Biomedical subjects

P Kaeser

Publications and source records attributed to P Kaeser.

8 recordsLinked to original sources

PubMed1995

[Horton's disease: ophthalmological and neurological complication].

We report the case of a 74-year-old women admitted to the hospital because of rapidly developing diplopia. The admission anamnesis revealed fronto-temporal headaches and pain in the maxilla for three days. A cerebral cT scan was normal, and a corticosteroid therapy was initiated. Diagnosis of Horton's syndrome was confirmed by the good response to treatment and by biopsy of the temporal artery. Different ocular and neurologic complications of Horton's disease, their clinical appearances and therapeutic measures are discussed by the authors.

Acute Disease↗

PubMed1995

[Anaphylactic shock].

Anaphylactic shock is an unexpected, sudden and sometimes deadly event that attacks the patient in 75% of the cases without pre-existent history of allergy. In general, drugs, hymenopteric poisons and nutrients (according to the recent concept) are responsible. Beside the classical IgE-mediated anaphylactic shock there exists another anaphylactic shock, identical in its clinical picture and treatment but not in the mechanism of development. Epinephrine is the only effective drug in case of respiratory (bronchial asthma, laryngeal edema) or cardiovascular (hypotension, arrhythmias, hypovolemic shock) manifestation. It has to be administered as rapidly as possible.

Anaphylaxis↗

PubMed1995

[Nontraumatic coma in extramural practice].

After a short review on pathophysiologic mechanisms of comatose states and their complications, a cohort of 392 comatose patients (Glasgow Coma Scale < or = 8) hospitalized in intensive care is analyzed in order to estimate the relative frequency of the different causes of nontraumatic coma. Depending on pathology, the following practical, sequential procedure is recommended: at first, identification and treatment of disorders of vital functions, objective estimate of the severity of the coma and rapid diagnostic orientation with a targeted neurologic investigation; then, simple therapeutic interventions in order to treat reversible causes of a metabolic encephalopathy as well as immediate measures for neuroprotection (anticonvulsive and antihypotensive therapy, oxygen, etc.). An initial, adequate control of the comatose patient is mandatory in order to limit disabling cerebral complications.

Brain Diseases, Metabolic↗

PubMed1994

Prevalence of IgE antibodies specific for food allergens in patients with chronic urticaria of unexplained etiology.

We investigated whether some cases of chronic urticaria of unexplained cause might be related to food allergy which had remained undetected during routine examination. This investigation was undertaken as the consequence of the availability of a new in vitro assay for specific IgE with increased sensitivity. The following three groups of subjects were studied: 1) a control group of 60 nonatopic subjects, 2) 60 patients with allergy to perennial aeroallergens without skin involvement, and 3) 60 patients suffering from chronic urticaria with no evidence of any triggering factor despite careful clinical investigation. Specific IgE against 19 food allergens frequently involved in urticaria were investigated in all subjects with the new CAP System (Pharmacia). Positive results (CAP > 0.70 kU/l) for one or more food allergens were found in none of the nonatopic controls, in six of the subjects with respiratory allergy, and in 16 of the urticaria patients. The use of an in vitro test with an increased sensitivity allowed us to detect a significant prevalence of IgE specific for food allergens in patients with chronic urticaria of unknown origin. This suggests that, in several of those patients, chronic urticaria might be triggered by a food allergy undetected by the usual methods.

Adolescent↗

PubMed1993

[Secondary polycythemias: the role of erythropoietin].

The discovery of high hemoglobin and hematocrit values in a patient necessitates the determination of the red blood cell mass in order to confirm the absolute character of the polycythemia. If a true polycythemia is confirmed, its etiology must then be established. The diagnostic approach of polycythemia is presented in this paper. It is illustrated by a case presentation in which a polycythemia secondary to a renal carcinoma is discussed. Erythrocytosis is a classical, albeit rare manifestation of this type of tumor, and has the advantage of allowing early detection. Thus, it permits a prompt treatment plan, thereby improving the prognosis of such a neoplasia. The usefulness of a serum level of erythropoietin (EPO) is subsequently discussed. The diagnostic value of EPO remains controversial because of the overlapping values recorded amongst healthy patients, patients with polycythemia vera and others with secondary polycythemia. Finally, we discuss the presence of substances in paraneoplastic polycythemias whose biological activity is close to that of EPO. However, this molecules of a different structure would not be detected by the radioimmunoassay used to measure erythropoietin level.

Algorithms↗

PubMed1993

[Neurological manifestations of Lyme disease].

Lyme's disease, transmitted by Borrelia Burgdorferi (BB), is a polymorphic and multisystemic illness. Its neurological manifestations are encountered in 10-50% of cases and occur in the acute disseminated stage as well as in the late stage. This article initially reviews the principal clinical pictures of the neuroborreliosis and distinguishes them from neurological disorders whose association with BB infection is not proven. The paper then discusses the relative usefulness of the different ancillary tests in the diagnostic workup. We hope to stimulate interest in the research of intrathecal specific antibody production (especially in the early central nervous system diseases), instead of measuring levels of anti-BB antibodies in the serum and in the cerebrospinal fluid. Finally, a treatment plan is proposed, whose efficiency constitutes another argument in favor of the correct diagnosis but whose failure may reflect a diagnostic error.

Aged↗

PubMed1993

[Chronic urticaria: evaluation and long-term follow-up].

Two major difficulties occur as soon as one is confronted to a patient suffering from chronic urticaria: the determination of an etiology that might be amenable to treatment and the establishment of an efficient treatment and satisfying follow-up for the patient. After having reviewed the different possible etiologies of chronic urticaria, this paper attempts to propose a logical diagnostic approach for the primary care physician. This will allow him to identify the etiologies that are the most common and responsive to a specific treatment and then to detail the modalities of this treatment.

Chronic Disease↗

PubMed1993

[Polyglandular autoimmune syndrome].

Polyglandular autoimmune syndrome (PGA's) are defined as the coexistence of one or several primary endocrine gland autoimmune insufficiencies, possibly associated with other immunological pathologies. We present the case of a female patient suffering from a primary thyroid failure associated with Biermer anemia and hypophysitis with secondary adrenal insufficiency. We then describe the PGA's, focusing on their interest to the pediatrician, internist, and primary case physician. The three types of polyglandular syndromes, types I and II with adrenal insufficiency, and type III without it, are discussed. (Classification of Neufeld et al.).

Female↗