ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718301

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

SummaryStreptococcus pneumoniaeis one of the most frequent causes of pneumonia, meningitis, and otitis media. Persons at high risk are young children, elderly, and individuals with immunodeficiency or with an underlying disease. Thanks to a network ot 111 laboratories spread all over Belgium, the evolution of the number of deep isolates ofS. pneumoniaehas been followed from 1986 to 1991: the recorded frequency increased with a mean number of isolations per laboratory and per year rising from 3.6 in 1986to6.2in 1991.The objectives of this paper are to study the evolution of age and sex distribution of the patients, and of the origin of the isolates, and to propose solutions for slowing down this evolution.

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718302

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

SummaryBetween May 87 and December 91, 33 children aged from 2 months to 13 9/12 years were admitted for haemolytic uraemic syndrome (HUS) . Treatment consisted of daily fresh-frozen plasma infusion (20 ml/kg/day) during 14 days. On admission, 20 patients (61 %) had an oligoanuria: 18 underwent a peritoneal dialysis and 2 an haemodialysis with a median duration of dialysis of 14 days. A good outcome was rapidly observed in all patients. A normalisation of the platelet count and a sustained normal level of haemoglobin were obtained after a median of 8 days. The follow-up ranged from 7 months to 4 8/12 years: all patients had a normal blood pressure with correct growth. Only 3 children (9%) still had urinary abnormalities: one an isolated microscopic haematuria 3 years after diagnosis and 2 others a mild proteinuria after 1 3/12 year and 4 8/12 years with reduction of the renal function to 80% of the normal for the last one.In our series, plasma infusions lead to a rapidly favourable outcome in all patients and seem to be an effective therapy of HUS in chilhood.

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718303

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

SummaryVon Recklinghausen’s neurofibromatosis is a hereditary disease predisposing to distinctive malignant hemopathies. These often develop during early childhood and are characterized by particular cytologic subtypes: juvenile chronic myeloid leukemia, monosomy 7-associated myeloproliferative syndrome and myelomonocytic leukemia. The etiopathologic mechanism underlying this association begins to be elucidated: the neurofibromatosis gene behaves like a tumor suppressor gene; its inactivation by mutation results in activation of the corresponding oncogenes. We report here the cases of two late-aged adults with neurofibromatosis: the first developed acute myelogenous leukemia, the second polycythemia vera. Based on a review of the literature, we suggest that, in opposition to childhood, the association between neurofibromatosis and malignant blood diseases is not demonstrated in adulthood.

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718304

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Summary1αl-antitrypsin is an antiprotease that inhibits the neutrophil elastase enzyme, and belongs to a family of structurally related serine proteinase inhibitors (serpins). Its methionine358residue determines the specificity for elastase.2 The normal M-type al-antitrypsin is mainly synthesized in the liver parenchymal cells and transPorted to the plasma. Abnormal Z-mutantαl-antitrypsin is retained in the endoplasmic reticulum, which leads to its intracellular accumulation and to Markedly decreased plasma levels.3 In normal conditions, al-antitrypsin protects the lungs from destruction by the proteolytic neutrophil elastase. A protease/antiprotease imbalance in the lung is responsible for the development of emphysema in severe al-antitrypsin deficiency and in cigarette smokers, and accounts for the marked acceleration of e lung disease in smoking al-antitrypsin deficient patients. Smoking has to be avoided in al-antitrypsin deficient patients. Replacement therapy with plasma-derived al-antitrypsin seems indicated inαl-antitrypsin deficient patients with emphysema.Intracellular accumulation of abnormal Z-αl-antitrypsin molecules in liver parenchymal cells may lead to liver disease, ranging from neonatal cholestasis to adulthood cirrhosis and hepatocellular carcinoma.

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718305

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

SummaryAlmost all epidemiologic studies have shown that the age-adjusted incidence of osteoporotic hip fracture has been increasing during the last decades. Although the age-related bone loss is considered to be a crucial determinant of the incidence of hip fracture, spontaneous fractures appear to be uncommon: about 90% of hip fractures in the elderly result from a fall.This article focuses on the different risk factors for falls. Poor health status (especially chronic illness), impaired mobility and postural instability, and ahistory of prior falls have been associated with the risk of falling. Balance can also be impaired by disease (such as a broad spectrum of ophthalmologic and neurologic disorders) or age-related changes in number of anatomical structures, by medications which reduce their efficient functioning (such as some psychotropic or antihypertensive drugs) and by environmental hazards. The identification of elderly patients at risk for falling and intervention to minimize risk without compromising functional independence should receive a high priority in the health care of elderly persons.

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718306

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

SummaryTwo forms of 5 alpha-reductase deficiency have been described and two genes have been cloned. In view of the psychoendocrinological complexity of the Primary form, the early diagnosis preferably in infancy, is crucial. Rearing up those who are assigned as females to the male gender identity could minimize the risk of gender identity and role disorders when puberty is reached.

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718307

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

SummaryA 64-year-old white male with cavitary lung disease is presented.Mycobacterium aviumwas isolated from sputa and gastric lavage and the American Thoracic Society criteria for nontuberculous mycobacterial disease were met. Seven years follow-up and treatment regimens are discussed.This case illustrates that medical treatment of M.aviumpulmonary disease can be disappointing and requires regularclinical, radiological, microbiological and haematological reassessment to evaluate efficacy and toxicity of therapy.Despite in vitro resistance to the standard antimycobacterial agents, prolonged treatment regimens can be successful and are the therapy of choice. Another drug combination, based on in vitro susceptibility patterns, has to be started for patients who fail to respond or who relapse. Lifelong treatment may be necessary to keep the patient stable and to prevent further destruction of lung parenchyma.

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718308

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

SummaryWe report a case of association between genetic haemochromatosis and mixed gonadal dysgenesis. To our knowledge, this case is the first reported in the literature. We discuss the mechanisms of hypogonadism observed in this patient.

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718309

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

ISSN:1784-3286    

DOI:10.1080/17843286.1993.11718310

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor