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Biomedical subjects

R Pieron

Publications and source records attributed to R Pieron.

At least 19 recordsLinked to original sources

[Bronchiolo-alveolar carcinoma complicating systemic scleroderma under long-term treatment with factor XIII].

A 52-year old woman with systemic scleroderma had been treated since 1978 with factor XIII. The skin lesions had improved, and respiratory lesions had become stabilized. In 1984, she developed a bronchiolo-alveolar carcinoma which was treated by surgery. The authors emphasize that factor XIII is well tolerated and has beneficial effects on the skin and probably also on the lungs, without tachyphylaxis; however, the possibility of a bronchioloalveolar carcinoma occurring cannot be ruled out.

Adenocarcinoma, Bronchiolo-Alveolar↗

[Comparative study of the human basophil degranulation test and total and specific IgE levels in schistosomiasis. 54 cases].

In 54 patients (45 Africans and 9 West-Indians) we searched schistosomiasis and the presence of immunoglobulins E by different tests (total immunoglobulin E levels, measurement of specific IgE, human basophil degranulation test). In patients with an excretion of living eggs we observed 91.6% of positive responses for the II. B. D. T. and 100% for the specific IgE. In cases only identified by examination of rectal mucosa biopsy specimens showing apparently living eggs, we observed 75% and 87.5% of positive responses for the same tests. But in both categories of patients, the parasitological examination is the most important. Moreover the authors observed "false-positive" and "false negative" tests compared with the parasitological results and between the tests. It suggests that the best use of these is in case of very probable schistosomiasis without positive parasitological results.

Africa↗

[Serodiagnosis of Yersinia infections in cirrhotic patients. Study apropos of 73 patients].

It is well-known that cirrhosis is a predisposing factor to Yersinia septicemia. This study includes 73 cirrhotics and shows a high number of positive serologic tests (47/73 : 64.4%). However, there is no correlation with clinical features or bacteriological findings. The most frequent serotypes, i.e. pseudotuberculosis IV and enterocolitica 0:9, differ from those which are usually found in Yersinia septicemias. Iron overload in cirrhosis, increased intestinal load of gram-negative bacilli and possible latent bacteremia may partly explain these results. However, the role probably played by as yet poorly known cross-reactions between Yersinia and other pathogens (Shigella, E. Coli...) must be underscored. The authors conclude that slightly positive, stable, serodiagnostic tests have little meaning in cirrhotics.

Humans↗

[Hepatic granulomatosis and positive serodiagnosis of Yersinia infections].

Four cases of hepatic granulomatosis with positive Yersinia serologic tests are reported. In one case, the Wright serodiagnostic tests were also positive. In the three other cases, no other likely etiology was demonstrated. The authors recall the main causes of hepatic granulomatosis, diagnostic criteria of Yersiniosis infections, and the possible occurrence of simultaneous positive serodiagnostic tests for Yersinia enterocolitica type 9 and Brucella abortus.

Adult↗

[Fiessinger-Leroy-Reiter's syndrome : serological conversion for Yersinia enterocolitica type 9, positive serodiagnosis for Shigella flexneri and Chlamydia].

A case of Reiter disease in a HLA B27 positive man with urethritis followed by polyarthritis is reported. During the disease, serologic conversion for Yersinia enterocolitica type 9 was detected as well as positive serologic tests for Shigella flexneri and Chlamydia. The features of reactive arthritis related to Yersinia and the etiologies of Reiter disease are recalled.

Arthritis, Reactive↗

[Therapeutic and economic aspects of dracunculosis in a Parisian hospital].

