Biomedical subjects
Publications and source records attributed to C Cachin.
Non specific low back pain is commonly a persistent or recurrent problem associated sometimes with impairment to return to work. In this article, we study some treatments strategies through a typical history.
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A monoarthritis may correspond to a localized inflammatory process or to the onset of rheumatoid disease that may later on spread over few or several of the other joints. In this article the different diagnostic and therapeutic steps to approach monoarthritis are presented. One of the first investigations consists in an analysis of the synovial fluid. It should take place before any therapeutic step is initiated and may allow to diagnose a microcrystalline or a septic arthritis. By means of a literature review monoarthritis is described as a disease, whose cause remains often undisclosed inspite of intensive investigations, whose further course, however, is often favorable.
The authors report four cases of stress fracture of the distal tibia simulating acute arthritis of the ankle. Two patients had a noninflammatory tibiotarsal joint effusion whose cause is discussed.
Crural neuralgia can initially present as an involvement of the hip joint. We studied some clinical factors helpful for the diagnosis, which is sometimes difficult.
Meningoradiculitis or polyradiculoneuritis can manifest itself as a back pain of inflammatory nature. Two case reports give us information about the characteristics of a back pain at the onset of a neurological disease.
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We studied 61 patients with a first stroke, admitted in our rehabilitation center. Functional evolution is usually good, 84% of patients are able to return at home, after a mean of 4.6 months of rehabilitation. Age, sex, severity of the initial deficit, shoulder-hand syndrome, etiology and localisation of stroke are the factors which determine the functional recovery and duration of hospitalisation.
We studied clinical characteristics and coexisting causes of stroke in 305 patients admitted to a population-based primary care center with an initial ischemic stroke and a potential cardiac source of embolism (PCSE). Using systematic standardized cardiac, arterial, and cerebral investigations and the logistics of the prospective Lausanne Stroke Registry, we found that nonprogressive onset, hemianopia without hemiparesis or hemisensory disturbances, Wernicke's aphasia, ideomotor apraxia, involvement of specific territories (posterior division of middle cerebral artery, anterior cerebral artery, cerebellum, multiple territories), and a hemorrhagic component were associated with the presence of a PCSE, as compared with 1,006 initial ischemic stroke patients without PCSE. Although age and sex did not differ, the frequency of hypertension, diabetes, cigarette smoking, elevated blood cholesterol, and deep hemispheric or brainstem infarcts was higher in the patients without a PCSE. Nearly one-fourth of the patients with a PCSE had a coexisting potential arterial cause of stroke (large artery greater than or equal to 50% stenosis or small-vessel disease). In the majority of patients with a PCSE (76.7%), cardioembolism was the most likely cause of stroke, although a direct source of embolism was uncommon (4.3%) and intracranial embolic occlusions were present in less than one-half of the patients who were angiographed.
We studied 305 patients with a first stroke and a potential cardiac source of embolism (PCSE), on the basis of the Lausanne Stroke Registry. We have compared these patients with 1006 patients with stroke but without PCSE, admitted into the Registry during the same period, in order to assess the potential role of PCSE and the coexistence of other causes of stroke. Analysis of the various types of PCSE suggests that some neurologic characteristics are more frequent in patients with than without PCSE (infarcts of the posterior division of middle cerebral artery with Wernicke's aphasia and lateral hemianopia; maximal neurologic deficit at onset; haemorrhagic infarcts).
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