[Q fever: diagnostic contribution of bone marrow biopsy. Apropos of a case].
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Biomedical subjects
Publications and source records attributed to C Conri.
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The authors report about the case of a 69-year-old patient suffering from intestinal angina, in whom an endoluminal angioplasty of the superior mesenteric artery for a stenosis located 3 cm from the ostium allowed suppressing the symptoms. The published series of arterial angioplasty for gastrointestinal care are still rare, but they indicate that angioplasty may be an interesting alternative to or a complement to surgery for patients with intestinal angina.
A group of 63 patients infected by HIV and presenting with CD8 hyperlymphocytosis (CD8+) has been studied. CD8 hyperlymphocytosis was defined by the presence, during at least three months, of at least 1,500 CD8 circulating lymphocytes. The CD8+ patients (n = 63) were identified and followed within the cohort (1,444 patients) of the "Groupe d'Epidémiologie Clinique du SIDA en Aquitaine " (GECSA). CD8+ patients were compared with a control group of 126 HIV infected patients without CD8 hyperlymphocytosis recruited within the GECSA cohort and followed in the same manner during two years. The occurrence of opportunistic infections was less frequent in CD8+ patients. The proportion of patients with a CD4 lymphocyte count below 200/mm3 was lower in the CD8+ group than in the CD8- group at inclusion and at the last check-up (P less than 0.01). A tendency for longer survival and delayed onset of AIDS was noted in CD8+ patients. Such a difference in prognosis might be due to a peculiar cytotoxic response against HIV among CD8+ patients. Further follow-up of a larger group of patients is needed to confirm this hypothesis.
One colonic Crohn's disease case is reported in a young woman under pill. Stopping it, recovery was observed. Oral contraceptive responsability is pointed out.
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A report of two cases of aorto-caval and ilio-caval A.V. fistulas, where the authors examine the mechanisms for anuria. The renal venous hypertension, which is due to the arteriovenous shunt, seems to be a determining factor in the occurrence of this unveiling complication, as shown by the roentgenological findings.
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Giant cell arteritis is an inflammatory disease that can affect the arteries anywhere in the body. Two cases are reported in which the arteries of the lower limbs were involved. Intermittent claudication with a walking distance of only 30 m was the inaugural manifestation in both cases. A biopsy of the superficial femoral artery provided the diagnosis in the first case. Ergotamine toxicity was considered initially in the second case. Acute ischemia and gangrene requiring amputation can complicate giant cell arteritis of the lower limbs and consequently corticosteroid therapy in an effective dose should be given as soon as the diagnosis is made. The inflammatory arterial lesions improve under therapy, but irreversible fibrosis with stenosis can develop if treatment is initiated late.