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Biomedical subjects

L J Courbil

Publications and source records attributed to L J Courbil.

52 records · Page 3Linked to original sources
PubMedDate not supplied

[Surgical treatment of pulmonary tuberculosis in tropical environment (indications and technics) (author's transl)].

A study of 85 clinical records of patients with pulmonary tuberculosis who were operated in hospitals of South Vietnam and West Africa. Some common features may be noted: --an ongoing clinical evolution before the indication for a surgical intervention (more than 5 years in half of the cases); -- positive bacilloscopies in 70 p. 100 of the cases; -- bilateral lesions in one case out of three; -- unilateral lesions restricted to one lobe in one case out of two; -- surgery limited to a thoracoplasty for 48 p. 100 of the patients; for the remaining 52 p. 100, half underwent lobotomy, half pneumonectomy.

Adult↗
PubMedDate not supplied

[Necrotizing amoebic colitis (a propos of 12 cases observed in Dakar)].

Twelve cases of necrotizing amoebic colitis recorded in Dakar Hospital Principal are studied. The authors draw basis rules for an early surgical indication giving opportunity to detect not too extensive lesions and implement intensive care which may prove effective. Prognosis is still unfavourable with a death rate of two thirds.

Adolescent↗
PubMedDate not supplied

[A left pseudo-pleurisy syndrome manifesting as a liver abscess complicating malignant localized amebic colitis].

The authors report on a case of localised bipolar malignant colic amebiasis in a 34 year old man, as a complication of undiagnosed benin colic amebiasis; the initial signs consisted of left basi-thoracic symptoms for which a sub phrenic abcess secondary to rupture of two abcesses of the left lobe of the liver was responsible. The surgical intervention consisted of a right hemicolectomy without anastomosis with a double derivation by ileostomy colostomy and drainage of the abcesses. The evolution was rapidly fatal by an irreversible state of shock.

Adult↗
PubMedDate not supplied

[Urogenital tuberculosis in African (author's transl)].

A report of nine recent cases of urogenital tuberculosis in Africans with a review of literature. This possible but rare complication must be discovered, although it is a difficult process mainly in rural areas, since tuberculosis may bring about severe urogenital tract damage. Schistosomiasis and unspecific epidimymitis may hide it. Acido-alcoolo-resistant bacillus, detected in urin, must be cultivated on Loewenstein medium to remove contaminants and to confirm tuberculous pathogenesis.

Adult↗
PubMedDate not supplied

[Primary liver cancer in the tropical environment. Classical and current data].

In most cases, primary liver carcinoma in tropical areas remains an hepatoma. The high incidence of this malignant tumor of the liver in some regions, and especially in black Africa, is still unexplained. As compared with the form found either in the European or in the North-African, this hepatoma shows special features since it occurs in younger people (35 years), follows a bursting-out course and is precipitously associated not to an alcoholic cirrhosis but to a post-hepatitic one. An humoral syndrome leading to a presomptive diagnosis consists of hypoglycemia, hypercholesterolemia, hyperlipemia, and high blood level of alcaline phosphatases. In 85% of the cases, these tumors secrete an alpha fetoprotein determined by radioimmunoassay. A major etiologic factor is the oncogenous activity of hepatitis virus B which could be either an induction factor or a "co-factor" which would initiate, facilitate or increase the activity of the carcinogen. In this respect, aflatoxin has to be regarded as a "co-factor" too. The best treatment, when it is possible, is an exeresis carried out through a partial hepatectomy. If such a surgical intervention is unadvisable, chemotherapy is the only possibility. Immunization against viral hepatitis has raised hope for the prophylaxis of hepatoma. But it will not be possible to evaluate it before the year 2.000.

Adult↗
PubMedDate not supplied

[Esophageal cancer in the tropical environment].

UNLABELLED: The esophageal cancer is unevenly distributed within the Tropical regions: while its prevalence rate is high in East and South Africa and in the Far-East, this rate is much lower in West Africa. In most cases, the practitioner will face very evolutive forms, generally out of range of any therapy. In developing countries, efforts must be directed towards three goals: -- EPIDEMIOLOGY: Detection of the predisposing factors such as traumatisms, the use of bethel, kath, tobacco, and, above all, alcohol (beer consumption is steadily increasing in African countries). -- DIAGNOSIS: Development of the endoscopy of the digestive tract. -- SURGERY: Its remains the only therapeutic solution; but it is costly, time consuming and major surgery.

Adult↗
PubMedDate not supplied

[Birth control overseas].

After reminding the changes of ovarian cycle during sexual life, the authors propose some indications on the reversible means that can be used for birth control in the developing countries where they practice. As practicing is very peculiar to these countries and in order to enable married couples to decide freely upon different advisable possibilities, the authors underline the importance to develop all the educational ways and means on this topic.

Adolescent↗
PubMedDate not supplied

[Anatomopathological aspects of schistosomiasis. A study of 286 pathological specimens. (author's transl)].

Schistosomiasis pathology demonstrates the successive stages of the specific inflammation and accounts for the large variety of its macroscopic and histological features. This paper reviews 286 bilharzial lesions studied between 1956 and 1979 at the ""Institut de Médecine tropicale du Service de santé des Armées". - First, the histopathological caracteristics of the disease are considered. Some lesions are caused by schistosomules and adult worms, but the proeminent role is devoted to egg: the bilharzial granuloma get developped around it, and is the elementary and specific lesion, after three successive phases: exsudative nodule, productive granuloma and scleral nudule. Some recent researches about histogenesis of this granuloma have pointed out the role, in the immune response, of cell mediated cytotoxicity. - The the pathological aspects due to each of the four parasitic species are described: S. haematobium is predominant (249 cases). 34,2 percent of the examined lesions are of vesical and/or ureteral nature. Vesical changes are increased because their chronic evolution and are frequently modified by secondary infections: lesions of uretere, giving stricture, frequently induce severe complications in the upper part of the urinary tract. The different parts of female genital tract (61 specimens) may be affected, with cervix and fallopian tubes more often hit. Testis and epididymis frequently show tumoral features, mainly in young patients. Appendicitis (41 cases) may have various pathological aspects. S. mansoni infections (34 cases) specially affect liver and côlon. Three degrees of inflammation are described in liver where Symmers fibrosis is characteristic. Inflammatory lesions as well as tumors are observed in côlon, rectum and anus. Lesions caused by S. japonicum have been detected in three specimens (liver and appendix). A brief description about S. intercalatum lesions is presented. - The study gives some information regarding the geographical origin of the patients, their age and the polymorphorus features of the lesions. Diagnosis of tumors requests special staining techniques. Completing the parasitologic and immunologic methods, anatomopathology may help diagnosis of bilharziasis. It should be included in any multidisciplinary and long term eradication programme.

Adolescent↗
PubMedDate not supplied

[Surgical indications in urogenital schistosomiasis in West Africa (author's transl)].

Surgical indications in urogenital schistosomiasis are discussed after 12 years of experience in Senegal hospitals. Stenosis or achalasia of lower ureter might cause ureterohydronephrosis which appears to be the main sequella. The local hospitals conditions and the difficulties met with in the long-range surveillance of the patients both require a prudent approach. The replacement plastics with intestine is the logic and ideal solution, but other and simpler techniques are available and may be selected according to the localization and to the value of renal functions.

Acute Kidney Injury↗