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S Arfi

Publications and source records attributed to S Arfi.

29 records · Page 2Linked to original sources
PubMed1983

[Blount's disease in the Antilles. Apropos of 26 cases].

Blount's disease is associated with agenesis of the medial tibial plateau leading to tibia vara. It appears to be more frequent in Scandinavian countries and in black populations. Twenty-six cases had been seen in Martinique (Antilles) of whom twenty were children. A classification into six stages was described. Stage IV is a critical one. Before it, corrective osteotomy will often lead to complete healing. After stage IV, lateral epiphysiodesis must be added to avoid recurrence of deformity. The technique of osteotomy was variable according to the age of the child and the obliquity of the joint line. In young children, a subtraction closing wedge osteotomy is suitable. In older children a "V" shaped osteotomy is recommended to lessen the amount of shortening. At the end of the growth period, a medial opening wedge osteotomy is advisable. In adults (six cases) whose deformity can reach as much as 50 degrees with considerable ligamentous laxity, reefing of the ligament must be added to the osteotomy. The problem of the opposite knee is discussed. Even when the disease is not bilateral, it can tend to develop towards arthrosis.

Adolescent↗
PubMed1980

[Cortisone-induced osteonecrosis: knowledge acquired from observations in man and comparison with the results of animal experimentation].

Aseptic osteonecrosis is observed in 25% of cases after renal transplantation. This etiological variety of osteonecrosis is unusual in that it is frequently bilateral and has multiple localisations. Apart from the classical radiological signs, attention in attracted by isolated images of osteocondensation in the metaphyses and/or the diaphyses suggesting massive bony infarction and the appearances of fatigue fractures observed frequently (14%). In 43% of cases, the obvious necrosis was proceeded by early bone pain, around the 7 th day, during massive administration of corticosteroids in the prevention or cure of graft resection. This finding suggested to us that the best time to observe ischemia of the bone or marrow is very early and led us to undertake an experimental study in the rabbit. Two series of New Zealand White rabbits were treated with massive doses of corticosteroid and sacrificed between the 3rd and the 21st day. The treated animals presented an early peak of hyperlipemia from the 7th day onwards, and diffuse lesions of hepatic and renal steatosis. Fat emboli associated with appearances of parietal thrombosis were observed in most cases. In the same animals, there were also appearances of stage I or stage II necrosis. Referring to the description of bone marrow necrosis in stages by Arlet and Ficat, there was observed in all the series, a frequency of marrow lesions of all stages much higher in treated animals (16 out of 20) than in controls. Only one lesion of stage I was observed in controls; the difference was highly significant. (0,000001 < p < 0,00001). If one only considers necroses of stage II and III (10/20 in the treated group nil in controls) the frequency was still significant p < 0.001. The preliminary results of the fixation of tetracycline are reported.

Adrenal Cortex Hormones↗
PubMed1979

[Use of the computer in teaching rheumatology. Trial application in the diagnosis of an adult polyarthritis].

The immense possibilities offered by the computer can be utilized in medical education, through a free dialogue between the student and the machine thanks to a terminal. A diagnostic simulation program has been carried out in diagnosing adult polyarthritis. This program neccesitates an analysis of diagnostic behavior and, on this basis, the preparing of a diagnostic tree or graph. The reasons leading to the plan adopted in constructing the graph, are discussed. Cases of increasing difficulty are proposed to the student, who must follow the course plan in order to arrive at a diagnosis. This teaching method, applied for thing pedagogical advantages both for the teacher and the student. The operating cost seems reasonable.

Adult↗
PubMed1978

[Immobilisation hypercalcaemia. 1 case (author's transl)].

A 21-year-old man suffered severe (up to 15.5 mg%) and prolonged (7 months) hypercalcaemia as a result of immobilisation following severe trauma. During the period of hypercalcaemia, plasma parathormone and calcitonin levels were undetectable. A study using radioactive calcium revealed a very marked increase in bone resorption, a moderate increase in accretion and virtually no intestinal absorption. Iliac biopsy revealed dense calcification front and there was no osteoid substance. This hypercalcaemia appeared to be due to increased bone resorption, while the synthesis of osteoid substance seemed to be insufficient to permit an equivalent increase in calcium accretion.

Adult↗
PubMed1975

[Radiographic aspects of aseptic osteonecrosis following renal transplantation. Apropos of 65 localizations in 30 patients].

