[Gamma-delta T-cell lymphoma: outcome of a hyperactive malarial splenomegaly?]. / Lymphome T gamma-delta: complication possible d'une splénomégalie palustre hyperactive?

We report a gamma-delta T-cell lymphoma, in a male patient having a hyperactive malarial splenomegaly. The immunological disorder caused by chronic antigenic stimulation could be one of the causes leading to the occurrence of such hematologic disease. The prognosis of this type of lymphoma remains poor, partly due to delayed diagnosis. Therefore, it seems appropriate to investigate any atypical hyperactive malarial splenomegaly. In our observation, the macrophagic activation syndrome led us to discover the lymphoma.

Risk factors for death among patients in French Guiana: 1996-2005.

Risk factors for death in an HIV-infected cohort in French Guiana were studied in 1374 patients between 1996 and 2005. Of these patients, 48.5% were male and 76% were immigrants. Covariates were measured at the time of consultation. There were 223 deaths. Addictions [adjusted hazard ratio (HR)=13; 95% confidence interval (CI) 5.5-30.6; P<0.001], age>60 years (HR=1.5; 95% CI 0.9-2.5; P=0.13), male gender (HR=1.5; 95% CI 1.03-2.5; P=0.03) and CD4 count<50 cells/microL (HR=9.1; 95% CI 5.1-16.3; P<0.001) were independently associated with death. These results suggest that strategies promoting early diagnosis and better follow-up of addicted patients would have a significant impact on mortality.

[Impact of weight difference between donor and recipient on the function of the transplanted kidney]. / Effet de la différence de poids entre donneur et receveur sur la fonction du rein greffé.

OBJECTIVE: The objective of this retrospective study was to determine whether the difference between the donor's weight (wd) and the recipient's dry weight (wr) could influence the function of renal transplants. METHODS: Between 1987 and 1994, 185 patients with a mean age of 43.3 years +/- 12 were transplanted with a locally harvested cadaver kidney, corresponding to 120 men (42.2 years +/- 1.4) and 65 women (45 years +/- 12.8). The weight variation between donors and recipients (wd - wr) was 0.06 for men and 0.22 for women. The serum creatinine of recipients at 1 year was 147 mumol +/- 41.7. We used analysis of variance for univariate statistical analysis and multiple linear regression for multivariate analysis. RESULTS: On univariate analysis, the serum creatinine at 1 and 2 years was significantly higher (p < 0.02 and p < 0.035 respectively) when the donor's weight was 10% lower than the recipient's weight. Multivariate analysis, taking into account the donor's age and sex and the recipient's serum creatinine, confirmed the influence of the donor-recipient weight difference on serum creatinine at 2 years (p0.03), but also the role of the donor's age at 1 and 2 years (p < 0.0001 and p < 0.0004, respectively). CONCLUSION: In our study, the donor-recipient weight difference was a factor influencing the recipient's serum creatinine at 2 years. The donor's age also influences the recipient's serum creatinine, 1 and 2 years after renal transplantation.

The relationship between behavioural pattern, overall and central adiposity in a population of healthy French men.

The relationship between obesity, both general obesity (BMI) and central obesity (measured by the ratio of iliac and thigh circumferences), and a behavioural pattern, which includes alcohol consumption, smoking, stress and lack of sporting activity, was investigated in 467 middle-aged French working men. BMI and central obesity were closely correlated (r = 0.34). Alcohol consumption was positively associated with central obesity (P < 0.001) but it did not significantly influence BMI. BMI decreased with cigarette smoking (P < 0.001), but central obesity only increased significantly after adjustment for BMI (P < 0.05); thus for a given BMI, smoking was associated with a greater degree of central adiposity. Resting heart rate (considered as a measure of stress) was positively associated with both BMI and the iliac-thigh ratio (P < 0.01, P < 0.05), the latter association being due to general obesity. Sporting activity and BMI were only marginally associated (P < 0.07) but central obesity decreased with activity (P < 0.01). Jointly, alcohol consumption, cigarette smoking, the resting heart rate and sporting activity explained 8% of the variance in the iliac-thigh ratio; after adjustment for BMI these behavioural variables still explained 6% of the variance. Central adiposity, which has recently been described as a risk factor for coronary heart disease, non-insulin dependent diabetes and hypertension, was significantly associated with a potentially modifiable behavioural pattern.