PubMed Health⌕ Search

Biomedical subjects

J Cabane

Publications and source records attributed to J Cabane.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Nasal septal perforation and systemic disease].

INTRODUCTION: Nasal septal perforations are mainly due to trauma. Our review highlights systemic diseases leading to this disorder. CURRENT KNOWLEDGE AND KEY POINTS: Various systemic diseases may be responsible of nasal septal perforation: Wegener's granulomatosis, systemic lupus erythematosus, antiphospholipid syndrome, sarcoidosis, cryoglobulinaemia. But, very few data are available about the frequency of septum nasal perforation in each disease. Clinical manifestations are numerous and not specific: obstruction, epistaxis, postnasal discharge, whistling, crusting. Asymptomatic forms are frequent. Biopsy of nasal septum is poorly useful for the diagnosis except when granuloma or vasculitis is found. Pathophysiologic mechanisms of nasal septal perforation are ischemic, infectious or inflammatory. FUTURE PROSPECTS AND PROJECTS: Systemic disease may be suspected in unclear nasal septal perforation. More, in systemic disease, even when symptoms are absent, intranasal examination is required.

Antiphospholipid Syndrome↗
PubMed2001

[Otorhinolaryngologic pain in the adult. A comparison of the analgesic efficacy of lysine acetylsalicylate and paracetamol].

OBJECTIVE: Unlike paracetamol, aspinin has anti-inflammatory properties which may be helpful in relieving pain associated with inflammation. To confirm this hypothesis, we performed a randomized, double-blind, double-dummy study to compare the relative analgesic efficacy of lysine acetylsalicylate (LAS) and paracetamol (PAR) in ENT pain in adults. PATIENTS AND METHODS: After initiation of the treatment by a placebo (PLA), both drugs were given at the same dose (1 g twice daily on D1 and 1 g three times daily on D2) for two days. From the third day to the seventh day, the patients could freely take the same drug if necessary. The analgesic effect was assessed by measuring the area under the curve (AUC) of pain severity as scored by patients on a visual analogue scale. The secondary efficacy criteria were the difference relative to the basal pain score of the scores at each evaluation time (PID), the sum of these differences (SPID), and the proportion of patients responding to the treatment (i.e. experiencing a decrease of at least 50% in the pain score). RESULTS: A total of 312 patients, included by 30 French centres, were treated by LAS (n = 156) or PAR (n = 156). Pain was related to an infection in 98% of the cases. Nine percent of patients in each treatment group were responders to the PLA and were consequently not included in the per protocol (PP) analysis but in the intent-to-treat (ITT) analysis. During days 1 and 2, patients in the LAS group had less pain than those of the PAR group, the difference becoming significant at Day 2 whatever the population analysed, PP (p = 0.01) or ITT (p = 0.01). LAS also showed better analgesic efficacy than PAR as assessed by measures of PID and SPID, the difference being significant at several times of evaluation for PID, and on Day 2 for SPID evaluation in the PP (p = 0.01) and ITT analysis (p = 0.007). The proportion of responders was significantly higher in the LAS group than in the PAR group (70% versus 56%, p = 0.01). Safety was comparable between the treatment groups. The overall efficacy judgement of investigators and patients was significantly better for LAS than for PAR (p = 0.01 and p = 0.006 respectively, at the Day 2 evaluation). CONCLUSION: In this study, LAS proved to be more effective than PAR in the treatment of ENT-associated pain in adults. This is probably related to the anti-inflammatory activity of LAS.

Acetaminophen↗
PubMed2001

[Acquired hemophilia: current diagnostic and therapeutic approaches].

PURPOSE: Acquired haemophilia is a rare disease, occurring most frequently in elderly patients, caused by the development of autoantibodies against factor VIII. CURRENT KNOWLEDGE AND KEY POINTS: The disease is characterised by spontaneous haemorrhagic complications which can be fatal in 15-20% of the patients. However spontaneous remission is possible and in fact natural evolution and aetiology are still partly unknown. Acquired haemophilia may arise in association with auto-immune diseases, lymphoproliferative malignancy, pregnancy and also as a drug reaction. The aims of the treatment are first to treat the bleeding which is the most common cause of morbidity and mortality, and second to eliminate the inhibitor by immunosuppression. However no consensus exists for these two parts of the treatment. Bleeding may be controlled by prothrombin complex concentrates, recombinant factor VIIa or porcine factor VIII. The inhibitor is abolished in up 70% of patients using prednisone and cyclophosphamide. Other combinations of prednisone with azathioprine or with cyclophosphamide and vincristine or the use of high-dose immunoglobulin or double-filtration plasmapheresis have also proven effective in some patients. FUTURE AND PROJECTS: The rare occurrence of the disease, the associated with various diseases, and lack of consensus about treatment, require multicentric prospective studies.

Aged↗
PubMed2001

[A unique case of destructive polyarthritis associated with multicentric Castleman's disease].

