Digestive Signs Research Articles

Aspects épidémiologiques et cliniques de l'intoxication par les déchets toxiques dans le district d'Abidjan

In the nights of 19 to 21 August, 2006, highly toxic waste products were dumped at various sites in Abidjan, and numerous cases of poisoning were reported to the health authorities, who were unprepared for such a problem. The research group on Environment and Health in Urban Environment from the Swiss Center of Scientific Research and its partners at the Swiss Tropical Institute undertook this study whose objectives were to: describe the epidemiologic profile of the people poisoned; identify the main clinical symptoms and the risk factors for poisoning; and recommend steps to attenuate the effects and to prevent intermediate- and long-term consequences. This cross-sectional study examined the populations living around the discharge sites (n=6). The sample size was calculated at 619 people per site, to identify a 1% risk and a standard error of 0.4%, because of variability of the human impact factor at the different sites. Households were chosen at each site by the transect technique. Six teams, each including a physician, a public health agent and a local guide collected the data, after specific training. A pilot investigation made it possible to validate the final questionnaire. Of 4573 people surveyed, 4344 people, about 95%, were home during the toxic waste discharge. In all, 2369 (51.8%) had signs of poisoning. Sex, district of residence, and presence at home at the time of the discharge were all statistically related to poisoning. The distribution of poison victims according to health centre shows that 1297 people (64.4%) visited a health center AA(3/4) 615 of them (about 47.4%) a public or official centre, and 778 (about 60%), an unofficial centre; 379 (29.2%) were managed by an NGO, 159 individuals (12.3%) by mobile units, 63 individuals (4.8%) by the unofficial public health centre, and 35 (2.7%) at an unspecified site. Of those who sought care, 673 people (about 51.8%) received a medical prescription, and 815 (or 62.7%) had been given the drug directly, for free. 94 individuals (about 7.2%) chose their own self-medication, and 74 people (5.7%) a traditional treatment. In all, 34 people, about 2.6% of those who sought care, were hospitalized. Of the subjects who went to a health centre, 1421 (72.8%) had a positive course and 532 (27.7%) an unfavourable course. The latter complained especially of respiratory signs, in particular a cough and thoracic pains (21.8%), digestive signs (diarrhoea and abdominal distension, about 21.5%), and cutaneous (pruritus) and neurological (headaches) signs (20.7%). Overall, 532 people (21.%) still presented signs during the investigation. This study highlighted the persistence of the symptoms among many of those poisoned more than 4 months afterwards. This phenomenon continues, although the sites have been partially cleaned: the long-term effects on population health remain alarming. Thorough multidisciplinary studies are essential to explore the long-term effects.

Association of body mass index with digestive symptoms and signs in northwest of Iran

Aim : To evaluate the association between body mass index (BMI) and certain digestive symptoms and signs. Background : Obesity is of substantial health significance all over the world, and it is categorized by the world health organization among top ten global health problems. There is much evidence that indicates a higher prevalence of digestive symptoms in obese people. Patients and methods : This cross-sectional study was conducted in city of Tabriz in north-west of Iran. One-thousand and seventy-one families with 4225 members were randomly selected. The association of digestive symptoms and signs with BMI was assessed. Results : Of 4225 family members, 2485 who were above 18 years old agreed to participate in the study. The prevalence of obesity was 20.1%, and 33.3% were overweight. There was a positive relation between increased BMI and specific digestive symptoms. Constipation (P=0.043), bloating (P=0.03), dysphagia (P=0.024), protruding anal mass (P Conclusion : In our community, increased BMI is associated with increased digestive symptoms and signs such as constipation, bloating, dysphagia, anal mass, hepatomegaly, and abdominal tenderness in deep palpation.

Pneumonie chez un voyageur au retour d’Asie

A case of Salmonella paratyphi A infection was diagnosed late in a patient treated for febrile pneumonia after his returning from India. This case was remarkable in two aspects: first, it illustrated the reemergence of S. paratyphi A infections in people having traveled to India, with increasing fluoroquinolone resistance, and second the difficulty of diagnosing this disease, since the patient was initially treated for pneumonia and flu-like syndrome. Salmonella typhi or paratyphi infections should be evoked in case of persistent fever in patients having traveled to endemic areas, even if digestive signs are absent. Furthermore, choosing an empiric antibiotic treatment with fluoroquinolones could lead to treatment failure if the patient traveled in a country where fluoroquinolone resistance is high, as in Asia and especially in India.

