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Biomedical subjects

F Simon

Publications and source records attributed to F Simon.

At least 217 records · Page 12Linked to original sources

Prognostic factors and treatment of multiple myeloma: interest of a cyclic sequential chemohormonotherapy combining cyclophosphamide, melphalan, and prednisone.

1. A type 2 therapeutic trial consisting of the administration of monthly cycles of chemohormonotherapy, each cycle combining weekly sequences of mephalan, prednisone, cyclophosphamide, and prednisone, has been achieved in 20 stage II or III myeloma patients. Tolerance of this regimen in treated out-patients was found to be excellent. Preliminary data indicate that the better survival rate in patients treated by this regimen is still not reached at a 30-month follow-up examination by three other nonrandomized control groups of patients receiving continuous therapy with prednisone alone, prednisone + cyclophosphamide, or prednisone + melphalan. 2. Analysis of the main prognostic factors of the four trials indicates that a) IgG-type myelomas are associated with a better prognosis than IgA type; nonexcreting myelomas are associated with the best prognosis, while Bence Jones myelomas are associated with a prognosis as poor as that of the IgA type; b) tumor volume as well as renal insufficiency, at the time of diagnosis, are also prognosis factors; this study confirms the prognostic value of the recently proposed clinical staging system based on these parameters but outlines that 10% of the patients died from a cause not directly related to myeloma plasmocyte proliferation. 3. In conclusion, these results point out: a) the possible advantage of using two alkylating agents instead of one at the beginning of the disease; b) the need to classify multiple myeloma according to prognosis before attempting therapeutic trials.

Adult↗

Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc.

The findings are reported of a controlled clinical trial comparing in 66 rheumatoid arthritis patients 0 g (placebo), and 0.50 g a day and 1 g a day of penicillamine. Each of these groups has been subdivided into two, one part receiving 5 mg a day of zinc metal supplement, the other a placebo. The trial was planned to be double-blind, and for each patient to take part for 4 months. The results prove the effectiveness of penicillamine in rheumatoid arthritis. 0.50 g a day has the same effect as 1 g a day but gives less side effects. Zinc supplement inhibits the clinical effects of penicillamine but does not prevent the side effects.

Arthritis, Rheumatoid↗

[Myeloma and osteocondensation (apropos of 2 cases)].

The authors report two cases of multiple myeloma which were typical both clinically and in the laboratory but XRay examination, on the other hand, showed appearances of osteocondensation. In the first case, XRay showed both lesions of osteolysis in the cranial vault and homogeneous condensation of D11 and L1, together with the left iliac crest. In the other case, there was osteolysis of the acetabulum together with areas of osteocondensation distributed throughout the pelvis and upper ends of the femurs, with two areas of annular fibrosis circumscribing the area of osteolysis, finally, homogeneous condensation of the skull. In both cases, bone biopsy confirmed the diagnosis of multiple myeloma showing both osteofibrosis and plasma cell infiltration of the bone marrow. This also permitted the authors to note the absence of any myelofibrosis or metamorphic neo-osteogenesis. Illustrated by these two cases, condensing multiple myeloma is a rare entity, the special clinical characteristics of which reside in its fairly frequent coexistence with peripheral neuritis which is probably similar to a para-neoplastic syndrome. The radiological appearances are mainly of four types: 1) Focal areas of bony condensation. 2) Areas of annular fibrosis circumscribing osteolysis. 3) Appearances of radial spicules, or 4) Osteocondensation extending to a fairly large part of the skeleton. The laboratory signs are identical with those in other types of multiple myeloma with a few exceptions, such as, rareness of hypercalcemia, more frequent tendency to hypocalcemia, rise in alkaline phosphatase, in a few cases. Bone biopsy confirms the diagnosis. The osteofibrosis resulted here from thickening of the osteoid seams by laying down of successive layers of bony substance, irregularly calcified and, also secondarily, metamorphic neo-osteogenesis in a few rare cases which also included myelofibrosis.

Adult↗

[Treatment of hemophilic arthropathies by medical synoviorthesis].

The effects of medical synoviorthesis were studied by the authors in the haemophiliac. The use of radioisotopes was limited in view of the young age of the patients but a good result was achieved for the 5 elbows treated and for the 4 knees (yttrium 90) the results were 2 good, 1 fair and 1 failure. Osmic acid was injected in 44 knees. The results were good and fair in 51% of 39 knees. The results can be improved by a second injection. Synoviorthesis should be kept for joints with very few destructions because of the danger of worsening the osteocartilaginous lesions, specially with osmic acid.

Adolescent↗