This is an original report of a 75-year-old woman suffering from multicentric Castleman's disease associated with a destructive polyarthritis, which do not correspond to any known rhumatologic disease. Cattleman's disease (angiofollicular lymph node hyperplasia) is a lymphoproliferative disorder of unknown etiology. Two forms are described: a localized and a multicentric. In the literature, associations of Cattleman's disease and connective tissue disease such as rheumatoid arthritis have been described. Association with POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M component, skin changes) and amylosis have also been described.

Aged↗
PubMed2000

[Laryngeal amyloidosis: a rare cause of hoarseness].

INTRODUCTION: The larynx is a rare site of deposition for amyloidosis. Diagnosis may be delayed and evoked in patients with prolonged hoarseness. We have reported two cases of laryngeal amyloidosis. EXEGESIS: One man and one woman suffered from hoarseness during one and three years, respectively. Laryngoscopic examination showed diffuse infiltration of the larynx. Amyloidosis was confirmed by the characteristic Congo-red staining of laryngeal biopsies. The search for other localizations of amyloidosis was negative. No monoclonal plasma cell proliferation was detected. Both patients received endoscopic CO2 laser excision. In one case, chemotherapy was initially associated due to dystrophic plasma cells in bone marrow aspiration and then withdrawn because of clinical failure. With a 6-month follow-up, hoarseness remained stable. CONCLUSION: Laryngeal amyloidosis is an essentially localized disease revealed by hoarseness. Treatment is endoscopic by laser excision. In nearly half of the cases in the literature, it had to be repeated due to localized recurrent lesions. Long-term prognosis of localized laryngeal amyloidosis is better than systemic AL amyloidosis.

Amyloidosis↗
PubMed2000

[Mooren ulcer].

Explore the source record for details and available documents.

Adrenal Cortex Hormones↗
PubMed2000

[Quantitative assessment of carotid stenosis: comparison between Doppler ultrasound, spiral computed tomography angiography, magnetic resonance angiography and digital angiography].

BACKGROUND: The North American Symptomatic Carotid Endarterectomy Trial has confirmed the benefit of carotid endarterectomy in comparison to medical treatment in stroke prevention in symptomatic patients having a carotid stenosis of 70% or more. The Asymptomatic Carotid Atherosclerosis Study has concluded that the benefit of surgical treatment remains significant in asymptomatic patients with 60% (or more) stenosis of the ipsilateral internal carotid artery, when mortality rate remains inferior to 3%. In these two trials, angiography has been used to quantify the stenosis. Though this test is carrying some neurological and renal risks, replacing the angiography stenosis grading for a non or less invasive test, seems to be permissible. METHODS: In our retroprospective study, the assessments of the carotid stenosis by several non-invasive tests findings were compared to the angiography results. Nineteen carotid arteries of fifteen patients, both symptomatic and asymptomatic, having a carotid stenosis at least 60% or more and being detected by the Doppler ultrasound were explored either by magnetic resonance angiography (MRA), spiral computed tomography angiography (SCTA) and angiography. RESULTS: The ultrasonography and angiography findings were well correlated (r=0,88; p<0.002) according to the Spearman test. The assessments of the MRA were better correlated to the angiography than to the SCTA (respectively r=0.91, p<0.0001 and r=0,68, p<0.001). Using both ultrasonography and MRA as a confirmatory test, the rate of injustified carotid endarterectomy was 25%. And this rate rose up to 33% when the ultrasonography was used with the SCTA. It is noteworthy that negative predictive value of ARM was 100%. To reduce the mortality rate, several surgical teams managed the carotid stenosis without angiography. CONCLUSION: MRA could replace angiography, on condition that the rate of unjustified carotid endarterectomy lowers and becomes acceptable. Far reaching complementary studies are necessary to confirm the fiability of those non-invasive tests. In order to raise the benefit to carotid endarterectomy, the research studies should turn to the predictive score determination of a surgical international risk and towards the "High benefit" patients groups after endarterectomy.

Angiography↗
PubMed1999

[Bone marrow transplantation in the treatment of autoimmune diseases. ISAMAIR Group].

EXPERIMENTAL BASIS AND CLINICAL OBSERVATIONS: Remission of an autoimmune disease has been observed in certain patients after bone marrow allograft from a healthy donor. Autoimmune disease in the donor can also be transmitted to an unaffected recipient. These phenomena would be hematopoietic-dependent. BONE MARROW ALLOGRAFTS: Indications for the treatment of refractory autoimmune diseases are exceptional due to the related mortality even in patients without malignant hematologic disease. A NEW THERAPEUTIC CONCEPT: Therapeutic intensification, followed with autologous peripheral stem cell grafts, a procedure with a mortality below 3% in 1997, constitutes a therapeutic alternative in these difficult indication concerning severe refractory autoimmune diseases including: sclerodermia, vasculitis, lupus, inflammatory myositis, autoimmune cyopenia.

Autoimmune Diseases↗
PubMed1999

[A paraneoplastic acrosyndrome].