Proliferative and necrotising pneumonia and severe vascular lesions in pigs naturally infected with porcine circovirus type 2

Severe disease induced by porcine circovirus type 2 (PCV2) was observed in three pigs originating from a large herd affected by respiratory and digestive signs as well as wasting. Proliferative and necrotising pneumonia (PNP) was diagnosed in two animals, while severe acute interstitial pneumonia characterised by the presence of abundant hyaline membrane in the alveoli and fibrin in the bronchioles was found in one pig. In all cases, large amounts of PCV2 antigen were found in each tissue sample collected from the lungs and mediastinal lymph nodes. Neither porcine reproductive and respiratory syndrome virus (PRRSV) nor swine influenza virus (SIV) was detected, and no bacteria could be cultured in any of the cases. Vascular lesions, e.g. degeneration of endothelial cells, perivascular and intramural oedema, fibrinoid necrosis, vasculitis, perivasculitis, and vascular thrombi were observed in all cases, associated with the presence of PCV2 antigen. The viral antigen was present in the intravascular mononuclear cells, endothelial cells, myocytes and infiltrating inflammatory cells in lymph and blood vessels. In one case, obliterating thrombi in the lymph and blood vessels were directly connected to areas of tissue necrosis and were associated with abundant PCV2 antigen. The results further suggest the causative role of PCV2 infection in PNP, and the importance of the vascular system in the pathogenesis of PCV2-associated diseases of swine.

Aura visuelle migraineuse et crise épileptique : la migralepsie revisitée

Introduction The term of “migralepsy” has been proposed to define migraine-triggered epileptic seizures. Although already reported in the literature for more than fifty years, a number of observations remain debatable because of possible confusion between migraine and epileptic seizure clinical manifestations, including hemifield visual hallucinations, digestive signs and severe headache. Observation We report on the case of a young patient suffering from both diseases, in whom a visual aura preceded either migraine attacks or epileptic generalized tonic-clonic seizure. Subtle modification in the primitive visual hallucination, which suddenly contained colored figures and was accompanied by fear before a prolonged loss of contact, suggested a continuum between migraine aura and epileptic seizure in this patient. Brain MRI was normal and EEG showed some sharp waves in the right posterior area. Conclusion The presence of a neurophysiological continuum between migrainous aura and epileptic seizure is supported by this observation of “migralepsy”. Recent findings from genetic and epidemiological studies further support this link.

Fréquence de l’allergie à la pénicilline autodéclarée dans le département de Seine-Saint-Denis

Purpose Penicillin allergy is a well-known notion among the general population. Because it is rarely questioned, many patients carry this label unnecessarily and cannot use this efficient and cheap antibiotic family. In previous studies, 8–10% subjects declare a penicillin allergy. But these data came mainly from studies done in hospitals and we found interesting to evaluate a general non-hospitalised population. Methods We set up a study in ambulatory patients of Seine-Saint-Denis (French geographic area in the north east of Paris). It was a transversal study, on a single day, in March 2005. Hundred general practitioners were randomised in this geographic area. All their patients from that day were included and were asked to complete a simple questionnaire. Results Among 1057 patients who participated, 99 (9.4%) declared to be allergic to penicillin. Penicillin A was the most cited antibiotic. The most frequently reported clinical manifestations were skin rash (58.6%) and 13 patients (13.1%) reported some severe signs (coma or emergency hospitalisation) of which 11 were anaphylactic shock; eight patients (8.8%) reported digestive signs less compatible with an allergic mechanism. Asthma and eczema appeared to be significantly reported to penicillin allergy in our population sample. Conclusion The percentage of self-declared allergy found in this study is similar to previous publications. Among penicillins, Penicillin A is the most frequently involved. This study also shows the importance of meticulously questioning patients as it can correct a false diagnosis of penicillin allergy.