We studied 18 cases of dracunculosis treated in our department of Internal Medicine in Paris. The mean duration of the hospital stay is 38 days (15 to 90). The cost of this stay, calculated on the basis of the daily charge, accounts for 93.3 % of the total cost. The longest stays are due to serious subcutaneous infections at the site of the worm and to multiple or complex associated diseases. Average charge for laboratory test, roentgenograms or other investigations amounts to 4.4 % of the cost of the hospital stay. A significant part of these investigations is warranted by cellulitis and the diagnosis of associated conditions. Antibodies prescribed for subcutaneous infections account for almost all of the drug expense (2.3 % of the total cost). Thus, investigations and treatment together amount to only 6.7 % of the daily charge. Traditional treatment of dracunculosis is based on manual extraction of the worm. Thiabendazole was added in 12 of the 18 patients. The average duration of hospitalization (34 days) and average charge for investigations and drug treatment (FF 611) were less in these 12 patients than in the 6 others (47 days, FF 1286). However, this result is to be considered with caution as the number of patients in each group is small, treatments were assigned without any statistical rule, subcutaneous infections were more or less serious and associated diseases may have had a bearing on results.

Adult↗

[Hepatopathies associated with chronic carriage of HBs antigen in black African immigrants in France].

The authors report two studies : 1) Retrospective : study of liver biopsies in 44 Africans : 22 were HBs Ag positive and 22 HBs Ag negative ; 10 of the HBs Ag positive subjects were found to have chronic persistent hepatitis (CPH), 4 chronic active hepatitis (CAH) and 3 cirrhosis ; 2 of the HBs Ag negative subjects were found to have CPH and 3 CAH ; as far a biological findings are concerned, only the CAH and cirrhosis groups differed from the control group, with higher prothrombin times, transaminase levels and gammaglobulin levels. 2) Prospective : study of the incidence of HBs Ag carriage in 168 Africans ; 17.8 % of them were found to be carriers ; no correlation was found between HBs Ag carriage and S. haematobium schistosomiasis or hemoglobinopathies.

Adult↗

[Gram-negative septicemia and bacteremia in an internal medicine department].

Among 31 patients with positive blood cultures for gram-negative bacilli seen in a department of internal medicine, 13 had at least 3 positive blood cultures from samples taken over more than 12 hours and were diagnosed as having septicemia (group I) ; 18 patients had less than three positive blood cultures over the same period or had several positive blood cultures over a shorter period and were diagnosed as having bacteremia (group II). There were no significant differences between these two groups concerning age, sex, fever, other clinical features, or biological findings. E. coli was recovered in 70 % of cases and was almost always related to urinary infection. 8 patients died (3 in group I, 5 in group II), 6 of whom had cirrhosis. The sensitivity of the pathogens to the main antibiotics is described. The most often used antibiotic combination was ampicillin-gentamycin. It is suggested that in departments receiving patients from outside the hospital rather than from intensive care units the ampicillin-gentamycin combination can be advocated as the first treatment. As there were no significant differences between patients with septicemia or bacteremia, in severe infections a single positive blood culture should be taken into account and discrimination between septicemia and bacteremia is useless.

Adult↗

[Angiocholitis and polymicrobial septicemia caused by food obstruction in a patient with a biliodigestive anastomosis].

A case of angiocholitis with polymicrobic septicemia in an 85-year-old man with a history of cholecystectomy and choledocho-duodenal anastomosis is reported. The biliary tract was obstructed by a piece of tomato skin. Antibiotherapy and fibroscopic extraction of the skin ensured recovery. The authors recall the low incidence of polymicrobic septicemias, diagnostic criteria, promoting factors, poor prognosis, and the responsibility of digestive reflux and above all of stasis and high pressure in angiocholitis and septicemia following biliodigestive anastomosis.

Aged↗

[Bladder bilharzioma and carcinoma in a bilharzial bladder].

Over 7 years, 592 patients infected by Schistosoma haematobium were detected. Among these, 102 had a cystoscopy which found carcinoma in 3 patients, polypi in 1 and vesical "bilharzioma" (so-called pseudo-polyps) in 14. From the results of the biopsies and data from the medical literature the relationship between schistosomiasis and carcinoma in the schistosomial bladder is discussed, as well as the meaning of various lesions, such as malpighian metaplasia, papillomatous hyperplasia and glandular cystitis, seen in biopsy specimens from "bilharziomas". The cystoscopic diagnosis of one (or several) tumours resembling "bilharzioma" requires biopsy, resection and close monitoring.

Carcinoma, Squamous Cell↗