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Biomedical subjects

A Dutoit

Publications and source records attributed to A Dutoit.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Spondylodiscitis disclosing bacterial endocarditis. Apropos of a case. Review of the literature].

The authors report a case of infectious spondylodiscitis revealing a staphylococcal endocarditis in a patient with a Carpentier aortic heterograft. This case, along with 60 descriptions from the literature, has enabled them to specify the characteristics of occurrence of endocarditis during a spondylodiscitis. The clinical factors in favor of this association are: a pre-existing cardiopathy, an oral port of entry, occurrence of other rheumatoid manifestations, even more the presence of complications of endocarditis. The laboratory factors in favor of an association are: discovery of an inflammatory anemia, of circulating immune complexes, of a cryoglobulinemia, of a rheumatoid factor, of hematuria. But it is mostly the demonstration of streptococcus in blood cultures and other samples that should be an indication to search for an endocarditis, the course of which dominates the prognosis.

Discitis↗
PubMed1988

[Clinical and developmental aspects of Horton's disease. Retrospective study of 100 cases].

100 patients, from three internal medicine departments, were the subject of a retrospective study concerning the clinical manifestations and the evolution of Horton's disease. The mean age is 71 years, with a 2/1 female predominance. A temporal artery biopsy was obtained in all cases. Besides the prevalence of clinical symptoms (headaches: 80 p. cent; weight loss: 78 p. cent; fever: 65 p. cent; local inflammation: 52 p. cent, frequent pseudo-polyarthritis: 40 p. cent and sometimes severe ocular localizations (11 p. cent blindness), other signs should be emphasized: muscular pain (49%), skin hyperesthesias (37%), painful jaw (33%), etc. The inflammatory syndrome dominates the biological picture (96%); the alkaline phosphatases are increased in 37 p. cent of cases. Temporal artery biopsy was positive in 82 p. cent of cases, which confirms the excellent sensitivity of this test, preceded by a Doppler study in only 28 cases. Extension of the inflammatory process to the large vessels was demonstrated 8 times, on clinical data. Finally, the mean length of the steroid treatment was two years with 14 relapses and 8 deaths.

Aged↗
PubMed1987

[Primary liposarcoma of the left atrium surgically treated].

A case of myxoid liposarcoma of the left atrium in a 35-year old man is reported. The tumour, revealed by an atrial flutter, was excised. The patient died 13 months later, with multiple metastases. A review of the literature yielded only 7 cases of primary liposarcoma of the heart, including 4 which were surgically treated. This confirms the extreme rarity of a tumour which has a very poor prognosis due to recurrence in situ or metastatic spread.

Adult↗
PubMed1987

[Infectious endocarditis caused by rare germs. Review of the literature apropos of 2 cases].

The authors report two new cases of endocarditis secondary to exceptionnally encountered germs: one to Pasteurella pneumotropica, the other ascribed to Leptospira ictero-haemorragiae, on serologic criteria. Concerning these two cases, they propose to take a census of rare germs, from a detailed study of the literature. Among more than 5,000 cases of endocarditis published after 1944, are considered as rare germs those causing a disease in less than one p. cent of the cases. This purely "mathematical" definition enable to include 45 germs. A synthesis of all the cases reported attempts to demonstrate a few particular traits of these endocardites secondary to rare germs.

Adult↗
PubMed1986

[Congestive cardiomyopathy in addiction to clobenzorex, an anorexigenic drug].

Cardiac failure caused by high doses of amphetamine-like drugs is rare. We report a case of decompensated congestive cardiomyopathy occurring in a 29 year old woman addicted to clobenzorex (Dinintel). This patient had been taking 5 to 7 capsules per day for 5 years. No other cause of cardiac failure was detected. A rapid improvement was obtained by digitalis and diuretic therapy; no further episodes of cardiac failure were observed after one year. However, the drug could not be completely withdrawn and echocardiography has shown increasing left ventricular dilatation. The possible mechanisms of amphetamine induced myocardial toxicity are discussed and the analogy with the group of adrenergic cardiomyopathies is underlined.

Adult↗
PubMed1986

[Iatrogenic pathology in coronary intensive care units. Results of a prospective survey on 802 patients].

Iatrogenic disease in the coronary care unit was detected and analysed using a grid over a 17.5 month period (16.09.82 to 25.02.84). The cases of 802 patients, mean age 65.8 years, predominantly male (56.6%) were examined. Minor or minimal pathology in which the causal relationship was conditional or doubtful according to Karch's criteria was excluded. Only those conditions, moderate, severe or even lethal, specific or not to this type of unit, requiring specialised hospital care and in which the causal relationship could be adequately established were retained. Iatrogenic pathology was common: 11.84% of admissions. This group of 95 patients did not differ significantly from a control group with respect to age [average 4 years older (NS)] or mortality. However, there was a clear cut female predominance (68%, p. less than 0.01) and a different distribution of the organic pathology (p less than 0.001). The iatrogenic disease developed before hospital admission in 40% of patients and during hospitalisation in 60% of patients. It increased the duration of the patient's stay by half (2.77 days). Nearly a quarter of these patients had two or more types of iatrogenic disease. The undesirable effects of drugs were mainly bradycardia (44 cases), tachycardia (11 cases), haemodynamic changes, vascular, renal, gastrointestinal, metabolic and endocrine complications. Twenty-one complications of medical procedures and 13 of surgical procedures were also noted. This study, the first to have been performed in a Coronary Care Unit to the author's knowledge, confirms the high incidence of iatrogenic pathology. This fact should be born in mind before taking any therapeutic decision or before performing invasive diagnostic investigations.

Adult↗
PubMed1980

[Arteriovenous fistula of the renal pedicle after nephrectomy (author's transl)].

Two cases of arteriovenous fistula of the renal pedicle after nephrectomy are described, and the general features of this type of lesion reviewed in relation to the findings in these 2 cases and 52 other patients reported in the published literature. The following points are emphasized : the importance of local signs for revealing the presence of a fistula; the long period during which no signs of cardiac complications appear; the high-output cardiac failure which finally occurs is unaffected by medical treatment but responds remarkably well to surgical cure of the fistula. Hemodynamic tests were conducted in one case. The treatment of choice is resection of the aneurysmal sac with suture of the vessels, but less complex procedures, ligature of the artery and vein or the artery alone, may be sufficient.

Angiography↗