Consultations et réadmissions avant l'âge d'un mois aux urgences pédiatriques, Brazzaville (Congo)

Objectives To identify and analyze factors influencing the readmission of newborns to the paediatric emergency unit of university hospital of Brazzaville after their stay in maternity. Material and methods A prospective survey was conducted in newborns discharged from maternity for household, excluding infants delivered by caesarean section. Results A total of 458 (6.3%) newborns were recruited among 7233 children admitted in the paediatric emergency unit. The visits took place between 8 am-1 pm (51.7%), 14 pm –19 pm (31.7%) and 20 pm–7 am (16.4%). Visit motives were cough, fever, digestive signs, and malformations. Main causes of hospitalization were severe sepsis (21.8%), bronchopulmonary infections (23.0%), isolated fever (12.6%), malformations (5.3%). Low bith weight newborns and newborns with shorter length of stay at maternity (less than 24 h) were most often hospitalized than infants with normal weight ( P < 0.01). Conclusion Increased length of hospitalization in maternity, systematic medical examination of newborn in maternity, better information of mothers on breastfeeding, and improved health care should contribute to decrease the rehospitalization rate during the first month of life.

Exocrine pancreatic insufficiency in pigeons

Exocrine pancreatic insufficiency (EPI) is a well-studied syndrome in domestic animals. EPI occurs when severe progressive loss of tubulo-acinar tissue from atrophy or inflammatory destruction results in insufficient secretion of digestive enzymes and clinical signs of malabsorption. However, the literature on EPI in birds is limited. The syndrome has been previously described in several cases where the diagnosis was based on clinical signs due to malabsorption-like light-coloured voluminous faeces, voracious appetite, coprophagia and weight loss, and on the response to treatment with pancreatic enzyme formulas. To enable a more scientific approach to the diagnosis of pancreatic functional disorders in pigeons, reference values of plasma amylase (382 to 556 IU/l), lipase (0 to 5 IU/l), and faecal activities of amylase (13 to 16 IU/l) and trypsin (11 to 14 IU/l) were determined in 24 adult pigeons. A case of EPI in a racing pigeon (Columba livia domestica) is reported, based on the clinical signs and the measurement of faecal amylase and trypsin activity. Insuffisance pancréatique exocrine chez le pigeon L'insuffisance pancréatique exocrine (EPI) est un syndrome qui a été bien étudié chez les animaux domestiques. L'EPI apparaît quand des pertes progressives et graves du tissu tubulo-acinaire, à partir d'atrophie ou de destruction inflammatoire, entraînent une sécrétion insuffisante des enzymes digestives et des symptômes de malabsorption. Cependant, la littérature concernant l'EPI chez les oiseaux est limitée. Le syndrome a été décrit précédemment dans plusieurs cas quand le diagnostic était basé sur les symptômes, notamment en présence de fèces volumineuses légèrement colorées comme dans les cas de malabsorption, d'appétit vorace, de coprophagie et de perte de poids, ainsi que sur la réponse au traitement avec des formules comprenant des enzymes pancréatiques. Pour permettre une approche plus scientifique au diagnostic des disfonctionnements pancréatiques chez le pigeon, des valeurs de référence de l'amylase plasmatique (382–556 IU/L), de la lipase plasmatique (0–5 IU/L), et des activités fécales de l'amylase (13–16) ainsi que de la trypsine (11–14) ont été déterminées chez 24 pigeons adultes. Un cas de d'EPI chez le pigeon voyageur (Columba livia domestica) a été rapporté, basé sur les symptômes et l'analyse de l'activité fécale de l'amylase et de la trypsine. Exokrine Pankreasinsuffizienz in Tauben Die exokrine Pankreasinsuffizienz (EPI) ist ein bei Haustieren gut untersuchtes Krankheitssyndrom. EPI tritt auf, wenn hochgradig progressiver Verlust von tubuloazinösem Gewebe durch Atrophie oder entzündungsbedingte Zerstörung zu ungenügender Sekretion von Verdauungsenzymen und klinischen Symptomen einer Malabsorption führen. Berichte über EPI beim Vogel sind jedoch eher selten. Mehrere Fälle dieses Syndroms sind kürzlich beschrieben worden, wobei die Diagnose auf den klinischen Symptomen wie malabsorptionsähnlichem hellem, voluminösen Fäzes, gierigem Appetit, Koprophagie und Gewichtsverlust und der Reaktion auf die Behandlung mit Pankreasenzympräparaten basierte. Um eine wissenschaftlichere Methode für die Diagnosestellung einer funktionellen Pankreasstörung zu erlangen, wurden Referenzwerte der Plasmaamylase (382–556 IU/L), der Lipase (0–5I U/L) sowie der fäkalen Aktivität von Amylase (13–16) und Trypsin (11–14) bei 24 adulten Tauben bestimmt. Ein Fall von EPI bei einer Reisetaube (Columbia livia domestica) basierend auf den klinischen Symptomen und der Messung der fäkalen Amylase- und Typsinaktivität wird beschrieben. Insuficiencia pancreática exocrina en palomas La insuficiencia pancreática exocrina (EPI) es un síndrome muy bien estudiado en animales domésticos. La EPI ocurre cuando una pérdida grave y progresiva de tejido túbulo-acinar debido a la atrofia o bien a un proceso inflamatorio resulta en una secreción insuficiente de enzimas digestivos que comporta signos clínicos de malabsorción. A pesar de ello, las publicaciones de la EPI en aves son escasas. Este síndrome ha sido previamente descrito en varios casos en los que el diagnóstico se basó en los síntomas clínicos debido a la malabsorción, como heces voluminosas y de color claro, apetito voraz, coprofagia y pérdida de peso y a la respuesta al tratamiento con fórmulas de enzimas pancreáticos. Para una aproximación más científica al diagnóstico de los desórdenes funcionales pancreáticos en palomas, se determinaron los valores plasmáticos de la amilasa (382–556 IU/L), lipasa (0–5 IU/L), y las actividades de la amilasa (13–16) y de la tripsina fecales (11–14) en 24 palomas adultas. Se describe un caso de EPI en una paloma de carreras (Columba livia domestica), basado en los síntomas clínicos y en la medición de la actividad de la tripsina y amilasa fecales.

