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Biomedical subjects

A Saraux

Publications and source records attributed to A Saraux.

At least 73 records · Page 4Linked to original sources
PubMed1996

Is collagenous colitis a new etiology of sicca syndrome?

We conducted a prospective cross-sectional study of seven patients with collagenous colitis to determine the clinical, immunologic and histologic features of sicca syndrome associated with this condition. Four patients reported dryness of the mouth and/or eyes. No laboratory evidence of autoimmune disease was found, except in one patient with ankylosing spondylitis. Collagenous infiltration of the salivary glands was quantified in each patient as the percentage of the total gland surface examined. Histologic studies of salivary glands demonstrated significantly more collagen in the group of patients with collagenous colitis than in the group of age-matched controls (30.52% versus 11.8%, p < 0.05). No inflammatory infiltrates were seen. Our data suggest that a common mechanism may underlie the various lesions found in patients with collagenous colitis. However, the mechanism that initiates the fibrotic process in the colon and salivary glands remains unknown.

Adult↗
PubMed1995

The antiperinuclear factor in spondylarthropathies.

The aim of the present study was to evaluate the prevalence of antiperinuclear factor (APF) in patients with spondylarthropathy and the relationships between this autoantibody and a variety of clinical, radiological and serological findings. We conducted a retrospective review of the medical records of all patients first admitted to the Rheumatology Unit of the Brest University Medical School Hospital from 1 January 1986 to 31 December 1994, and who met the European Spondylarthropathy Study Group (ESSG) criteria at admission. Each patient had a standard battery of tests. Serum samples from 123 of 126 patients suffering from spondylarthropathy were examined for the presence of APF. Thirty-three patients (26.8%) had APF at a titre > or = 1/80. There were no significant relationships between various demographic, clinical or radiological characteristics and the presence of APF. However, the subgroup of APF-positive patients had a higher prevalence of both rheumatoid factors (RF), although not significant, and antikeratin antibody-positive serum than the rest. These results suggest that some patients had rheumatoid arthritis (RA) and three patients with APF > 1/100 and who were RF positive met ACR criteria for RA. APF should thus be used only as an additional serological marker in cases where clinical features suggest the association of spondylarthropathy with RA.

Adult↗
PubMed1995

How useful are tests for rheumatoid factors, antiperinuclear factors, antikeratin antibody, and the HLA DR4 antigen for the diagnosis of rheumatoid arthritis?

To evaluate the usefulness for the diagnosis of rheumatoid arthritis of tests for rheumatoid factors, antiperinuclear factors, antikeratin antibodies, and the HLA DR4 antigen, we retrospectively reviewed the medical records of 138 patients consecutively admitted to our rheumatology department between January 1, 1988 and December 31, 1990 for evaluation of peripheral inflammatory joint manifestations. Each patient had a standard work-up including a physical examination, laboratory tests, and roentgenograms. In 1994, after a follow-up of three to six years, the final diagnosis was rheumatoid arthritis in 39 patients and another well-defined disorder in 63; no diagnosis was established in 36 patients, among whom nine were lost to follow-up. The decreasing order of diagnostic usefulness was antiperinuclear factors, HLA DR4, rheumatoid factors (latex test), and antikeratin antibody. The likelihood of rheumatoid arthritis was greatest in those patients with positivity of two of the three following markers: rheumatoid factors, antiperinuclear factors, and the HLA DR4 antigen.

Adult↗
PubMed1995

[Septic meningitis in children in Rwanda from 1983 to 1990. Retrospective study at the Kigali Hospital Center].

To assess septic meningitis in pediatric units in terms of the bacteriologic distribution, mortality, and groups at risk, we conducted a retrospective study in the pediatric department of the Kigali Hospital Center (Rwanda). Based on bacteriologic study of 1215 cerebrospinal fluid samples, there were 321 cases of septic meningitis due to identifiable germs and 68 involving cloudy fluid with no detectable germs, i.e. 1.5% of admissions to the Pediatric Unit of the Kigali Hospital Center. The most common organisms were pneumococcus (36.5%), Haemophilus influenzae (31%), salmonella (13%), and meningococcus (11.5%). Most of the children (75%) presenting septic meningitis were under the age of 5 years. Overall mortality was 38% with rates of 52% and 39% for cases involving pneumococcus and salmonella respectively. The predominant clinical symptoms of pneumococcus meningitis were coma (p:0.000055) and respiratory compromise (p:0.02). In contrast Haemophilus influenzae meningitis was associated with a lower incidence of coma (p:0.05) and malnutrition (p:0.017). Salmonella meningitis was characterized by a higher incidence of fever over 38.9 degrees C (p:0.025) and malnutrition (p:0.01). In patients with meningococcus meningitis, the incidence of convulsions appeared to be higher, at the threshold of statistical significance (p:0.052), whereas coma (p:0062) and respiratory distress (p:0.0024) were uncommon. Independently of etiology, no clinical symptom was associated with a statistically higher risk for death.

