Biomedical subjects
Publications and source records attributed to F Lustman.
We present an unusual observation actinomycosis involving muscles of the back and probably of one thigh in a patient with pulmonary lesions. The patient was alcoholic and a heavy smoker and his teeth were in very poor repair. Opportunity is taken to review the literature on the rare cases of muscular actinomycosis.
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We report an unusual observation of Yersinia enterolitica (YE) bacteremia with subcutaneous with subcutaneous abscesses on the scalp and, by gradual extension, cerebritis in a diabetic patient. All clinical signs disappeared after surgical drainage of the abscesses and protracted antibiotherapy. The well-known affinity of YE for iron led us to demonstrate an unrecognized hemochromatosis.
Idiopathic acquired sideroblastic anemia is not a common disease. We studied the renal tubular function in such patients. Patients have lower calcium than controls (8.46 mg/dl +/- 0.59 vs 9.16 +/- 0.53). We have highlighted the multiple renal anomalies observed in patients with this type of hemopathy. The serum phosphate levels are lower in patients than in controls (2.73 +/- 0.36 vs 3.3 +/- 0.55 mg/dl, p = 0.0048). We found higher glycosuria (21:43 +/- 42.58 vs 0.0 +/- 0.0 mg/dl), total aminoaciduria (6280 +/- 3943 vs 4138 +/- 2269 microMol/g creatinine, p = 0.19) and lower maximum capacity for phosphate reabsorption by the renal tube (TmPO4) (2.11 +/- 0.38 vs 2.9 +/- 0.73 mg/100 ml GFR, p = 0.0027) in the patients. The association between idiopathic acquired sideroblastic anemia and the multiple tubular anomalies corresponding to the syndrome initially described by Fanconi has not been reported to date. The underlying mechanism is not understood, but, taken separately, these two anomalies commonly present heme metabolic anomalies in the mitochondria. We hypothesize that this syndrome could represent the clinical expression of a mitochondrial cytopathology.
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Two hundred and thirty-three patients (66 males and 167 females), aged 24 to 92 years, with congestive cardiac failure were entered into a long-term study to evaluate the efficacy and tolerability of treatment with a fixed dose combination tablet containing 1 mg bumetanide and 5 mg amiloride. One hundred and fifty-five patients were treated for 52 weeks. The daily dosages were 1 tablet (113 patients), 2 tablets (35 patients), 3 or 4 tablets (7 patients). Treatment was associated with a marked reduction in the prevalence of ankle oedema, dyspnoea and pulmonary crepitations, and with statistically significant decreases in body weight, pulse rate and calf measurement. Mean serum potassium showed a small but statistically significant increase, but serious hyperkalaemia was not encountered. Although serum sodium decreased, serious hyponatraemia did not occur. No clinically significant effects on hepatic, renal or haemopoietic function were observed. Minor adverse effects, most of which resolved spontaneously, were reported by 60 patients. Only 14 (6.0%) patients ceased treatment because of adverse effects.
We present a case of bilateral oculomotor nerve paralysis induced by alpha II-interferon in a patient with hairy-cell leukemia. After the drug was withdrawn, the neurological abnormalities disappeared. The more frequent neurological psychiatric, and electroencephalographic side effects are reviewed.
A case of chronic lymphocytic leukemia (CLL) is described during the course of which paraplegia appeared caused by epidural compression of the tissue by leukemic cells. This complication in CLL is rare. The disorders of the nervous system during the course of leukemia are summarized, and, in particular, the circumstances pertaining to the occurrence of paraplegia during chronic lymphocytic leukemia.
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Sucralfate is an effective medication for treatment of gastroduodenal ulcers, and 99mTc-labeled sucralfate has been found to adhere to ulcers. In this study, we examined the reliability of confirming the diagnosis of gastroduodenal ulcers--previously detected by endoscopy and histology--by means of sucralfate labeled with 99mTc, imaging 1 and 2 hr after oral administration. Eighteen out of 23 patients were positive by scintigraphy with this method (sensitivity = 78%). In five patients with gastroduodenal bleeding, the study was positive. The procedure was well tolerated and offered a noninvasive procedure that can be performed at the bedside in critically ill patients, and in follow-up of fragile patients.
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