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Biomedical subjects

F Bonnaud

Publications and source records attributed to F Bonnaud.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Symptomatic renal metastases of bronchial carcinoma].

Renal metastasis from carcinoma of the lung is rarely a clinical problem. Autopsic series however prove that the kidney is a frequent metastatic organ (20%). We report the case of a 43-years-old male patient affected with a squamous cell carcinoma of the lung, with bilateral renal extension. These secondary localizations were detected through a left flank pain prior to a systemic inflammatory response syndrome. The absence of hematuria (even microscopic) contrasted with the importance of the lesions. The age, along with the poor general state of our patient and the absence of any CT specificity justified an exploratory lobotomy. The pathologic analysis of the renal biopsies confirmed the metastatic nature of the lesion.

Adult↗
PubMed1997

Carboplatin as radiosensitizer in non-small cell lung cancer after cisplatin containing chemotherapy. A phase I study of a groupe francais de pneumo-cancerologie (G.F.P.C.).

A Phase I trial of carboplatin therapy was performed on patients with locally advanced non-small cell lung cancer who had been previously treated with cisplatin, mitomycin and a vinca aklaloïd. This was administered as a daily bolus infusion or as a continuous infusion for 6 weeks with concurrent daily thoracic radiation. All patients had to be objective responders or to show no change after chemotherapy. The carboplatin was started at 10 mg/m2 per day, and increased to 15 mg/m2 per day and 20 mg/m2 per day, if treatment was feasible in successive cohorts of at least six patients. The radiation therapy consisted of 62-66 Gray on the tumor and the ipsilateral mediastinal nodes, 50 Gray on the mediastinum and 40-45 Gray on the supraclavicular lymph nodes. Twenty-nine patients took part in this study. Thrombocytopenia was the principal dose-limiting toxicity, with 15 mg/m2 per day of bolus or continuous infusion. Other toxicities included a fall in haemoglobin level, a fall in white-blood cell count, nausea and vomiting. The median survival time was 12 months, but the response rate cannot be determined among patients selected on the basis of response to chemotherapy. The recommended Phase II dose for patients previously treated with cisplatin containing chemotherapy, is 10 mg/m2 per day of either a bolus or continuous infusion.

Adult↗
PubMed1997

Airway obstruction and rheumatoid arthritis.

The aim of this study was to assess the percentage of respiratory disorders and airway obstruction in patients with rheumatoid arthritis by comparing lung function test results between patients with rheumatoid arthritis and control subjects with other rheumatological conditions. A prospective case-control study of respiratory symptoms and lung function abnormalities was performed in a series of 100 patients with rheumatoid arthritis. Eighty eight patients with other rheumatological diseases served as controls. Diagnosis of respiratory disorders was based on clinical, radiological and spirometric findings. Airway obstruction was determined from predicted values. The results were compared using Student's t-test and Chi-squared tests. An explanatory analysis was carried out by linear regression. The number of symptoms, respiratory disorders (including bronchiectasis) and lung function abnormalities was higher in patients with rheumatoid arthritis than in controls. After exclusion of smokers, the proportion of airway obstruction in patients with rheumatoid arthritis was 16% (versus 0% in controls), although the patients with rheumatoid arthritis still had more symptoms and respiratory disorders. The Chi-squared test did not identify any relationship between airway obstruction, duration of rheumatoid arthritis and type of treatment and occurrence of Sjögren's syndrome. In the nonsmokers, different explanatory models for the patients with and without a history of cardiac and respiratory disease emerged from multivariate analysis of indices of obstruction. These models included variables characterizing the severity and course of the rheumatoid arthritis. Respiratory disorders (including bronchiectasis) and airway obstruction are more frequent among patients with rheumatoid arthritis than in rheumatological controls. Although the exact pathophysiology of the link between bronchial obstruction and rheumatoid arthritis is still a matter of debate, explanatory factors for obstruction included variables characterizing the rheumatoid arthritis.

Adult↗
PubMed1997

[Pulmonary infection caused by Fusobacterium nucleatum].

Thoracic infection by anaerobes are uncommon diseases and often presents difficulty in diagnosis. We report a case of thoracic infection due to Fusobacterium Nucleatum. A 60-year old man presented a lesion infiltrating from the lung to the thoracic wall. Fusobacterium Nucleatum was isolated on pus collected. Treatment by penicillin, metronidazole combined with surgical drainage was highly effective.

Anti-Bacterial Agents↗
PubMed1996

[Calmette-Guerin (BCG) vaccination].

