La Revue de médecine interne
-
Letter Case Reports
[A new case report of J-Baltimore hemoglobinopathy in a diabetic caucasian].
-
In view of the advent of effective medically assisted procreation (MAP) techniques, it is now more necessary than ever to use the most strict and systematized methods in the management of couples who consult for infertility. The authors present the modalities of this management and review the present MAP techniques which are all based on bringing together the gametes in an optimal environment conditioned by the clinical situation of the couple. The main results obtained are presented under the headings: percentage of success, multiple pregnancies prevention policy and future of the children.
-
Risk factors were analyzed in a group of 117 blood donors seropositive for hepatitis C virus antibody. One risk factor, at least, was found in 63 (53.8%) subjects. ⋯ Our study emphasizes the high percutaneous transmission of hepatitis C in contrast with the low sexual transmission. No risk factor could be found in 54 (46.2%) of the 117 seropositive subjects: the route of transmission in these cases is an intriguing issue which certainly deserves further epidemiological investigations.
-
About 30% of lumbar punctures are complicated by the lumbar puncture syndrome the main symptom of which is a characteristically posture-dependent headache (the so-called "spinal headache"), sometimes accompanied by nausea, vomiting and stiff neck. The syndrome usually begins in the days which follow lumbar puncture and subsides within 10 days. ⋯ The epidural blood patch technique is seldom used. Prevention relies entirely on the use of small calibre lumbar puncture needles; keeping the patient lying supine after the puncture is a classical recommendation, but its preventive value has not yet been fully demonstrated.
-
Pleuro-pulmonary manifestations are frequent in systemic lupus erythematosus (SLE), being found in 40 to 70% of patients with this disease. However, these manifestations can be attributed to SLE only when other pathologies, and notably infections, have been excluded. The truly SLE-related pleuro-pulmonary manifestations can be divided into five types: pleurisy, interstitial pneumonia, lupus pneumonia and two new entities: diffuse pulmonary haemorrhage and pulmonary arterial hypertension. ⋯ Pulmonary arterial hypertension is a classical, but hitherto unrecognized manifestation of SLE which benefits from new exploratory techniques, such as doppler-ultrasonography. At present, its diagnosis rests on data supplied by cardiac catheterization which is generally performed too late, making it irreversible and resistant to all treatments. Some of these pleuro-pulmonary manifestations are probably underestimated and they require new methods of investigation, such as bronchoalveolar lavage or doppler-ultrasonography, resulting in earlier diagnosis and treatment at an accessible stage.