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Biomedical subjects

C Richart

Publications and source records attributed to C Richart.

At least 91 records · Page 5Linked to original sources
PubMed1996

Metastatic breast carcinoma presenting as obstructive jaundice.

A case of obstructive jaundice due to extrahepatic intraductal biliary metastasis from a breast carcinoma is reported. This clinical picture was a late manifestation and the first evidence of spread of the disease. The patient was treated by surgical decompression with relief of jaundice but died 5 months later. In patients with a history of carcinoma of the breast, the possibility of extrahepatic biliary metastasis should always be considered in the differential diagnosis of jaundice. Because this condition is amenable to palliation, it is important to differentiate it from jaundice due to hepatic involvement by this tumor.

Adenocarcinoma↗
PubMed1995

Medullary thyroid carcinoma mimicking an autonomous functioning nodule.

A 42-year-old woman with a medullary thyroid carcinoma (MTC) inside of an autonomously functioning thyroid nodule is reported. The patient was initially diagnosed of a hyperfunctioning autonomous thyroid adenoma but the histopathological and immunohistochemistry study were diagnostic for a MTC. This is the first case of a medullary thyroid carcinoma associated with thyroid hyperfunction which was presented as a hot nodule in the scintigraphy. We propose a systematic performance of a fine needle biopsy in all thyroid nodules because of the possibility of carcinoma associated to functioning nodules could be present.

Adult↗
PubMed1995

A tumor necrosis factor-beta polymorphism associated with hypertriglyceridemia in non-insulin-dependent diabetes mellitus.

Non-insulin-dependent (type II) diabetes mellitus is associated with significant abnormalities of lipoprotein metabolism. Control of glycemia rarely completely corrects the alterations in lipid metabolism, suggesting a participation of environmental and genetic factors. The observation that tumor necrosis factor (TNF) can modulate triglyceride metabolism offers a new genetic candidate to be analyzed. Samples of DNA from 91 control subjects and 61 diet-treated type II diabetic patients were analyzed to determine the lipid profile and a possible association with TNF genetic polymorphisms. For TNF restriction fragment length polymorphisms, we used the Nco I restriction enzyme and a TNF-alpha probe obtaining two allelic bands at 10.5 and 5.5 kb. We found a significant association (P < .01) of the 10.5-kb homozygous genotype in type II diabetic subjects with high triglyceride levels. Furthermore, these patients showed significant differences in triglycerides as compared with matched control subjects with the same genotype (P < .001). This study provides support for considering the TNF locus as a susceptibility genetic region in the hypertriglyceridemia of type II diabetes.

Adult↗
PubMed1995

[Esophageal intramural pseudodiverticulosis].

Esophageal intramural pseudodiverticulosis is an uncommon and benign primary disease of the esophagus. Less than 150 cases have been reported. We report a new case diagnosed by endoscopy during the investigation of an upper gastrointestinal bleeding, in a 48-year-old man who was assymptomatic from the esophageal point of view. We discuss the clinical, pathogenic, diagnostic and therapeutic aspects of this disease.

Diagnosis, Differential↗
PubMed1995

[Evaluation of serum adenosine deaminase as a prognostic marker in the treatment of human immunodeficiency virus infection with zidovudine].

BACKGROUND: Adenosine deaminase (ADA) is a key enzyme in cellular immunity. It catalyses the reaction 2'deoxyadenosine to 2'deoxiinosine, a critical step in the production of essential metabolites for the synthesis of nucleic acids. Its main physiological activity occurs in T cells of lymphoid tissue. The advanced HIV infection is characterized by a severe and progressive cellular immunity compromise. Partial positive results have been obtained with Zidovudine (AZT), a drug which Serum adenosine deaminase has been proposed as a useful marker for the assessment of the therapy response in these patients. METHODS: Serum ADA activity was determined in patients infected with HIV in stage II, before and after four months of therapy with AZT, regarding variations in its activity with improvements in biological parameters--CD4 and CD8 lymphocytes. RESULTS: Patients infected with HIV showed a significant increase in ADA activity compared with patients in the control group: 21.6 +/- 5.4 vs. 10.4 +/- 2.3 U/l (p < 0.001). Therapy with AZT decreased ADA activity: 21.6 +/- 5.4 vs. 15.2 +/- 4.3 U/l (p < 0.001) and correlated with an increase in CD4 counts: 187 +/- 105 vs. 353 +/- 145/mm3 (p < 0.001) and in CD4/CD8 ratio: 0.188 +/- 0.10 vs. 0.382 +/- 0.18 (p < 0.001). CONCLUSIONS: The detection of a decrease in ADA correlates significantly with a favourable outcome in immunological parameters in individuals infected with HIV in stage II of disease treated with AZT.

Adenosine Deaminase↗
PubMed1994

Analysis of the contribution of the HLA system to the inheritance in the Wolfram syndrome.

The Wolfram syndrome (WS) is an autosomal recessive disorder beginning in childhood that consists of four clinical features: diabetes insipidus, diabetes mellitus, optic atrophy and deafness. Its pathogenesis remains unknown, although the tendency to develop this syndrome has been related to some class II antigens of the HLA system. We report six new cases in four families. A review of published data from the genetic features of this syndrome is performed, establishing the high frequency of the HLA-DR2 antigen in the WS (44.4%) compared with a control group (21.9%; relative risk, 2.8) and to patients with Type 1 insulin-dependent diabetes mellitus (Type 1 diabetes) (6.77%; relative risk, 9.7). We also comment the high frequency of the HLA-DQw1 antigen (85.5%) in this syndrome, without statistical significance. A familial segregation study of the HLA haplotypes has been carried out without finding correlation between the autosomal recessive pattern attributed to the WS, and the major histocompatibility complex. In conclusion, whereas HLA may increase susceptibility to the WS, as shown by the existence of an HLA-DR2 association, the major genetic influence on the inheritance of the WS must be at another locus.

Female↗
PubMed1994

[Granulomatous hepatitis and fever of unknown origin].

In this paper, we review the etiological, clinical and evolutive aspects of patients with fever of unknown origin (FUO) whose hepatic biopsy showed the presence of granulomas (GH). This is retrospective study covering a period of 10 years (1982-1991). The clinical records of all the patients hospitalized due to FUO (n = 71) and of all those in whose hepatic biopsy the presence of GH (n = 70) was documentated, were reviewed. Thirty patients fulfilled both criteria: FUO + GH. In our environment, Q Fever is the most frequent cause of FUO and GH in patients without infection by the HIV. On the contrary, in patients infected by HIV, the most frequent etiology is tuberculosis.

Adult↗
PubMed1993

T wave alternans associated with amiodarone.

T wave alternans is an intriguing phenomenon widely observed in some experimental conditions, but rare in clinics. The authors describe a case of T wave alternans associated with amiodarone treatment. This electrocardiographic finding spontaneously reverted and was not associated with ventricular arrhythmias or hemodynamic depression. Mechanisms that may be responsible for alternation of the T wave are discussed.

Amiodarone↗