The reappearance of tuberculosis in France, in Europe and throughout the world has rekindled interest not only in curative treatment of the disease but also in its prevention. Since its appearance in 1921, the BCG vaccine has been the subject of debate; however, recent studies have fully demonstrated its interest, particularly in countries where tuberculosis is most endemic. The technical aspects of the treatment have changed little and are essentially based on intrademic administration, but the impact of BCG, especially for individual protection, are discussed. Its role in protection of the general population and in prevention of tuberculosis requires careful analysis. Study of iatrogenic effects of the vaccine shows that its side effects are minor when recommendations for use are followed. With the development of molecular biology techniques and mycobacteria genetics, the future use of the BCG vaccine seems promising.

Adolescent↗
PubMed1996

Antioxidant activity in bronchoalveolar lavage fluid from patients with lung cancer.

Glutathione (GSH) is one of the key components of the lung antioxidant defenses. Chronic smokers have higher GSH concentrations in their epithelial lining fluid than do nonsmokers. The aim of this study was to compare antioxidant concentrations in epithelial lining fluid (ELF) from nonsmokers, smokers with, and smokers without non-small-cell lung cancer. The study found that GSH in ELF from patients with lung cancer was significantly greater than in ELF from smokers and nonsmokers, at 1,485.5 +/- 208, 544 +/- 97.6 microM, and 339.3 +/- 112 microM, respectively (p < 0.05). In contrast, superoxide dismutase (SOD) was lower in ELF from patients with lung cancer than in that from smokers and nonsmokers, at 3.52 +/- 0.99, 30.82 +/- 8.2, and 43.91 +/- 10.1 U/ml, respectively (p < 0.05). Spontaneous superoxide anion release by adherent alveolar macrophages (AM) showed no difference between smokers with and without lung cancer. These data indicate that patients with lung cancer have marked modifications in their ELF antioxidant defenses by comparison with those of smokers. It is difficult to distinguish whether changed antioxidant status is a primary disturbance involved in the cancer process or whether it is a consequence of the neoplastic changes in malignancy.

Adult↗
PubMed1996

Perindopril-associated pneumonitis.

We report two cases of perindopril-associated pneumonitis with typical drug-induced clinical features. In the first case, biopsies showed granulomatous sarcoid-like lesions; in the second, bronchial wall eosinophil infiltratf2p4was reported with increased blood eosinophil count. In these two cases, improvement was obtained by withdrawal of the drug and was completed with steroids. All other causes were ruled out. Angiotensin-converting enzyme inhibitor (ACEI)-induced pneumonitis is still rare but has to be recognized as a real side-effect.

Aged↗
PubMed1996

[Explanatory factors of length of stay at the diagnosis-related group 129: common pneumonia and pleurisy, aged over 69 and/or associated co-morbidities].

BACKGROUND: Utilization of diagnosis related groups (DRGs) for hospital comparison, based on length of stay (LOS). OBJECTIVES: Inside a DRG (Pneumonia and pleurisy > 69 and/or associated comorbidities), to point out the explicative factors of LOS and the variables which could be recorded for a better description of these patients. SETTING: Pneumologic unit of Limoges' teaching hospital. METHODS: From 01-01-94 to 31-12-94, the DRG 129 was studied through the medical unit summary, the performance status at entrance, the social complexity, the characteristics of pneumonia (symptoms, temperature, arterial pressure...), the severity by American Thoracic Society (ATS) criteria, the procedures (chest X-ray, biology, fibroscopy...), the antibiotic treatments (intravenous and oral). Statistical tests associated univariate analysis, linear and logistic regressions. RESULTS: LOS was 15.53 d +/- 8.57 (m +/- SD). The mathematical model explains 69% of the variance of LOS logarithm. The logistic regression found 5 variables with a significant odds-ratio (OR) for an increased LOS: a high ATS score, repeated laboratory tests, a complex social situation, an increase length of antibiotic treatment (intravenous and oral). CONCLUSION: A better description of LOS, inside a DRG, needs supplementary variables. For pneumonia admitted in Limoges' hospital, the severity of the disease, the number of laboratory tests, the antibiotic treatment, the social complexity are the more significant indicators.

Age Factors↗
PubMed1995

Work related distal airway obstruction in an agricultural population.

