To ascertain the responsibility of renal artery thrombosis for the genesis of arterial hypertension, the methods available are not sufficiently sensitive and reproducible, and the residual revascularization maintained by a vicarious arterial network is not easy to demonstrate. Renal scintigraphy with technetium 99m-labelled mercaptoacetyltriglycine (MAG3) was performed in 4 old and severely hypertensive male patients with chronic thrombosis of one renal artery. With this tracer the thrombotic kidney was detected lately and weakly at the vascular and nephrographic stages. When the functions of both kidneys were compared, that of the affected kidney was always estimated at less than 5%. At the excretory stage a residual activity could be detected in the kidney with renal artery thrombosis. Owing to the specific biophysical behaviour of the tracer, MAG3 scintigraphy coupled with arteriography and assays of plasma renin activity in the veins contribute to the decision concerning nephrectomy.

Aged↗

PubMedDate not supplied

[Is anorexia nervosa a cultural disorder?].

Several epidemiological studies as well as clinicians' experience indicate that during the last four decades anorexia nervosa, perfectly described in the 19th century, has become increasingly frequent in industrial societies. In contrast, the disease is said to be extremely rare in traditional societies where it appears only when the life style has been "occidentalized". As a pathology of starvation in a society of abundance, anorexia nervosa lies at the cross-roads of biology and society by referring to two sectors with strong cultural determinations: the ideal body shape and the moral value of food. In a more subtle way, the ever growing incidence of the disease might also coincide with the expansion of such occidental moral values as self-control and individualism and with changes in family structure. Anorexia nervosa may be regarded as a culturally determined illness that "shapes" in a stereotyped mould psychological or even neuroendocrine disorders which vary from one patient to another. This brings it very close to the "culture-bound syndromes" or "ethnic disorders" described by ethnopsychiatrists.

Anorexia Nervosa↗

PubMedDate not supplied

[Antiprothrombinase and myocardial infarction. Apropos of 2 cases].

Among the thrombotic events associated with a circulating anticoagulant of the antiprothrombinase type, myocardial infarction is exceptionally reported, which justifies the presentation of two cases. In both patients, myocardial necrosis occurred some time after the antiprothrombinase was discovered, and there was nothing special in its clinical features. No obvious atherosclerotic lesion and no image suggestive of vasculitis were found at coronary arteriography, which suggested that the antiprothrombinase played a predominant role in the genesis of infarction. Relationships between antiprothrombinase, arterial thrombosis (particularly of the coronary arteries) and the presence or absence of systemic lupus erythematosus (SLE) are discussed. As observed in thrombosis of other arteries, it is not certain that the presence of SLE constitutes an additional risk factor, except in cases with unquestionable vasculitis or if the treatment of SLE requires prolonged corticosteroid therapy. On the other hand, the appearance of an antibody directed against phospholipids is not necessarily related to the presence of SLE; in fact, this antibody itself might be a risk factor of myocardial infarction, as has recently been suggested.

Adult↗

PubMedDate not supplied

[Clinical study of 105 cases of isolated weight loss in internal medicine].

We arbitrarily define "isolated weight loss" as the loss of at least 10 p. 100 of body weight over less than one year, without any single cause being disclosed by questioning, physical examination and such paraclinical examinations as blood electrolytes, blood count and differential, routine dipstick urinalysis and X-ray of the chest. Among the 105 patients we studied, the causes of isolated weight loss were: (1) psychic disorders (chiefly depression) in 60 p. 100 of the cases; (2) a variety of organic diseases in 29 p. 100, including gastrointestinal diseases (8 p. 100), cardiovascular and respiratory diseases (6 p. 100), Horton's disease (4 p. 100), Portuguese amyloidosis (1 p. 100), unexplained inflammatory syndrome (1 p. 100), endocrine disease (hyperthyroidism, 4 p. 100) and intoxication with medicines, alcohol or heroin (5 p. 100); (3) no definite cause could be found in 11 p. 100 of the cases. We suggest a diagnostic approach involving a limited number of examinations, viz.: erythrocyte sedimentation rate, measurement of transaminases, gamma GT and alkaline phosphatase enzymes, abdominal ultrasonography and ultra-sensitive TSH assay. We consider it important to switch from useless paraclinical tests to the detection and management of psychic disorders. Weight loss is a frequent motive of consultation, but its diagnostic value is often misunderstood. The purpose of this study was to provide data for the artiological diagnosis of isolated weight loss--a relatively frequent problem in internal medicine.

Adult↗

PubMedDate not supplied

[Uveitis: etiological aspects].

Explore the source record for details and available documents.

Humans↗

PubMedDate not supplied

Mucosal ulcerations revealing primitive hypereosinophilic syndrome.

We report the case of a 27 year-old man developing recurrent oral aphtosis associated with fever and 8 kg of weight loss. Moderate splenomegaly was observed on physical examination and neurological and cardiac examination were normal. Laboratory findings included marked eosinophilia at 3280 giga/l. Bone marrow (BM) examination revealed a myeloproliferative syndrome with mature eosinophils. Splenectomy was performed because of a suspected nodule on the BM, the histopathology revealed a myeloid metaplasia. The diagnosis of myeloproliferative form of hypereosinophilic syndrome (HES) was made. He was treated with interferon-alfa and hydroxyurea. After two years of treatment he had no ulcer recurrence and eosinophil count was at 180 giga/l. Mucosal manifestations as a prodromal symptom of HES are rare. The histology of the lesions shows numerous eosinophils; immunohistochemical analysis confirms the presence of eosinophil peroxydase, major basic protein and eosinophil derived neurotoxin. A few cases have been described. Death occurs 11 months to 5 years after the diagnosis of oral ulcerations. The treatment consists of interferon-alfa and hydroxyurea.

Adult↗