Biomedical subjects
Publications and source records attributed to J Bonal.
From 1989 to 1991, the level of resistance to ciprofloxacin in our hospital increased from 0.47% to 6.7% in opportunistic Enterobacteriaceae, from 9.9% to 16% in Pseudomonas aeruginosa and from 8.27% to 31.8% in Campylobacter jejuni-coli. We also observed an increase in quinolone consumption from 1.1 in 1989 to 1.5 defined daily doses per 1000 inhabitants per day in 1991.
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alpha-Tocopherol is transferred from serum to erythrocytes by high-density lipoproteins (HDL). We have studied total serum, HDL and erythrocyte tocopherol concentration in uremic patients on hemodialysis (HD; n = 18) and continuous ambulatory peritoneal dialysis (CAPD; n = 14), and the relationship between HDL and erythrocyte tocopherol content. Serum and erythrocyte tocopherol were determined by high-performance liquid chromatography. Serum tocopherol levels were higher in CAPD patients (p < 0.05) than in control (n = 30) and HD groups. Erythrocyte tocopherol was lower in HD patients than in the controls but there were no differences between CAPD patients and the control group. Bioavailable tocopherol was found to be normal in both HD and CAPD patients. HDL-tocopherol was lower in both HD and CAPD groups, but probably enough to reach a normal level of tocopherol in erythrocytes, as has been demonstrated in CAPD patients. So, although a defect in the transfer of tocopherol to red blood cells is possible, some other causes could influence it too, as a greater antioxidant consumption in HD patients.
A case of glomerulocystic disease in a young adult with no family history or presence of other extrarenal malformations is described. Histological study revealed the presence of numerous cortical cysts corresponding to dilatations of Bowman's space. The patient had mild stable chronic renal failure for 5 years. In our patient, the disease corresponded to a sporadic adult form of glomerulocystic disease.
The authors report two cases of myocarditis in young individuals in whom clinical and electrocardiographic findings during the acute phase could have led to an erroneous diagnosis of myocardial infarction. The problem in such cases is that of a differential diagnosis with infarction with normal coronary arteries. Few clinical or paraclinical arguments are of diagnostic value, endomyocardial biopsy remaining the reference investigation. Proof of viral infection is not always obtained. It is often the retrospective argument of "complete return to normal" which supports the clinical impression. This usual benign outcome is not always the case, since cases of cardiogenic shock have been reported. The dual nature of the pathogenesis ("myositis" and/or "vasculitis" with thrombus and actual MI) is stressed.
The mass transfer area coefficient (MTC) is the best parameter for solute transport evaluation in continuous ambulatory peritoneal dialysis (CAPD) patients. We compared three simplified MTC methods (calculated according Garred, Krediet, or Lindholm) and the peritoneal equilibration test (PET) (Twardowski) to complex MTC (MTCX) (Randerson and Farrell) for urea and creatinine, by means of 29 tests performed in 24 stable CAPD patients. There were no significant differences (paired t-test) between MTCX and each of the simplified MTC, except for creatinine MTC calculated by Krediet's method, which was significantly different (MTCX: 9.36 +/- 4.32, K-MTC: 10.48 +/- 4.55, p < 0.05). Likewise, there was an acceptable correlation between complex MTC and each of the simplified methods including the PET. However, a more detailed study of the MTC's categorizations shows poor agreement with complex MTC categorization. Better results are obtained by PET categorization, which reaches good likelihood ratios either for positive or negative events. We conclude that simplified MTC or the dialysate/plasma ratio at 240 minutes for urea and creatinine has an acceptable correlation with complex MTC and can be useful in clinical practice. There is poor agreement between solute transport categorizations of simplified MTC and complex MTC. There is a better coincidence between the PET (D/P at 240 minutes) and complex MTC categorizations.
The authors report the case of a patient with a serious recurrence of pulmonary embolism with echocardiographic evidence of a floating serpentine thrombus of the right atrium. The outcome was rapidly satisfactory with disappearance of signs of acute cor pulmonale and lysis of the right atrial thrombus after infusion of two thrombolytic agents: Rt PA and streptokinase. There is no evidence in the literature to indicate that one form of treatment, i.e. surgical thrombectomy or thrombolysis, is markedly superior to the other. Thrombolysis appears to be a useful alternative to surgery. The use of Rt PA and of the combination of two thrombolytics has not been published previously and merits confirmation.
The authors report a case of a single secondary tumour of the pericardium presenting as tamponade and occurring three years after sigmoidectomy for an adenocarcinoma of the colon. Gastrointestinal investigations confirmed the absence of any local tumour recurrence. The originality of this case lies in the presentation and isolated nature of this metastasis. Attempted surgical excision failed which, in view of the patient's good general condition, led to suggestion of FUFOL type chemotherapy.
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Two cases of athero-embolic nephropathy unrelated with known precipitating factors such as aortic surgery, angiography, anticoagulation or pharmacological fibrinolysis are reported. In one, the histological study additionally disclosed endo-extracapillary proliferative glomerulonephritis. Hypocomplementemia or hypereosinophilia, which some authors consider very characteristic findings, could not be demonstrated in any of the two patients. The difficulties in the diagnosis of athero-embolic nephropathy and the possible indications of renal biopsy are discussed. Emphasis is made on prevention as the best approach to management, no specific treatment being available.
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