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Biomedical subjects

D Gosset

Publications and source records attributed to D Gosset.

At least 19 recordsLinked to original sources
PubMed1997

Immunoassay of digoxin in hair.

Digoxin analysis in blood is an essential tool for therapeutic drug monitoring in cardiology because compliance with the treatment is a critical issue for the patient. Unfortunately, in postmortem cases blood digoxin concentration is of poor quality because there is a possible drug redistribution in the corpse and because of digoxin-like factors present in some people's blood. On the other hand, no biological fluid can be obtained at the autopsy. The aim of the present study was to evaluate the ability of an immunological method to determine digoxin in hair, in order to confirm that hair analysis can provide information on digoxin use before death. We studied 35 elderly patients who had been taking digoxin (60-250 micrograms/day) for 1-5 years. Two decontamination procedures were tested: washing by dichloromethane or by water and methanol. Three extraction procedures were compared: crushing in a ball mill and chloroform/acetone: crushing and methanol; enzymatic digestion. Immunoassays were performed by a microparticulate enzyme immunoassay. Serum digoxin levels were also assayed when sampling hair. The best results were obtained after decontamination with water and methanol followed by enzymatic digestion. Hair digoxin concentrations range from 3.6 to 11.4 pg/mg. Those very low concentrations are probably due to low and narrow range serum digoxin levels (0.3-1.4 ng/ml). No correlation was found between hair and blood digoxin. A forensic case is presented with 5 pg/mg digoxin in hair.

Aged↗
PubMed1995

A fatal case of buflomedil self-poisoning: toxicological data and literature review.

A fatal case of buflomedil (Fonzylane) self-poisoning is presented. Drug identification and quantification in postmortem blood, urine and gastric contents was achieved by means of high pressure liquid chromatography with diode-array detection (HPLC/DAD). Blood concentration was 275 micrograms/ml, > 70 times the usual therapeutic values. Toxicological results are discussed in the light of the existing literature.

Adrenergic alpha-Antagonists↗
PubMed1994

[Behçet disease. Comparative aspect of diagnostic criteria].

OBJECTIVES: Different diagnostic criteria for Behçet's disease are proposed in the literature. We compared the criteria proposed by Mason and Barnes with those proposed by the International Study Group and with those proposed by the Japanese committee. METHODS: This retrospective study included 41 patients with Behçet's disease according to the criteria set by Mason and Barnes. There were 16 patients of French origin and 25 patients of North African origin. RESULTS: Genital ulcerations were more frequent in the North African population (p < 0.007) and typical Behçet skin lesions were more frequent in the French population (p < 0.021). Comparing the clinical data among the 41 patients with Behçet's disease according to the Mason-Barnes criteria revealed that only 83% met the criteria set by the International Study Group and only 54% the criteria of the Japanese committee. For the International Study Group criteria, the requirement for recurrent buccal ulcerations with at least 3 episodes over a 12 month period (a major criteria) was the most limiting element. Likewise, genital ulcerations were not always recurrent. CONCLUSION: These findings confirm the variability of clinical manifestations of Behçet's disease with ethnic origin. Proposed diagnostic criteria vary depending on the study committee and should be used as diagnostic guidelines rather than as criteria required for positive diagnosis.

Adult↗
PubMed1994

[Predictive signs of cancers in dermatomyositis. Study of 29 cases].

Dermatomyositis (DM) is characterized by an inflammatory myopathy and typical cutaneous lesions. In a retrospective study, 29 adult cases without overlap syndrome were reviewed. Our aim was to define predictive signs of cancer. Ten (four women, six men) of the 29 patients (35%) had DM associated with malignancy. The diagnosis of cancer was made concomitantly in six cases, more than year after (two cases), more than year prior to (two cases) the occurrence of DM. No extensive diagnosis procedures were necessary for identifying the tumors. A paraneoplasic evolution was certain for any patient, probable for six, improbable for fourth. For the group with malignancy: age was higher (P = 0.01), albumin lower (P = 0.04), C reactive protein higher (P = 0.0061). These parameters seem to have predictive value for the presence of malignancy.

Adult↗
PubMed1993

Conjunctival biopsy in scleroderma and primary Sjögren's syndrome.

Keratoconjunctivitis sicca complicates both scleroderma and Sjögren's syndrome. Scleroderma of recent onset is difficult to diagnose, but is easily recognized late in its course. To assess the value of the conjunctival biopsy in the diagnosis of scleroderma, we used light, scanning, and transmission electron microscopy to compare in a masked fashion specimens from 21 patients with scleroderma and 14 patients with primary Sjögren's syndrome. Epithelial changes permitted diagnosis of early scleroderma in the two groups of patients. Lymphocytic infiltrate was always present in Sjögren's syndrome, but not in scleroderma. Fibrosis was always found in scleroderma, even in scleroderma of recent onset, but was absent in Sjögren's syndrome. The fibrosis was distributed around capillaries in a band-like pattern and was associated with degranulating mast cells. Conjunctival biopsy is valuable for the early diagnosis of scleroderma and for differentiating between scleroderma and primary Sjögren's syndrome.

