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Biomedical subjects

C Laverdant

Publications and source records attributed to C Laverdant.

At least 37 records · Page 2Linked to original sources

[Hepatic amebiasis: study of 152 cases].

The purpose of this study was to describe and analyse retrospectively the clinical, serological, anatomical and evolutive features of 152 cases of hepatic amebiasis in young adults, treated and followed up in France from 1969 to 1983. The disease was revealed 3 times out of 4 by tender hepatomegaly with fever, but only in 6 cases by complications. Serological tests (immunofluorescence or hemagglutination) were always positive for amebiasis, whereas Entamoeba histolytica was absent from stools in 96.7 p. 100 of the cases. Hepatic amebiasis always caused a hepatic abscess: in these cases, the superiority of ultrasonography over all other diagnostic methods was confirmed, especially concerning the detection of multiple abscesses (47 p. 100). Complete recovery was obtained by medical treatment in 117 cases, either alone (98 cases), or combined with needle aspiration (19 cases). Nitro-imidazoles are the simplest treatment, but nevertheless in 5 cases they were not effective. These patients were then treated with dehydroemetine, associated in 2 cases with surgery. Four patients relapsed at mid or long-term after apparent recovery, in the absence of any obvious reinfection. A significant correlation between the course of the treated disease and the size and number of abscesses was demonstrated: it was possible to define a group characterized by a slow and/or complicated course (with single abscess of the right lobe whose diameter is equal to or greater than 10 cm, or multiple abscesses). The pathogenesis of hepatic amebiasis is not yet fully understood.

Adult↗

[Changes in HBs antigen and anti-HBs antibody in 77 patients with acute B-virus hepatitis].

Serum HBs antigen (HBs Ag) and anti-HBs antibody (anti-HBs), as determined by radioimmuno-assay or ELISA methods, were studied in a group of 77 patients with acute icterogenic viral hepatitis over a period of at least three months and correlated to the evolution of the disease either to return to good health or to a chronic state. The cumulative rate of patients in whom HBs Ag had disappeared (n = 53) was a linear function of time during the first sixteen weeks. Correlation seemed even stronger in the subgroup of patients restored to good health before the third month. Time of HBs Ag disappearance ranged from 5 days to 5 months in common forms of hepatitis. There was no evident correlation between the time of disappearance and the normalization of ALAT levels. Among the four cases of chronic persistent hepatitis, three had no detectable antigenemia six months later. Development of anti-HBs preceded the loss of HBs Ag in one case, was simultaneous or posterior to it in all other cases; the absence of any serologic HBV marker could last up to 4 months. No chronological link was found between seroconversion and normalization of ALAT levels. The correlation between time and HBs Ag disappearance from the blood could be specific for a given group of patients placed under specific conditions; its determination might help in understanding the factors that influence the course of the disease.

Acute Disease↗

[Neurogenic tumor of the anterior mediastinum. An uncommon diagnosis: neurofibroma of the vagus].

Case report of an endothoracic neurofibroma of the left vagus nerve, presenting as an anterior mediastinal mass in a 62 years old man without other signs of Recklinghausen's disease. Rarity of such cases is noted. Previously published sixty one reports are studied. Only four are localised in anterior mediastinum. The authors emphasize absence of specific signs of vagal involvement, importance for diagnosis of surgical extirpation, and mildness of post operative course.

Cranial Nerve Neoplasms↗

[Ultrasonographic appearances of hepatic amebic abscesses. Findings in 22 cases].

Ultrasonographic findings in 22 patients with hepatic amebic abscesses are described. All patient were febrile, complained of pain in the liver region, and had a raised ESR with polymorphonucleosis, and enhanced immunofluorescence or hemagglutination. Initial ultrasonography demonstrated a preferential site for the lesion in the right side of the liver, with three non-specific types of image. Indirect signs and the severity of the disease could be determined. Patients were followed up during specific treatment with metronidazole by means of clinical, biological, and ultrasonographic examinations, confirmation of healing depending entirely upon clinical evidence of absence of hepatic signs. Three types of healing, as shown by ultrasonography, are described: the homogeneous hypoechogenic form, known as the slow healing form, can raise ultrasonographic diagnostic difficulties. Apart from routine straight radiography of the chest and abdomen, ultrasonography was, in the majority of cases, the only radiological examination conducted, even in cases of recurrence or relapse; it enables the puncture to be controlled directly. Scintigraphy and scanning were rarely employed, except when ultrasonography was ineffective, and arteriography was reserved for certain very particular differential diagnosis problems. An algorithm, employed for facilitating diagnosis of hepatic amebic abscesses, emphasizes the primary role played by ultrasonography.

Adult↗

[Gastroduodenal ulcers in young adults. An epidemiological study (author's transl)].

An epidemiological survey of gastroduodenal ulcers was carried ut in an homogenous population of 100000 young adults of National Service age, and the results were compared with those of a similar survey which had taken place 6 years previously. Between 1971 and 1977 the overall incidence of gastroduodenal ulcers had risen from 1,57 to 2.14 p. 1000, but there ws a sharper and more significant increase (from 0.14 to 0.41 p. 1000) in gastric ulcers during the same period. Some of the aetiological factors investigated, such as age of onset of the disease, closed or open community housing conditions, individual predisposition, family history of ulcers, family status and inaugural symptoms, had remained unchanged, but there appeared to be a growing tendency for the disease to strike predominantly students and executives. If this were confirmed, these two social categories would be those which bear the brunt of the increase in gastroduodenal ulcers observed during the last few years.

Adolescent↗

[Delayed relapses of hepatic amoebiasis initially cured by metronidazole: 2 cases (author's transl)].

Two cases of hepatic amoebic abscesses are reported as having relapsed--one three times, the other twice--after from several weeks to several months of apparent cure by mitronidazole, without recontamination. The following hypothesis can be eliminated: resistance of E. histolytica to metronidazole, poor absorption or faulty diffusion of the drug, its possible inactivation. The persistance of amoebae in the digestive tract, even if they are not detected, seems probable however: either because they are situated in such a way as to be inaccessible to the active metabolities of the metronidazole or because the intra-luminal concentration of these metabolites is not sufficient. The fact that the intestinal parasitism repeatedly leads to the constitution of successive hepatic abscesses in the same person presupposes the privileged anatomic situation of a colonic ulceration which brings about reiterated dissemination through the portal veinous system.

Adult↗