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N Cailleux

Publications and source records attributed to N Cailleux.

At least 55 records · Page 3Linked to original sources
PubMed1998

Manometry of the upper intestinal tract in patients with systemic sclerosis: a prospective study.

OBJECTIVE: To assess both the prevalence and the characteristics of motor disorders of the small bowel in patients with systemic sclerosis (SSc) and to investigate for an association between clinical manifestations in the upper intestinal tract, capillaroscopic features, esophageal motor impairment, and manometric evidence of motor disturbances. METHODS: Fasting and postprandial motor activity of the upper intestinal tract was studied in 17 consecutive patients with SSc (6 with and 11 without clinical manifestations of small bowel involvement) and 17 age- and sex-matched healthy control subjects. RESULTS: The prevalence of manometric evidence of intestinal involvement was as high as 88% in the SSc patients; normal motor activity was present in only 2 patients. The median values for duodenal and jejunal interdigestive phase III migrating motor complex duration, amplitude, and velocity and the postprandial motility index were therefore lower in SSc patients compared with controls. Our manometric findings indicated that there are both neuropathic and myopathic stages of upper intestinal tract dysfunction in SSc. Furthermore, no association could be found between the severity of the intestinal manometric abnormalities and clinical presentation, SSc subsets, disease score, capillaroscopic findings, or esophageal manometric impairment. CONCLUSION: We suggest that manometry of the upper intestinal tract may be useful in SSc patients with clinical manifestations in the small bowel (i.e., malabsorption syndrome or pseudoobstruction) in that it can be used to accurately evaluate both the nature and the severity of motor disturbances. Furthermore, this procedure can be used to assist in the selection of patients who may require octreotide therapy.

Adult↗
PubMed1998

[Langerhans histiocytosis in adults: cutaneous and mucous lesion regression after treatment with thalidomide].

BACKGROUND: Langerhans cell histiocytosis is a rare disorder with a wide spectrum of diseases and various clinical behaviours. The prognosis depends on the patient's age at onset and the extension of the disease. Treatment is function of evolution and extension of the disease. CASE REPORT: We report one case of Langerhans cell histiocytosis in a 33-year-old woman with resistant vulvar involvement whose cutaneous lesions improved with thalidomide. Complete healing of the genital lesions occurred within 1 month, but the patient discontinued her treatment after 3 months because of somnolence. Recurrence of the symptoms was observed within 2 weeks without treatment, but complete control was obtained with reintroduction of thalidomide. No severe adverse effect was detected at electrophysiological and clinical examinations. CONCLUSION: The simplicity and the rapid effect of thalidomide on cutaneous lesions suggest that new clinical evaluation of this old drug that can also be used in some systemic disease might be of the value.

Adult↗
PubMed1998

[Deep venous thrombosis of the upper limbs. Apropos of 49 cases].

PURPOSE: Upper-extremity thrombosis appears to be more frequent today, comprising about 2% of all deep venous limb thrombosis. Its severity depends on the type of possible complications, i.e., pulmonary embolism and post-thrombotic sequelae. In this retrospective series, we investigated both the predisposing factors and the evolution of upper-extremity deep venous thrombosis. METHODS: Forty-nine consecutive patients (24 men and 25 women, mean age 50.2 years) with upper extremity deep venous thrombosis documented by color Doppler ultrasonography (n = 47) or phlebography (n = 2) were included in the study. RESULTS: Clinical manifestations were mainly pain (81.6%) and edema (93.9%). Mean time between the onset of clinical signs and diagnosis was 7.2 days. Thrombosis involved humeral (26.5%), axillary (46.9%), subclavian (73.5%) and jugular (24.5%) veins. Causative factors were malignancies (32.7%), venous catheters (22.4%), deep venous thrombosis related to effort or thoracic outlet syndrome (22.5%) and thrombophilic states (8.2%). During the 6-month follow-up, six patients developed symptomatic pulmonary embolism (12.2%); one recurrence (2.2%) and 19 post-thrombotic sequelae such as residual edema (36.7%) were also observed. Initial therapy included heparin administration, principally subcutaneous low molecular weight heparins (n = 36/49). CONCLUSION: This series highlights the fact that upper-extremity deep venous thrombosis is mainly secondary to either malignancies or catheterization. Moreover, it confirms that color Doppler ultrasonography may be useful in the diagnosis of the disease and also underlines the high frequency of severe complications, i.e., pulmonary embolism and post-thrombotic sequelae. Finally, this study also demonstrates that low molecular weight heparins should be considered as the initial treatment of choice.

