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O Decaux

Publications and source records attributed to O Decaux.

12 recordsLinked to original sources

[Thoracic infectious aortitis: microbiology, pathophysiology and treatment].

BACKGROUND: Thoracic infectious aortitis are currently rare. They are always lethal without any treatment. The microorganisms involved are numerous with particular pathophysiological characteristics for each bacterium. Treatment is difficult and must associate medical and surgical care. RECENT FINDINGS: Bacterial epidemiology of infectious aortitis has been profoundly modified with the large use of antibiotics. Syphilitic aortitis were frequent in the beginning of the twentieth century but its incidence has dramatically fallen. It still exists and its clinical presentation must be known to begin an adequate treatment. Other bacterial aetiologies of these aortitis are more classical with high frequencies of Staphylococcus aureus and Streptococcus, which are often associated with infective endocarditis. Among Gram-negative bacteria, Salmonella spp are the most frequently met microorganisms. Atherosclerosis represents the principal risk factor of these infectious aortitis. It provokes arterial parietal damage useful for bacterial attach. A saccular aneurysm of infective origin can then appear. Treatment must consist on antibiotics before surgery; Tuberculous aortitis are also possible but are much more rare. CONCLUSION: Thoracic infectious aortitis are very rare but must be known because of their poor prognosis. Treatment is difficult and prevention of atherosclerosis which is the most important risk factor of these diseases is therefore of greatest importance.

Anti-Infective Agents↗

[Diffusion weighted MRI of spine tumors].

PURPOSE: To evaluate the contribution of diffusion weighted MR imaging in malignant spine pathology. Materials and methods. Between February 2004 and January 2005, 49 patients (43 to 86 years old) were included. Three groups were made: osteoporotic collapses (n = 13), malignant collapses (n = 15) and malignant spine lesions (n = 21). The MRI (Symphony 1.5T) allowed SENSE imaging. After conventional MRI examination (T1, T2 fat sat, T1 with Gadolinium), all patients underwent diffusion weighted imaging (Spin Echo) with variable b values: 0, 250, 500, 750 and 1000. The diffusion sequence lasted 2 min 29 s. The Apparent Diffusion Coefficient (ADC) was calculated automatically. The analysis was qualitative (signal study b = 1,000 mm2/s) and quantitative (ADC measurement). RESULTS: The image quality was good except for some cervical examinations. Qualitative analysis did not show a difference between benign and malignant lesions. Quantitative results are: malignant spine lesion (mean ADC = 0.826 10-3 s/mm2), malignant spinal collapses (mean ADC = 0.912 10-3 s/mm2) and benign spinal collapses (mean ADC = 1.497 10-3 s/mm2). There was overlapping results between benign and malignant lesion. The statistical study showed a significant difference (t test with p < 1/10 000). For an ADC threshold value of 1.089 (malignant lesion ADC < 1.089), ROC curve showed a specificity = 80% and a sensitivity = 83.3%. CONCLUSION: Performing diffusion weighted imaging of the spine is easy with new MR technology. The ADC measurement of spine lesion provides important additional information, but does not serve as a substitute for the routine MRI sequences. In the future, it could become an important point in this difficult diagnosis.

Adult↗

[Cryptococcal infections in non-HIV infected patients. Study of four cases and review of literature].

BACKGROUND: Cryptococcal infections are frequent in HIV-infected patients and are regularly looked after. This infection may occur in others immunosuppressives situations and, in those cases, diagnosis is often delayed. METHODS: We report four cases of cryptococcal infections in patients whose immunosuppression isn't related with HIV infection but due to chronic lymphocytic leukemia, giant cell temporal arteritis, gastric neoplasm and lupus. Diagnosis, prognostic and treatment are detailed. RESULTS: Four patients aged from 25 to 76 presented a cryptococcal infection (three meningitis). A woman died at the admission. Another died seven years later. The two others are still alive under treatment. When infected, all patients were immunodeficiency. CONCLUSION: Cryptococcal infection may occur in patients non-HIV-infected patients. Early detection is needed to improve prognostic.

Adult↗

[Syphilitic aortitis. Experience of an internal medicine unit].

INTRODUCTION: Infectious aortitis remains a rare disease. It is characterized by an endarteritis of infectious origin generally followed by the development of a so called mycotic aneurysm. Those infectious aneurysms account for 0.5 to 1.3% of all aortic aneurysms. Of the infectious agents, Treponema pallidum has a particular place. Cardiovascular syphilitic infection was very common at the beginning of the XX(th) century with a prevalence of 6.9% of all autopsies. In 1950-1960, the prevalence had decreased to less than 1%. Since 1990, syphilis was considered as disappeared. EXEGESIS: we report syphilitic aortitis in four patients. Diagnosis, treatment, and prognosis are detailed. CONCLUSION: A syphilitic infection of the aorta should be looked for in every patient suffering from an inflammatory or infectious disease of aorta.

Adult↗

[Digital flow exploration by color Doppler ultrasound in patients with Raynaud's disease or systemic sclerosis].

