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Biomedical subjects

A Tabib

Publications and source records attributed to A Tabib.

100 records · Page 6Linked to original sources

Coronary artery lesions and human immunodeficiency virus infection.

The postmortem anatomopathological examination of eight heart-and-lung specimens obtained from eight HIV-seropositive patients was performed. Three patients were CDC stage II and five patients were CDC stage IV. The mean age was 27 (range: 23-32). Distal and proximal vascular lesions of the coronary arteries were observed. These impairments were marked by major excentric atherosclerosis (with 80-90% obstruction of the arterial lumen) or by fibrosis two-fold or six-fold the thickness of the tunica media. Sclero-hyalinosis of the smaller arteries and myocardial interstitial fibrosis lesions was also revealed. In view of the severity of the described lesions, the absence of any associated cardiovascular risk factors and the context of immunodepression, the role of a virus in the genesis of these lesions is suggested, in particular a virus of the herpes group.

Adult↗

[Sudden death during anesthesia: human error, drug related or cardiac death?].

We carried out a retrospective analysis of 1500 forensic autopsies following sudden unexpected cardiac death. This analysis showed a group of 43 cases that could have been related to surgery and/or anaesthesia. Pathological examination revealed the existence of cardiac lesions in 40 cases: arrhythmogenic right ventricular cardiomyopathy (14 cases), coronary artery disease (9 cases), cardiomyopathy (8 cases), structural abnormalities of the His bundle (7 cases), mitral valve prolapse (1 case) and acute myocarditis (1 case). These disorders are compatible with a paroxysmal (rhythmic) phenomenon at the origin of the cardiac arrest. Identification of the cause of death in a patient who was presumed to be at low risk may provide major relief to the patient's family and the medical staff.

Adolescent↗

[Cardiotoxicity of 5-fluorouracil: report of 6 cases].

5-fluorouracil (5-FU), a fluoropyrimidine antimetabolite, is widely used in the treatment of cancers of the digestive tract and breast. The clinical cardiotoxicity of 5-FU was first reported in 1975. Adverse cardiac effects include coronary disorders, heart failure and sudden death of suspected cardiac origin. Six new cases are reported, including 5 cases of angina and one of heart failure. The patients, 4 males and 2 females, were 26 to 71 years of age (mean: 56.2). They had no medical history of heart failure, myocardial ischemia or electrocardiographic anomalies prior to 5-FU treatment. Three patients had hypertension of whom one had had type-II diabetes mellitus for the past 20 years. Clinical symptoms included chest pain in 4 patients and heart failure in one, whereas the last patient had ECG changes with no associated clinical symptoms. Clinical symptoms of angina totally disappeared after the cessation of 5-FU administration, but heart failure was alleviated only after the introduction of digitalis, a converting-enzyme inhibitor and a diuretic. It has been estimated that 1.6% of patients treated with 5-FU develop adverse cardiac effects. Patients at greater risk are those with a history of ischemic cardiac disease, thoracic radiotherapy or high-dose 5-FU therapy. The mechanism involved is not clearly elucidated. Spasms of the coronary arteries or toxic inflammation of the myocardium have been suspected. These 6 new cases confirm the potential for cardiotoxicity of 5-FU and the need for careful cardiac monitoring of treated patients.

Adult↗

[Proposal for macroscopic examination of the heart , of the great vessels and of the lungs in forensic pathology].

Our work presents a kind of proceeding for the cardio-pulmonary dissection and forensic examination. As a result of the necessity to have right from the time of the autopsy more clear data regarding the cause of death, in order to be able to direct the judicial investigation towards a certain type of death, this proceeding presents, in our opinion, several important advantages--in comparison to the common examination method--such as the facility macroscopic diagnosis in some heart diseases: arrhythmogenic displasy of the right ventricle, mitral valve prolapse and other valvulopathies.

Aorta↗