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Biomedical subjects

A Elias

Publications and source records attributed to A Elias.

At least 127 records · Page 7Linked to original sources
PubMed1986

Autoimmunity, fetal losses, lupus anticoagulant: beginning of systemic lupus erythematosus or new autoimmune entity with gynaeco-obstetrical expression?

Among the various autoantibodies commonly found in women with systemic lupus erythematosus, the so-called lupus anticoagulant has been described in association with fetal losses. Recently, women with repeated spontaneous abortions and lupus anticoagulant, but no apparent systemic lupus erythematosus have been described. We have studied prospectively the possible connections between fetal losses and autoimmunity in a large control study of 130 idiopathic habitual aborters. These non-pregnant patients without any antecedent autoimmune disease were explored for the presence for autoantibodies especially lupus anticoagulant. Ten percent of the patients exhibit an antithromboplastin antibody (lupus anticoagulant) and half of this group possesses a striking association of biological manifestations of autoimmunity. In conclusion, two points appear: firstly, statistical correlation is demonstrated between antithromboplastin antibody and habitual abortion; secondly, doubt remains about the significance of the association between autoimmunity, fetal losses and antithromboplastin: beginning of systemic lupus erythematosus or new autoimmune entity with gynaeco-obstetrical expression.

Abortion, Habitual↗
PubMed1986

High-dose combination alkylating agent chemotherapy with autologous bone marrow support for metastatic breast cancer.

Seventeen patients with metastatic breast cancer were treated with a high-dose combination chemotherapy regimen and autologous bone marrow support. Thirteen patients had prior combination chemotherapy. Fifteen patients were treated with a phase II regimen of cyclophosphamide (5.625 g/m2), cisplatin (165 mg/m2), and BCNU (600 mg/m2). Bone marrow harvest and reconstitution were uncomplicated. All patients became profoundly myelosuppressed. Fourteen of 16 evaluable patients (88%) responded, including six complete responses (CRs) (38%). The median time to tumor progression was 5 months. The median survival was 8 months. CRs occurred more frequently in patients with no prior chemotherapy for metastatic disease, inflammatory breast cancer; and patients treated within 3 months of first recurrence. The rate of tumor regression was rapid, with a median of 11 days to partial response (PR) and 12 days to CR. Those patients achieving a PR by day 7 had a greater likelihood (P = .03) of attaining a CR than those patients whose PR occurred later. Three deaths (18%) occurred, all in women with inflammatory breast cancer treated with prior chemotherapy. High-dose combined alkylating agent therapy produced high PR and CR rates in metastatic breast cancer patients, most of whom had failed prior chemotherapy. The rate of tumor regression was rapid. Current efforts are directed at developing a regimen using drugs specifically active in breast cancer, with an intent of combining an effective high-dose regimen with additional modalities of therapy in the treatment of breast cancer.

Adenocarcinoma↗
PubMed1986

[Role of phlebography in the diagnosis of deep venous thromboses of the legs].

Phlebography makes the diagnosis of lower limbs venous thrombosis possible, and points out as well both site and extension. The technique used is the "free flow" technique which is modified so as to visualize the iliac veins as well as inferior vena cava. The presence of lacunar image or cupula-shaped interruption demonstrates a recent thrombosis above all if associated with venous dilatation; absence of a main venous trunk and collateral circulation do demonstrate a previous thrombosis. Phlebography fails to explore easily some veins, especially pelvic and deep femoral veins, as well as to determine the clot initial appearance. Non-invasive methods, such as labelled fibrinogen, Doppler ultrasonography and rheoplethysmography are less sensitive and specific; only Doppler ultrasonography associated with ultrasound can supply quite good results. Despite such efficient methods, especially ultrasound combined with Doppler ultrasonography, phlebography appears as the main examination in the patients presenting with various thrombosis or pulmonary embolism.

Humans↗
PubMed1986

[Value of thrombolytic agents in venous thrombotic states].