OBJECTIVE: To assess the prevalence of distal airway obstruction and its risk factors in agricultural areas. METHODS: A cross sectional study of respiratory symptoms and lung function was performed among French farmers and their spouses (1122 subjects) who came for preventive medicine examinations. They answered a respiratory questionnaire and performed pulmonary function tests on a portable spirometer. Diagnoses of chronic bronchitis were made on the basis of reported chronic respiratory symptoms. Airway obstruction was determined from predicted values. Odds ratio (OR) and linear regression coefficients were calculated after stratification by smoking and history of cardiac and other respiratory diseases. RESULTS: Of respiratory symptoms prevalence of chronic cough was 8.47%, and chronic bronchitis 7.66%. Prevalence of distal airway obstruction was 11.4%, and overall airflow obstruction 3.2%. Smokers were 20.2% men, and 5.7% women. Linear regressions showed high association between pack-years in smokers or exsmokers and forced expiratory volume in one second/forced vital capacity (FEV1/VC) and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75). In non-smokers without any history of cardiac or respiratory diseases, age and the size of farms had the highest correlations with these variables. OR for distal airway obstruction was 2.1 in subjects > 50 years old v the younger ones and 3.02 in the smaller farms v the larger ones. CONCLUSION: After stratification by smoking and history of cardiac and respiratory diseases, distal airway obstruction is present in agricultural areas. The age, and the size of farm are the highest respiratory risk factors in non-smokers.

Adolescent↗
PubMed1995

[Carboplatin-VP16 combination in non small cell lung cancers in the aged patient. A study of the French group in pneumology (GFPC)].

UNLABELLED: Between February 1992 and May 1993, 22 patients older than 75 years, with non small cell lung cancer, were treated with carboplatin and oral etoposide. There were 18 men and four women with a median age of 79 years. Fourteen patients had an epidermoid carcinoma: four had an adenocarcinoma and four had an undifferentiated carcinoma. Carboplatin was administered intravenously on day 1 at a dose of 300 mg/m2; oral etoposide was administered at a dose of 600 mg/m2 (two capsules daily) for 9, 10, 11, or 12 days according to body surface. Courses were repeated every 28 days for a total of three courses. TOXICITY: 15 patients (68%) had received previous chemotherapy. Myelosuppression was the main problem with one grade IV and five grade III hematologic toxicities. We observed one mild neurologic toxicity. RESULTS: 19 patients were evaluable for response. We observed one complete response (5%), five disease stabilizations (26%) and 13 disease progressions. Median survival was 5 months. These results led to discontinue this study.

Aged↗
PubMed1995

[Explanatory indicators of the length of stay in a pneumology department].

BACKGROUND: Utilization of Diagnosis Related Groups (DRGs') for hospital payments in France. OBJECTIVES: To search the variations and the explicative factors of length of stay in a pneumologic unit, to analyse the relevance of the indicators by using the DRG's and the supplementary variables in a medical and economical perspective. SETTING: Pneumologic unit of Limoges' teaching hospital. METHODS: From 1-4-93 to 31-5-94, a prospective study analysed 1081 stays (one-day-longer) by the medical unit summary and by some variables describing the stay (planned admission, appropriateness), the patient (physical mobility at entrance, severity of disease), the procedures (physiotherapy, social needs). Statistical tests associated univariate analysis, linear and logistic regressions, hierarchic segmentation. RESULTS: DRG's explain 23% of logarithm length of stay. The mathematical model has separated five variables, which are associated with an increase of length of stay (age, number of procedures, physical mobility at entrance, social complexity, intensity of physiotherapy), one associated with a decrease of length of stay (planned admission). CONCLUSION: DRG's, alone, do not describe the dispersion of the length of stay, which is usually used to assess the consumption of resources during an hospitalization. The record of supplementary variables needs further studies, to improve the patients' classification.

Age Factors↗
PubMed1995

[Impact on the quality of life of respiratory symptoms and airway obstruction in an agricultural population].

Respiratory diseases are known to have consequences on health status. The objective of this study was to assess the quality of life of subjects with obstructive respiratory disorders coming for preventive medicine examinations. We conducted a study on a sample of adults living in agricultural areas (n = 1,235). We used two questionnaires: a respiratory questionnaire and the Nottingham Health Profile (NHP), which is a questionnaire designed to capture self-reported morbidity. It has been recently validated in french. Each subject performed a pulmonary function test on a portable spirometer to separate lung function obstructive abnormalities. Statistical analysis was realized by non parametric test. The number of positive responses (which shows bad health status) and the scores of the six dimensions are higher in females than males. According to sex and smoking habits, cough and chronic bronchitis are responsible for bad scores of health profile (for the total number of positive responses and the scores of each dimension). In case of airway obstruction, there is no major consequences on health profile. Subjective health measurements are interesting tools in subjects with non-chronic diseases. They can be associated with medical questionnaires because they give complementary inquiries.

Adolescent↗