Annales de médecine interne
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Ann Med Interne (Paris) · Dec 2003
Comparative Study[Meteorologic conditions and esophageal varices rupture].
While meteorologic conditions are thought to be related to the incidence of certain cardiac and cerebrovascular events, very little information is available concerning the onset of variceal bleeding. We undertook this study to determine whether there is any correlation between esophageal variceal hemorrhage and several meteorologic and astronomic parameters. ⋯ No relationship was found between variceal bleeding and mean atmospheric pressure, daily hours of sunshine, nebulosity, direction and velocity of wind and mean humidity. On the contrary, a significant correlation was observed with the mean temperature (18 degrees C vs 21.16 degrees C; p=0003), rainfall (p<0.01) and stormy weather (p=0.008), the latter being the only parameter retained as an independent factor at multivariate analysis: OR=13.37 (95% CI=1.5-118.5). Furthermore, a negative correlation was found with full moon but only at univariate analysis (p=0.04). The seasonal distribution of variceal bleeding episodes showed the highest percentage during winter with a significant variation at multivariate analysis: OR=3.2 (95% IC=1.6-6.54). Occurrence of variceal bleeding also showed a circadian variation with the higher prevalence night between 6 and 0 PM (p<0.001).
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Cluster headache is characterized by recurrent unilateral attacks of headache of great intensity and brief duration (15-180 minutes), accompanied by local signs and symptoms of autonomic dysfunction including conjunctival injection, lacrimation, nasal congestion, rhinnorrhea, forehead and facial sweating, miosis, ptosis or eyelid edema. Attacks occur in so-called cluster periods lasting for weeks or months. ⋯ There are only two abortive treatments with proven efficacy: subcutaneous sumatriptan and nasal oxygen inhalation. Prophylactic treatment is often needed to reduce the daily frequency of attacks: verapamil in episodic cluster headache and lithium in chronic cluster headache.
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Ann Med Interne (Paris) · May 2003
Case Reports[Cephalic tetanus and Bell's palsy in an elderly man].
Cephalic tetanus is a rare form of tetanus defined as trismus plus paralysis of one or more cranial nerves. The seventh cranial nerve is most commonly involved. ⋯ We describe the case of an elderly Caucasian man who developed cephalic tetanus after head trauma with a facial wound. Bell's palsy was inaugural.
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Ann Med Interne (Paris) · May 2003
Case ReportsAseptic meningitis associated with intravenous administration of dexchlorpheniramine.
Drug-induced aseptic meningitis has been reported mainly with the use of nonsteroidal anti-inflammatory drugs, antibiotics, intravenous immunoglobulins and OKT3 antibodies. We describe today a very unusual reaction on intravenous dexchlorpheniramine with this case of aseptic meningitis.
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Ann Med Interne (Paris) · Feb 2003
Review Comparative Study[Progress and stagnation in chemotherapy protocols for primary osteosarcoma].
Thirty years ago, osteosarcoma of a limb meant amputation and death. Two years after diagnosis, 80% of the patients died from pulmonary metastases, despite early amputation. ⋯ The cornerstone is high-dose methotrexate. We present data accumulated over the last 30 years on the treatment of osteosarcoma and point out the fundamental steps of this success story.