L’allergie Aux Protéines De Lait De Vache Peut Être Prévenue Et Traitée

Cow milk allergy is the first to arise in children. Digestive and cutaneous signs are those which occurs the most. Numerous milk allergy symptoms and mechanism are documented as well as allergens that are well identified and sequenced. Moreover, the diagnosis has been standardized. It grounds the oral provocation test, which can confirm either the diagnosis or the tolerance acquisition. With this biological test, the prognosis can be reliable. Even if 90% of milk allergic kids can tolerate it when they are 10, the use of substitution formula (hydrolysed protein by-products) is essential in young growing infants.

Symptômes douloureux de l'endométriose

Endomitosis is a benign chronic disease of the woman, responsible for the well-known chronic pelvic pain (CPP). However, the relationship between CPP and endomitosis remains unclear, primarily due to the high frequency of painful symptoms in women free of this disease, and to the frequency of asymptomatic endomitosis. In women with diagnosed endomitosis, the disease is responsible for CPP in less than 50% of the cases. A well documented relationship exists between severe dysmenorrhoea and endomitosis, probably causal. Severe dysmenorrhoea doesn't seem to be related to a specific type of lesion or to a particular location. Adherences may also be responsible for severe dysmenorrhoea. Regarding other painful symptoms, histological and pathophysiological evidences suggest the responsibility of deep sub-peritoneal endomitosis (DE) in their genesis. Such pain is probably related with compression or the infiltration of the pelvis-sub-peritoneal area by the DE lesions. Therefore, painful symptoms due to DE present some specific characteristics. They characterize a precise anatomically localized lesion (severe dyspareunia, painful defecation) or organ (functional urinary signs, digestive signs). Such symptoms may therefore be qualified as “localizating pains”. The precise semiotic analysis of the CPP characteristics is very useful for the diagnostic and therapeutic management of endomitosis-induced CPP. Hormone drug therapies generally show efficacy on all pains related to endomitosis lesions that comprise active glandular tissue. In some conditions with predominant fibrosis, adherences or cystic lesions, hormone therapies have no action on painful symptoms.

Prevalence of gastrointestinal tract lesions in 73 brachycephalic dogs with upper respiratory syndrome

To determine the prevalence of gastrointestinal tract lesions in brachycephalic dogs with upper respiratory tract disease. The gastrointestinal tract and respiratory disorders of 73 brachycephalic dogs presented with upper respiratory signs were evaluated. Clinical signs and endoscopic and histological anomalies of the upper digestive tract were analysed. A very high prevalence of gastrointestinal tract problems in brachycephalic dogs presented with upper respiratory problems was observed clinically, endoscopically and histologically. Endoscopic anomalies of the upper digestive tract were present even in dogs without digestive clinical signs. Furthermore, histological evaluation of the digestive tract sometimes showed inflammatory lesions not macroscopically visible at endoscopy. Statistical analysis showed a relationship between the severity of the respiratory and digestive signs. This was significant in French bulldogs, males and heavy brachycephalic dogs. These observations show a correlation between upper respiratory and gastrointestinal tract problems in brachycephalic breeds with upper respiratory disease. Surgical treatment of respiratory disease could improve the digestive clinical signs, and/or gastro-oesophageal medical treatment could improve the outcome for surgically treated brachycephalic dogs.

