Biomedical subjects
Publications and source records attributed to P Cathebras.
The authors report a case of right ventricular insufficiency by constrictive pericarditis revealing aortic and retroperitoneal fibrosis. Only one similar case has been published. We discuss the etiology of this affection, the possible analogies with idiopathic systemic fibrosis and Takayasu's disease and the possible participation of thyroiditis disease and therapy (particularly propranolol).
We report a case of arthritis, hypercalcemia, and lytic bone lesions that occurred shortly after repeated administration of recombinant hepatitis B virus (HBV) vaccine in a 44-year-old man who had had myasthenia gravis 20 years earlier. He presented with ankle and knee arthritis and hypercalcemia. Radiographs revealed small lytic lesions and densitometry showed severe osteopenia. Quantimetric bone biopsy confirmed major bone loss and showed dramatic increase in bone turnover, as well as an unusual periosteal apposition of woven bone. Short term treatment with prednisone and furosemide and longterm treatment with clodronate allowed rapid improvement. After one year, the patient remains clinically asymptomatic. Despite negative immunologic investigations to sustain the hypothesis of HBV vaccination as a causal factor, we believe the bone lesions could be attributed to unusual bone "hyperremodeling" triggered by an immune process in a predisposed individual.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A first level of immateriality of the human body is very classic for anthropologists: it concerns the different conceptions of soul, of a supernatural component of the human being. It refers also to different kinds of continuity and exchange between the human body and society. The other immateriality appears as an answer to the biological reductionism of the body. As we can see in biomedical conception of the body, as well as in different totalitarian utopias, biological reductionism tends to reduce the whole person to its biological body. Consciously or unconsciously, people cannot accept it. Contemporary ways of healing reflect this contradiction: people accept biological knowledge but they do not accept a purely biological conception of their own body. They conceive that there is an immaterial part in the human body; however it is not supernatural but a part of nature. In this way this 'not divine immateriality' can be conciliated with some kind of scientific approach. The refusal to enclose the person in the biological body appears as a constant through human societies. At the medical level, this refusal is always present in the ill person's image of his body and of his illness. At a more general level, this refusal is probably necessary in order to keep human freedom as well as human specificity.
The authors report 11 cases of multiple autoimmune syndromes. Autoimmune thyroid disorders and Sjogren's syndrome seem to be non-randomly associated and might share a genetic predisposition linked to HLA phenotype B8 DR3 and B12 DR4.
The authors report three cases of syncope due to systemic mastocytosis. This is a rare cause of syncope but should be recalled in certain circumstances. In the light of these cases, the authors review the literature with respect to this unusual presentation. Syncope may occur at any age. Loss of consciousness may be more or less complete, brief or prolonged, isolated or recurrent and usually accompanied by prodromal symptoms. The least controversial physiopathogenic mechanism of these syncopes is intense vasoplegia induced by the release of vasoactive mediators, especially histamine. When there is a clinical suspicion of mastocytosis, even in the absence of skin changes, the diagnosis is confirmed by biopsy which shows abnormally high numbers of mastocytes irrespective of the organ biopsied. The treatment of acute forms with collapse is based on intravenous infusion of macromolecular fluids and injections of epinephrine. Prevention is by drugs which inhibit the synthesis of histamine, the degranulation of mastocytes and the production of prostaglandin D2.
Two new cases of eosinophilic ascites and a brief review of 40 cases found in the literature are presented. In three quarters of the cases eosinophilic ascites affects women aged 40 years on average. Because the patients present with a history of allergy (55%), blood hypereosinophilia (69%), associated pleural effusion (11%), gastrointestinal disorders and, above all, eosinophilic infiltrations in the walls of the digestive tract or the serous membranes (63%), this pathology may be regarded as a clinical form or eosinophilic gastroenteritis. The outcome is favourable in 90% of the cases; relapses occur in 26%. Is eosinophilic gastroenteritis and independent pathological entity, or should it be considered a minor clinical form of Chusid's idiopathic hypereosinophilic syndrome? The lack of decisive arguments precludes a firm conclusion.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In order to determine the proportion of tuberculosis (TB) patients in Bangui (Central African Republic) infected with human immunodeficiency virus (HIV), we collected prospectively serum samples from all new TB patients seen at the University Hospital in Bangui during a three-month period (nov. 87-Jan. 88). 220 serum samples were tested for antibodies to HIV, by an Elisa assay and confirmed by Western-Blot. The general HIV seropositivity rate among TB patients was 27.7% (31.2% in adults (N = 183), and 10.8% in children (N = 37)). Within the adult population, there was non association between HIV infection and sex or previous history of TB. Seropositivity was more common in patients with extrapulmonary TB, especially lymphadenitis, and in patients with mediastinal adenopathy, or extensive pulmonary involvement without cavitation. Seropositivity was also strongly associated with negative tuberculin skin tests, chronic diarrhoea, generalized lymphadenopathy, and thrush. It is concluded that HIV infection is responsible for the increasing incidence of tuberculosis in Central African Republic, and that investigations for TB should be carried out in every symptomatic African patient infected with HIV.