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I Azais

Publications and source records attributed to I Azais.

At least 19 recordsLinked to original sources
PubMed1997

Open synovectomy for the prevention of recurrent hemarthrosis of the ankle in patients with hemophilia. A report of five cases with magnetic resonance imaging documentation.

Hemophilic arthropathy is an incapacitating complication of severe hemophilia resulting from recurrent bleeding in the same joint. Open synovectomy has been used since 1969 to prevent recurrent hemarthrosis of target joints. Between 1988 and 1993 we performed open synovectomy of the ankle in five hemophiliacs aged 6 to 9 years with early-stage hemophilic arthropathy. Magnetic resonance imaging proved very useful for evaluating the severity of joint damage, usually underestimated on plain radiographs; for determining the degree of synovial membrane hypertrophy, which is a critical factor in the decision to perform synovectomy; for planning the surgical procedure and for explaining treatment failures. A decrease in the frequency of hemarthrosis episodes occurred in all five ankles. A repeat synovectomy was needed in one case and in another patient the frequency of hemarthrosis episodes increased somewhat after the fourth year. There was no loss of range of motion. Our data suggest that open synovectomy is effective and safe for reducing the frequency of hemarthrosis and that magnetic resonance imaging should be routinely performed before the procedure.

Ankle↗
PubMed1995

Prognostic factors in low tumour mass asymptomatic multiple myeloma: a report on 91 patients. The Groupe d'Etudes et de Recherche sur le Myélome (GERM).

Between January 1985 and July 1989 we diagnosed asymptomatic stage I multiple myeloma according to Durie and Salmon [Durie and Salmon: Cancer 36:842, 1975] in 91 patients. All patients were followed without chemotherapy. Disease progression occurred in 41 patients and the median time to progression for all patients was 48 months. In the Cox multivariate regression analysis, hemoglobin levels < 12 g/dl (P < .01), bone marrow plasmacytosis > 25% (P < .01), and M-component size > or = 30 g/l for Ig G or > or = 25 g/l for Ig A (P < .01) were the only significant prognostic factors for progression. The 38 patients without any harmful factor remained free of progression for a median of more than 50 months. The 18 patients with two or three of these characteristics (high-risk group) had the shortest median time to progression of 6 months. Despite different times to progression, the response rate and survival after chemotherapy were similar for all groups of patients. Patients in the high-risk group for progression have to be frequently monitored for disease progression and might benefit from early treatment.

Adult↗
PubMed1995

Strategy for identifying primary malignancies with inaugural bone metastases.

The diagnosis of primary tumors with inaugural bone metastases is a serious and difficult problem commonly encountered in rheumatology. Helpful information can be derived from the radiologic appearance of the metastases, history of the patient, clinical findings, chest film, standard laboratory tests, imaging studies, serum marker assays, and histologic findings. Based on our personal experience and on previously published data, we have developed a decision tree aimed at enhancing the efficacy of the diagnostic process while ensuring optimal patient comfort and containing costs.

Adult↗
PubMed1994

[Disk calcinosis].

Intervertebral disc calcification in children is a rare, primary and benign disease which often disappears after a single painful crisis, especially in cervical involvement. In adults, thoracic and lumbar discs are mainly involved; calcification is less expressive and is often detected during a casual radiograph. Intervertebral disc calcification is primary or secondary to chondrocalcinosis, apatite deposition disease, ochronosis and hemodialysis spondylarthropathy. Except CPPD deposits in chondrocalcinosis, calcium complex accounting for most discal calcinosis is hydroxy-apatite. Iatrogenic intervertebral disc calcification was recently described in patients treated with a discal injection of a long-acting corticosteroid.

Adrenal Cortex Hormones↗
PubMed1994

[Chemonucleolysis of disk herniation with low back pain as the single symptom: 20 cases].

