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At least 235 records · Page 13Linked to original sources

[Measurement of arterial distensibility by the QKd method a new vascular marker].

INTRODUCTION: Distensibility is the ability of large elastic arteries to increase in diameter from diastole to systole. Pulse wave velocity (PWV) is one of the ways to measure this parameter. Several techniques, including QKd, are able to measure PWV. PURPOSE: QKd is the time interval between the Q wave on EKG and auscultation of the second Korotkoff's sound at the brachial artery. QKd is measured by a specific apparatus that registers ambulatory blood pressure as well as EKG (normal > 200 ms). Arterial distensibility seems to be able to predict cardiovascular morbidity and QKd has been demonstrated to predict such morbidity in a sample of elderly hypertensives. Currently the relationship between QKd and prognosis is under investigation in systemic sclerosis (ERAMS study). CONCLUSION: QKd is a noninvasive ambulatory method that measures arterial distensibility as well as blood pressure.

Age Factors↗

[Henoch-Schonlein purpura and prostate cancer].

INTRODUCTION: The association between adult Henoch-Schonlein purpura and prostatic carcinoma is exceptional. We report a new case. EXEGESIS: The diagnosis of prostatic adenocarcinoma, suspected because of prostatic induration is made after anatomopathological study. The patient has all the clinical (purpura, polyarthralgia), biological (circulating monocmonal IgA), and histological (leukocytoclastic vasculitis, with IgA and C3 deposits) criteria of Henoch-Schonlein purpura too. The simultaneous appearance of vasculitis and neoplasia is known. The association between adult Henoch-Schonlein purpura and malignant neoplasm like lung carcinoma or lymphoma exists too. The initial events leading to the development of these vasculitis could be tumor antigens or abnormal IgA production. CONCLUSION: The simultaneous appearance of these two disease asks here the question of mechanisms implicated in these association.

Adenocarcinoma↗

[High levels of factor VIIIc and risk of venous thrombosis: critical analysis of case-control studies].

INTRODUCTION: Deep venous thrombosis is a frequent and potentially serious disease. Its causes are multifactorial, associating facilitating circumstances and genetic or acquired coagulation abnormalities. Genetic currently well known abnormalities are quantitative deficiencies of some natural anticoagulants (proteins C and S, antithrombin), and mutations of V and II (G20210-A) genes. The Leiden group has recently shown that the elevation of some coagulation factors level could also constitute a risk factor for deep venous thrombosis. CURRENT KNOWLEDGE AND KEY POINTS: Elevation of factor VIIIc is associated with a higher risk for thrombosis than in the general population but the threshold for normality of this factor is difficult to define. It is a probable constitutional abnormality whose prevalence in the general population vary from 6 to 36%. Risks of deep venous thrombosis associated to this factor elevation is more elevated in patients who have this anomaly (odds ratios vary from 2,2 to 10,3) (95% CI). FUTURE AND PROJECTS: The frequency of this anomaly and its association with a high risk for thrombosis are reasons to assess the potential usefulness of screening for these anomalies in patients who had thrombosis or in their family. The probable genetic origin of these anomalies has to be confirmed by other studies.

Case-Control Studies↗

[Cardiac involvements in scleroderma: study with echocardiography and cardiac Doppler in 38 patients].

A study of heart lesions has been conducted in 38 patients with systemic sclerosis using echocardiography, doppler and colour doppler. Abnormalities were found in 66% patients. Valvulopathies (mainly mitral regurgitation) were the most frequent lesions (45%). The presence of anti-SCL70 antibody was correlated to right cavities dilatation. Pulmonary hypertension was found in 6 patients.

Adult↗

[Prognostic role of pregnancy on the course of HIV infection: a retrospective cohort study (1985-92)].

In a hospital-based cohort study of HIV-infected patients, we compare the progression of the disease (occurrence of CDC group IV, death, decline of CD4 below 200/mm3) between 55 women with delivery and 89 matched control HIV positive women with no history of pregnancy. After a mean follow-up of three years, no significant difference was observed between the two groups even after adjustment on prognostic variables.

Cohort Studies↗

[Membrane fatty acids and blood antioxidants in 77 patients with HIV infection].

We have measured the fatty acid (FA) composition of erythrocyte membranes and plasma anti-oxidants in HIV+ patients. Saturated FA are higher and poly-unsaturated FA lower than in controls (P = 0.02). Selenium (Se) is lower in patients less than 400 CD4 cells/mm3 (P = 0.002). Vitamin A is lower in the HIV+ regardless of the CD4 cell count. Se and vitamin A are correlated to nutritional markers (body mass index and albumin).

Antioxidants↗

[Interferon and blood tumor necrosis factor in 95 patients with HIV infection].

We have measured TNF-alpha and interferon alpha in 95 HIV positive patients and 20 healthy subjects. TNF-alpha was higher in the HIV+ patients (P = 0.0001) and was correlated to the CD4 cell count (P = 0.02) and cholesterol (negatively) (P = 0.04). Interferon-alpha was correlated to the wasting syndrome (P = 0.002), hypertriglyceridemia (P = 0.004) and haematocrit (P = 0.04).