The authors report 30 cases of aseptic osteonecrosis in 65 different bones, including 37 hips, 13 knees, 5 taluses, 1 cuboid, 8 shoulders, 1 humeral condyle, following renal transplantation. One patient had osteonecrosis in six different bones. In 24 cases, the necrosis occurred before the end of the 18th month following the graftmin 21 cases, radiodiagnosis of the first localisation was made before the end of the first month following the first clinical sign. The usual presenting symptom of osteonecrosis is a clear, sub-chondral crescent. In 2/3rds of cases of osteonecrosis of the femoral neck, there is a rapidly destructive form often well tolerated clinically. In 1/3rd of cases, the course was slow with mainly osteocondensation. The course is particularly destructive when, following failure of the graft, the transplanted patient is submitted to periodic hemodialysis. In 8 cases, the femoral condyles were involved, and in 4, the tibial condylesm the appearance may be that of osteochondritis dissecans, but more often the course resembles the destructive form of aseptic necrosis of the femoral head. Shoulder involvement leads to a radiological picture identical with that of the hips. One transplanted patient out of 5, has a chance to develop osteonecrosis within two years following the graft.

Adolescent↗
PubMed1975

[Aseptic osteonecrosis in renal transplantation ; apropos of 29 cases].

Over a period of observation of 14 years, one or more aspetic osteonecroses (AON) were discovered in 29 patients who had undergone renal transplantation. Altogether 64 AON were discovered. In patients who had survived at least 1 year, the frequency of this lesion was 18 percent. These transplantation necroses were often bilateral (16 cases out of 21 AON of the femoral head) or multiple (6 patients presenting AON in more than 3 sites) ; necroses were sometimes found in unusual sites (shoulder, ankle, upper end of the tibia, scaphoid, condyle of the humerus). The AONs of the lower limbs were remarkable because of their extent and because of the rapid evolution of the radiological signs. This is in contrast to the moderate nature of the pain. Latent types of necrosis are also found (3 cases of AON of the femoral head). During a search for factors favouring the development of AON, the authors noted that the average duration of haemodialysis was longer in the patients with AON than in a control group of transplant patients. The average daily dose of corticoids for the first six months after transplantation was not significantly different in the two groups studied. However, the 15 patients with transplants who were not given corticoids did not develop AON.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Sarcoidosis and leukemia/T-cell lymphoma associated with HTLV-1 virus infection in adults (apropos of a case)].

The HTLV-1 virus causes a disturbance of the immune system, the evaluation of which is often difficult. We report a case of sarcoidosis in a 49 year old woman of Martinique as evidenced by bilateral hilar adenopathy, hypercalcaemia, uveitis and granulomatous lesions on histological examination. Serological was positive for HTLV-1 antibodies. Three years later she developed an adult T-cell leukemia/lymphoma. The relationships between the HTLV-1 retroviral infection and different pathologies observed are discussed.

Female↗
PubMedDate not supplied

Refractory multicentric reticulohistiocytosis treated by infliximab: two cases.

We report the effect of infliximab, a monoclonal anti-TNFalpha antibody, in two patients with refractory cutaneous and articular multicentric reticulohistiocytosis (MRH). One 37-year-old woman and one 53-year-old woman with polyarthritis, facial rash and nodular lesions on the hands related to MRH were refractory to multiple agents: cariolysine, corticosteroids, hydroxychloroquine and cytotoxic agents. Infliximab at 3 mg/kg which was then increased to 5 mg/kg in combination with methotrexate or azathioprine was effective on cutaneous manifestations of the disease but not on polyarthritis. A switch to etanercept did not improve polyarthritis in the second patient. Some data suggest that TNFalpha is involved in MRH, but based on our cases anti-TNFalpha therapy needs further evaluation in patients with refractory MRH.

Adult↗
PubMedDate not supplied

Isolated conjunctival ulcerations as the first sign of Behçet's disease.

PURPOSE: To report an unusual incident of isolated conjunctival ulcerations which preceded all other signs of Behçet's disease. METHODS: Description of a 34-year-old woman of West Indian origin with an unremarkable medical history presenting with bilateral bulbar conjunctival ulcerations. RESULTS: The authors noted the presence of a diffuse bilateral conjunctival hyperemia which was more pronounced at the temporal bulbar conjunctiva of the right eye and the nasal conjunctiva of the left eye, each having one ulceration. The rest of the ophthalmologic examination was normal. One month later, the appearance of buccogenital aphthosis led to the diagnosis of Behçet's disease. CONCLUSIONS: This observation is unusual, as the conjunctival ulcerations are isolated and precede the onset of all other symptoms of Behçet's disease. Conjunctival ulcerations are rarely seen with Behçet's disease, but are characteristic enough to be included among the diagnostic criteria.

Adult↗