Disk herniation can manifest as isolated low back pain, which is usually intermittent and accompanied with stiffness of the lumbar spine. There is almost general agreement that neither neurosurgical treatment nor chemonucleolysis is appropriate in patients with this clinical pattern. We used chemonucleolysis in 19 patients with recurrent episodes of isolated low back pain and one patient with severe permanent isolated low back pain dating back to a conservatively-treated episode of sciatica. All 20 patients had disk herniation documented by imaging studies. A very good or satisfactory outcome was recorded in ten patients after three months, 11 after six months and 12 in March 1993 after a mean follow-up of 72 months. The treatment was well tolerated, even in those patients who were not improved; a single patient developed an episode of acute low back pain that required surgical treatment. In patients with low back pain and disk herniation, there is currently no means of determining whether a causal relationship links these two abnormalities. Nevertheless, we believe that chemonucleolysis can be proposed in severe forms, provided the patients are apprised of current success rates.

Adult↗
PubMed1993

[Idiopathic retroperitoneal fibrosis and ankylosing spondylitis].

A case of ankylosing spondylarthritis in which retroperitoneal fibrosis developed 16 years after onset is reported. The patient also had aortic incompetence and cardiac conduction disorders. Eight other cases of ankylosing spondylitis with retroperitoneal fibrosis have been published. Potential relationships between the two conditions--including the possible role of indomethacin used by the patient for 16 years--are discussed.

Aortic Valve Insufficiency↗
PubMed1993

[Association of rheumatoid arthritis and Kaposi disease. Apropos of a case arising after intraarticular corticotherapy].

A 66 year old Corsican HLA A2 and DR5-positive male with moderately active seropositive destructive rheumatoid arthritis developed Kaposi's sarcoma after intraarticular administration of corticosteroids. He had no history of oral corticosteroid therapy, organ transplantation, AIDS, or cancer. Chlorambucil proved ineffective but the outcome was spontaneously favorable following discontinuation of oral corticosteroid therapy initiated after the development of the skin lesions. Six previous reports of concomitant rheumatoid arthritis and Kaposi's sarcoma were found. All six cases occurred following systemic corticosteroid therapy. The high incidence of rheumatoid arthritis and the small number of patients with rheumatoid arthritis and Kaposi's sarcoma suggest that concomitant occurrence of the two conditions may be fortuitous. However, the responsibility of corticosteroid therapy, which preceded development of Kaposi's sarcoma in every case, cannot be ruled out.

Aged↗
PubMed1992

VAD or VMBCP in severe multiple myeloma. The Groupe d'Etudes et de Recherche sur le Myélome (GERM).

A randomized trial has been performed in which 91 patients with stage III myeloma and additional severe criteria were randomly allocated to either VAD or VMBCP. No significant difference was noted between these two groups using the following criteria: response rate (VMBCP: 54%; VAD: 39%), impact on symptoms, median survival (VMBCP: 14 months, VAD: 17 months). However, toxic effects and refusal to pursue treatment were more frequent with VAD than with VMBCP (12 v 6). Therefore, in this trial, VMBCP appears to be more useful than VAD.

Adult↗
PubMed1992

[Infectious spondylodiscitis. Analysis of a series of 105 cases].

Among 105 cases of infectious spondylitis diagnosed and treated from 1971 through 1990, 23 were due to tuberculosis (TS) and 82 to other causes (NTS). The annual number of cases of NTS rose over the study period, partly because of an increase in iatrogenic spondylitis, whereas the number of TS cases fell. In both groups, mean age of patients was higher than in earlier studies. The leading causative agents in NTS were staphylococci, followed by streptococci, then Escherichia coli. Diagnosis of spondylitis was dependent on the imaging techniques used; among available methods, the most reliable was magnetic resonance imaging which improved diagnostic performance by detecting early, specific changes. Except in patients with positive blood cultures and in TS patients with Koch bacilli recovered from other visceral foci, bacteriologic diagnosis rested on studies of samples taken from the spinal infection site. Half the subjects underwent discovertebral needle biopsy, with a success rate of 47.5%, a figure comparable with those reported in other studies. In 30% of patients, bacteriologic documentation of the infection was not obtained and diagnosis rested on a set of clinical, biological, and radiological criteria.

Bacterial Infections↗
PubMed1991

[Calcifications after intra-disk injection of triamcinolone hexacetonide in lumbar disk hernia. Evaluation of therapeutical results in 3 years].

