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Biomedical subjects

D Knockaert

Publications and source records attributed to D Knockaert.

28 records · Page 2Linked to original sources
PubMed1985

Lung metastasis of malignant epithelioid hemangioendothelioma mimicking a primary intravascular bronchioalveolar tumor. A histologic, ultrastructural, and immunohistochemical study.

A 40-year-old woman presented with multiple nodules in both lungs and a small tumoral mass at the level of the left brachial artery. A pathologic diagnosis of pulmonary intravascular bronchioloalveolar tumor (IVBAT) and epithelioid hemangioendothelioma of the limb was established. Morphologic and immunohistochemical studies highly suggest that both tumors are manifestations of the same neoplastic process. In this case a metastatic nature of the IVBAT is suggested. The diagnosis of pulmonary IVBAT should be followed by a search for sclerosing vascular tumors elsewhere. Finally, the results substantiate the vascular origin of the IVBAT.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1984

Effect of prenalterol on orthostatic hypotension in the Shy-Drager syndrome.

Treatment of idiopathic orthostatic hypotension is often unsatisfactory. A patient with the Shy-Drager syndrome, in which the most important symptom is orthostatic hypotension, was treated with prenalterol, initially 30 mg six times daily. The dosage was reduced to 30 mg four times daily because of the development of complex ventricular premature beats. Orthostatic symptoms were reduced and standing blood pressure increased. Fludrocortisone 0.5 mg a day was added to treatment with further improvement. This clinical effect was maintained throughout 12 months of follow up, during which the treatment was continued unchanged. Prenalterol was effective in reducing orthostatic symptoms in this patient. Further studies in patients with a similar haemodynamic pattern are indicated.

Adrenergic beta-Agonists↗
PubMed1984

Prenalterol in the treatment of orthostatic hypotension in Shy-Drager syndrome.

The effects of prenalterol, a selective beta 1-adrenoreceptor agonist, were studied in a patient with the Shy-Drager syndrome, presenting with incapacitating orthostatic hypotension. The main haemodynamic defect was an impressive postural fall in stroke volume and cardiac output pointing to denervation of the capacitance vessels. Prenalterol 4 X 30 mg orally produced a marked increase in supine and standing blood pressure, along with substantial symptomatic improvement. Notable positive chronotropic and inotropic effects were observed. Association of fludrocortisone 0.5 mg/day resulted in further haemodynamic and symptomatic improvement, presumably due to plasma volume expansion. Haemodynamically, prenalterol and fludrocortisone resulted in a substantial increase in standing cardiac output, primarily due to the chronotropic effects of prenalterol. In addition to the haemodynamic effects, prenalterol stimulated the renin-aldosterone system and restored the normal diurnal pattern of water and sodium excretion, the latter may have contributed to the improvement of orthostatic tolerance. Prenalterol could be a valuable adjunct to the existing treatment schedules of neurogenic orthostatic hypotension.

Adrenergic beta-Agonists↗
PubMed1979

Osteopathia striata and focal dermal hypoplasia.

A 43-year old female, presenting with pain in the left knee, attributed to a stress fracture of the tibia, was found to have osteopathia striata and numerous other congenital anomalies, not only of the skeleton, but also of other tissue systems. Of the latter the most important was the presence of focal dermal hypoplasia, a disorder of the skin. Review of the radiological and dermatological literature has shown this to be the fourteenth case in which these excessively rare entities have been associated. Such an association is considered to be more than a coincidence. A radiological diagnosis of osteopathia striata, therefore, should be followed by a careful dermatological examination for focal dermal hypoplasia. Conversely, diagnosis of this rare dermatological disease should indicate the necessity for radiological survey of the skeleton.

Abnormalities, Multiple↗
PubMedDate not supplied

The antibiotic and anti-inflammatory treatment of bacterial meningitis in adults: do we have to change our strategies in an era of increasing antibiotic resistance?

Community acquired bacterial meningitis remains a feared infection because of its high morbidity and mortality. During the last decade, the incidence and the microbial resistance patterns of pathogens causing bacterial meningitis have changed considerably. A sharp increase in meningococcal disease has been observed and meningitis caused by penicillin resistant Streptococcus pneumoniae emerged as a matter of major concern. Since pneumococcal resistance in Belgium to third generation cephalosporins remains rare and low level, addition of vancomycin to the initial empirical therapy including third generation cephalosporins is not yet necessary. However, the evolution of the resistance patterns of invasive S. pneumoniae should be followed very carefully. The emergence of penicillin resistant pneumococci also raises concern about the safety of adjuvant anti-inflammatory therapy with dexamethasone. Although there is a growing evidence suggesting a decrease of neurological complications after administration of adjuvant dexamethasone, this therapy may lower the already borderline penetration through the blood-brain barrier of the currently used antibiotics. This may result in therapeutic failure. We therefore presently do not advocate the routine use of dexamethasone in the therapy of adult bacterial meningitis.

Adult↗