[Apropos of Freiberg's disease or Kohler's 2d disease (primary juvenile osteonecrosis of the head of the 2d metatarsal)].
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Biomedical subjects
Publications and source records attributed to A Denis.
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Several studies have shown that estrogen replacement therapy protects postmenopausal women against coronary artery disease. This protective effect has been ascribed to the hormone's effect on serum lipids, as well as a direct action on the vascular wall. Concurrent administration of a progestin to protect women from the risk of endometrial hyperplasia may alter the protective effects of estrogen. The aim of this study was to assess the evolution of the endothelial function in postmenopausal women given a sequential combination of oral 2 mg estradiol valerate for 11 days, followed by 2 mg estradiol valerate associated with 1 mg cyproterone acetate for ten days (Climène). Each 21-day sequence was followed by a seven-day treatment-free interval. The women received a three-month treatment course. Thirty-one healthy postmenopausal women participated in the study (median age: 51 years; range: 45-59 years). Flow-mediated dilatation (FMD), a reflection of endothelium-dependent vasomotor function, increased from 8.47% at baseline (range: 4.57-11.02%) to 9.64% (range: 7.07-13.12%) at the end of the first treatment cycle; i.e., a 15% increase over baseline (P < 0.0001). FMD further increased after three treatment cycles to 10.59% (range: 8.09-15.22%); i.e., a 28.6% increase over baseline (P < 0.0001). FMD at the end of the first combined sequence or after the 11 days of estradiol only were similar (delta = 0.25%; range: -2.31-5.81%; not significant). In conclusion, in postmenopausal women, a three-month sequential treatment combining estradiol valerate and estradiol valerate plus cyproterone acetate (Climène) has beneficial effects on endothelial function as demonstrated by the evolution of the FMD. There was no decrease in the effect of estradiol on FMD when cyproterone acetate was added to estradiol.
A new UV filter, the 1-(4-tert-butylphenyl)-2-decanyl-3-(4'-methoxyphenyl)-propane 1,3-dione called C10-DBM, was prepared by grafting a ten-carbon aliphatic chain to the alpha-carbonyl position of 4- tert -butyl-4'-methoxydibenzoylmethane (BM-DBM).(1) UVA absorption efficiency of a cosmetic preparation containing this new filter, called C10-DBM, was tested and compared to an identical preparation containing BM-DBM. The two preparations were irradiated under a 150-W xenon lamp or exposed to natural sunlight. The originality of this new filter resided in that its UVA absorbance appeared during the irradiation of the molecule. Moreover, although the molar absorption coefficient of C10-DBM in the UVA domain was lower than that of BM-DBM, its absorption showed much more photostable behavior under both methods of irradiation. After two hours of sunlight exposure, the preparation containing the BM-DBM lost 85% of its UVA absorbance, whereas the UVA absorbance of the preparation containing C10-DBM showed a decrease of 3% in comparison to the maximum absorbance obtained after 30 minutes of irradiation. Also, after two hours of exposure to natural sunlight, the UVA absorbance of the preparation containing C10-DBM remained above its initial value (before the irradiation began).
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The authors report a case of bacterial endocarditis from unidentified bacteria, responsible for a rupture of chordae of the mitral valve in a 4 month-old infant with a previously normal heart. Bidimensional echocardiography led to diagnosis. The importance of the mitral loss thus created made a mitral plasty necessary with cardiopulmonary by-pass at age 2 years. Ultrasonographic data were then confirmed. Postoperative result was excellent. The features of acute bacterial endocarditis in infancy are reviewed.
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