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Biomedical subjects

B Herer

Publications and source records attributed to B Herer.

27 records · Page 2Linked to original sources

[Broncho-alveolar lavage in pulmonary involvement in rheumatoid arthritis].

This study was designed to investigate by bronchoalveolar lavage (BAL) the characteristics of lung involvement in rheumatoid arthritis (RA). Twenty six patients with RA were included; ten were active smokers. Chest X Ray, pulmonary function tests and BAL were performed in all patients. Bronchiolitis was found in 7% of cases, pleurisy in 30% of cases. 83% of patients were found to have diffuse alveolar and/or interstitial disease, 17% rheumatoid nodules. Functional evaluation showed a restrictive pattern and a significant reduction in the carbon monoxyde diffusing capacity. Smokers had elevated BAL macrophages and decreased lymphocytes compared with non-smokers: respectively 89% vs 62.9% and 7.3% vs 18.9%. Patients with bronchiolitis had lower FVC than others: 38 +/- 14% vs 61 +/- 3%, and their BAL neutrophils were increased: 71 +/- 23% vs 7.5 +/- 2%. There was an inverse correlation between neutrophil counts and FVC in non-smokers, and diffusing capacity. We conclude that BAL inflammatory cells profiles are abnormal in RA and modified by a smoking history and the existence of a bronchiolitis.

Arthritis, Rheumatoid↗

[Left ventricular insufficiency in chronic obstructive bronchopneumopathies. A cause to look for: dilated cardiomyopathy].

Dilated cardiomyopathy was observed in 2 patients with chronic obstructive lung disease. This association raises first a diagnostic problem: the low specificity of clinical, radiographic and electrocardiographic signs makes it difficult to diagnose a left ventricular failure in such patients. Echocardiography is useful, but right and left heart catheterization and coronary arteriography are needed to establish the diagnosis of dilated cardiomyopathy and exclude other causes of left cardiac failure. The cause-effect relationship between the 2 diseases is not easy to evaluate. It is studied here in the light of the different mechanisms suggested to explain the repercussions function and notably the interactions between ventilation and right and left ventricular function. However, the association of the 2 diseases seems to be fortuitous. Their reciprocal repercussions, notably in the field of haemodynamics, are unquestionable and make the overall prognosis worse.

Aged↗

[Failure of anti-pneumococcal vaccination and prophylactic antibiotic therapy in 2 splenectomized subjects].

Asplenic patients are at high risk for the development of fulminant pneumococcal bacteremia. The mortality rate in those infected patients remains high. Therefore pneumococcal polysaccharide vaccine has been recommended, but despite penicillin prophylaxis pneumococcal sepsis can occur in vaccinated patients. We have observed two cases (one fatal) of overwhelming postsplenectomy pneumococcal sepsis in vaccinated patients who received long-term antibiotic prophylaxis. Both exhibited a poor antibody response to polyvalent vaccine.

Adult↗