Adolescent↗
PubMed1995

[Neuropapillitis in Behçet disease. A case].

The authors report the case of a 34 year old woman, who developed acute neuropapillitis, which appeared to be the first ophthalmologic manifestation of Behçet's disease. One year later, this patient recurred with another neuro-ophthalmologic sign: a sixth nerve palsy.

Abducens Nerve↗
PubMed1995

Insufficiency fractures of the sacrum in elderly subjects.

Elderly patients who develop insufficiency fractures of the sacrum usually have generalized bone loss and/or lesions of the pelvic bones (due to radiation therapy or previous fractures). The sacral fracture occurs either spontaneously or after a trivial traumatic episode. We compared patients admitted for sacral fractures (n = 12) or vertebral crush fractures (n = 56) in an effort to identify risk factors for sacral fractures. We conducted a retrospective review of the medical records of the 12 patients older than 70 years who were admitted to the rheumatology department of the Morvan Hospital between January 1, 1985 and December 31, 1994 for evaluation of a sacral fracture. The onset of symptoms was abrupt in 11 patients and occurred after an unremarkable fall in three. Patients admitted for sacral fractures were significantly more likely to have a positive history for a fracture, femoral surgery, or pelvic radiation therapy than patients admitted for vertebral fractures (58% versus 9%, p = 0.0005). In contrast, levels of calcium, phosphorus, 25-OH vitamin D and 1,25(OH)2 vitamin D were comparable in the two groups after exclusion of those patients with endocrine disorders or a history of calcium and vitamin D supplementation. In conclusion, populations of elderly patients with sacral fractures and crush fractures are comparable and the occurrence of a sacral fracture is dependent on the presence of pelvic and/or femoral osseous abnormalities.

Aged↗
PubMed1995

Superantigens in autoimmune disease.

The recent identification of superantigens (of retroviral origin in mice and bacterial origin in humans) has given rise to several hypotheses linking superantigens to autoimmune responses. The most compelling argument in support of such a link is restricted V beta gene usage by lymphocytes in rheumatoid joint fluid and Sjögren's syndrome salivary tissue. However, a substantial body of evidence from mouse models militates against a link between the presence of self-superantigen-reactive T-cells and the development of autoimmune disease. Nevertheless, superantigens are powerful instruments for investigating tolerance.

Animals↗
PubMed1994

Pulmonary cryptococcosis associated with HIV-1 infection in Rwanda: a retrospective study of 37 cases.

OBJECTIVES: To study the demographic, clinical, radiographic and diagnostic features, the clinical course and therapeutic response of pulmonary cryptococcosis in HIV-1-infected patients. DESIGN: Retrospective review. SETTING: The Department of Medicine of an urban reference hospital in Central Africa. METHODS: All the records of HIV-1-infected patients with pulmonary cryptococcosis were reviewed retrospectively with regard to the parameters described above. RESULTS: Over a 3-year period, pulmonary cryptococcosis was diagnosed in 37 HIV-1-infected Rwandan patients (21 men, 16 women; mean age, 35 years; range, 26-55 years). Twenty-nine patients (78%) had primary pulmonary cryptococcosis. Cough (94%), weight loss (65%), fever (51%), dyspnoea (46%), thoracic pain (30%), headache (13%) and haemoptysis (8%) were the predominant clinical findings. A diffuse interstitial infiltrate on chest radiograph was observed in 76% of the patients, an alveolar pattern in 19%, mediastinal and/or hilar adenopathy in 11%, nodules and pleural effusion each in 5%. Bronchoalveolar lavage, with a yield of 82%, was found to be the most sensitive diagnostic procedure. Screening of cryptococcal antigen in the serum failed to detect cases of primary pulmonary cryptococcosis. Twelve patients with primary pulmonary cryptococcosis treated with itraconazole as acute and maintenance therapy were all protected against disseminated cryptococcal disease; seven out of 10 (70%) of those who did not receive a specific anticryptococcal drug developed disseminated cryptococcal disease. CONCLUSION: Pulmonary cryptococcosis is not a rare complication of HIV-1 infection in Rwanda. Its clinical and radiographic patterns are non-specific and bronchoalveolar lavage is the procedure of choice for its diagnosis. The natural history of untreated primary pulmonary cryptococcosis is disseminated cryptococcal disease. Itraconazole is highly effective in the prevention of disseminated cryptococcal disease in patients with primary pulmonary cryptococcosis.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Does septic arthritis occur in human immunodeficiency virus infection?].