IgA anti-transglutaminase antibodies as a tool for screening atypical forms of coeliac disease in a French at-risk paediatric population

The diagnosis of coeliac disease (CD) is often delayed because many children are free from the major symptoms characteristic of this enteropathy. The aim of the present study was to determine the efficacy of antibodies directed against tissue transglutaminase (tTG Abs) for early detection of CD in a population with few symptoms of the disease, as well as in children with an autoimmune disorder. This was a prospective study in a paediatric population including 638 patients with clinical symptoms frequently associated with CD, autoimmune diseases such as type 1 diabetes mellitus (DM1), autoimmune thyroiditis or hepatitis, and Turner's syndrome. Anti-endomysium, tTG Abs and antigliadin antibodies were analysed in these patients using an indirect immunofluorescence technique and enzyme-linked immunosorbent assay techniques. Intestinal biopsies were performed for some patients with positive or negative antibodies. tTG Abs were detected in 2.6% of children with symptoms associated with CD, such as digestive signs and growth failure, and in 5.4% of children with DM1. No other autoimmune disease was positive for tTG Abs. Biopsies performed in the patients with positive tTG Abs showed mucosal atrophy confirming the diagnosis of CD in all cases. Children displaying minimal symptoms frequently associated with CD and children with DM1 should be systematically screened for tTG Abs.

Traitement par le diazépam du syndrome de sevrage néonatal aux opiacés (23 cas)

Introduction. – The fetal opiate exposure presents many risks for the newborn. One of the most important is the neonatal abstinence syndrome that associates neurological and digestive signs. In some cases the vital prognosis can be involved. The evaluation of the syndrome’s severity is based on certificated scales. The mortality has been reduced by the improved management of these neonates. Diamorphine, phenobarbital, chlorpromazine and diazepam are the most currently used. However, there is no consensus on the treatment. The data concerning the treatment are controversial, especially for the use of diazepam. The aim of our study was to describe the effects of diazepam obtained in three different centers and to compare our results to those of the literature. Population and methods. – Twenty-three neonates were included. They were all hospitalized for abstinence syndrome and treated by diazepam. The Finnegan scale was used to evaluate the symptom’s severity and the effects of the diazepam. The principal evaluation criteria were the duration of treatment and hospitalization, the timing in recovery of birth weight and the percentage of birth weight loss. Results. – The average treatment duration was 7 days, the average hospitalization duration was 18 days, the birth weight was recovered at 10 days of life and the percentage of loss of birth weight was 6.5%. Diazepam treatment failed in only one case. No case of intense dehydration occurred. Conclusion. – Due to the retrospective design of the study, the diazepam could not be compared to other drugs. Nevertheless, it argues against the “anti-diazepam” attitude. A controlled randomised prospective study is needed to evaluated the optimal therapeutic strategy.

L’INTOXICATION DIGITALIQUE AU COURS DU TRAITEMENT D’ENTRETIEN

Digitalis is the most common drug of choice used in cases of heart failure and atrial fibrilation. Long-term utilisation of this drug may cause an intoxication as its therapeutic index is short. Visual and digestive signs are classical as the rhythmic and condative troubles which may interfere with the vital prognosis. The aim of this review is to analyse the characteristic clinical and therapeutic findings of this intoxication.

Cashew allergy: observations of 42 children without associated peanut allergy.

