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Biomedical subjects

F Piette

Publications and source records attributed to F Piette.

180 records · Page 10Linked to original sources
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[Apolipoprotein E and bleomycin hydrolase. Polymorphisms: association with neurodegenerative diseases].

Several studies indicate a possible association between different genes and chronic neurodegenerative diseases including Alzheimer's disease (DTA). To further investigate, we have analyzed association between the apolipoprotein E (apo E) and bleomycin hydrolase (BH) polymorphisms and three groups of elderly patients: control subjects (T) (n = 68), late-onset sporadic DTA patients (DTAst) (n = 65) and other non vascular neurodegerative diseases (MNDA) (n = 52). Apo E-epsilon4 and BH-G alleles frequencies (%) are: 8.2 (T), 31.5 (DTAst), 16.4 (MNDA) and 41.4 (T), 35.6 (DTAst). No association has been observed between carrying the G allele and DTA in epsilon4 negative subjects but, our data have confirmed the earlier reports: carrying the epsilon4 allele is a dose-dependent risk factor for the DTAst (OR: 6.0, IC 95 %: 2.6-13.7) and decrease the age of symptom onset (p < 0.005). They have also suggested that apo E genotyping may be of interest to perform differential diagnosis of neurodegenerative diseases in elderly subjects.

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Subcorneal pustulosis and Pyoderma gangrenosum associated with a biclonal gammopathy.

Pyoderma gangrenosum and subcorneal pustulosis are two neutrophilic dermatoses. Their occurrence in the same patient is rare and may be related to an IgA dysglobulinemia. We report a case presenting these two conditions associated with a biclonal benign IgA and IgG gammopathy. A 67-year-old man exhibited typical pyoderma gangrenosum associated after three years duration with subcorneal pustulosis lesions, confirmed by cutaneous biopsy. Laboratory results showed a biclonal benign IgA and IgG kappa gammopathy. Therapeutic management was difficult: Pyoderma gangrenosum responded well to corticosteroids but subcorneal pustulosis management was harder and treatments were poorly effective.Pyoderma gangrenosum and subcorneal pustulosis are a part of the neutrophilic spectrum. Their association has been only reported in eleven patients. In eight cases, an IgA dysglobulinemia was associated suggesting its responsibility in the occurrence of both dermatoses. Treatments are various and not fully effective. If the Pyoderma gangrenosum usually responds to corticosteroids, the subcorneal pustulosis treatments are not well defined and often not efficient. Our case illustrates the dissociated evolution of these two dermatoses and their difficult global management. During the follow-up, a regular search for dysglobulinemia is required in order to detect malignant transformations.

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[Good clinical practices in therapeutic trials in geriatrics especially in Alzheimer type senile dementia].

The rules of "Good clinical practices" 1987 and the law of December 20, 1988 concerning biomedical research give guidelines that are difficult to apply in Geriatrics. Pragmatic solutions have to be proposed if we want to avoid delay in clinical research especially in degenerative diseases and in the evaluation of therapeutics in old age. We can focus the problems on the chapter "Responsibilities of the investigator": 1) His professional qualification whereas gerontology in not yet considered as a specialty; 2) Obtention of informed consent in general, especially written informed consent and leaflet informations given to patients; 3) Constitution of staff according to low motivation of nurses to research and low methodological knowledge; investigators' disponibility considering low density of nurses and physicians in geriatric units. Among specific points of "Good clinical practices" for home trials we need a careful selection of general practitioners interested in both geriatrics and therapeutic trials. Finally obtaining pharmacokinetic data in elderly needs probably a clear distinction between two ways: classical pharmacokinetic studies with samples of old healthy paid volunteers and pharmacokinetic study of a population in therapeutic trials.

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[Disseminated essential telangiectasis].

The authors report on their observation of disseminated primary telangiectasia over fifteen years. Many results, all negative, have been necessary in order to eliminate a subjacent auto-immune affection caused by the associated Raynaud's phenomenon. Attempts at treatment using tetracyclin and ketoconazol have been thwarted by failures.

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[Growth hormone in adults. An elixir of youth?].

Studies have revealed a partial deficiency of growth hormone (GH) secretion in the elderly. Aging has a central effect on the GH secretion and probably a peripheral effect on insulin-like growth factor 1 (IGF-1) or somatomedin C through changes in body composition. Simultaneously therapeutic efficiency of recombinant GH was confirmed in adults with GH deficiency. These notions have led to some controlled trials of GH treatment in elderly. Further studies of GH replacement are needed, examining issues such as dosage, tolerance (still inadequate) and efficacy before the widespread use of GH or IGH-F 1 in the elderly is advocated.

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PubMedDate not supplied

[Survey of the incidence of undesirable events in geriatric services].

In elderly with the risk of side effects of drugs is more important due to the age-related changes in organs and the drug interactions. It's why 26 gerontologic centers performed a multicentric survey about side effects (SE) incidence during a short period of 15 days. This survey was realised by REGATES (Network of Evaluation in Gerontology of Activity of Treatments and Side Effects). 2829 patients were included (8% acute patients, 23% Geriatric medicine, 69% nursing home). 74 SE were noticed in 64 patients among 21 centers. There were 23 men and 41 women with an average age 81.2 +/- 6.5 y. taking 5.7 +/- 1.6 drugs/per day. The main SE were neurological or cardiovascular (26% each). SE incidence is high with extrapolation 636 SE per year for 1000 geriatric patients. Considering the 100,000 hospital beds for elderly, we may measure the lack of informations which don't reach the pharmacovigilance centers, in relation to the weak medical density.

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