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Biomedical subjects

A Didier

Publications and source records attributed to A Didier.

At least 127 records · Page 7Linked to original sources
PubMed1987

Role of the quaternary ammonium ion determinants in allergy to muscle relaxants.

Anaphylaxis to muscle relaxants appears to be a very useful model to study the IgE-dependent mechanisms of mediator release in humans. The serum IgE binding sites of the drugs appeared to be the ammonium ion determinants. In patients allergic to suxamethonium, one of the most frequently used muscle relaxants for general anesthesia, significant histamine release could be obtained in each case with simple diammonium salts. The length of the chain linking the ammonium groups appears to play an important role. In fact, when the length was less than or equal to 4 A, no significant histamine release could be obtained, whereas the optimal length for histamine release appeared to be greater than or equal to 6 A. Furthermore, muscle relaxants with a rigid backbone between the ammonium determinants (such as pancuronium) are less active than flexible molecules (such as suxamethonium) in initiating mediator release. This study suggests that small divalent molecules can induce anaphylactic shock in sensitized patients and that the length and the flexibility of the chain bearing the haptenic determinants appear to be important factors in the elicitation of mediator release.

Drug Hypersensitivity↗
PubMed1987

Allergy to suxamethonium: persisting abnormalities in skin tests, specific IgE antibodies and leucocyte histamine release.

Twenty-one patients, who had previously experienced an anaphylactic reaction to suxamethonium during general anaesthesia, were selected for this study. Initially, skin tests with muscle relaxants were carried out in the twenty-one patients, detection of specific anti-choline IgE in nineteen, and leucocyte histamine release in seventeen. These three tests were then repeated between 1 year and 4 years after the initial evaluation. In the majority of patients, sensitization to the muscle relaxants persisted for more than 1 year after the anaphylactic reaction. Only three patients out of twenty-one (4%) had negative skin tests when retested 1-4 years later. A reduction in leucocyte histamine release was noticed in one of the seventeen retested patients (6%). Modifications of anti-choline IgE were observed in five of nineteen patients (26%). The persistence of sensitization to suxamethonium may result from repeated stimulation by occasional contacts with quaternary ammonium compounds. This study demonstrates the reliability of skin tests, leucocyte histamine release and detection of anti-choline IgE to diagnose allergic reactions to suxamethonium, even when they are performed a long time after the initial anaphylactic reaction.

Alcuronium↗
PubMed1987

[Acute primary alveolar hemorrhage or Goodpasture's syndrome?].

We report a case of idiopathic diffuse alveolar haemorrhage with fatal outcome in a 23 year old man. In the absence of any renal abnormality of circulating antiglomerular basement antibody the diagnosis of Goodpasture's syndrome was made taking into account the history and the autopsy evidence of linear deposits of immunoglobulin on the glomerular basement membranes.

Acute Disease↗
PubMed1986

[Anaphylactic complications due to suxamethonium].

A study was carried out on 36 patients who had presented with an anaphylactic reaction when they had been received anaesthetic induction agents including suxamethonium. After having been examined, they were assessed with various immunoallergic tests (skin tests, LHL, a search for specific anticholine IgE antibodies). They were compared with a group of 120 control patients with the same age, sex and professional characteristics. This study confirmed the part played by specific IgE antibodies in accidents involving suxamethonium. The specificity of the tests that could be used for the diagnosis was excellent. However, as far as sensitivity of the tests went, skin tests and LHL were more sensitive than the search for specific IgE antibodies. There was no statistical relationship between the limit for skin reactions and the degree of histamine release of the level of anticholine IgE antibody.

Adult↗
PubMed1985

Anaphylactic reactions to suxamethonium prevention of mediator release by choline.

IgE antibodies cross-reacting with choline and suxamethonium were found in the sera of 15 of 22 patients with life-threatening sensitivity to suxamethonium, one of the most commonly used muscle relaxants. Furthermore, choline that is one of the metabolites of acetylcholine and a monovalent part of the suxamethonium molecule could act as a hapten inhibitor in vitro and in vivo, blocking specifically the basophil histamine release induced by suxamethonium and the positive skin tests to the drug in allergic patients. These results confirm the IgE dependency of allergic reactions to suxamethonium and suggest a possible way of preventing such reactions with choline.

Anaphylaxis↗
PubMed1985

[Complete branch blocks in asymptomatic patients].

Basing themselves on their personal experience and a review of the international literature, the authors study complete bundle branch blocks in asymptomatic subjects. They show that before the age of 50 these complete bundle branch blocks rarely progress towards a complete A-V block. They emphasise the excellent prognosis in the long term for isolated right or left blocks without obvious signs of cardiovascular disease and they cite cases of prolonged survival (20 to 40 years after discovery of the bundle branch block).

Adolescent↗
PubMed1983

[Neurogenic tumor of the anterior mediastinum. An uncommon diagnosis: neurofibroma of the vagus].

Case report of an endothoracic neurofibroma of the left vagus nerve, presenting as an anterior mediastinal mass in a 62 years old man without other signs of Recklinghausen's disease. Rarity of such cases is noted. Previously published sixty one reports are studied. Only four are localised in anterior mediastinum. The authors emphasize absence of specific signs of vagal involvement, importance for diagnosis of surgical extirpation, and mildness of post operative course.

Cranial Nerve Neoplasms↗
PubMed1983

[Hot pseudonodule disclosing a thyroid cancer in a child].

The authors report on a 11 1/2 year-old boy presenting with a palpable thyroid nodule. 99mTc and 131I scintigrams showed hyperfixation of this nodule (hot nodule). Surgical removal showed follicular-papillary carcinoma. These thyroid carcinomas revealed as hot nodules, seem to be exceptional.

Adenocarcinoma↗
PubMed1980

[Long-term administration of calcium-heparin in thromboembolism (author's transl)].

The profound importance of thrombosis in natural history of venous and arterial thromboembolism justifies long-term use of heparin, the best antithrombotic agent. Through the study of 88 cases concerning patients treated by subcutaneous calcium-heparin for a time from 3 months to 6 years, in several indications of venous and arterial thromboembolism, we can bring the following results: - The treatment is easily accepted when patients are inquired and trained. The doses must be adapted according to clotting assays, which do no more restrain patients than during oral anticoagulant treatment. - The frequency of hemorrhagic complications is the same than during antivitamine K treatments. - Thrombosis occur rarely during heparin therapy, but with high frequency during oral anticoagulant treatments. - Osteoporosis is a real but acceptable risk (10 p. cent) of long-term heparin prescription. - The true limit of treatment is the frequency (34 p. cent) of cutaneous hypersensibility reactions with high blood eosinophilia rate. Always mild, this reaction is related to the subcutaneous administration, and heparin is likely not the single impeached substance. These undesirable effects bind us to their thorough study, in order to obtain better tolerated drugs.

Adult↗