Cashew allergy seems to be increasingly frequent. The goal of the present study was to analyse the clinical features and results of investigations of 42 children with cashew allergy. The clinical features and results of skin prick tests, specific IgE assays, and food challenges were analysed. The mean age at first allergic reaction was 2 years and the mean age at diagnosis of cashew allergy was 2.7 years. One in five children (12%) had a prior history of exposure to cashew nuts. Fifty-six per cent had skin symptoms, 25% had respiratory signs and 17% had digestive signs. Eighteen children had proven, associated food allergies (pistachio, seven; egg, five; mustard, three; shrimp, two; cow milk, one). The mean wheal diameter of the skin prick tests was 7 mm (3-16 mm) and the mean specific IgE level was 3.1 kUA/L (<0.35->100 kUA/L). Eight children had positive food challenges. The increase in cashew allergy is worrying because it affects young children who may have a reaction without ever having been exposed to cashews. Almost one-third of children are allergic to pistachios, which belong to the same botanical family as cashews. Clinical history is generally and sufficiently suggestive to diagnose cashew allergy without recourse to food challenges.

Intoxicação por amônia em bovinos causada pela ingestão de uréia dietética: conceitos básicos e novas descobertas

o uso de uréia dietética é comum na suplementação de bovinos criados extensivamente. A ingestão excessiva de uréia freqüentemente é causa de intoxicação por amônia, composto derivado da digestão da uréia. A amônia, em quantidades elevadas no organismo, provoca severo quadro nervoso, pulmonar e digestivo, podendo levar o bovino à morte. A partir de estudos recentes, que demonstraram a importância dos rins na eliminação da amônia do organismo, recomenda-se também que o tratamento desta intoxicação seja realizado por meio de rápida reposição de fluidos e uso de diurético [iv]. A intoxicação é prevenida por uma série de cuidados dietéticos.

Enfermidade gastroentérica e respiratória em bezerros inoculados com amostras brasileiras do vírus da diarréia viral bovina tipo 2 (BVDV-2)

Duas amostras brasileiras do vírus da Diarréia Viral Bovina tipo 2 (BVDV-2) foram inoculadas em bezerros com o objetivo de avaliar a sua virulência e estudar a patogenia da infecção. Previamente à inoculação, os animais foram imunodeprimidos com dexametasona. Quatro bezerros com idades entre 45 e 90 dias (grupo A) foram inoculados com a amostra SV-260 (n=2) ou LV-96 (n=2) e quatro bezerros com 6 a 8 meses de idade foram inoculados com a amostra SV-260 (grupo B). Após a inoculação, os bezerros do grupo A apresentaram anorexia, depressão, hipertermia, sinais de infecção respiratória e diarréia profusa, acompanhada de melena em dois animais. Os sinais respiratórios e digestivos progrediram, e os animais morreram ou foram sacrificados in extremis entre os dias 7 e 12 pós-inoculação. Úlceras e erosões no trato digestivo (língua, n=4; esôfago, n=1; rúmen, n=1 e abomaso, n=3), edema pulmonar (n=4) e na mucosa do abomaso (n=3); equimoses e sufusões na serosa do baço (n=2), no rúmen, no intestino delgado e no ceco (n=1), no coração (n=1) e na mucosa da bexiga (n=1) e intussuscepção intestinal (n=1) foram os achados macroscópicos mais marcantes. Úlceras e erosões, acompanhadas de infiltrado mononuclear na mucosa e submucosa do trato digestivo e depleção linfóide nos linfonodos e placas de Peyer, foram as alterações microscópicas mais freqüentes. O vírus foi detectado em vários tecidos e órgãos. Antígenos virais foram demonstrados por imuno-histoquímica, principalmente em células epiteliais do trato digestivo; em células mononucleares nos espaços perivasculares e peribronquiais; na cápsula e septos de linfonodos; e em linfócitos e células mononucleares das placas de Peyer e baço. Os animais do grupo B apresentaram depressão, hipertermia, sinais moderados de infecção respiratória e digestiva, ulcerações na língua e bochecha, mas recuperaram-se após alguns dias. Esses resultados demonstram que as amostras de BVDV-2 foram capazes de reproduzir a enfermidade aguda quando inoculadas em bezerros e que as conseqüências clínico-patológicas da infecção foram mais severas nos animais mais jovens.

