[Saccharomyces boulardii fungemia. Apropos of a case].
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Biomedical subjects
Publications and source records attributed to G Leroy.
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In a series of 296 patients treated in our centre by dialysis and/or renal transplantation over the last 15 years, the actuarial survival rates at 5, 10 and 15 years were 79, 68 and 57 percent respectively. Comparing the influence on survival of each of these two treatments separately should avoid two methodological biases represented by the sequential risk due to the succession of treatments and by different pretherapeutic situations. We therefore analysed these patients' survivals by the unbiased Mantel-Byar method, using a comparison of multiple survival factors (Cox's technique). We showed that treatment was an independent factor of survival and that transplantation had a more beneficial effect than dialysis. However, these replacement techniques seem to have less influence on survival than the pretherapeutic situations.
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The possibility of cardiac involvement in Takayasu's disease is well known, but this involvement generally appears to be secondary to reno-vascular hypertension or to pulmonary arteritis and, exceptionally, as a result of coronary disease. In the case reported here, the inflammatory myocardial lesion localised to the left ventricle was demonstrated while the patient was still alive. It was responsible for an episode of severe heart failure which finally resolved after 2 years. The inflammatory involvement of the myocardium was associated with laboratory signs of inflammation and with inflammatory arterial lesions. Several haemodynamic investigations were performed to follow the course of the disease. The diagnosis was confirmed by myocardial biopsies and by the pulmonary arterial and renal arterial involvement. A review of the literature revealed that this condition was extremely rare and has only been proven in a few autopsy cases.
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Scintigraphy of salivary glands might appear to be a relatively minor test in the study of the morphology of the salivary glands and especially tumours. However, with recent technical progress, it is an extremely useful test in th study of the function of the principal salivary glands. Changes in salivary secretion in certain severe facial paralyses could become an interesting prognostic test; on this subject, the simultaneous abnormalities in sub-maxillary and parotid salivary secretion in these cases of paralyses poses a physiological problem. The study of salivary junction is indispensable in the exploration of aptyalia (in particular in the Sjögren's syndrome), and in sialosis.
The skin trauma due to the surgical incision used to get at the middle ear can produce an epidermic cyst. This thesis is backed up by four cases of epidermic cysts which appeared several years after an operation on the middle ear, and in three cases it was in the temporal region and in one case in the parotid region. It is therefore quite probable that such cysts can be mistaken for relapsing cholesteatoma. For the same reason, one can never exclude a priori an epidermic cyst in the middle ear or around the ear in a patient who has been operated, and in whom no epidermic tissue was seen during the operation.