[Presentation of the face].
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Biomedical subjects
Publications and source records attributed to J C Pons.
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A case of isolated necrotizing, granulomatous hepatitis of Brucella origin is discussed, together with 6 similar cases reported in the published literature. The clinical picture is dominated by the history of the patient (occupation, geographical location), fever, right hypochondrial pain, and altered general condition. Radiological examination shows characteristic calcifications. Diagnosis is confirmed by serology, Brucella suis usually being involved. Pathological appearances are typical : large foci of hepatic necrosis surrounded by marked inflammatory zones with histiocytic cells arranged in palisades. The only possible treatment is surgical.
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In order to estimate the protection afforded by low levels of rubella antibody, pregnant women were tested by haemagglutination inhibition (HAI) and latex agglutination (LA). Fifty-nine women whose sera were HAI-negative (less than 25 IU/ml) or weakly positive (25 IU/ml) received rubella vaccine (RA 27/3) after delivery. Serum samples were collected one week and one month after immunization and tested for rubella total antibody and rubella IgM and IgA antibody. No patients found positive by HAI and LA showed any evidence of primary immunization. Furthermore, rubella IgM antibody was never detected after immunization in women who were HAI-negative and LA-positive during pregnancy. These results show that low antibody titres detected by LA are sufficient to protect individuals against infection with the attenuated virus. It is conceivable that such low titres also ensure protection against natural rubella infection.
Interferon (IFN) therapy is currently not approved for use during pregnancy. Two HIV-seropositive pregnant women, who were due to undergo abortion in the second trimester of pregnancy, were given a single intramuscular dose of IFN-alpha, with their informed consent. Blood samples were taken simultaneously from the mothers and fetuses, together with amniotic fluid. IFN was undetectable in the fetal blood and amniotic fluid in both cases. Pharmacokinetic parameters were similar to those in nonpregnant women. We conclude that maternal IFN-alpha during pregnancy should be safe for the fetus. The indications for IFN therapy in pregnancy could therefore be the same as those in the non-pregnant state.
The authors report the case of a women who took retinoids (Roaccutan, isotretinoin) during the first trimester of pregnancy, and a therapeutic abortion was carried out. The interest in this case report lies in the determination of the concentration of isotretinoin and its metabolites (4-oxo-isotretinoin, and tretinoin) in fetal tissues, using high performance liquid chromatography. The findings show the significant transplacental crossing of isotretinoin, an accumulation of 4-oxo-isotretinoin in the liver, and a low concentration of retinoids in the brain of this 4-month-old fetus. The authors emphasize that contraception must be used during retinoid treatment, and 4 weeks after retinoids have been stopped.
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A normal infant was born to a 25 year-old mother with phenylketonuria who had never been treated. The mother had been fed a phenylalanine restricted diet for 3 months before the beginning of the pregnancy. Dietary control was maintained throughout the whole gestation. The problems of dietary control in a mentally retarded woman are analysed.