[Bran and stools in the tropics].
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Biomedical subjects
Publications and source records attributed to P Capdevielle.
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Owren's disease is a rare hemorrhagic diathesis which can occur in infancy as a severe hemorrhagic disorder. It also appears in adult life when clinical manifestations are those of acquired deficiencies of other coagulation factors. A familial survey enables a definite diagnosis to be made as it demonstrates the presence of deficiency in factor V in one or several members of the family. Such a case is reported in a young adult with an associated intestinal malabsorption syndrome due to lambliasis. After administration of vitamin K the deficiency in factor V remained an isolated disorder, and the hemostatic anomaly was found in three other members of the family. The deficiency was a partial one, which explains why the Owren's disease only became evident during the course of the malabsorption syndrome due to lambliasis which caused a reduction in the level of vitamin K dependent factors II, VII, and X.
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The authors study the serological distribution of 143 strains of Pseudomonas aeruginosa isolated in hospital Grall (Saigon-Vietnam) according to the country (South Vietnam), the kind of pathological specimens and the various departments of the hospial. They describe a special distribution of serological groups in Vietnam with a large predominance of groups 0 = 6 and 0 = 11. They consider the possibility of adapting a polyvalent vaccine including the 10 serological groups now prevailing in Vietnam.
The authors report the observation of a 23 years old man, who presented an urinary schistosomiasis (S. haematobium) and an intestinal schistosomiasis (S. mansoni). Important abdominal pains, and an enormous splenomegaly compressing stomach and colon, lead to a laparoscopy, which gave evidence of a big liquid cyst of the spleen. Its exeresis brought recovery.
Peritonel tuberculosis is quite frequent overseas and specially in Africa; as an example, it is about 0,5 p. 100 of the admittances and 13 p. 100 of the total number of tuberculous cases recorded in Dakar and Djibouti, over a period of four years. First symptoms are not caracteristic but rapidly one may observe either ascitic or non-ascitic forms, with eventually pseudo-tumoral or adhesive aspect. Diagnostic criteria are reviewed as well as the therapeutic rules and results.
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This survey has been conducted among blood donors and patients with hepatitis, cirrhosis, liver carcinomas and various causes of liver dysfunction or enlargement. The frequency is 5,4 p. 100 among blood donors and 50 p. 100 among cases of hepatitis.
Report of 11 cases of rheumatoid arthritis observed in Malagasy. Frequently, a single joint is concerned at the on-set period and this may raise some questions to differetiate rheumatic fever, gout and osteo-articular tuberculosis, as these three diseases are of high and almost equivalent frequency in the country. Clinical, biological and radiological features are the same as observed in Europe. Evolution is often severe as a consequence of requently delayed diagnosis and difficulties encountered in treatment of out-patients.
Report of a typical case of cerebral malaria with coma during 3 days, pneumopathy and renal insufficiency with failure of concentration. The delivery of a dead foetus has been started by prostaglandines.
Diagnosis of jaundices in tropical medicine complies with the same rules as in Europe. Some etiologies occur more frequently than in Europe; others, specific to tropical areas require peculiar investigations. Most jaundices observed overseas are hemolytic or hepatitic. Their diagnosis is generally easy. However, chronic viral hepatitis, a frequent infection, requires liver needle-biopsy for a valid diagnosis. The diagnosis of cholestatic jaundice must be conducted in a systematic fashion: if abdominal echotomography is not available, laparoscopy with or without liver needle-biopsy and percutaneous lateral transhepatic cholangiography (OKU-DA's technique) are easily performed in tropical countries and give a certain diagnosis.
Extra pulmonary tuberculosis are frequent in Africa and have a special severity due to delayed diagnosis and multifocal forms. Various punctures and biopsies may be necessary to demonstate the tuberculous infection. Even with modern treatment it too often implies important risks of severe sequelae.
This survey has been conducted among blood donors and patients with hepatitis, cirrhosis, liver carcinomas and various causes of liver dysfunction or enlargement. The frequency is 5,4 p. 100 among blood donors and 50 p. 100 among cases of hepatitis.
A clinical and biological study of 200 cases in Tananarive. The conventional clinical form is still frequent because patients have no immunity and report too late to the hospital. The main complications concern the heart and the digestive tract. Hemoculture is the main clue for the diagnosis. Biochemical and specially enzymatic unconventional data whichs have been recently reported are frequently observed. No resistance to chloramphenicol has yet been detected in Tananarive.
Reviewing 67 cases of human adult shigellosis observed in Madagascar, the authors emphasize some epidemiologic and clinic features : high frequency during rainy season, usual dysenteriform aspect or diarrhoeas with fever, hemorragic forms, severity according to anterior state of colon and rectum, severity if cases associated with amoebiasis or schistosomiasis (Schistosoma mansoni).