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Biomedical subjects

F Maurice

Publications and source records attributed to F Maurice.

6 recordsLinked to original sources

Allergy in long-term hemodialysis. II. Allergic and atopic patterns of a population of patients undergoing long-term hemodialysis.

Maintenance hemodialysis is widely used throughout the world, and anaphylactic reactions appear to be increasing in number and severity. However, the exact incidence of sensitization and the role of atopy in these reactions are not yet fully understood. All of the 111 patients routinely dialyzed in a center were tested. All patients had a complete investigation of atopy, RAST to chemicals released during the procedure of dialysis (ethylene oxide (Eto), formaldehyde, phthalic anhydride, and toluene diisocyanate), skin tests with the effluent, and the titration of blood eosinophils. The incidence of atopy was found to be lower (13.5%) than in the normal population of the area. Skin tests with either histamine or allergens are significantly (p less than 0.001) smaller than those of nondialyzed subjects, and this method does not appear to be ideal in this population of patients. Eto sensitivity ranked first (5.5%), followed by phthalic anhydride sensitivity (3.6%); 5/6 patients who had a sensitivity to Eto and/or phthalic anhydride presented symptoms during dialysis, but they never were life threatening. Formaldehyde RAST was only found in one patient who had a life-threatening reaction. Finally, three patients presenting pruritus had positive skin prick tests with the effluent of the dialyzer. All patients having a first use syndrome and 80/81 symptom-free patients did not have serum-specific IgE against the released chemicals, 5/17 patients who had a pruritus during dialysis had either positive RAST to released chemicals or skin tests to the effluent, 5/8 patients who suffered from anaphylaxis had positive RAST to released chemicals, but only those who had a positive RAST presented a severe reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Allergy in chronic haemodialysis. 1. Double-blind intravenous challenge with formaldehyde.

Patients undergoing chronic haemodialysis are often exposed to formaldehyde formaldehyde (F) has been reported to cause IgE-mediated anaphylactic shock. Many other patients reported pruritus or anaphylaxis-like symptoms when dialysed with F-sterilized dialysers. Ten patients presenting such symptoms were compared with five control subjects. Intravenous double-blind challenges were performed on six consecutive occasions, with capillary flow dialysers sterilized with or without F. Dialysis was performed by an investigator who was not aware of the sterilization procedure. Among the ten F-sensitive patients, five had symptoms with F-sterilized dialysers and no symptoms with new dialysers, sterilized by ethylene oxide and free of F. Symptoms included pruritus and hypotension. These five patients were subsequently dialysed with new dialysers, not sterilized with F, and symptoms subsided. The five other patients had inconclusive challenges. The five control subjects had no symptoms during challenges. Skin-prick tests with F showed that only one of the five patients who had symptoms with F-dialysers had a strongly positive prick test. RAST to F was titrated with HSA-discs but it was negative in all patients and control subjects. Formaldehyde was shown to cause symptoms in some patients under chronic haemodialysis but an IgE-mediated mechanism was not demonstrated.

Adult

Anaphylactic shock caused by formaldehyde in a patient undergoing long-term hemodialysis.

Formaldehyde (F) elicits contact dermatitis and asthma in subjects who are exposed to this chemical when it is applied on the skin or inhaled. An immediate-type hypersensitivity reaction was never confirmed in these reactions. F is widely used in hemodialysis to sterilize adhesives, surgical devices, or reconditioned dialyzers. A 20-year-old woman who was subjected to hemodialysis for the past 4 years had a contact dermatitis to F. When hemodialysis was performed with a new dialyzer not sterilized with F, there were no symptoms. She had minor symptoms of anaphylaxis characterized by rhinitis, wheezing, and headache on the first use of a reconditioned dialyzer. Two days later, she was dialyzed with the same reconditioned dialyzer and developed within minutes a severe anaphylactic shock requiring resuscitation. The patient had no personal or family history of atopy. Prick tests and RAST to common food and inhlant allergens were negative. Prick tests performed with 0.1% and 1% F were positive in the patient, whereas they were negative in control subjects. RAST to F was performed with discs specially prepared and coated with human serum albumin. RAST was strongly positive. RAST to ethylene oxide was negative. A patch test with F was performed and induced an anaphylactic shock 26 hours after the skin application of F. The patient did not present any anaphylactic symptoms with the use of nonreconditioned dialyzers. An immediate-type allergy to F mediated by IgE may be envisaged in this patient.

Adult

Bronchiectasis: assessment by thin-section CT.

To assess the accuracy of computed tomography (CT) in the evaluation of bronchiectasis, we performed thin-section CT in 36 patients with clinical findings suggestive of this diagnosis. CT was performed with 1.5-mm section thickness and 10-mm intersection spacing. Bilateral (eight patients) and unilateral (28 patients) bronchograms were obtained. CT and bronchographic findings were correlated in 44 lungs. In 15 lungs no bronchiectasis was observed on CT scans and bronchograms. In 25 lungs both examinations accurately indicated the presence and extent of bronchiectasis. In two lungs the extent of disease was underestimated on CT, which failed to indicate bronchiectasis in one segment of the affected lobe. In one case CT findings suggested focal bronchial disease, but the lung was misinterpreted as not bronchiectatic; the bronchogram showed cylindric bronchiectasis. In one case CT disclosed cylindric bronchiectasis in a lobe that was bronchographically normal, but in this case the bronchogram was probably misinterpreted as false negative. In two cases lung findings were better visualized on CT scans than on bronchograms. It is concluded that thin-section CT is an accurate procedure in the recognition of bronchiectasis.

Adolescent

[Spontaneous fracture of the sacrum due to "insufficiency". An overlooked cause of low lumbago in elderly women].

A case of insufficiency fracture of the sacrum is reported. These fractures usually occur in elderly women and are secondary to various conditions, mainly postmenopausal or steroid-induced osteoporosis and radiation therapy. They are often overlooked or confused clinically and radiographically with metastatic disease. Findings on plain films are often subtle. Radionuclide bone scan shows a characteristic H or butterfly shaped pattern of increased uptake in the sacral alae. The diagnosis is confirmed by conventional tomograms or CT which show the fracture always surrounded by prominent sclerosis.

Aged