Biomedical subjects
Publications and source records attributed to M Le Bras.
A case of spontaneous chronic lumbar epidural hematoma, in a 70-year-old woman is reported. The clinical, roentgenographic and anatomic findings of this case and of six others found in the available literature are studied. This clinical entity occurs in elderly and must be considered in the differential diagnosis of protruded disk syndromes.
Prevalence of intestinal helminthiasis: 1 223 stool specimens are examined in Louda and 690 in Damesma (Kaya, Upper-Volta). In this sample eggs of N. americanus are seen in 14,7% of the specimens in Louda and 9,3% in Damesma. Eggs of H. nana are seen in 10% of the specimens, for the two villages. Eggs of T. saginata are seen in 7.4% of the specimens of the two villages. And eggs of A. lumbricoides, T. trichicera are found inters then 0.5% of the specimens.
Pathological and clinical features of the portal hypertension in schistosomiasis are reminded. The value of the para-clinical investigations (immunology, endoscopy, angiography and hemodynamic controls) is discussed. Medical treatment is limited to parasiticidal action but an attempt to prevent the formation of granulomas by use of antilymphocytic serum has been reported. The surgical intervention is aimed at suppressing the splenomegaly and decreasing the portal hypertension. The indications of the various techniques are discussed (splenectomy, spleno-renal anastosomis associated with splenectomy, vascular porto-caval anastomosis, omentopexy, triple arterial ligation).
In the schistosomiasis endemic sub-sahelian region, a study of the prevalence of the disease was carried out on three different areas: the highest was around a small river, the lowest in the hydro-agricultural management region, mean prevalence was noted around a natural lake. Human activities have been classified with regards to the areas of transmission. Activity is closely linked to prevalence. For the populations, symptoms of urinary schistosomiasis (Rudzenga) constitute a real disease, traditional healers are the masters of earth (Tengsoba), water has hardly any importance in transmission.
With regard to its distribution the drepanocytic trait has a slight pathological incidence and does not appreciably alter the vital prospect. It is not, still, completely asymptomatic and may be, in special pathophysiological conditions, a morbidity and even lethality risk factor. Its connexions with various other diseases should be considered.
Glomerular lesion appears frequently in patients with S. mansoni or S. japonicum infection. This nephropathy may bring clinical changes and leads to severe evolution with letal risk. It may be induced or aggravated by the specific treatment but it has then, in most cases, a short duration and a good prognosis. Specific treatment fixed in order to reduce the amount of circulating antigens may be benefic. In some cases, on the contrary, the nephropathy is not reactive to any specific or symptomatic treatment and has an evolution of its own under the action of various factors; the most important is the hepatosplenic damage. Consequently glomerular function must be controlled in patients with schistosomiasis in order to fix the prognosis and the treatment.
Report of a case of biharzial myelitis appearing 6/8 weeks after bathing in an infected river. Recovery was complete after medical treatment with niridazol and hycanthone. The authors review the 47 detailed cases previously reported, selected among 60 cases observed from 1905 to 1963. They consider the clinical and pathological aspects and discuss the various pathogenic problems. Treatment requires specific antibilharzial compounds and anti-inflammatory drugs and, in compressive forms, sometimes surgery.
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