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Biomedical subjects

B Duflo

Publications and source records attributed to B Duflo.

At least 19 recordsLinked to original sources

Unusual cutaneous cytomegalovirus involvement in patients with acquired immunodeficiency syndrome.

Two patients with acquired immunodeficiency syndrome presented unusual keratotic cutaneous lesions with a protracted course. Pathologic examination in both patients, cultures, and DNA hybridization techniques of skin biopsy specimens in the second patient were characteristic of cytomegalovirus cutaneous infection. Cytomegalovirus skin lesions are rarely described in acquired immunodeficiency syndrome in contrast with the high frequency of ocular and visceral involvement. Skin biopsy specimens may lead to early diagnosis of cytomegalovirus disseminated disease and to specific treatment.

Acquired Immunodeficiency Syndrome

[Development of drug resistance in cases of P. falciparum malaria of African origin in a Parisian hospital. Comparison with field data and therapeutic consequences].

The number of P. falciparum malaria cases, contracted in Africa, diagnosed by the department of Parasitology and Tropical diseases of the Pitié-Salpêtrière Hospital Group has shown a significant increase in 1985-1986 when compared with the 15 past years (+23%). This fact is related to the spread of chloroquine or amodiaquine resistant falciparum malaria from East Africa (1980-1983: 54%) to Central Africa (1985: 54.5%) and now to a country of west Africa (Benin 1986).

Africa

[Effectiveness of treatment during osteoarticular pain crises in drepanocytosis; based on the example of pentoxifylline].

Many drugs have been used for prevention and treatment of vaso-occlusive attacks in sickle cell anemia. Pentoxifylline is one of the most recent. It increases deformability and filtrability of normal or sickled red cells. In this double-blind study it is compared with a placebo for treatment of 20 osteoarticular crisis during SS or SC sickle cell anemia in Mali. Pentoxifylline did not decrease intensity nor duration of crisis. On the other hand the clinical assessment used for testing drugs efficiency over pain seemed effective and reproducible.

Adult

[African histoplasmosis in Mali].

Twenty-four cases of histoplasmosis have been diagnosed since 1945 in native Malians (20 cases) or Europeans living in Mali (4 cases). Seventeen cases have already been published and 7 other cases diagnosed recently in Bamako or Marseille are reported here. Mali is within the African histoplasmosis zone and the Kayes district may be a particularly endemic zone. The disease affected the skin (62 p. 100), lymph nodes (46 p. 100), bones (21 p. 100), gastrointestinal tract (26 p. 100) and lungs (4 p. 100). A rare lesion of the uvula is also reported. Direct fungal and histopathological techniques are the easiest and the most effective diagnostic investigations. All cases were due to Histoplasma duboisii. Amphotericin B was used in over 60 p. 100 of cases for an average period of 3 months. The total recovery rate was 66 p. 100.

Adolescent

[Estimation of the impact of the principal diseases in rural Mali].

The authors assess the health impact of major diseases in the circles of Kita, Bafoulabé and Kenieba (Western Mali) by measuring, for each of them, the number of healthy days of life lost through illness, disability and death. Malaria, birth diseases, infant gastro-enteritis and pneumopathies, measles, malnutrition and hemoglobinopathies account for 58.1% of healthy life lost due to all studied diseases. Parasitic diseases (except malaria), tuberculosis, leprosy are less important than usually said; on the contrary, the impact of hepatic, cardiovascular, and eyes diseases is great. In developing countries assessing the number of healthy days lost by the community due to different diseases is usefull to choose the health priorities and to compare the cost/effectiveness ratio of different health programs.

Adult

[Clinical and biological consequences of human immunodeficiency virus (LAV) infection in 15 Congolese subjects].

We report 15 cases of symptomatic HIV infection seen in Paris between June 1983 and June 1985 in Congolese patients. The first signs were diarrhea, weight loss, fever, pruritus. Disseminated lymphadenopathy was frequent. Twelve patients had AIDS, and the opportunistic infections were: isosporosis, oesophageal candidiasis, cerebral toxoplasmosis, Kaposi's sarcoma, CNS' cryptococcosis, cutaneo-mucosal.

Acquired Immunodeficiency Syndrome

[Cytodiagnosis of hepatoma. Apropos of 100 fine needle punctures of primary cancers of the liver].

The authors report the results of 100 liver biopsies with fine needle aspiration performed in patients with primary hepatocellular carcinoma (P.H.C.). The method is simple, quick, without danger and reliable: cytodiagnosis on aspirated material shows typical P.H.C. in 69 p. 100 of cases and probable P.H.C. in an additional 21 p. 100 of cases. Peritoneoscopic or ultrasonic guidance gives even better results.

Adult

[Hepatitis B and primary cancer of the liver in intertropical Africa].

During the past 15 years, a growing body of evidence incriminates hepatitis B virus as the major factor in the etiology of primary liver cancer. Epidemiological studies throughout the world reported a striking correspondence between areas where the frequency of primary liver cancer is high and where HBV infection is hyperendemic. Moreover, primary liver cancer is commonly associated with cirrhosis of the postnecrotic macronodular type. Such data suggested a sequence hepatitis-cirrhosis-PLC. Such sequence was confirmed by extensive serologic testing studies which reported a high frequency of HBV markers in PLC patients compared to matched control groups. Data collected in Senegal, Mali and Burundi on 12,000 individuals stress the importance of HBV infections in these countries, as the high rate of chronic carrier state in patients suffering from liver cirrhosis or primary liver cancer (62-63%) compared to the general population (12-17%). Other HBV markers including anti-HBs, anti-HBc, HBeAg and anti-HBe had no prognostic value in the sequence hepatitis-cirrhosis-PLC. A new HBV seric marker, the HBsAg/IgM complexes, observed in HBsAg positive individuals, is more frequently detected in PLC patients (50%) and cirrhosis (40%) than in healthy HBsAg carriers (14%). These results would indicate that HBsAg carriers are more likely to develop cirrhosis or primary liver cancer when they evidence HBsAg/IgM complexes. In conclusion, the seric markers of evolution towards primary liver cancer are: HBsAg (the highest known risk factor), the presence in such individuals of HBsAg/IgM complexes, and increased values of alphafoetoprotein.

Adolescent

[Hemoglobin C in a hospital milieu in Bamako (Mali)].

An hospital survey, performed in Bamako (Mali, West Africa) showed 7.5% haemoglobin AC, 0.4% haemoglobin CC, 1.6% haemoglobin SC and 0.2% haemoglobin CA (haemoglobin C-beta+thalassaemia). Haemoglobin C was mostly prevalent among Bobo, Mossi, Senoufo, Minianka and Dogon coming from the Southern border of Mali. Haemoglobin SC and to a lesser extent haemoglobins CC and CA often induce haemolysis and vasoocclusion. Microcytosis is common, even in the absence of anaemia.

Adolescent