Adult↗
PubMed1991

[Pericardial C-reactive protein. A marker of agonal cardiac disease ?].

We studied the influence of the agonal period on the concentrations of acute phase proteins in biological fluids obtained from 26 autopsy cases. We found significant differences for C-reactive protein concentrations in serum and in pericardial fluid, between short and long agonies. The other acute phase proteins studied (alpha-1 antitrypsin, alpha-2 macroglobulin, haptoglobin) failed to show any significant difference in serum and pericardial fluid levels between the two types of agony. The increase in C-reactive protein level in the pericardial fluid is attributed to an "agonal pericarditis" which may result from an agonal myocardial necrosis. Our results could be of interest in forensic medicine.

Adult↗
PubMed1990

[Alcohol and psychotropic drugs in fatal traffic accidents (the Nord-Pas-de-Calais region, France)].

UNLABELLED: Consumption of alcohol and tranquilizers reaches a very high level in France. Studies about simultaneous alcohol and psychotropic drugs involvement in motor related fatalities have never been described in this country. A retrospective study was done on 482 fatalities broken down by drivers and pedestrians within one year (1987) in Région Nord-Pas de Calais (France). METHOD: 132 cases met the criteria for complete study. Blood samples obtained at the time of death were analysed for alcohol (BAC) by gas-chromatography and assayed for barbiturates (BA), benzodiazepines (BE) and tricyclic antidepressants (TA) by Emit. RESULTS: Out of 132 fatalities there were 86% men (mean age 38.5 years) and 14% women (mean age 46 years). 57% belonged to the working population. Of the fatalities, 38% occurred from Friday 8 p.m. to Sunday 12 p.m. We distinguished 3 categories: pedestrians (18.2%), 2-wheel vehicles (19%) and 4-wheel vehicles (62.8%). Alcohol involvement is given in Table 2. [table: see text] Notice that 53% were above the legal limit (0.8 g/l) and 34.8% had no alcohol. Psychotropic drugs were detected in 10.6% of the cases (Table 3). [table: see text] BZ were found in 50% of men and 100% of women. drugs and alcohol were present simultaneously in 8.3% of the individuals. Results are in % of total in Table 4: [table: see text] Positive BAC and positive drugs are not related. No significant difference was found in the distribution of alcohol between positive or negative drugs findings. Our results are consistent with those described by North-American authors, but largely superior to those from French or other studies done only on injured persons.

Accidents, Traffic↗
PubMed1989

[Significance of arterial Doppler in Horton's disease. Prospective study of 59 case reports].

Several preliminary studies drew attention to the value of Doppler examination in temporal arteritis. This study involving 59 cases aimed to define the value of Doppler examination in the diagnosis of the disease, evaluation of ophthalmic risk and in the monitoring of treatment. The study involved 59 patients and 47 controls with no evidence of temporal arteritis, but of comparable mean age. The following arteries were investigated before treatment: arteries of limbs, subclavian, vertebral, carotid, temporal, occipital, facial and ophthalmic recorded via the internal nasal branch and also transocularly. The results were expressed in the form of a score from 0 to 3 describing the degree of deterioration of the curves. A mean score corresponding to the mean of the scores of the cephalic arteries was calculated for each patient and each control. The specificity and sensitivity of the investigation were studied, based on this mean score by ROC analysis. The progression under treatment was monitored for more than 24 months in 20 patients divided into 3 groups: group I: 6 patients cured; group II: 6 patients with late recurrence of temporal arteritis after steroid withdrawal; group III: 8 patients with progressive disease. 81.5% of temporal arteries were pathological, including 60% with tight stenosis (score 2 and 3). Morphological anomalies in the curves were also noted at the level of the occipital arteries (69%), facial arteries (80%), as well as the ophthalmic artery at both recording sites (internal nasal: 84.5%, transocular: (73%) (table I).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Antitrypsin activity of the urine and alpha 1 protease inhibitor].

The urinary trypsin inhibitory capacity (TIC) is mainly due to the excretion of an inhibitor which is immunologically related to inter-alpha:trypsin inhibitor (ITI). However, alpha 1 protease inhibitor (alpha 1 PI) can be found in urine of patients with proteinuria. When this one is greater than 1 g/l, the measured TIC is more or less markedly related to the amount of alpha 1 PI present in the analyzed sample. The antitryptic activity of alpha 1 PI can be ruled out by incubating urine with specific anti-alpha 1 PI immunoglobulins. An identical result is obtained by acidification of the sample prior to TIC determination. Moreover, after freezing of urine, only the antitryptic activity of alpha 1 PI is strikingly decreased. Thus, in the presence of a significant proteinuria (greater than 1 g/l), a preliminary acidification of urine allows a suitable and specific measurement of TIC due to the inhibitor immunologically related to ITI. Thus, this one is a sensitive, useful and easy test for detecting and monitoring infections.

Bacterial Infections↗