BACKGROUND: Paraneoplastic digital ischemia is an uncommon complication of metastatic adenocarcinomas. CASE REPORT: Two years after remission of an uterine adenocarcinoma, the patient developed an acrosyndrome involving all four limbs with digital ischemia. Recurrent carcinoma was evidenced by a very high antinuclear antibody titer. Chemotherapy improved the acrosyndrome. DISCUSSION: Vasomotor disorders which developed in older subjects with no other signs of autoimmune disorders should suggest a neoplastic origin. Icshemia of the fingers would be caused by vasculitis. An elevated antinuclear antibody titer may be a supplementary argument suggesting a neoplastic etiology.

Antibodies, Antinuclear↗
PubMed1999

[Treatment of chronic postinfectious fatigue: randomized double-blind study of two doses of sulbutiamine (400-600 mg/day) versus placebo].

PURPOSE: Chronic fatigue remains a medical mystery and a therapeutic failure. The subgroup of chronic fatigue postinfectious fatigue (CPIF) is an interesting one since it is quite frequent in general practice. METHODS: We studied sulbutiamine (Su), isobutyryl-thiamine disulfide in this context. We included 326 general-practice patients suffering from CPIF: they received randomly either Su, 400 mg daily (n = 106), or Su, 600 mg daily (n = 111), or placebo (n = 109) for 28 days in a double-blind, parallel-group study. 315 patients completed the study. RESULTS: The evaluation of fatigue, by multiple means including mainly MFI, a validated multidimensional fatigue scale, showed overall no significant difference between the groups. On the 7th day, however, women receiving Su, 600 mg had less fatigue (P < 0.01), but the figures were quite diverse and no persistent effect was noted at the 28th day. CONCLUSION: Thus, we showed for the first time that a high level general-practice study of fatigue is feasible using specific tools. Whether the effect observed after 1 week in women represents a true finding needs additional research. Further studies are in progress in order to characterize better the potential usefulness of Su in chronic fatigue.

Adult↗
PubMed1998

[Mixed corticomedullary tumor].

BACKGROUND: Pheochromocytoma and primary hyperaldosteronism rarely occur simultaneously. Few cases have been reported in the literature. CASE REPORT: A patient explored for hypertension was found to have hypokalemia related to primary hyperaldosteronism. Pathology examination of the ablated adrenal showed a co-existing pheochromocytoma suspected at history taking although urine catecholamines were normal. DISCUSSION: Different pathogenic hypothesis have been proposed. Such dual tumors could be a simple coincidence, occur in a particular genetic setting, be related to direct contact between cortical and medullary tissue leading to reactional cortical hyperplasia, pheochromocytoma produced factors stimulating aldosterone synthesis, or factor X, a substance produced by cortical adenomas and favoring growth of the pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1998

Acquired hemophilia due to factor VIII inhibitors in 34 patients.

BACKGROUND: Acquired hemophilia is a rare disease caused by the development of auto-antibodies against factor VIII. SUBJECTS AND METHODS: We studied the characteristics and outcomes of 34 patients (19 women and 15 men) with acquired hemophilia from 1980 to 1997. RESULTS: The mean age of the patients was 61 years (range, 22-93 years). An underlying disease was observed in 18 (53%) patients: 5 patients had cancer, 4 an autoimmune disorder, 2 a dermatologic disorder, 3 asthma, 3 were postpartum, and 1 had an adverse reaction to ampicillin. Factor VIII level was <5% in 30 (90%) patients; factor VIII antibodies were elevated (>10 Bethesda units) in 23 (69%) patients. Bleeding requiring transfusions was reported in 25 (75%) patients. Human factor VIII was given to 14 patients and porcine factor VIII to 5. Six patients received prothrombin complex concentrates and one desmopressin. Several immunosuppressive treatments were used, mainly corticosteroids, cyclophosphamide, and intravenous immunoglobulin. Bleeding stopped in all but one patient within 2 weeks. Most patients achieved complete remission, although two relapses were observed subsequently. CONCLUSION: This large study helps to clarify the presentation and clinical course of acquired hemophilia. Prospective studies are needed to determine the efficacy of treatment.

Adult↗
PubMed1998

[Buerger's disease or thromboangiitis obliterans].

PURPOSE: To review clinical data, pathophysiology and treatment of thromboangiitis (Buerger's disease). DATA SYNTHESIS: Buerger's disease or thromboangiitis obliterans (TAO) is an obliterative vascular disease that affects medium and small sized arteries as well as superficial veins. Young males and smokers are preferentially afflicted with the disease. TAO accounts for 0.5 to 5% of occlusive vascular disease. Though TAO has a world-wide distribution, it can be found with greater prevalence in Eastern Europe, the Mid-East, Asia, and Southeast Asia. Women account for 10 to 20% of the patients and 5 to 10% are more than 60-years-old. Approximately 95% are smokers and disease activity is strongly associated with the use of tobacco. The pathogenesis is poorly understood and most hypotheses are controversial. There is no specific marker of the disease and the diagnosis is based on clinical and angiographic criteria. The disease spontaneously leads to tissue loss and major amputations. This can generally be avoided by discontinuing smoking. Induced hypervolemia and prostacyclins are effective treatments of critical limb ischemia in TAO. CONCLUSION: If pathophysiology is still poorly understood, spontaneous evolution can be avoided by stopping tobacco and prostacyclin.

Adolescent↗