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Biomedical subjects

H Courtois

Publications and source records attributed to H Courtois.

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

[Platelet antiaggregants and atheromatous arteriopathy of the lower limbs].

Antiplatelet therapy (chiefly aspirine alone) greatly reduces the risk of vascular death and vascular events in patients with acute myocardial infarction, past history of myocardial infarction, unstable angina, stroke or transient ischaemic attack, and also in the large categories of patients at increased risk of occlusive vascular diseases. Studies of patients with peripheral arteriopathy demonstrate that antiplatelet therapy significantly reduces the risk of vascular occlusions in patients with intermittent claudication or with saphenous vein grafts or prosthetic implants or angioplasty for lower limb diseases. In trials in high risk patients where patients data were available, antiplatelet therapy produces a similar effect in middle age or old age, in men or women, in diabetic and non-diabetic or in hypertensive or normotensive patients. There is no clear evidence that antiplatelet therapy is indicated in primary prevention. Medium dose aspirin (75-325 mg/d), probably for indefinite continuation, is the most widely tested antiplatelet regimen.

Arterial Occlusive Diseases↗
PubMed1996

[Pseudothromboangiitis obliterans and qualitative protein C deficiency: report of a case].

Thromboangiitis obliterans is a segmental obliterating inflammatory arteritis, usually found in young (below 40) smoking males. Its diagnosis relies on patient history, clinical features, arterial angiography, and more rarely on pathological findings, though none of these is specific of the disease, and on the absence of other diseases such as early atheroma, thromboembolic processes, vascular malformation, trauma, collagen or blood disorders. Raynaud's phenomenon, digital arteritis, superficial and often migrating venous thromboses are further arguments for the disease. However, such associations can also occur during other diseases, especially congenital or acquired deficits in coagulation factors (antiphospholipid syndrome, S protein deficiency...). In our patient with suspected thromboangiitis obliterans, the occurrence of superior longitudinal and right lateral sinus thrombosis led to the discovery of a qualitative C protein defect. This observation stresses the need for careful elimination of a coagulation disorder before confirming the diagnosis of thromboangiitis obliterans.

Adult↗
PubMed1996

[Erythermalgia and systemic lupus erythematosus].

We report three cases of erythermalgia associated with systemic lupus erythematosus corresponding to different clinical situations in such an association. The first patient developed erythermalgia during the course of systemic lupus erythematosus. In the second, erythermalgia preceded other symptoms of systemic lupus erythematosus by four years. In the third, erythromelalgia was not related to a flare-up of systemic lupus erythematosus, but to thrombocythemia, a complication of immunosuppressive therapy. These cases permit a discussion on terminology and classification of erythromelalgia and erythermalgia. However, more than terminology or classification into three types or into adult-onset and early-onset (childhood) erythromelalgia, the important is to consider primary and secondary forms. We used a classification into two types: primary (or erythermalgia) with subdivision into sporadic and familial subtypes, and secondary with subdivision into erythermalgia related to myeloproliferative disorders and erythermalgia related to other diseases, such as systemic lupus erythematosus, or to drugs (erythermalgia-like syndrome).

Adolescent↗
PubMed1996

[Should watermelon stomach be considered to be an unrecognized localization of scleroderma?].

We reported a typical case of watermelon stomach which occurred during the course of a limited cutaneous systemic sclerosis. Watermelon stomach is an important source of upper gastrointestinal bleeding which requires endoscopic treatment. Such an association has already been described and we suggest that watermelon stomach could be an unrecognized localization of scleroderma stomach involvement. Because gut involvement may precede skin manifestations. A search of progressive systemic sclerosis should be done with clinical examination, antinuclear antibodies research (especially anticentromere antibodies) and nailfold capillaroscopy when a such endoscopic appearance is noted.

Gastrointestinal Hemorrhage↗
PubMed1996

[Acquired autoantibodies against human factor VIII: a new case].

The finding of a prolonged partial thromboplastin time and a normal prothrombin time localized the coagulation defect to the intrinsic or contact activation limb of the coagulation cascade. Because the situation is a source of hemorrhage, a rational and rapid approach is necessary with measure of factors of intrinsic limb of coagulation (especially factors VIII and IX, for the diagnosis of classic hemophilia), study of von Willebrand factor and search of coagulation factor inhibitors. We report the case of a 25-year old woman with high titer postpartum antibody against factor VIII for illustrating the diagnosis approach.

Adult↗
PubMed1995

[Childhood acromelalgia a propos of a case revealing Fabry's disease].

The occurrence of an acrosyndrome (Raynaud's phenomenon, erythermalgia, acrodynia...) in childhood may be the first manifestation of a general disease. Though it can be an early onset Raynaud's disease, it could also be the first sign of a connective tissue disease (juvenile polyarthritis, mixed connectivitis...) or of a overload disorder. We report a case of childhood-onset acromelalgia leading to the discovery of Fabry's disease. This chromosome X-linked hereditary disorder, resulting in the ubiquitous accumulation of neutral sphingolipids, is usually rapidly suspected by the finding of "boxer-short" angiokeratoma. Diagnosis is confirmed by the ophthalmic examination (cornea verticillata), by the pathological examination of a skin sample, and by the measure of alpha-galactosidase A activity. Treatment is usually only symptomatic, but the discovery of the mutations responsible for the disease could open the way to specific therapy.

Adult↗
PubMed1994

Localization and solubilization of hyaluronan and of the hyaluronan-binding protein hyaluronectin in human normal and arteriosclerotic arterial walls.

Hyaluronectin (HN), a hyaluronan (hyaluronic acid, HA)-binding glycoprotein isolated from human brain, was studied in normal and atherosclerotic human arteries. It can be detected and assayed in tissue samples by immunohistochemistry. In addition, its high and specific affinity for HA makes it possible to develop specific histological localization of HA using HN as a probe. We tested the presence of HN and HA in human carotid artery samples from adults and newborns. In atheroma-free arterial samples HN was found in the intima, between smooth muscle cells and in the adventitial extracellular matrix. In atherosclerotic lesions, HN was strongly expressed in the diffuse thickened intima and surrounding extracellular microcrystalline calcium deposits, and very little in the lipid core. HA was found in the same locations. The similar localizations of HN and HA shown by immunohistology and demonstration of HN-HA complexes by high pressure liquid chromatography (HPLC) suggest that they are associated in vivo.

Adult↗
PubMed1994

Prevalence and evolution of anticardiolipin antibodies in giant cell arteritis during corticosteroid therapy. A prospective study of 20 consecutive cases.

IgG and IgM anticardiolipin antibodies (aCA) were studied prospectively in 20 consecutive patients (12 females, eight males, mean age 74.6 +/- 14 yr, range 62-86 yr) with giant cell temporal arteritis before and during corticosteroid therapy (days 7, 30, 90 and 180). IgG-aCA were present in 10 out of 20 cases and in nine out of 12 with positive temporal artery biopsy but were not found in 20 paired control subjects. During steroid therapy aCA levels returned to within the normal range in 60% of patients with positive aCA at day 7 and in 80% at day 30. In two cases aCA persisted during the 6-month follow-up despite clinical and biological success. No association was found between aCA and thrombotic events.

Adrenal Cortex Hormones↗