RESUMO
The objective of this cross-sectional survey was to assess the prevalence of psychoactive substance use (PSU) in people attending 11 French Sexual Transmitted Infection Centers, and to specify their profiles (PSU and link with risky sexual behaviors) using the ascending hierarchical clustering method. Among the 5220 individuals who completed the survey, 55.6% were men and the median age was 24 years [IQR: 20-31]. Among the participants, 2751 (52.7%) reported PSU at least once in their life. Ascending hierarchical clustering identified seven distinct profiles of participants based on their PSU. This study shows a high prevalence of PSU and alcohol consumption in this young population. Moreover, subgroup analysis allowed identifying groups of psychoactive substance users who presented specific risks or vulnerabilities and who should be priority targets for interventions, particularly sexual minority groups.
Assuntos
Heterossexualidade/estatística & dados numéricos , Uso da Maconha/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Estimulantes do Sistema Nervoso Central , Estudos Transversais , Feminino , França/epidemiologia , Infecções por HIV/epidemiologia , Alucinógenos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Assunção de Riscos , Inquéritos e Questionários , Adulto JovemRESUMO
Two cases of Castleman's disease (angiofollicular lymphoid hyperplasia) with abdominal localisation are reported. The first case was a mesenteric localisation with compressive symptoms in a sixty year-old patient; its histological type was hyalino-vascular; the evolution was favorable one year later following cobaltherapy; but ultimately pathological examination of a peripheral lymph node led to the discovery of a malignant nodular lymphoma of the follicular center cell type. The second case involved the retroperitoneal space with multiple lymph nodes and IgA dysglobulinemia in a 49 year-old patient; its evolution was favorable as judged six months after surgical resection. Twenty cases of mesenteric and thirty one of retroperitoneal involvement of Castleman's diseases have been previously reported. The nosology and pathogenesis of this disease remain unclear.
Assuntos
Linfonodos/patologia , Doenças Peritoneais/etiologia , Humanos , Hiperplasia , Masculino , Linfadenite Mesentérica/etiologia , Pessoa de Meia-Idade , Doenças Peritoneais/patologia , Espaço RetroperitonealRESUMO
The changes in the levels of plasma prolactin, progesterone and oestradiol were studied in 20 women during labour and immediately after delivery. The study of these levels shows that there is a mechanism for inhibiting the galactopoietic action of prolactin. Lifting this inhibition allows the milk to come in. This inhibition is probably due to circulating steroids, but this study does not allow us to differentiate clearly between the respective roles of oestradiol and progesterone, chiefly because of their short half-life.
Assuntos
Estradiol/sangue , Trabalho de Parto , Período Pós-Parto , Progesterona/sangue , Prolactina/sangue , Feminino , Meia-Vida , Humanos , Lactação , Gravidez , Fatores de TempoRESUMO
A report of 2 cases of acute renal insufficiency in african women, 8 months pregnant and suffering of malignant malaria. In both cases labor has been induced by artificial breaking of the membranes and use of oxytocin. One of the children was still-born and the other died 3 days later. Delivery has been followed by a resumption of the urinary flow, facilitated by high dosages of furosemide. This diuretic drug when associated with hypoprotidic diet, hypercaloric intravenous infusions of glucose hypertonic solutions supplemented with amino-acids gives a good chance of recovery without extra-renal dialysis.
Assuntos
Injúria Renal Aguda/etiologia , Malária/complicações , Complicações Infecciosas na Gravidez , Injúria Renal Aguda/terapia , Adulto , Feminino , Humanos , Malária/terapia , Plasmodium falciparum , Gravidez , Complicações Infecciosas na Gravidez/terapiaRESUMO
The authors present a case of muco-cutaneous leishmaniasis in the Republic of Chad. In that case, a long duration treatment with corticoids entailed the generalization of the disease in the form of a secondary kala-azar and the appearance of a histiocytosarcoma on the scar left by the oriental sore. Comments on the pathogenesis of leishmaniasis are then exposed.
Assuntos
Corticosteroides/uso terapêutico , Leishmaniose Mucocutânea/complicações , Leishmaniose Visceral/etiologia , Linfoma Difuso de Grandes Células B/etiologia , Neoplasias Nasofaríngeas/etiologia , Adulto , Humanos , Imunidade Celular/efeitos dos fármacos , Síndromes de Imunodeficiência/imunologia , Leishmaniose Mucocutânea/tratamento farmacológico , Leishmaniose Mucocutânea/imunologia , Linfoma Difuso de Grandes Células B/patologia , Masculino , Meglumina/uso terapêutico , Neoplasias Nasofaríngeas/patologia , Nariz/patologia , Pentamidina/uso terapêuticoRESUMO
Report of a case of biharzial myelitis appearing 6/8 weeks after bathing in an infected river. Recovery was complete after medical treatment with niridazol and hycanthone. The authors review the 47 detailed cases previously reported, selected among 60 cases observed from 1905 to 1963. They consider the clinical and pathological aspects and discuss the various pathogenic problems. Treatment requires specific antibilharzial compounds and anti-inflammatory drugs and, in compressive forms, sometimes surgery.
Assuntos
Mielite/parasitologia , Esquistossomose/complicações , Adulto , Humanos , Hicantone/uso terapêutico , Masculino , Mielite/diagnóstico , Mielite/tratamento farmacológico , Niridazol/uso terapêutico , Schistosoma mansoni , Esquistossomose/diagnóstico , Esquistossomose/tratamento farmacológicoRESUMO
The most frequent symptom with leiomyoma is menometrorrhagia. However, it can be responsible of pelvic pain, dysmenorrhea or urinary and digestive compression when it is particularly voluminous. These recommandations were made in order to review medical management of fibroids. If no therapy is able to have them disappear, various drugs may reduce their related symptoms. Tranexamic acid, non-steroidal anti-inflammatory drugs and high dose of oestrogen may be useful in the management of acute hemorrhagic disorders. Progestin, such as lynestrenol induces small reduction in leiomyoma volume and moderate increase in hemoglobin level before surgery. Pregnane and nor-pregnane may improve menstrual bleeding in short or mild delays. The use of Gonadotropin Releasing Hormone (GnRH) agonists can reduce menstrual bleeding with hemoglobin recovery. Add-back therapy using tibolone seems interesting since secondary effects encountered with GnRH agonists may be reduced. Levonorgestrel-releasing intrauterine system is proven to reduce increased menstrual bleeding and restore hemoglobin level. Aminoglutethimide and fadrozole have been underevaluated to conclude when letrozole seems as efficient as GnRH agonists to reduce leiomyoma volume and provide less hot flushes. Anastrozol is associated with reduction in leiomyomata volume, pain and menstrual bleeding. Mifepristone reduces the size of uterine leiomyomata, improves symptomatology, but could be associated with development of endometrial hyperplasia. SPRM evaluated in females have shown to improve leiomyoma related symptomatology. Danazol could be useful to reduce leiomyoma related symptoms in short terms. Tamoxifen and raloxifen show modest overall benefit. Because of insufficient data concerning fulvestrant, pirfenidone or interferon, their prescription cannot be recommended in patients with leiomyomata.