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Biomedical subjects

E Vidal

Publications and source records attributed to E Vidal.

At least 109 records · Page 6Linked to original sources
PubMed1992

Twelve cases of pituitary apoplexy.

In 12 cases of pituitary apoplexy, a preexisting unsuspected adenoma was found. The initial manifestations were sudden onset of headache (12 patients), signs of meningeal irritation (10) with fever (four), altered consciousness (12), and ophthalmologic disturbances (eight). The diagnosis was retrospective in three cases. Radiologic investigations were always suggestive if carefully considered. The plain skull roentgenograms, in particular, showed an enlarged sella turcica in 11 cases. Three patients had prolactin adenomas, and nine had nonfunctional adenomas. Medical treatment was successful in only three patients; surgery was performed in 10 cases by means of a sublabial transseptal microsurgical approach. Postoperative neurologic complications were serious in two cases. Endocrine insufficiencies were common: eight cases of permanent panhypopituitarism, two cases of pluritropic anterior pituitary dysfunction, and three cases of persistent hyperprolactinemia.

Adenoma↗
PubMed1990

[Inflammation proteins in Horton's disease. Prospective study of 25 patients].

In a study of 25 giant cell arteritis patients, whose diagnoses were made by temporal artery biopsy, the authors compared the evolution of the erythrocyte sedimentation rate (ESR) with those of the acute phase proteins (APP): fibrinogen (F), C reactive protein (CRP), orosomucoid (O), haptoglobin (H) and alpha 2-globulins (alpha 2-G), before, during and after corticotherapy; 165 laboratory analyses were made. Prior to treatment, ESR was increased in 96% of the patients, O and H in 100%, F and CRP in 96% and alpha 2-G in 92%. CRP showed the greatest mean increase (21x). Statistically significant positive correlations were found between ESR and alpha 2-G, F, CRP and O. No significant relationship was observed between APP and the occurrence of ophthalmological complications or the length of treatment. The CRP level returned to normal within the first week of steroid therapy for 76% of the patients, before ESR, F and O. During the withdrawal phase of corticotherapy, an ESR greater than 30 mm almost always corresponded to an inflammatory syndrome and an ESR of less than 15 mm to its absence (kappa coefficient = 0.64, p less than 0.001); however, an ESR between 15 and 30 mm did not enable us to draw a conclusion as to the absence or presence of such a syndrome. After terminating steroid therapy, the relationship between ESR and an inflammatory syndrome was weaker (kappa coefficient = 0.57, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[AL amyloidosis and primary fibrinolysis. Study of the mechanism of fibrinolysis].

A 45 years old woman with AL amyloidosis presented with a hypofibrinogenemia (fibrinogen 100 mg/dl) without severe bleeding. There was laboratory evidence of fibrinolysis with shortened euglobulin lysis time, decreased alpha-2 plasmin inhibitor and decreased plasminogen. The mechanism of this primary fibrinolysis remains unclear, since there is no enhancement of the tissue-type plasminogen activator. Analysis of the 8 cases related in the literature of excessive fibrinolysis associated with amyloidosis demonstrated improvement of bleeding manifestations and abnormal fibrinolysis following the administration of antifibrinolytic agents.

Amyloid↗
PubMed1989

Surgical significance of persistent cholecystohepatic ducts.

Anatomical variations of the biliary tract occur frequently enough so as to worry the general surgeon dealing with this problem. Generally speaking, these anatomical variations are not identified prior to surgery. Anomalous drainage of the common hepatic duct into the gall bladder was identified while performing a cholecystectomy. The common bile duct proximal to the cystic duct was atretic. The problem described above was successfully managed by hepatico-jejunostomy.

Adolescent↗
PubMed1988

[Antithyrotropin receptor antibodies in a series of Basedow's disease].

Thyrotrophin binding inhibiting immunoglobulins (TBII) were tested in 40 Graves' disease patients with hyperthyreosis, by an isotopic receptor assay (TRAK-Assay Behring). The samples were taken before, during and at the end of the hyperthyroid treatment. TRAb were present in serum of 86.67% of the patients before the treatment and in none of the 20 healthy control volunteers. There was no correlation between TRAb values and either the clinical signes of the disease neither the other thyroidal antibodies. After discontinuation of the antithyroid therapy (18 to 24 months after the onset) TRAb were negative in 71.4% of the patients; among this group 33% had a late relapse of the disease. In the positive TRAb group after discontinuation of the antithyroid therapy, 83.3% had a relapse of the disease and this relapse occurred shortly. There is a significant correlation between the TRAb values and the occurrence of relapse. In conclusion, TRAb values at the end of hyperthyroid treatment in Graves' disease patients seems to be a useful predictor value of the clinical course of the disease. This may be also a good help in the decision to continue or discontinue antithyroid therapy in Graves' disease patients with hyperthyreosis.

