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J Cabane

Publications and source records attributed to J Cabane.

At least 145 records · Page 8Linked to original sources
PubMed1981

[Toxic-shock syndrome. Three cases (author's transl)].

Several cases of toxic shock syndrome (T.S.S) have been recently reported from the U.S.A. Clinical features of this new syndrome include fever, desquamative scarlatiniform rash, hypotension and involvement of central nervous system, liver, kidney and muscles. More than 90% of cases are women with staphylococcic vaginitis using tampons during menstruations. A toxin produced by staphylococcus aureus is thought to be the causative agent, because the germ has been isolated in local (vaginal, pharyngeal, subcutaneous or other sites) but not systemic (blood, cerebrospinal fluid) cultures. The mortality rate is 3-10%, and relapse can occur. We report the first three french cases of T.S.S.: a 17 year old girl with typical tampon-associated vaginitis, a 36 year old woman with a postoperative peritonitis and a 20 year old man with a popliteal abscess. Staphylococcus aureus of type I or IV was identified at the site of infection in all cases, but never in blood cultures. These three patients recovered with antistaphylococcic antibiotics and supportive therapy, but local treatment of infections seems to have been of utmost importance. These cases suggest that T.S.S. can occur with several staphylococcus serotypes and confirm that this syndrome is not always associated with tampons and vaginitis.

Adolescent↗
PubMed1980

[Gamma-heavy chain disease with autoimmune abnormalities and peripheral neuropathy (author's transl)].

The authors report the case of a 72 year old woman affected by gamma heavy chain disease in whom the heavy chain was detected in the serum and the urine as well. Further study of the paraprotein showed that it belonged to the gamma 1 subclass. This observation was unusual because of the presence of a 15 year-long peripheral neuropathy and the existence of various auto-antibodies, especially intrinsic factor antibody.

Aged↗
PubMed1979

Fate of circulating immune complexes in infective endocarditis.

To examine the role of circulating immune complexes (CIC) in infective endocarditis, we studied 64 patients with infective endocarditis for the presence of CIC by the polyethylene-glycol (PEG)-precipitation test and the Clq binding test. This study was repeated during the course of the disease in 23 patients. CIC were found in 84 per cent of patients (66 per cent with acute infective endocarditis, 89 per cent with subacute infective endocarditis) during the active phase of the disease. Higer PEG precipitates were associated with typical cutaneous signs, cryoglobulins and nonstreptococcic culture-positive infective endocarditis. Under appropriate antibiotic treatment, the PEG precipitate levels of 17 patients fell within 1 month to the normal range, with a concomitant drop in cryoglobulinemia and rheumatoid factor. Conversely, uncontrolled sepsis always (six of six) yielded a rising level of CIC. These findings support the hypothesis that CIC may be important in the pathogenesis of peripheral lesions in infective endocarditis.

Adolescent↗
PubMed1977

[Risk factors in mitral valve replacements].

The authors report 137 isolated mitral valve replacements carried out between 1966 and 1975, with an operative mortality of 13.1%. Certain risk factors are demonstrable:--from the clinical point of view: previous cardiac surgery, 3 or more attacks of cardiac failure, a prolonged preoperatives course, atrial fibrillation, and cardiomegaly on the X ray. The combination of these risk factors is very serious as when three or more risk factors are operative at the same time, the mortality is 40%. Reduced ventricular function preoperatively was an essential factor governing operative mortality; improved results follow earlier indications for surgery.

Adolescent↗
PubMed1977

[Outcome of corrected and uncorrected tricuspid insufficiency after repair with prostheses in mitral and mitro-aortic valve diseases. Apropos of 159 cases].

This is a study of 159 patients with tricuspid incompetence (TI) associated with a mitral or mitro-aortic valve defect. The mean age of the patients at operation was 25.5 years. The TI was left untreated in 84, corrected by semi-circular annuloplasty in 39, and corrected by a prothesis in 28, by a Carpentier ring in 6, and by Kay's plasty in 2. The 33 early deaths (21%) are regrettable. The long-term outlook was studied with a mean follow-up period of 26 months. The overall mortality rises, if these are included, to 42 (26%). By comparing the preoperative findings in those with good and poor results, we have been able to identify a certain number of risk factors: a preoperative course of greater than or equal to 6 years, a number of attacks of cardiac failure greater than or equal to 3, a cardiothoracic ratio greater than or equal to 0.70, a mean right atrial pressure greater than 12, a mean pulmonary arterial pressure of greater than or equal to 50. Severe TI is also a poor prognostic factor. If the three groups of patients are compared, bearing in mind the fact that their preoperative state was very similar, and that the TI was either left untreated or repaired by annuloplasty or prosthesis, it appears that such a correction improves neither the surgical mortality nor the long-term prognosis. It therefore seems to us that a functional TI can be treated expectantly since its resolution depends more on the unified treatment of the whole underlying disorder and on the state of the myocardium than on any localised correction of the TI.

Adolescent↗
PubMed1977

[Long-term outcome of valve prostheses. Apropos of 299 operated patients].

