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Biomedical subjects

A Weissman

Publications and source records attributed to A Weissman.

205 records · Page 12Linked to original sources

[Extra intestinal manifestations of Crohn's disease (author's transl)].

The extra intestinal manifestations of Crohn's disease (CD) are not devoid of interest. They can, by themselves, aggravate the CD. Some of them have to be searched systematically (urinary complications, spondylarthritis and sacro-iliac arthritis). Amongst our 60 cases of Crohn's disease of the colon or of the ileon and colon, articular manifestations were the most frequent: arthralgias 25 cases (42%), true arthritis 17 cases (28%), spondylarthritis 5 cases, aacro-ileitis 9 cas (13%), finger hippocratism 11 cases (18%). In second cause, the cutaneous manifestations: 29 cases (48%) among which 6 cases (10%) of erytheme nodosa and 9 cases of allergic troubles (15%). Then came ocular troubles (5 cases), jaundice (5 cases). We observed 4 renal lithiasis and an hepatic sarcoïd granuloma revealed by the liver biopsy. Some complications were the local consequence of a local disease (hydronephrosis). Others represented the distant repercussion of a severe chronical intestinal disease. Some were true extra-intestinal localisations of the disease (perineal ulcerations and para-stomal ulcerations). Finally some complications, though non specific of Crohn's disease, evolued in parallel to it (some articular, ocular; dermatologic complications). In some cases they were anterior by several months or years to the intestinal symptoms of Crohn's disease, which suggests the existence of common etiological factors, especially genetical.

Arthritis↗

[Medical mangement of Crohn's disease (author's transl)].

Medical management of Crohn's disease is above all symptomatic. According to the severeness of the case, treatment varies and may be simple (regimen, antidiarrheic agents and sulfamid drugs) or more sophisticated (continous parenteral alimentation). Sulfamids and antibiotics have a definite although temporary action. Pathogenic medication includes: 1) steroid therapy who is active, but its effects are not long stand; 2) immunosuppressors who allow for the reduction of steroid therapy dosages; 3) immunostimulants as proposed by Geffroy. Among those presently studied are Calmette-Guérin vaccine, either given orally or by scarification, and two anti-parasitic drugs, metronidazole and levamisole. Short term results are good but they worsen with time. The main problem is to know when to discuss surgery. As need be, resection although mutilating, should be timely indicated.

Adrenal Cortex Hormones↗

Clinical patient management and the integrated health information system.

Emerging progress in clinical applications of patient care computing is identified. The essential clinical skill is understanding what data are appropriate in any given patient care situation and extracting enough information to make the correct management decision. The value of the computer has less to do with the internal intellectual process of diagnosis than its contribution to the more manifest actions in support of clinical patient management. Techniques with which the computer is assisting in improving the clinical decisionmaking process are reviewed, and a mechanism to link them to active patient care settings is described. In addition, a trend toward the integration of various independent subsystems, so that expensive resources can be optimized for patient needs, is noted.

Computers↗

[Rectocolic lymph node appearance in adults (author's transl)].

A very characteristic rectocolic "lymph follicle appearance" was observed on radiological examination by double contrast enemas in 3.5 p. cent of 480 cases explored. The usual typical appearance is that of small lacunae of 1 to 3 mm in diameter, with indistinct borders, extending through several colon segments. The frequency with which these images are observed is probably a function of the double contrast technique employed, particularly the adherence of the barium. In most cases, the "lymph follicle appearance" is a variation of the normal, but several rare forms could result from a partial immunity deficiency. Differential diagnosis includes colon wall oedema and most polyposis disorders in their initial stages. Coloscopy with biopsy is necessary when diagnosis is uncertain.

Adolescent↗

[Ambulatory preparation for double contrast enema. Retrospective study involving 100 nonhospitalised patients (author's transl)].

The authors present a technique of preparation for double contrast barium enema, using the oral route only. It was used in 100 consecutive, suitable non-hospitalised patients with the following results: colonic empyting was perfect in 64% of cases, satisfactory in 25% and inadequate in 11%. Tolerance was deemed to be good. The authors do not suggest that the technique should be used in hospitalised patients, often proving inadequate under such circumstances.

Barium Sulfate↗

Association of the Lewis blood-group phenotype with infertility in women.

OBJECTIVE: To evaluate the distribution of Lewis blood group phenotype and secretor status among women treated for infertility. SETTING: In vitro fertilization unit of a university hospital. PATIENTS: Forty-seven consecutive infertile women with mechanical (n = 31) or unexplained (n = 16) infertility scheduled for IVF-ET. The control group was formed of 47 fertile women from our database and additional new women matched for age. MAIN OUTCOME MEASURES: Determination of ABO and Lewis blood group phenotypes. RESULTS: Of the 47 subfertile women, 12 had blood type A (25.5%), 10 type B (21.3%), 4 type AB (8.5%), and 21 type O (44.7%); 38 had Le (a-b+) (80.9%), 4 had Le (a+b-) (8.5%), and 5 had Le (a-b-) (10.6%). Of the 47 controls, 17 had type A (36.2%), 12 type B (25.5%), 4 type AB (8.5%), 14 type O (29.8%); 26 had Le (a-b+) (55.3%), 11 had Le (a+b-) (23.4%), and 10 had Le (a-b-) (21.3%). The difference in the proportions of the A, B, AB, and O phenotypes was not statistically significant. The proportion of combined recessive and nonsecretor phenotypes Le (a+/-b-) was significantly lower in subfertile women (9/47) as compared with fertile controls (21/47) (P = 0.014). The difference in the proportions of the Lewis blood group phenotypes between the unexplained and the mechanical infertility groups was not statistically significant. CONCLUSIONS: Subfertile women have an increased frequency of the Le (a-b+) blood group phenotype. Our hypothesis is that the presence of exposed fucosylated determinants such as Le(b) on the surface of endometrial cells may interfere with implantation.

ABO Blood-Group System↗