Adolescent↗
PubMed1988

[Agranulocytosis caused by dapsone. Apropos of 3 cases. Review of the literature].

Authors describe three cases of agranulocytosis in patients with giant cell (temporal) arterities treated with Dapsone and corticosteroids. The culture in vitro of CFU.GM. cells of two patients, four healthy subject and two patients treated with Dapsone with out granulopenia, demonstrates no any toxic effect of Dapsone. A review of the literature finds 59 cases of agranulocytosis in patients treated with Dapsone alone or in combination with other drugs. Doses of Dapsone ranged from 25 mg to 300 mg a day. Agranulocytosis occurred between the 4th and the 12th week, more often near the 8th week. Agranulocytosis occurred suddenly without previous granulocytopenia. These facts argue for immunoallergic mechanism. This Dapsone side effect requires to restrict its use and to reserve it to serious diseases or failures of other therapeutic drugs. It needs too to keep a close eye on the patients between the 6th and 12th week.

Aged↗
PubMed1987

[Dietary carotenodermias].

Four cases of carotenodermia are presented, secondary to marked ingestion of carotenoid-rich vegetables. The first case was a 34 year old woman who presented with yellow palms and soles while on Weight Watchers diet. Loss of weight was accompanied by irregular menses. The second case was a 21 year old woman with orange palms and soles probably due to lycopenemia by tomatoes rich regimen. The third case is a 52 year old woman with the same type of diet as in case 1, associated with high cholesterol level. The fourth case is a 1.5 year old boy with a high intake of commercially available meals ("petits pots"). All the patients were free of disease usually associated with high level of carotenemia. Irregular menses or amenorrhea may be observed in such cases, either due to the rapid weight of loss, or as a manifestation of psychiatric disorder, and anorexia nervosa is possibly encountered. The toxicity of carotenoids is unproven and others substances ingested with high content vegetables diets are possible answerables.

Adult↗
PubMed1986

[Disulon in the treatment of Horton's disease. Experience with 20 patients].

Disulon (Dapsone) was used in 20 patients with Horton's disease, with the object of reducing steroid therapy. In a retrospective series, Dapsone was prescribed in 12 patients with severe complications of steroid therapy; it was possible to reduce the dose of steroids by about 50 p. 100 in under 3 months without causing a flare-up of the disease. In a prospective series of 8 patients, Dapsone was given at the outset with Prednisone; the results were compared with a control series of 8 patients--the dose of steroids could be reduced earlier, the total duration of steroid therapy was shorter, and the total dose of steroids was lower. The main side effect of Dapsone is haemolysis which may give rise to anaemia, the severity of which is usually dose-dependent. A daily dosage of 75 to 100 mg would seem to provide a good compromise between the anti-inflammatory and haemolytic effects. Dapsone should always be given in association with steroids in the treatment of temporal arteritis; a closer biological surveillance of patients treated with association is necessary.

Aged↗
PubMed1986

[Arterial stenoses of the arms in Horton's temporal arteritis. Apropos of 3 cases. A review of the literature].

The authors describe three histologically documented cases of temporal arteritis complicated by arteritis of the upper limbs confirmed by arteriography. The evolution during treatment was followed up until recovery. A review of the literature underlines the frequency of upper limb arteritis in Horton's disease. It may be the presenting feature or, more commonly, occur during the evolution of the condition. It may give rise to ischaemic symptoms and/or an arterial bruit and/or asymmetric blood pressure readings which should be looked for routinely. Doppler ultrasound may be helpful. Arteriography shows that the lesions are usually bilateral, on the subclavian and axillary arteries. Giant cell arteritis has been found on arterial biopsy. Upper limb arteritis necessitates renewed or increased steroid therapy which may be beneficial in the absence of thrombosis. These arterial lesions have also been reported in some cases of polymyalgia rheumatica. Several cases of isolated upper limb arteritis without temporal arteritis or polymyalgia rheumatica have also been described.

Aged↗
PubMed1981

[Doppler examination in temporal arteritis. Preliminary results (author's transl)].

Nine patients with histologically confirmed Horton's diseases were explored by Doppler ultrasound examination, before and after corticotherapy, of the cervical arteries, temporal arteries (N = 9), and branches of the ophthalmic artery: internal nasal (N = 9), central retinal, and supraorbital (N = 6). Excellent correlations existed between histological findings and results of Doppler examination, concerning the severity of the lesions (80% correlation). Circulatory slowing was evident in the ophthalmic vessels studied, with alterations in the shape of peak velocities in 6 of the 9 cases. Major abnormalities were present in 3 patients; two of them presenting transient or permanent amaurosis. Doppler curves improved after corticotherapy, their shape and amplitude becoming equivalent to those of a control population of the same age. Doppler examinations appear to be of diagnostic value in Horton's disease, as well as being able to predict the risk of ophthalmological complications; more effective surveillance of corticotherapy is possible.

Adrenal Cortex Hormones↗