had lymphocytic and hypoglycorrachic meningitis. Cytochemical findings were independent of the delay between the first clinical symptoms and lumbar puncture. A. C. T. scan of the brain was performed in 8 patients with neurologic complications. Hydrocephalus was found in 3, and after the injection of contrast material, focal high-density areas in the basal cistern and the sulci of the cerebrum were observed in 2. Chest X ray showed miliary TB in 13 patients; but positive skin test for tuberculosis and hyponatremia were rarely helpful. To confirm adult tuberculous meningitis, we suggest that two spinal fluid samplings are necessary, but mycobacterium tuberculosis must be looked for simultaneously in the sputum, gastric contents, urine and bone marrow. Specific treatment can be started immediately after the first spinal fluid sampling. Chest X ray may be helpful, but C.T. scan of the brain and tuberculin test are of no value.

Adult↗
PubMed1983

[Tuberculous meningitis in adults. Prognostic factors].

Clinical and biochemical data likely to constitute prognostic factors were investigated in a retrospective study of 32 cases of tuberculous meningitis. Age appeared to be a much more important factor than the initial clinical severity of the disease and the delay of treatment. Over the age of 50 years, the mortality rate was doubled. There was no correlation between age and initial severity of the clinical picture. The number of cells and level of glucose in the CSF on admission were of no prognostic significance. CSF protein levels were higher in patients who died or developed complications than in those who made an uneventful recovery (p less than 0.05). The time required for temperature and CSF protein and glucose levels to return to normal had no prognostic value. An unfavourable or complicated course should be feared when CSF protein levels are higher than 7 g/l and in the presence of persistently low CSF glucose levels.

Adult↗