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P Rapoport

Publications and source records attributed to P Rapoport.

11 recordsLinked to original sources
PubMed1998

Ischemic choroidopathy in primary Sjögren's syndrome.

PURPOSE: The authors describe a 68-year-old woman in whom ischemic choroidopathy and optic neuropathy developed in association with primary Sjögren's syndrome with central nervous system involvement. METHODS: Diagnosis of primary Sjögren's syndrome was made upon the association of keratoconjunctivitis sicca, minor salivary gland biopsy and serologic abnormalities. Fluorescein angiography showed signs highly suggestive of ischemic choroidopathy. The authors discuss differential diagnosis and pathophysiology of such choroidal manifestations. Treatment consisted in massive steroid therapy. Secondarily, an immunosuppressant agent (azathioprine) was successfully added because of neurological recurrences. CONCLUSION: Primary Sjögren's syndrome should be considered in the differential diagnosis of ischemic choroidopathy.

Aged↗
PubMed1998

[Juvenile glaucoma. Seven case reports].

BACKGROUND: Juvenile glaucoma is an uncommon form of chronic open angle glaucoma that appears between 3 and 35 years of age. METHODS: We report in this study seven cases of juvenile glaucoma that occurred in patients melanoderma. RESULTS: Three of them had unilateral blindness and in two others visual acuity was reduced to light perception in one eye. The intraocular pressure is above to 30 mmHg in 64.3% of the cases and a myopia was frequently associated. CONCLUSION: The insidious development of this pathology and the difficulty of its diagnosis among children often result in severe clinical manifestations with high visual field defects and optic disc cuppings particularly in melanoderma patients. Recent studies have proved autosomal dominant transmission with variable penetrance for one kind of juvenile glaucoma and location of the defective gene on chromosome 1q.

Adolescent↗
PubMed1998

[Benign intracranial hypertension. Retrospective study of 20 cases].

PURPOSE: We conducted a retrospective study in 20 cases of idiopathic intracranial hypertension (IIH) referred to the ophthalmology out-patients department at the Centre Hospitalier Universitaire of Fort de France. The objectives were to characterize symptomatology, severity, disease course and to discuss treatment. METHODS: We performed a complete ophthalmological and neurological examination, calculated the body mass index (BMI) and evaluated visual field. Each patient underwent a CT scan with injection and a lumbar punction with measurement of cerebrospinal fluid pressure. We also specified the treatment chosen and its duration, and the number of recurrences. RESULTS: This study included 20 cases, 19 women and 1 man, with a mean follow-up of 28.6 months. The average BMI was of 32.2 kg/m2. Fifteen patients out of 20 were obese (75%), all of them women, so 79% of the women were obese. Sixteen patients had headache (80%), 15 a loss of visual acuity (75%) and 5 transient visual loss (25%). For all the clinical examination showed bilateral papilloedema. Visual field disturbances were observed in 11 patients (73.3%). Papilloedema disappeared after medical treatment of a mean 2.4 months duration for each access. In 9 cases of 18 (50%) recurrences were observed after gradual treatment with-drawal. CONCLUSION: The long-term treatment, the side effects, the possible severity of the ocular disease, the difficulties of dietary restriction and the high rate of recurrence, would, for us, indicate a need to reconsider surgical treatment. We propose to perform lumboperitoneal shunt or optic nerve sheath decompression if medical treatment fails at the first onset of IIH or in case of severe visual loss, pregnancy or recurrence.

Adult↗
PubMed1997

[Bilateral optic neuropathy disclosing primary Gougerot-Sjögren syndrome].

A case of optic neuropathy and central nervous system disease developed in association with primary Sjögren's syndrome is described. Initial visual loss was partially reversible with intra veinous steroid therapy but four months later she underwent a controlateral visual loss and showed for the first time clinical manifestation of sicca syndrome. Fluorescein angiography showed signs of ischemic choroidopathy. Laboratory studies and histological findings on minor salivary gland biopsy was suggestive of primary Sjögren's syndrome. Attempts to taper oral steroid therapy resulted in worsening neurological disease and immunosuppressive therapy by azathioprine was successfully added to her regimen. Because of therapeutics and prognosis consequences, primary Sjögren's syndrome should be considered in differential diagnosis of optic neuropathy.

Aged↗
PubMed1993

Diagnostic and prognostic value of coronary arteriography.

Coronarography can be used as a diagnostic test when the clinical evaluation and the non-invasive test are inconclusive, although some conceptual problems remain. In known ischemic heart disease, the estimation of the prognosis is an important factor for the treatment decision, but coronary arteriography does not give a clear picture, and apart from the most severely ill patient, the prognosis usually remains very difficult to evaluate.

Coronary Angiography↗
PubMed1991

[Implantable automatic defibrillator. Evaluation after 8 years of use].

The thirty nine patients (30 men and 9 women, mean age 49 +/- 14 years) who were implanted with an automatic cardioverter defibrillator (AICD) between October 1982 and April 1990 were reviewed retrospectively. This group included 22 patients with ischaemic cardiomyopathy (55%), 9 primary cardiomyopathies (23%) 5 ventricular tachycardias in patients with normal hearts (13%), 1 case of arrhythmogenic right ventricular dysplasia and two of mitral valve prolapse. The mean ejection fraction for the whole group was 38 +/- 14%. The indication for implantation of the AICD was life-threatening ventricular arrhythmias for which other forms of treatment were either ineffective (29 patients), impossible to assess (9 patients) or poorly tolerated (1 patient). Two patients died during the perioperative period and the follow-up is too short in two other cases. Therefore, 35 patients were studied over an average of 23.7 +/- 16 months. During follow-up, 5 patients died, 3 of progressive cardiac failure and 2 suddenly, one of whom was waiting for a replacement of an exhausted generator. The AICD never functioned in 40% of patients. In addition, it was impossible to determine for the majority of shocks delivered if they had been triggered by a sustained ventricular arrhythmia. Long term tolerance was generally good but two patients developed cardiac constriction induced by the epicardial patch electrodes. The results of this review confirm the efficacy of AICD in preventing sudden death at the expense of a low operative mortality and with good long term tolerance. Quite a large proportion of AICDs never functioned and the interpretation of the delivered shocks remains questionable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Auricular flutter disclosing cardiac tumor].

It is unusual that an atrial flutter reveals a tumor of the atrium. Two cases are reported: one occurred in a patient with a myxoma of the left atrium, the other was found in a patient with a non-hodgkinian lymphoma of the right atrium. The diagnosis was made possible by sonocardiography in both cases. The transesophageal view improves the quality of the images. MRI provided further informations regarding the lymphoma. Modern techniques of cardiac imaging permit the early diagnosis and treatment of cardiac tumors which must be investigated in case of apparently isolated atrial arrhythmias.

Atrial Flutter↗
PubMedDate not supplied

[Isolated ocular melanosis. Apropos of a case].

A case of an eighteen month child with ocular melanocytosis is reported. The authors describe clinicopathological features of the affection. Ocular melanocytosis is a neural crest disorder more frequently found in pigmented populations. Differential diagnosis are naevus of Ota, blue sclera disease and scleritis. The risk of malignant degeneration especially in caucasian people explain that patient should be followed-up at regular intervals.

Black People↗