The development of disk or epidural calcifications is a frequent possibility following intra-disk injection of triamcinolone hexacetonide. It was found 10 times in 26 follow-up CT scans obtained 2 to 3 years after the injection. These calcifications are often clinically silent, but they sometimes accompany a recurrence of the initial painful symptomatology. Furthermore, evaluation at 3 years of therapeutic results in a previously published series of patients who had received an intra-disk injection of triamcinolone hexacetonide showed a marked decrease in favourable results (30% vs 67% at 6 months). These two arguments: disappointing long term results and possibility of disk calcifications, are felt by the authors to justify abandoning the technique of triamcinolone hexacetonide by intra-disk injection in the treatment of lumbar disk prolapse.

Adult↗
PubMed1990

[Articular manifestations in Wegener's disease. Report of 13 cases].

Seventeen cases of Wegener's granulomatosis have been reviewed in search of articular involvement. Articular symptoms were present in 13 cases (76 p. cent), and were inaugural in 9 cases (53 p. cent). Six of these patients experienced arthralgias, which were most often migratory, and were inaugural in 3 cases. Seven patients had arthritides, which were inaugural in 6 cases; they were fixed and additive in 6 of these 7 cases, making up a distal polyarthritis in 3 patients, and an oligoarthritis in the 3 other ones; they were transient and migratory in 1 case. The 3 cases of distal polyarthritis were inaugural and fulfilled the ARA criteria for rheumatoid arthritis; two of them were accompanied by nodules which were quite identical to rheumatoid ones. There was no axial involvement. Joint involvement was not destructive and had a favourable course under disease treatment. Myalgias were present in 3 cases, one of which simulated Horton's disease. Biological manifestations chiefly consisted of marked inflammatory changes. Antineutrophil cytoplasm antibodies were present in 11 out of 16 patients in whom they were searched; among 6 of these patients who had active disease, they were present in 5. The antibody level decreased as treatment reduced disease activity and suppressed joint involvement. Joint involvement in Wegener's granulomatosis seems to be the inconstant hallmark of disease activity. It requires no specific treatment.

Adult↗
PubMed1989

[Post-traumatic reactive arthritis. Etiologic, clinical and diagnostic aspects. Apropos of 6 cases].

The relationship between trauma and reaction arthritis, although controverted must be interpreted in each specific cases, after chronological analysis of the events. The localizing role of a trauma occurring before the infectious episode and affecting, topographically, a specific joint, may be accepted. It is reasonable to admit that a trauma, following an infectious episode, may possibly trigger rheumatism, providing that one of these arthritis corresponds topographically to the trauma. On the contrary, it does not seem possible to accept, in the present state of our knowledge, that an isolated trauma occurring on a genetically predisposed individual, may generate, out of nothing, a Fiessinger-Leroy-Reiter syndrome.

Adult↗
PubMed1987

Hemodialysis is not essential for the development of destructive spondylarthropathy in patients with chronic renal failure.

Since 1984, there have been several reports of a destructive spondylarthropathy occurring in patients who have received hemodialysis over a long period of time. Two cases of a similar syndrome were observed in nonhemodialyzed patients with chronic renal failure, one of whom underwent a lumbar disc excision. The results of disc examination and of radiographic and biologic investigations prompted reconsideration of factors previously considered to be pathogenetic (amyloidosis, hydroxyapatite crystal deposition, aluminum toxicity), except one: secondary hyperparathyroidism.

Aged↗
PubMed1987

[Retrospective study of the possible role of injuries in the genesis of ankylosing spondylitis, Fiessinger-Leroy-Reiter syndrome and other reactive arthritis, unclassified B27 rheumatism in adults and chronic B27 arthritis in children].

If the revealing or aggravating effect of traumas is known in the course of ankylosing spondylarthritis, their etiological role is debatable. We have reviewed 370 files of patients with ankylosing spondylarthritis, 11 of which were mentioning a post-traumatic onset, without being able to find a single case which could satisfy irrefutably the criteria of imputability. It was the same for 51 cases of the Fiessinger Leroy Reiter syndrome 29 cases of reactional arthritis and 42 cases of unclassifiable Rheumatism HLA B27+, and all affections that could develop into an ankylozing spondylarthritis. On the contrary, in 53 cases of chronic juvenile arthritis HLA B27+, we found 5 cases which satisfied the criteria attributable to a trauma. The critical review of the literature also leads us to question the causal role of trauma in cases of ankylosing spondylarthritis and the Fiessinger Leroy Reiter syndrome where trauma is presented as such.

Adult↗