[Multiple congenital arteriovenous fistulas. Case report concerning a late manifestation].
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Biomedical subjects
Publications and source records attributed to M Delmas.
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The authors relate the case of a young North-African man who presented during one month several peripheral thrombophlebitis before a ganglionary tuberculosis of the mediastinum appear. With specific antibiotherapy, the cutaneous lesions disappear and can be so considered as a paratuberculous syndroma.
A case of adrenal cortical adenoma and arterial hypertension is reported. We emphasize interest of scintillation scanning with 131 I 19 iodo cholesterol, worth of routine examination when seeking for these tumors.
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Although primitive plasma cells leukaemia is uncommon, it still stands in a particular place among malignant lymphoplasmocytary syndroms. It borrows from multiple myeloma and acute leukaemia some of its clinical and biological manifestations. Its course is quickly adverse, its treatment ineffective and the average life expectation is three months.
A case of spontaneous chronic lumbar epidural hematoma, in a 70-year-old woman is reported. The clinical, roentgenographic and anatomic findings of this case and of six others found in the available literature are studied. This clinical entity occurs in elderly and must be considered in the differential diagnosis of protruded disk syndromes.
An epidemiological study involving 616 subjects carried out in the Man region, Côte-d'Ivoire, showed endemic goitre in 54,4% of the group overall and in 80 % of females. Thyroid function of subjects chosen at random in the goitrous and nongoitrous group (105 G and 71 NG respectively) was identical. Compared with a French control group T4 was significantly lower but T3 and TSH were higher, which represents a high TBG level with low iodine elimination. High levels of TSH are not necessarily associated with low T3 or T4 levels, or with clinical signs of a hypothyroid condition. They are probably the result of a transient reaction. T4-TSH and T3-TSH correlations for NG subjects were (--0,40) but the T3-TSH correlation for the G subjects was significantly lower (--0,23). These differences could be explained by the simultaneous high levels of T3 and TSH more frequently encountered in G subjects and by the fact that serious hypothyroid conditions are more frequent in the NG group (6 out of 9). The percentage of hypothyroid conditions is high in both clinical and biological investigations. No anti-thyroglobulin antibodies were found in any of the hypothyroid cases with goitre. The histograms illustrate the clinical and biological heterogeneity of a homogeneous non-medicalised population.
Pathological and clinical features of the portal hypertension in schistosomiasis are reminded. The value of the para-clinical investigations (immunology, endoscopy, angiography and hemodynamic controls) is discussed. Medical treatment is limited to parasiticidal action but an attempt to prevent the formation of granulomas by use of antilymphocytic serum has been reported. The surgical intervention is aimed at suppressing the splenomegaly and decreasing the portal hypertension. The indications of the various techniques are discussed (splenectomy, spleno-renal anastosomis associated with splenectomy, vascular porto-caval anastomosis, omentopexy, triple arterial ligation).
With regard to its distribution the drepanocytic trait has a slight pathological incidence and does not appreciably alter the vital prospect. It is not, still, completely asymptomatic and may be, in special pathophysiological conditions, a morbidity and even lethality risk factor. Its connexions with various other diseases should be considered.
Glomerular lesion appears frequently in patients with S. mansoni or S. japonicum infection. This nephropathy may bring clinical changes and leads to severe evolution with letal risk. It may be induced or aggravated by the specific treatment but it has then, in most cases, a short duration and a good prognosis. Specific treatment fixed in order to reduce the amount of circulating antigens may be benefic. In some cases, on the contrary, the nephropathy is not reactive to any specific or symptomatic treatment and has an evolution of its own under the action of various factors; the most important is the hepatosplenic damage. Consequently glomerular function must be controlled in patients with schistosomiasis in order to fix the prognosis and the treatment.
Report of a case of biharzial myelitis appearing 6/8 weeks after bathing in an infected river. Recovery was complete after medical treatment with niridazol and hycanthone. The authors review the 47 detailed cases previously reported, selected among 60 cases observed from 1905 to 1963. They consider the clinical and pathological aspects and discuss the various pathogenic problems. Treatment requires specific antibilharzial compounds and anti-inflammatory drugs and, in compressive forms, sometimes surgery.