HIV Seropositivity↗

[Pneumopathy caused by amiodarone in internal medicine: 8 cases].

We report on eight cases of amiodarone pulmonary toxicity. Main clinical symptoms are acute/subacute dyspnea or progression in some cases. Amiodarone responsibility is difficult to ascertain. Several arguments can be presented: clinical symptoms with dyspnea and/or fever and/or cough, interstitial or in diffusing capacity for carbon monoxide, abnormal broncho-alveolar lavage cytopreparation smear with increased percentage of lymphocytes and polymorphonuclear leucocytes in typical cases; trans-bronchoscopic lung biopsy failed to provided information on amiodarone toxicity in the two patients where biopsy were performed. Differential diagnosis is an essential step to eliminate other possible causes ie pulmonary micro-organism infections, cancer or pulmonary oedema secondary to heart failure. In one case acute pulmonary toxicity occurred early, after introduction of amiodarone, with a proposed immuno-allergic mechanism. In other cases, chronic amiodarone deposition in the lungs can explain clinico-radiologic features. In six cases improvement was observed after discontinuation of therapy within a 6-months period.

Aged↗

[Periarteritis nodosa-type vasculitis and infection with human immunodeficiency virus].

The human immunodeficiency virus (HIV) may be responsible for several types of vasculitis: leucocytoclastic vasculitis, granulomatous angiitis, angiitis associated with lymphoproliferative syndromes or necrotizing vasculitis including periarteritis nodosa (PAN). We report a case of PAN in a 62-year old HIV1-positive woman. The patient had no co-occurrent hepatitis B virus infection and was negative for antinuclear antibodies. She presented with sicca syndrome, necrotic purpura, myalgias and polyneuropathy. Skin, muscle and nerve biopsies showed signs of necrotizing vasculitis. Multiple microaneurysms typical of PAN were present on branches of the abdominal aorta. The symptoms due to vasculitis regressed after treatment with corticosteroids in bolus injections and plasmapheresis. AZT was not given owing to intolerance. The literature on vasculitis associated with HIV infection is reviewed.

Adrenal Cortex Hormones↗

[Hypodermoclysis: a forgotten technique...].

Hypodermoclysis consists of infusing solutions in the subcutaneous tissues. It is a convenient means of correcting a moderate dehydration, notably in elderly people, when oral feeding is impossible or insufficient. The only potential problem with this technique is the occurrence of hypovolaemia due to infusion of hypo- or hypertonic solutions in subjects with previous severe salt and water disorders. For this reason, hypodermoclysis should not be used in emergencies.

Aged↗

[Hypocaloric and high-protein diet in obese patients: changes in the lean mass].

We have followed for 40 days seven hospitalized, young (age, mean SD : 33 +/- 8 yrs), and moderately obese (W/H : 35 +/- 3.92) women. During the first 5 days (DO to D5) they received a diet similar to their customary home-diet; from D6 to D40, their daily caloric intake was adjusted to 3,41 +/- 0.13 MJ (816 +/- 30 kcal). This diet comprised 21 p. 100 of sugars, 35 p. 100 of lipids, 1.57 +/- 0.09 g proteins per kg ideal body weight. Five seven-day periods have been studied. On the first day of each period, we recorded body weight and measured plasma albumin, pre albumin, retinol binding protein, complement (CH50 and C3) C peptide (in the fasting state and after glucagon stimulation), and thyroid hormones (T3 and rT3). On each of the 35 days of this study, total nitrogen was measured (Kjeldahl's method) in food, urine and faeces. On D0 and D41 lean and fat body masses were evaluated through measurements of total water (dilution of tritiated water) and of skin fold thickness respectively. From D0 to D40, the average weight loss was 8.76 +/- 1.86 kg; the cumulated nitrogen balances were negative in 6 patients and positive in one, with variations from one period to another and from one patient to another. Plasma proteins and hormones did not vary significantly. Changes in lean mass were comprised between + 0,7 and -- 1,6 kg in spite of the fact that all patients received the same caloric and protein intake.

Adolescent↗

[Anthropometric and biological evaluation of 44 patients with protein-calorie malnutrition].

In industrial countries protein-calorie malnutrition (PCM) is a frequent cause of hospital morbidity and mortality. In this study, 88 hospital patients were evaluated: 44 (25 men and 19 women) aged from 20 to 80 years) with PCM, and 44 without malnutrition; the two groups were matched with regard to sex, age and height. The following parameters were determined: arm muscle surface, whole-body muscle mass, proportion of body fat, serum albumin (Alb), prealbumin (PA), retinol-binding protein (RBP), transferrin, thyroxine-binding protein, thyroxine, triiodothyronine, reverse triiodothyronine and total complement. Anthropometric measurements were validated by planimetry of a computerized tomographic section of the arm in 60 patients. There were significant differences between the two sexes in anthropometric values. Alb, PA and RBP values were different in men and RBP only in women; all other biochemical parameters were the same in both sexes. Thus, the group with PCM could be distinguished from the control group by anthropometric values and RBP values. Anthropometric parameters have been reported as being more specific of PCM than biochemical parameters, but since the latter are considered more sensitive, both complement each other and must be taken into account.

Adult↗