Fibrinolytic efficiency in the treatment of deep venous thrombosis is superior to heparin efficiency, but appears as more expensive. It must thus been used only if strongly required. Thrombolytic role is then demonstrated on the clot lysis, as far as the latter is recent, near, and not really obstructive. Such a thrombosis can be performed such a treatment, thus reducing sequelae of post-phlebitic disease. However, it increases by 2.9 the hemorrhagic risk, thus requiring extreme caution as for fibrinolysis and by 70 for SK and up to 200 for UK as for the cost. On a practical point of view, using SK (100,000 U/h) UK (4,000 U/kg/h) after an initial dose or UK (2,000 U/kg/h) combined with heparin, the treatment will be performed at least three days and followed up every 6 hours thanks to a fibrinemia, biological control as for therapeutic efficiency, numeration and a TCK. Fibrinolytics are thus prescribed to young patients presenting with a recent phlebitis demonstrated thanks to phlebography.

Fibrinolytic Agents↗
PubMed1985

[Controlled prospective study of clinical and biological thyroid parameters in rheumatoid polyarthritis].

15 patients with rheumatoid arthritis (14 women and 1 man aged between 30 and 75 years) were compared to a control group of 12 women and 1 man (aged between 22 and 77 years) admitted to the rheumatology unit at the same time for benign diseases. Both groups were examined for: the presence of a goitre, family history and/or clinical hormonal dysfunction, the plasma levels of total cholesterol, free thyroxin (FT4), free triiodothyronine (FT3), before and 2 hours after 50 micrograms of thyrotropin IV, thyrostimulin half an hour before and one hour after thyrotropin and the levels of the antimicrosomal anti-thyroid antibodies and the anti-thyroglobulin antibodies. None of the patients with rheumatoid arthritis had any clinical hormonal dysfunction. However, 6 of the 15 patients presented a homogeneous goitre, 5 of these 6 patients had a family history of goitre and 2 had positive antibodies. In comparison with the control group, the 15 cases of rheumatoid arthritis had a significant decrease (m +/- sd) in the FT4 (13.20 +/- 2.50 pmol/l vs 15.60 +/- 2.47; p less than 0.02), FT3 (3.80 +/- 1.12 pmol/l vs 5.50 +/- 0.93; p less than 0.001) and a rise in the T3 with low thyrotropin (5.70 +/- 1.60 vs 8.50 +/- 1.50; p less than 0.001), while the levels of thyrostimulin and the thyrostimulin peak under thyrotropin were not modified.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Cost of transfusion in AIDS. Experience at the Claude-Bernard Hospital apropos of 28 cases].

The study of 28 confirmed cases of AIDS shows that transfused patients use a large amount of hospital's blood products, especially platelets. For these patients, the average cost of transfusion is higher than that, for intensive care unit patient's. The use of irradiated products increases the cost (+ 35%). As there is a shortage of donors, if the present precautions are respected, there is no reason why the hospital should not continue to ask the patient's family and circle of friends, to donate blood.

Acquired Immunodeficiency Syndrome↗
PubMed1983

[Phlebographic diagnosis of lower limb venous thrombosis].

Thrombosis of the veins of the lower limbs and of the inferior vena cava can be diagnosed by free flow phlebography completed by a technical device preventing puncture of the femoral veins. The thrombus shows as a lacuna or a cupshaped arrest of the contrast medium. This method can be used in most modern radiological centres and carries little risk in trained hands. Its field of application is limited in that the pelvic veins (iliac veins excepted) and the deep femoral vein are imperfectly explored or unexplored, but it is superior to other methods - such as labelled fibrinogen, Döppler ultrasonography or rheography - which are less sensitive, less specific and unable to localize precisely the site and extension of the thrombosis. However, these methods can be used at the patient's bedside and can be repeated at will, being painless. Whenever pulmonary thrombo-embolism is suspected on clinical grounds or on the results of other exploratory methods, phlebography should be systematically performed (except in pregnant women) as it helps to decide on the treatment. In contrast, it has no place in the routine detection and surveillance of the disease which are better carried out using non-invasive techniques.

Femoral Vein↗
PubMed1983

Cardiovascular changes in video-game players. Cause for concern?

