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B Wechsler

Publications and source records attributed to B Wechsler.

At least 289 records · Page 16Linked to original sources
PubMed1988

[Wegener's granulomatosis. Clinical aspects, nosologic problems. Review of the literature apropos of 30 cases].

Thirty cases of Wegener's Granulomatosis are reported, 16 men and 14 women aged 49.3 +/- 14 years at the onset of their illness. The presenting symptoms were oto-rhino-laryngeal in 22 cases and pulmonary in 16 cases. Renal disease was initial in only 1 case. The complete picture comprised oto-rhino-laryngeal (29 cases), pulmonary (26 cases), renal (27 cases), articular (16 cases), muco-cutaneous (19 cases), ocular (15 cases), neurological (13 cases), and muscular (10 cases) involvement. An increased sedimentation rate, leukocytosis, anaemia and thrombocytosis were common findings. The treatment comprised steroid therapy associated with immunosuppressor drugs (28 cases) and plasma exchanges (8 cases). External radiotherapy was used in 5 patients, including 3 with bronchopulmonary lesions, but was not effective. The probability of survival after the initial symptoms was 84 p. 100 at 1 year, 69 p. 100 at 3 years and 59 p. 100 at 5 and 10 years. Eight patients died; infection and renal failure were the principal causes. Late relapse occurred in 3 patients justifying long-term follow-up and the necessity of using the term "cure" with reserve. The clinical and therapeutic aspects are described in the light of the authors' experience and a review of the literature. The concept of localised form of the disease and bordeline forms with atrophic polychondritis, periarteritis nodosa, Churg and Strauss syndrome and lymphomatous granulomatosis are also discussed.

Adult↗
PubMed1988

[Behcet's disease in France. Apropos of 60 autochtonous subjects].

Based on a retrospective study of a series of 196 patients followed up from 1974, to 1986, 60 cases of Behcet's disease are reviewed in autochthonous French patients, defined as born of French parents in Metropolitan France. The group included 36 men and 27 women (sex ratio 1.45) age range 32 +/- 7 years at time of diagnosis. Semeiology and outcome were compared with those of North African patients, the bias related to their female under-representation being eliminated by analysis of findings in males only. No significant difference was noted between the two groups, particularly with respect to ocular, neurological and vascular lesions. Neither the sex nor the existence of HLA B5 (28/40 tests) had any influence on semeiology. Three deaths related to the disease were reported two pregnancies were conducted to term without neonatal effects despite maternal acute ocular episodes. Treatment was with corticoids (n = 33), immunodeppressants (n = 15), colchicine (n = 29) and anticoagulant and/or anti-aggregant therapy (n = 31). Lasting disappearance of aphthosis was obtained in 34 cases, of cutaneous signs in 27, articular signs in 26 and vascular signs in 16. The ocular lesions present initially in 41 patients had disappeared over long periods in 29 cases, and presented a satisfactory prognosis since less than 39 p. 100 of the patients had any significant handicap at 5 years. Among the relapses, 5 appeared after too hasty withdrawal of colchicine. The diagnosis of Behcet's disease should be evoked in autochthonous subjects if necessary, and confirmed on the basis of usual clinical criteria alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Localized tracheobronchial amyloidosis. A new case studied with x-ray computed tomographic and nuclear magnetic resonance. Review of the literature].

We report a new case of localized primary tracheobronchial amyloidosis revealed by haemoptysis and effort dyspnea. The CT scan image was a homogeneous and circumferential thickening of the bronchial wall measuring 282 on the Hounsfield scale. At magnetic resonance imaging the amyloid substance was a slightly less intense than fat tissue in T1 and T2-weighted sequences. Treatment using Yag laser photoresection stabilized the lesions with one year follow-up. The review of the literature enables us to summarize the clinical, endoscopic, morphological, prognostic and therapeutic features of tracheobronchial amyloidosis, as well as pathogenic hypotheses and relationship with tracheobronchopathia osteoplastica.

Adult↗
PubMed1988

[Is Behçet's disease associated with characteristic abnormalities of coagulation and fibrinolysis? Apropos of 70 case reports].

The frequency of thrombotic episodes in patients with Behçet's disease prompted us to study their hemostasis. Seventy patients were investigated and 27 of them (38%) had history of venous thrombosis; they were compared to 27 healthy subjects and to 16 hospitalized patients in whom the diagnosis of Behçet disease was ruled out. Fibrinolytic activity after a 10 minute venous occlusion was significantly decreased while fibrinogen, factor VIII and von Willebrand factor was increased as well as the tPA inhibitor (PAI-I): the last 3 proteins are synthetized by the endothelial cell. No significant difference was observed between patients with or without history of thrombosis. Coagulation and fibrinolysis changes observed are not specific of Behçet disease since they were also found in a population of patients without Behçet disease and without history of thrombosis.