BACKGROUND: Raynaud's phenomenon (RP) is a frequent vascular paroxysmal syndrome of the extremities. Generally benign, the condition is called Raynaud's disease (RD), which may reveal a connective tIssue disease, particularly systemic sclerosis (SS). We evaluated digital blood flow in patients with RD and SS using color Doppler ultrasound. PATIENTS AND METHODS: Ultrasound examination was performed with a newly developed multi-D linear array transducer (VFX 13-5 Siemens), which allows better resolution. We first measured the diameters of the digital arteries (appendix 1) then epidermal, dermal, and hypodermal thickness for each patient (appendix 3) and performed a qualitative and quantitative analysis of pulpar microcirculation (appendix 4 & 5). All measures were made at 25 degrees C, 45 degrees C, 11 degrees C and after recovery. Thirty-three patients were included: 14 with primary RD and 19 with SS as assessed by American College of Rheumatology criteria. RESULTS: The diameters of the digital arteries showed significant discrepancies allowed to distinguish primary RP from SS. At 11 degrees C, diameters were 0.6 +/- 0.2 mm for primary RP versus 0.2 +/- 0.3 mm for SS on lateral digital arteries (LDA) [p=0.005]; 0.7 +/- 0.2 mm for primary RP versus 0.4 +/- 0.3 mm for SS on medial digital arteries (MDA) [p=0.004]. After recovery, these diameters were respectively 1 +/- 0.2 mm versus 0.5 +/- 0.4 mm for LDA [p=0.000] and 1 +/- 0.2 mm versus 0.6 +/- 0.3 mm for MDA [p=0.000] (tables 1, 2, 3, 4). Similarly, pulpar vascularization was significantly higher in primary RP than in SS (tables 6, 7, 8). No difference was found in skin thickness nor in the epidermal aspect between the two groups (table 5). CONCLUSION: Color Doppler ultrasound shows morphological and dynamic differences between RD and SS.

Adult↗

[Periodic paralysis discovered in a 65-year-old woman: one case report].

INTRODUCTION: Familial hypokalemic periodic paralysis (FHPP) is an autosomal dominant disorder which usually begins before thirty years. EXEGESIS: We report a case of FHPP occurring in a 65-year-old woman whereas two members of her family have symptoms since childhood. Differential diagnosis are discussed. CONCLUSION: FHPP must be one of the differential diagnoses in front of an hypokalemic paralysis attack, even in the elderly.

Age Factors↗

[Epidemiologic description of amyloidosis diagnosed at the University Hospital of Rennes from 1995 to 1999].

INTRODUCTION: The frequency of amyloidosis is not well known in France. We compiled a register of amyloidosis diagnosed from 1995 to 1999 in the University Hospital of Rennes. PATIENTS AND METHODS: This retrospective study was performed between 01 January 1995 and 31 december 1999. Diagnosis was assessed on positivity of red Congo by anatomopathology. Immunohistochemistry allowed the definition the type of amyloidosis. Clinical data, staging and outcome of patients were analysed. RESULTS: Forty-three amyloidosis were diagnosed (27 women, 16 men) with an incidence of 8,6 new cases per year. Mean age was 63.7 years. Five diagnosis were realised in 1995, six in 1996, six in 1997, 12 in 1998, 14 in 1999. Twenty amyloidosis were AL type (46.5%), seven AA (16.3%), 1 beta2 microglobulin type, 15 (35%) remained of undetermined type. Thirty-three amyloidosis (77%) were systemic, 10 were localized to one organ (23%). When diagnosis was made, biopsies concerned affected organs in 86% of the cases, accessory sites (labial salivary glands, bone marrow) in only 14% of the cases. Twenty-five patients died (58%). Two deaths were treatment-related, 16 to amyloidois, seven patients died of another complaint. CONCLUSION: Increased incidence of amyloidosis needs to be confirmed. We emphasize the importance of immunohistochemical typing on frozen samples, the value of accessory biopsies and the need for complete extension staging.

Adult↗

Hyperferritinemia revealing Gaucher's disease.

Hyperferritinemia is frequently observed during Gaucher's disease but has never been described as an initial manifestation. We report the case of a 57-year-old woman without a previous medical history who presented with hyperferritinemia and IgG monoclonal gammopathy. The diagnostic procedure was negative except for the bone marrow biopsy, which revealed Gaucher's cells. Low beta-glucocerebrosidase activity in leukocytes confirmed the diagnosis of adult Gaucher's disease. We discuss the differential diagnosis and the mechanisms of hyperferritinemia in this disease.

Journal Article↗

[Follow-up of monoclonal gammopathy of undetermined significance in a population of 51 patients older than 70 years ].

UNLABELLED: Monoclonal gammopathy of undetermined significance (MGUS) are very frequent in the elderly. Its incidence is about 3% after 70 years. We have performed a retrospective study of patients aged of more than 70 years who were examined until 1995 for a MGUS. METHODS: The study included 51 patients: 24 men and 27 women. Information about evolution was obtained by medical file or by asking medical practitioner. We know the evolution of all patients until January 1st 2000. The median follow-up is 5.8 years (70 months). RESULTS: The MGUS remained stable for 34 patients (67%) with a median follow-up of 83 months (12 to 180 months). Nine patients (17%) developed malignant transformation of MGUS (6 multiple myeloma, 2 Waldenström macroglobulinemia, 1 malignant lymphoma). Eight (15%) developed a cancer. Twelve died without evidence of multiple myeloma or related disorder. The actuarial probability of malignant transformation at 5 years was 12%. CONCLUSION: The risk of malignant transformation of MGUS doesn't decrease in the elderly. A regular and prolonged follow-up is necessary.

Aged↗

[Nonsurgical treatment of chronic subdural hematoma with steroids: two case reports].

INTRODUCTION: Hemorrhages beneath the dura define a subdural hematoma. EXEGESIS: The course of chronic subdural hematoma may be asymptomatic for many months before diagnosis. Recovery is observed in 80% of patients after surgery. We report two cases of chronic subdural hematoma successfully treated with steroids. CONCLUSION: Steroids can be an alternative treatment of subdural hematoma, specially in elderly or alcoholic patients.

Anti-Inflammatory Agents↗