Video games are one of the most popular recreational activities among Americans of all ages, especially teenaged boys and young men. Studies of the health hazards of video-game playing have linked seizures, psychologic disturbances, and other health problems with the games. The study reported here measured changes in blood pressure and heart rate that occurred in 23 young men when they played a video game. The mean systolic blood pressure for the entire group was considerably higher during play than before or after and was significantly higher in novice players than in more skilled players. Heart rate was also significantly higher during play. In view of these results, other cardiovascular changes might be expected to occur during video-game playing. Although the changes reported here were minor, even minor cardiovascular alterations could potentially prove serious in persons with cardiovascular disease.

Adult↗
PubMed1983

[Course of pulmonary embolism].

One hundred and fifty-five patients with a mean age of 59 years and suffering a recent pulmonary embolism (P.E.) underwent angiopneumography and phlebocavography before and after treatment. The P.E. was minimal in 42 cases (Muller less than 11) and severe in 113 cases (Muller greater than 11). There was an associated venous thrombosis (V.T.) in 134 cases (86%) affecting the iliac veins or vena cava in 44 cases (28%). Several types of treatment were used: heparin 66, SK 24, high dose UK 16, low dose UK + heparin 37, surgery 16. Fifty-two patients underwent a procedure to interrupt the I.V.C. Four patients received two types of treatment in succession. SK resulted in more rapid disappearance of the pulmonary clot than UK at the dose used but the results were comparable on the 15th day (SK = UK = H). With regard to V.T., the Marder index failed to reveal any significant difference between the types of treatment. However, SK resulted in the lowest therapeutic failure rate (19%) and it was the only agent which produced disobliteration of iliac or vena cava thromboses (6 cases out of 13), other types of treatment being ineffective (0 cases out of 28). The mortality rate was high (14%) but 86% of the patients who died had a massive P.E. (greater than 60%). The recurrence rate was less (6%) but recurrences were fatal in 6 cases out of 10. Sixty-four patients were seen again after a mean period of 20.7 months. Pulmonary sequelae were minor (CPC 4.6%, dyspnoea 18%). By contrast, one patient in two suffered from post-phlebitis syndrome. The latter was all the more common when obstruction of the proximal veins persisted after treatment. On the basis of these data, the authors emphasise the gravity of pulmonary thrombo-embolic disease: fatal in the early phase essentially as a result of recurrences, incapacitating in the late phase as a result of post-phlebitis syndrome. They note that proximal V.T. associated with P.E. is responsible for such complications. Such iliocaval disease must therefore be sought routinely by phlebocavography. Their presence justifies aggressive treatment designed to destroy them (SK) or protect against their consequences (I.V.C.I.).

Drug Therapy, Combination↗
PubMed1982

[Phlebography in venous thrombosis of the lower limbs (author's transl)].

Phlebography is the best diagnostic technique for deep venous thromboses of the lower limbs. The authors use the "free flow" technique which they have modified by visualisation of the I. V. C. and I. V. A lacunar appearance or cupola-shaped interruption are indicative of a recent thrombosis, whilst the absence of a main venous trunk and a collateral circulation are more common in the presence of an old thrombosis. They emphasise the possible sources of error in interpretation and the difficulty in determining how long the thrombosis has been present. Despite its disadvantages, phlebography remains the essential examination in order to select treatment in patients in whom there is a suspicion of venous thrombosis or pulmonary embolism. Venous Doppler and rheoplethysmography, less sensitive and less specific, have a place in routine detection and the surveillance of treatment.

Diagnosis, Differential↗
PubMed1981

The influence of vitamin D intake on serum calcium in tuberculosis.

We report the first prospective controlled study designed to determine the effect of vitamin D ingestion on serum calcium concentration in patients with tuberculosis. Every patient admitted to the tuberculosis ward over a 6 month period, who was free of any condition which might influence serum calcium concentration, was randomly assigned to one of two groups. The diet of the first group was substituted with ergocalciferol 5000 units daily. The diet of the second group was not supplemented. In addition, the second group was randomly subdivided into two subgroups. The first subgroup received a diet unrestricted in vitamin D. The second subgroup received a diet containing less than 50 units of vitamin D. Serum calcium was determined at weekly intervals. In contradistinction to the results of a previously reported retrospective study, there was no significant difference between the group receiving supplemental vitamin D and the control group at any time during the entire period of study. Furthermore, there was no significant difference between the subgroup of patients receiving normal dietary vitamin D and the subgroup maintained on the diet restricted in vitamin D.

Adult↗