Gastroenteritis aguda infecciosa en Río Cuarto: Clínica, diagnóstico y epidemiología con especial referencia a infecciones virales

The objetives of the presents study me to describe the clinics view of acute infectious gastroenteritis (ge) ay the community, in primary and secondary attention healtsh centers., with special references to vital aetiology (VIGE) ; to correlate with drinkable water and excrete treatment; to develop for the first time a fast diagnostic using electron microscopy in Río Cuarto, Córdoba; Argentina, consideranding the university and community collaboration in the viral diagnostic. It has been during one year, 122 cases of acute GE, over its clinics epidemiology and diagnostic aspects (1999-2000). With conventional laboratory methods, in has been determinated the bacterian and micotic aetiology (NOVIGE); the virology diagnostic with electron microscopy; and the use of the statistics for the data analysis. The microbial findigs has been: pathogenics bacteria (31.7%), fungus ( 17%), parasites (1.2%), rotavirus (16.4%), calicivirus ( 1.6%) , adenovirus and coronavirus (1.6%). The clinics findings are presents like digestive and extradigestive signs, separated in NOVIGE (and no diagnosticated) and VIGE groups. The seasonal viral and no viral distributions are presents in fig. 5. There are statistics signification: the NOVIGE un summer period (49%) against the VIGE ( 12.5) (p&lt;0.003); the VIGE (12.5%), (p&lt;0.003), the GE aetiology (VIGE and NOVIGE) in associated with age groups (p&lt;0.0003); the momits preceding diarrhoea in VIGE was 58% and NOVIGE (19.5%) (p&lt;0.001). Its has been presented without significative differences all the clinics signs and laboratory examinations; the breeding signs for the younger 2 years group compared with the 2 years older; the age correlation (&lt; and 2 years) and season (winter-summer) with 16% for the first in VIGE (62.5% rotavirus); the absence of health systems at the NOVIGE (70%) and with both (29%); and others epidemiology considerations of the secuence. With came to conclusion that in our city: 1. there are VIGE with significative participation of rotavirus; 2. its distribution are winter and age group, also considering the other age groups and virosis; 3. the NOVIGE may difference at the clinic sign like vomit, between all the possible sintomatology; 4. the principal cause of diarrhoea and the no seasonal distribution are the NOVIGE; 5. there are not a strong relationship of diarrhoea by shortage envoronmental health in this study; 6. it's possible in Río Cuarto to made a fast and direct virology diagnostic using an electron microscopy.

Syndromes hémophagocytaires en phase d’aplasie post chimiothérapie

Material and methods. – This retrospective study reports 15 cases of hemophagocytic syndrome in children treated in our department during a eight-year period. Results. – Underlying diseases were acute lymphoblastic leukemia ( n=8) acute myeloblastic leukemia ( n=6) and Burkitt lymphoma ( n=1). Hemophagocytic syndrome was suspected after chemotherapy, in case of an unusual prolonged febrile neutropenia ( n=14) or isolated thrombocytopenia ( n=1). That fever was associated with cutaneous, pulmonary, hematologic, digestive and cardiac signs. Biological disorders included hypoprotidemia, hyponatremia, increased liver enzymes and fibrinopenia. Thrombocytopenia was observed in all patients and was associated with neutropenia for 14 of them. Diagnosis of hemophagocytic syndrome was always confirmed by bone marrow aspiration (infiltration with activated macrophages). Infection was documented in eight children. The treatment of hemophagocytic syndrome relied on steroids and resolution of symptoms occurred within three days of therapy. No recurrence of hemophagocytic syndrome was observed with a median follow up of two years and a half. Conclusion. – Such complication should be suspected in cases of prolonged febrile neutropenia and/or thrombocytopenia, and confirmed by bone marrow aspiration. Indeed, steroid therapy is effective and chemotherapy can be then pursued.

Peripheral neuritis in psittacine birds with proventricular dilatation disease

Necropsies were performed on 14 psittacine birds of various species suspected to have proventricular dilatation disease (PDD). Eight of the birds exhibited neurological signs (seizures, ataxia, tremors and uncoordinated movements) and digestive tract signs (crop stasis, regurgitation, inappetance and presence of undigested food in the faeces). At necropsy, the birds had pectoral muscle atrophy, proventricular and ventricular distention, thinning of the gizzard wall, and duodenal dilation. In addition, five birds had a transparent fluid (0.2 to 1.0 ml) in the subarachnoidal space of the brain, and one bird had dilatation of the right ventricle of the heart. The histological lesions differed from earlier reports of PDD in that peripheral (sciatic, brachial and vagal) neuritis was seen in addition to myenteric ganglioneuritis, myocarditis, adrenalitis, myelitis and encephalitis.