Adolescent↗
PubMed1988

[Behçet's disease and vascular surgery].

The role of vascular surgery in Behçet's disease is limited. It is concerned with the two types of lesion, venous and arterial, usually encountered. Indications for surgery in venous thrombosis did not differ from those in ordinary thrombo-embolic disease. The multicenter study reported divided arterial lesions into three groups: aneurysmal, occlusive or traumatic (arterial puncture) lesions. While surgery offers satisfactory results in the treatment of aneurysmal or traumatic lesions, the treatment of occlusive lesions is disappointing. Surgery is thus indicated only in patients with an aneurysm, bleeding or severe ischemia.

Aneurysm↗
PubMed1988

[Neuromuscular forms of hyperparathyroidism. Apropos of 2 cases].

The authors report two cases of hyperparathyroidism presenting mainly with muscular weakness. In the first case, a 74 year old woman had become completely bed-ridden and muscular recovery was obtained in 18 months. In the second case, a 24 year old sportsman had to stop all competition. Hypercalcaemia was suspected after finding radiological muscular calcification; the patient was able to start his sporting activities again two months after excision of the adenoma. After a review of the literature the authors discuss the principal physiopathogenic mechanisms; a direct action of parathormone is the probable cause but this has not been proved. Muscular forms of hyperparathyroidism are rare but this "pseudo-myopathic" presentation justifies the systematic exclusion of hyperparathyroidism in all cases of unexplained muscle weakness.

Adolescent↗
PubMed1988

[Horton's disease].

Explore the source record for details and available documents.

Adrenal Cortex Hormones↗
PubMed1987

[Deep venous thrombosis in Behçet's disease. 106 localizations in a series of 177 patients].

A retrospective study of 177 patients (137 male, 40 female) with a disease that fulfilled the criteria of complete or incomplete Behçet's disease showed 106 thrombotic lesions of a venous trunk in 62 (35%) of these patients, superficial phlebitis and retinal vein thrombosis excluded. The incidence of thrombosis was unrelated to race and sex. The venous lesions were single in 38 cases and multiple in 24 cases, including 4 with more than 4 territories involved. Arterial lesions were also present in 7 cases. The lesions were located in the sural (n = 63), iliofemoral (n = 14), inferior vena cava (n = 13), superior vena cava (n = 3), axillary (n = 2) and cerebral (n = 13) veins or territories. Thrombosis developed during the first 4 years of Behçet's disease in one half of the patients. It preceded the aphthosis by 1 to 10 years in 11 cases, was concomitant with it in 15 cases and appeared more than 10 years after the diagnosis in 8 cases. Pulmonary embolism occurred in 11 patients, requiring clipping of the vena cava in 2, but it was never lethal. However, 2 of the 5 patients who died had venous thrombosis (Hughes Stovin syndrome). Thirty-eight patients could be followed up for 12 to 192 months (mean 43) under anticoagulant or antiplatelet therapy. Five vascular recurrences (13%) were observed, 2 of them (1 arterial graft thrombosis, 1 cerebral thrombosis) under anti-vitamin K agents. Cerebral thrombosis (9 men, 4 women) accounted for 27% of the neurological lesions; its prognosis was favourable in the 7 patients successfully treated with anticoagulants. Thrombosis could not be explained. Haemostasis studies showed a decrease of fibrinolytic activity compared to a group of normal subjects and an increase in fibrinogen, factor VIII and Willebrand's factor levels; these abnormalities did not seem to be specific. Thus, phlebitis truly is an element of Behçet's disease. Until its mechanism is better understood, effective anticoagulant therapy in cases with proven thrombosis and preventive antiplatelet therapy in the other cases seem to be rational measures.

Adult↗
PubMed1987

Emergency percutaneous coronary dilatation for acute myocardial infarction in Behçet's disease.

We describe a young man with Behçet's disease who presented with acute coronary insufficiency: emergency coronary arteriography revealed 2 coronary aneurysms and a left anterior descending (LAD) artery stenosis which was successfully dilated. The reduction of the coronary stenosis by balloon angioplasty induced immediate relief of chest pain and decrease of ST segment elevation, and was probably responsible for the satisfactory evolution, with limited myocardial infarction on the ECG and no akinetic segment on the left ventricular angiogram 3 weeks after the acute event. Cardiac surgery was performed to avoid possible relapse or aneurysmal rupture with hemopericardium. Surgery confirmed the destructive arterial lesion of Behçet's disease with false aneurysms of the LAD and left circumflex arteries.

Adult↗