La Revue de médecine interne
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The peripartum cardiomyopathy is a rare condition in Europe but a very frequent disease in Sahelian Africa. The risk factors are: heat, hard physical exertion during pregnancy, hypertension, sodium diet, ablutions with hot water during the postpartum period, selenium deficiency and probably latent myocarditis (viral?)
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TNF-alpha, ICAM1, VCAM1, ELAM, CD44 and DR expression were studied (indirect immunoperoxydase methods) on labial salivary gland sections in 5 patients with proven rheumatoid vasculitis (before and after treatment), 5 patients with RA and 5 normal controls. TNF-alpha and cell adhesion molecules were particularly expressed in vasculitic areas of patients with systemic vasculitis and only before the onset of the treatment.
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Case Reports
[Spontaneous dissection of the anterior interventricular coronary artery in the postpartum period].
We report a case of anterior myocardial infarction which occurred in a young woman without history of cardio-vascular disease 10 days after she had given birth. Coronary arteriography performed 2 months later showed a pseudo-aneurysm of the anterior interventricular artery consecutive to spontaneous dissection of this vessel. The other coronary arteries were normal.
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We report four cases of multiple arterial dissection associated with an inflammatory syndrome. The features of lesions and the absence of histological inflammatory arterial disease suggest an arterial dysplasia complicated by an infectious disease.
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We report 18 cases of chronic hiccup (defined as lasting for more than 48 hours) in adults. Among the numerous possible causes, reflux esophagitis proved to be by far the most frequent (50% of the cases). However, hiccup often initiated a self-perpetuating vicious circle. ⋯ The treatment was difficult and whenever possible has been directed chiefly towards the cause. However hiccup remained intractable in many cases even after a possible cause had been adequately cured (e.g., successful Nissen procedure in reflux cases). Central nervous system depressants and myorelaxing drugs were not very helpful, except for baclofen (initial response rate = 60%).