Biomedical subjects
Publications and source records attributed to C Landais.
Abdominal pain is uncommon in patient with Epstein-Barr infection and is usually attributed to an enlargement of the liver or spleen. We report on an 8-year-old girl with a pseudoperitonitis due to a mesenteric lymphadenitis associated with Epstein-Barr infection. Outcome was favourable without surgery. We review the different causes of abdominal pain occurring during Epstein-Barr infection.
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The occurrence of a left atrial thrombus without a haemodynamic predisposing factor (arrhythmia, mitral valvulopathy, severe left ventricular dysfunction) is a rare event. We report a case during the progression of refractory myeloma, four months after stopping treatment with thalidomide. The promoting haemodynamic factors for left atrial thrombosis in sinus rhythm, described in the literature, had been excluded. In our case the potential role of thalidomide is debatable, in the light of recent publications about venous and arterial thromboses observed with this treatment.
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In 182 critically ill patients, after admission delayed hyersensitivity skin testing have been systematically performed with 3 antigens (tuberculin, candidin, varidase). Mortality in anergic patients was 55% while it dropped to 19% when at least one response was positive. A highly significant relationship was found between anergy and mortality (p less than 10(-5)) whether death was related to sepsis (p less than 10(-4)) or not (p less than 0.02). In patients with major sepsis, anergy was more frequent (38%) than in non septic patients (21%) (p less than 0.01). In 69 patients skin testing with phytohemagglutinin was performed. Seven out of 8 unresponsive patients were anergic and 5 died. The results suggest that in critically ill patients cellular immunity skin testing may early select high risk patients exposed to septic complication. In these patients several important measures should be promptly taken including superinfections prevention, adapted nutritional intake and septic focus eradication.
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