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Biomedical subjects

D Charles

Publications and source records attributed to D Charles.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Streptococcal puerperal sepsis and obstetric infections: a historical perspective.

The streptococcus, responsible for inestimable morbidity and mortality among parturient women since the 16th century, is no longer a significant cause of puerperal infection. Although the problem of the group A streptococcus in obstetrics has abated, the obstetrician is now confronted with the group B streptococcus, which is a major cause of fetal, neonatal, and maternal morbidity and mortality. Some historical insight into the infectious disease problems encountered by obstetric practitioners during the last four centuries allows comparison and contrast between the historic scourge of childbed fever and present day obstetric infections.

Anti-Bacterial Agents↗
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Diagnostic considerations in intra-amniotic syphilis.

Amniotic fluid is rarely used in the evaluation of syphilis during pregnancy but was available from a woman with positive serologic tests in the 30th week of gestation. Nonmotile intra-amniotic spirochetes were seen by dark-field microscopy 20 hr after treatment with benzathine penicillin G. The identity of the organism in amniotic fluid was confirmed by immunofluorescent staining. Less than 0.5 units/ml of penicillin was present in the amniotic fluid at this time. The amniotic fluid was positive in the Venereal Disease Research Laboratory (VDRL; Atlanta, GA) test, and the concentration of IgM was elevated as was the ratio of lecithin to sphyngomyelin. Phosphatidyl inositol and phosphatidyl glycerol were also present in the amniotic fluid. After treatment the lecithin-sphyngomyelin ratio declined; phosphatidyl glycerol disappeared, whereas phosphatidyl inositol was still present. Despite evidence of intrauterine growth retardation at 30 weeks, the infant born at 37 weeks was of normal weight and length; however, the head circumference was below the tenth percentile. These studies suggest that analysis of amniotic fluid may provide new insights into the biology of syphilis in pregnancy, but does not constitute a recommendation for routine examination of the amniotic fluid in mothers with reactive serologic tests for syphilis.

Adult↗
PubMedDate not supplied

Abnormalities of cilia in the middle ear in chronic otitis media.

We studied the fine structure of nasal and middle ear mucosa in 18 patients with chronic otitis media, comparing them with ten age-matched control patients. Electron microscopy revealed no single fundamental defect of cilia in the tissue samples; however, patients with chronic otitis media had a significantly higher incidence of abnormal cilia in the middle ear without correlating abnormalities of nasal cilia. These findings indicated that ciliary anomalies, including deletion of ciliary microtubules, presence of supernumerary tubules, and fusion of cilia, occur as a result of infection or inflammation. Such abnormalities would impair normal mucociliary clearance and exacerbate clinical complications.

Adult↗
PubMedDate not supplied

[From suspicion to diagnosis. Clinical, epidemiological, radiological and endoscopic aspects of bronchopulmonary cancer in Senegal. Apropos of 700 endoscopies performed at the Principle Hospital of Dakar from 1987 to 1990].

700 bronchial endoscopies were performed over a period of three years at the Dakar "Hôpital Principal". 40 bronchopulmonary cancers were identified (34 epidermoid, 4 adenocarcinoma, 2 with "small cells") out of 80 suspect cases. When we examine the clinical, radiological, endoscopic features, we are able to classify the following as the most established facts: 1. Higher radiological frequency of the pulmonary retractile condensation syndrome (40 cases). 2. Main frequency of proximal granulated tumors (45) in comparison with endoscopic bronchial stenosis (22). 3. Identification almost exclusive of bronchial epidermoid cancer in that series (34). 4. Male sex and smoking are two unequivocal elements of that pathology. Bronchial endoscopy, absolutely necessary test easy to perform and to get, enables to visualize a lesion and to bring forward the indisputable histological evidence through the biopsy either alone or associated with endoscopic brushing and alveolar washing.

Adult↗
PubMedDate not supplied

[Parietal fibroplastic endocarditis].

Parietal fibroplastic endocarditis is commonly observed in two main diseases: Löffler' endocarditis and Davies' endomyocardial fibrosis. Endocarditis' damage is explained by the cytolytic effects of basic proteins present in eosinophil granules (major basic protein and cationic protein); long standing and amount of eosinophilic cells condition anatomic lesions. The clinical features are explained by the ventricular seat of endocarditis lesions (right, left, or both). They include in all cases: tricuspid and/or mitral insufficiency, adiastolic syndrome. Two-dimensional echocardiography has improved the diagnosis; ventricular angiocardiography remains the reference examination. Prognosis has been largely improved these recent past years by surgical endocardiectomy and valvular conservative surgery among children.

Endocarditis↗
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[Deep mycoses rarely described].

Beside deep mycoses very well known: histoplasmosis, candidosis, cryptococcosis, there are other mycoses less frequently described. Some of them are endemic in some countries: South American blastomycosis in Brazil, coccidioidomycosis in California; some others are cosmopolitan and may affect everyone: sporotrichosis, or may affect only immunodeficient persons: mucormycosis. They do not spare Africa, we may encounter basidiobolomycosis, rhinophycomycosis, dermatophytosis, sporotrichosis and, more recently reported, rhinosporidiosis. Important therapeutic progresses have been accomplished with amphotericin B and with antifungus imidazole compounds (miconazole and ketoconazole). Surgical intervention is sometime recommended in chromomycosis and rhinosporidiosis.

Adult↗
PubMedDate not supplied

[Post-infarct posterior aneurysm of the left ventricle. Apropos of a successful surgical case in an African].

The authors report the first case in the literature of a post-infarction left ventricular (LV) aneurysm operated in a black African man of 31 years. The episode of infarction had been ignored, and the patient presented a posterior LV aneurysm with moderate mitral insufficiency and heart failure. The diagnosis was made by a cineangiogram in the LV and a coronary angiogram showing a total obliteration of the right coronary. The patient underwent a resection of the aneurysm with closure of the LV-aneurysm communication. Six months after surgery, the patient was asymptomatic and the size of the heart had decreased. With regard to this unique case, the authors discuss the literature on LV aneurysms in African, and on coronary atherosclerosis in Africa. They discuss also the surgical indication in case of post-infarction LV aneurysm.

Adult↗
PubMedDate not supplied

[Diagnosis of bilharziasis from Schistosoma mansoni in the early stage: apropos of 77 cases].

Schistosoma mansoni infection was diagnosed in 77 patients among 184 men (41.8%) coming from a regiment which had stayed in an endemic area. When it was recognized, this affection had no symptom in 48% of cases. When symptoms were present, they were general or allergic signs, and digestive troubles. Diagnosis, conjectured by hypereosinophilia, was confirmed by discovery of ova in 34 cases, and, in another hand, by positive immunofluorescence in 43 cases without evidence of parasite. This serological test is the best one for diagnosis, at the outset of disease.

Fluorescent Antibody Technique↗
PubMedDate not supplied

[Historical multifocal tuberculosis in an African (apropos of a case report)].

A case of multifocal tuberculosis, similar to historic description of the disease is reported in a clear skinned African. Lungs, bones and joints (vertebreae, sternum, os coxae), liver and esophagus were affected by the disease. The low level of resistance found in the patient could explain this dissemination. Generally, prognosis is not compulsorily bad if the germ is sensitive to an additional chemotherapy which needs to be sufficiently prolonged.

Adult↗