Biomedical subjects
Publications and source records attributed to C Jolidon.
Priapism is known from egyptian antiquity, but greek doctors give the name of god Priape, to this pathology. The physiopathology is controversial, between Paré and the authors of Middle age tradition medical. The treatment is at first the use of quack medicines, and the Velpeau used surgery.
Peyronie's disease on plastic induration of the corpus cavernosum was described by La Peyronie in 1743. Initial clinical descriptions, based on 5 cases, were extremely clear. A surprising similarity is seen between comments on pathology and etiopathogenicity made in the past and current concepts. As early as 1886 it was suggested that inflammation was followed by fibrosis. Similarly, it has been known from 1850 that diabetes and Dupuytren's disease are frequently associated with Peyronie's disease. Although surgical removal of nodules and the use of a prosthesis were not mentioned, a thesis by Merle in 1899 suggested that treatment should consist of contralateral plication to reduce the effect of deviation of the fold resulting from the disease itself.
The authors observed 9 patients submitted to prophylactic treatment with adequately doses subcutaneous heparin, for orthopaedic or traumatic surgery (chiefly total hip arthroplasty) who presented between the 7 and 9 day after starting heparin therapy, thrombotic complications including recurrent arterial occlusions and venous thrombosis associated with a profound thrombocytopenia, with a maximum platelet count below 30,000 per cubic millimeter. A rapid increase of platelet count after heparin withdrawal is observed, and the profound thrombocytopenia seems to be immune mediated with heparin dependent platelet antibodies, in most of the reported cases. We propose a platelet count for all surgical patients with heparin therapy, and if a thrombocytopenia appears, with a platelet count in the range of: 80,000 clinical inspection and platelet aggregation investigations, and immediate cessation of heparin therapy at 30,000 platelets/mm3.