Adolescent↗
PubMed1998

[A rare cause of intra-alveolar hemorrhage: a transfusion-related incident with leukoagglutination due to antigranulocyte antibodies (Trali syndrome)].

INTRODUCTION: Transfusion-related acute lung injury (TRALI) is an infrequent but life-threatening complication of hemotherapy, usually secondary to passive transfer of antibody from the donor's plasma to the recipient. TRALI is a diagnosis of exclusion often masked by underlying factors. EXEGESIS: We report a new case of TRALI in a patient with severe multinevritis associated with Sjögren's syndrome and cryoglobulinemia, who had received intravenous immunoglobulins. CONCLUSION: This case report underlines the difficulty to establish a diagnosis in both acute respiratory failure and intra-alveolar hemorrhage in patients with auto-immune disorders. This case report also emphasizes the necessity of taking precautions in these immunocompromised patients in whom hemoglobin transfusion is required.

Aged↗
PubMed1998

[An unusual way of detecting Horton's disease: inflammatory abdominal aortitis].

We report an original case of giant cell arteritis, revealed by abdominal aortic arteritis on CT-scan, which was performed because the patient presented with a biological inflammatory syndrome. Course was favorable with steroid therapy. CT-scan, one month later, demonstrated a stable appearance of both regular and concentric thickening of the abdominal aortic wall. Aortic involvement is rare and occurs late in the course of giant cell arteritis. Usually clinical and biological manifestations of aortitis associated with giant cell arteritis either absent or non specific, leading to diagnostic difficulties. Furthermore, aortic giant cell arteritis is a major cause of morbidity and mortality. Gravity of aortic impairment is mainly linked to the risk of development of aneurysm and/or acute dissection. A search for aortic involvement should therefore routinely be carried out, once a year, in patients with giant cell arteritis, particularly a complete vascular clinical examination and a chest X-ray. Finally, our case report suggests that non invasive methods, notably CT-scan, may serve as a helpful test in diagnosis and follow-up of aortic giant cell arteritis.

Aged↗
PubMed1997

[Cost of low molecular weight heparin used in the prevention or therapy of thromboembolic disease].

Low-molecular-weight heparin are widely used for prophylaxis or curative treatment of thromboembolic disease. In France, low molecular weight heparin can only be used for the surgical prophylaxis (general and orthopaedic) of thromboembolic disease, for the initial treatment of deep vein thrombosis and in haemodialysis. In an economic approach we try to assess costing information which takes account of drug acquisition costs but also costs of drug administration and costs of drug therapy failure (failed prophylaxis, bleeding and recurrent thrombosis). At least, it has been argued that low molecular weight heparin may take it possible to discharge patients earlier and even to treat patients at home or as out-patients, thus creating further cost savings.

Cost Control↗
PubMed1997

[Red fingers syndrome in the course of HIV infection. A new case].

Human immunodeficiency virus can be associated with vascular manifestations such as arteritis mainly with cerebrovascular localization, arterial aneurysms or accelerated formation of atherosclerosis lesions. Red fingers syndrome has been recently described in i.v.-drug patients with HIV and hepatitis C infection. We report a new case in a 36-year old woman, and suggest that this syndrome must be considered as a new microcirculatory manifestation of HIV infection. Red fingers syndrome in patients with HIV is likely secondary to co-infection with hepatitis C or immunological disturbances-associated such as cryoglobulinemia.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Pseudoxanthoma elasticum: a rare cause of leg artery diseases in young adults].

Pseudoxanthoma elasticum (PXE) is a rare inherited connective tissue disorder which is characterized by elastic tissue degeneration involving the skin, eyes and arteries. We describe the case of a hypercholesterolemic 25 year-old woman with typical genetic dominant form of PXE revealed by distal limb artery involvement after a pregnancy. In young adults with arterial disease, a non atheromatous cause should always be sought for, even if risk factors for atherosclerosis are present.

Adult↗
PubMed1997

[Lumbar sympathectomy by retroperitoneal endoscopy: feasibility study].

Endoscopic surgery has been used as a new procedure to simplify different surgical processes. The goal of this study was to evaluate the benefits of endoscopic retroperitoneal surgery for lumbar sympathectomies. Between February 93 and November 95 we performed 35 lumbar sympathectomies using this technique. All patients were arteritic. The results were as follows: for 25% of the patients, conversion classical open technique was required; 6% complications (septic); 3% of the patients died. In comparing the various techniques of sympathectomy and sympatholysis, it would appear that the endoscopic technique produces fewer complications. However we believe that a learning period is necessary before this technique can be fully mastered.

Adult↗