No prospective, longitudinal, cohort studies comparing septic arthritis in HIV-positive and HIV-negative individuals belonging to the various risk factor groups for HIV-infection are available. However, a review of the literature provided information on the main features of pyarthrosis in HIV-infected patients. The clinical and microbiological characteristics, as well as the outcome of this rare complication, vary with the risk factor group and with the severity of the immune deficiency. Pyogenic bacteria are the most common causative agents and should be looked for routinely since they usually respond well to antimicrobial therapy.

Arthritis, Infectious↗
PubMed1994

[Hemiplegia and contralateral multiple aseptic osteonecrosis].

A patient who received treatment for acute myelogenous leukemia (chemotherapy, irradiation, corticosteroid therapy) developed cerebral radionecrosis with hemiplegia (treated by corticosteroids) then multiple foci of osteonecrosis on the nonparalyzed side. The mechanisms which may have prevented osteonecrosis from occurring on the side of the hemiplegia are discussed.

Adult↗
PubMed1994

[Epidemiology of bone fluorosis of hydrotelluric origin].

Although endemic fluorosis occurs in many countries, epidemiological studies have been limited by funding problems, a lack of awareness of the public health impact of the disease, and the absence of inexpensive defluoridation methods. The effects of fluorides on human bone are reviewed and the methodological problems raised by epidemiological studies of endemic skeletal fluorosis are discussed.

Bone Diseases↗
PubMed1994

Persistent arthralgia and its association with HIV infection in Rwanda.

A prospective study of persistent arthralgia was carried out on 331 consecutive female patients admitted to the Department of Internal Medicine of the Centre Hospitalier de Kigali in Kigali, Rwanda. The aim of this study was to determine its association with HIV-1 infection and to describe its clinical characteristics. Ten additional HIV-1-seropositive patients with this condition attending the outpatient clinic were also included in the clinical study. Persistent arthralgia was significantly more common in HIV-1-seropositive hospitalized patients (14 of 209, 6.7%) than in HIV-1-seronegative hospitalized patients (one of 122, 0.8%; p = 0.02) and had a specificity and a positive predictive value for HIV-1 infection of 99.1% and 93.3%, respectively. HIV-1-related persistent arthralgia, studied in 24 patients in early as well as late stages of HIV-1 infection, commonly affected several and mainly large joints, was mostly distributed symmetrically, and was usually relieved with nonsteroidal antiinflammatory drugs. Recurrencies were noted in eight patients. In areas highly endemic for HIV-1, persistent arthralgia should be considered a probable manifestation of HIV-1 infection, and although it is uncommon, it can be regarded as a predictor of HIV-1 infection.

Adult↗
PubMed1993

[Osteoporosis during pregnancy. 4 cases].

Osteoporosis of pregnancy is an infrequent condition of unclear pathogenesis. We report four new cases. Mean age of patients was 28 years; diffuse bone loss was seen on pre-pregnancy roentgenograms in two patients. Two patients were primiparas. In all four cases, acute spinal pain led to the discovery of vertebral crush fractures and diffuse osteopenia predominating in the spine and pelvis. Urinary calcium was low in one case. Our cases and a review of the literature demonstrate that diffuse osteopenia exists prior to the pregnancy and becomes symptomatic during childbearing as a result of additional mechanical stresses with or without concomitant vitamin D deficiency and/or heparin therapy.

Adult↗
PubMed1993

[Inflammatory Gorham disease].

The case of a 48-year old female with massive osteolysis since the age of 13 years is reported. She had inflammatory flares which resolved spontaneously or after a transient discharge of lymph.

Female↗
PubMed1993

Acute arthritis and human immunodeficiency virus infection in Rwanda.

OBJECTIVE: To determine the etiology of acute arthritis observed in adults and to define its relationship with human immunodeficiency virus 1 (HIV-1) infection in Kigali, capital city of Rwanda. METHODS: From September 1, 1989 until March 31, 1990 we conducted a study of all new patients admitted with acute arthritis to the outpatient and inpatient services of the Department of Internal Medicine at the Centre Hospitalier de Kigali, in Kigali, Rwanda, a city highly endemic for HIV infection. RESULTS: Thirty-six patients (27 men 9 women; mean age: 31 years, range 18-65) were included in the study. Twenty-six (72%) were HIV seropositive. Two main diagnostic categories emerged, both strongly associated with HIV infection: (1) aseptic arthritis: 16 (44.5%) patients including 12 (33.5%) patients with spondyloarthropathy of whom 10 (83%) were HIV seropositive, and 4 (11%) patients with HIV related arthritis, (2) septic arthritis: 11 (30%) patients of whom 9 (82%) were HIV seropositive, including 4 with gonococcal, 2 with staphylococcal, 1 with Salmonella B and 2 with tuberculous arthritis. CONCLUSION: In an area highly endemic for HIV, acute arthritis should be considered a possible manifestation of HIV infection and should prompt HIV testing.

Acquired Immunodeficiency Syndrome↗