The authors report a series of 299 operated cases betwen 1966 and August 1975. The operative mortality was 16%, usually a result of low output states and arrhytmias. Long-term survival was 74% at 3 years and 64% at 6 years, being better in those with only one valve replacement. The late results were very good taken as a whole. The few poor results were associated especially with a degenerating myocardium. The mitral group were favoured with a better 5 year survival rate and by clinically, and above all haemodynamically severe tricuspid incompetence. Thromboembolic complications, which are a major hazard, were favoured by irregular and inadequate anticoagulant therapy. In patients under 20 it would seem possible to stop after 6 months' effective treatment. Children have had generally better results than adults, probably because of the better state of their myocardium.

Adolescent↗
PubMed1975

[Immunologic study of subacute infectious endocarditis through the search for circulating immune complexes. Preliminary results apropos of 13 cases].

The detection of circulating immune complexes by precipitation by polyethylene glycol represents a valuable technique of study in sub-acute bacterial endocarditis. In a series of 13 patients, this measurement was carried out, confirming the quasi-constant presence of circulating immune complexes in active S.B.E. This might be of diagnostic value in forms with negative blood culture and, further, make it possible, subsequently, to find the antigen responsible by dissociation of the circulating immune complexes.

Adult↗
PubMedDate not supplied

[Buccal lymphomatoid granulomatosis].

A 57 year old man was referred to us with multiple long-standing, recurring and refractory mouth ulcers involving the palate, the intermaxillary folds, the inner side of the cheeks, the frenum of the tongue, a tonsil, the pharynx, the gums and a lower lip. Multiple biopsies had excluded a lymphoma, a carcinoma and infection. A new biopsy showed a polymorphous granuloma with up to 40% of atypical lymphoid cells. No angiitis was present, but an angiocentric pattern was present in the granuloma. The atypical cells stained positively with OKT3 and OKT4 antisera. The patient also had cardiac rhythm disturbances with defects on the myocardial scan and a proteinuria. Thus, we suspected the diagnosis of lymphomatoid granulomatosis, although there were no pulmonary nodules. Cyclophosphamide and prednisone were given with immediate success. As the doses were gradually decreased, a small relapse occurred. It was controlled by increasing the cyclophosphamide dosage for six months. The patient is now in complete remission more than four years after having discontinued the treatment. Thus, lymphomatoid granulomatosis can be diagnosed on the basis of a biopsy of buccal ulcers and in the absence of the classical pulmonary nodules. We found no evidence that the atypical cells were lymphomatous; rather, the very good response to the treatment points to a curable granulomatosis.

Cyclophosphamide↗
PubMedDate not supplied

[Benefits of corticosteroids in the treatment of Horton's disease and rhizomelic pseudopolyarthritis: advantages and inconveniences. A meta-analysis].

Although corticosteroid treatment is clearly beneficial to patients with temporal arteritis, its exact risk/benefit ratio in these old and side effects-prone patients is unknown. We have thus surveyed that available French and English literature, in order to pool the published series and to evaluate the iatrogenic potential of corticosteroids in this situation. We selected 11 series, yielding a total of 1008 patients. A treatment failure resulted in the death of the patient in five cases. Twenty-seven patients became blind, but only 2 under treatment. The side-effects involved 29% of the patients and are responsible of 29 deaths (2.9%): osteoporosis was the main problem, followed by femoral head necrosis and muscle wasting. Gastroduodenal ulcers were uncommon and generally benign; sigmoid colon diverticulitis was infrequent but dangerous; some infectious complications were noted (herpes zoster, tuberculosis, etc...); high blood pressure and diabetes were common problems. Psychiatric side-effects were rare. Thus, the unwanted effects of corticosteroids in the treatment of temporal arteritis are relatively infrequent and generally not severe, except osteoporosis. They should be systematically prevented by appropriate diet and treatments (e.g., calcium, potassium, and vitamin D supplements).

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Treatment with iloprost of critical ischemia of the lower limbs associated with cardiac insufficiency. Study of the interaction with pharmacokinetics of digoxin].

Twelve patients with critical ischaemia of the lower limbs were treated with iloprost. The purpose of this study was to investigate for a possible iloprost-digoxin interaction and to evaluate the clinical benefit provided by short- or long-term iloprost therapy. The pharmacokinetics of digoxin were studied before and during iloprost treatment. Under iloprost the absorption of digoxin was delayed by about one hour, but the area under the plasma digoxin concentration curve remained unmodified. In 11 of our 12 patients the clinical effect of iloprost was satisfactory both immediately and after 6 months. Pain vanished in 6 patients and diminished in 6 patients. All skin ulcers were healed. In most cases this improvement persisted beyond the study period: 2 patients treated at the beginning of the study and who are still followed up have remained improved after 2 1/2 years. Two patients with pain relapse received iloprost in repeated 10 days' courses with successful results. The treatment was relatively well tolerated (headaches, flushing, abdominal pain). Thus, iloprost can avoid amputation in severe arteritis unsuitable for revascularization and for which there is no effective treatment. Patients under digoxin may continue to take this drug in the same doses during treatment with iloprost.

Adult↗