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Biomedical subjects

G Decaux

Publications and source records attributed to G Decaux.

At least 73 records · Page 4Linked to original sources
PubMed1988

Tetracycline-induced renal hypophosphatemia in a patient with a syndrome of inappropriate secretion of antidiuretic hormone.

A third case of acquired phosphate diabetes associated with a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), related to a pulmonary tuberculosis, is reported. Renal hypophosphatemia in this patient was caused by the erroneous intake of 1 g doxycycline. It is likely that the selective nephrotoxicity in these 3 patients with SIADH was induced by tetracycline.

Doxycycline↗
PubMed1988

Potassium homeostasis in liver cirrhosis.

Extrarenal mechanisms are important in the defense against hyperkalemia. During a potassium load, cellular uptake is essential to avoid severe hyperkalemia. Liver and muscles represent the major buffering system, partially mediated by insulin, in the distribution of potassium between intracellular and extracellular fluids. To study the potential role of the liver, we administered an oral load of potassium (0.75 mEq/kg) to nine male patients with compensated cirrhosis and ten normal subjects of similar age, sex, and weight. Despite identical renal excretion, cirrhotic patients had higher potassium levels two and three hours after oral administration. Moreover, only cirrhotic patients presented a clear-cut increase in serum C-peptide concentration after the potassium load without any change in glucose level. It is likely that, in cirrhosis, liver failure contributes to the decrease in hepatic cellular potassium uptake despite insulin hypersecretion.

Administration, Oral↗
PubMed1987

Urea treatment for water retention in hyponatremic congestive heart failure.

We have studied the efficiency of urea in the treatment of hyponatremia and hydrosaline retention in a 76-year-old man with chronic ischemic congestive heart failure. Since increase of furosemide worsened the hyponatremia (120 mmol/l), 30 g/day of urea was added and induced the following changes: progressive weight loss (6.5 kg in one week), increased diuresis (from 0.750 to 1.950 l/day), increased salt excretion (from 40 to 165 mmol sodium/day) and correction of the hyponatremia (120 to 136 mmol/l). Blood urea and creatinine serum concentrations rose moderately without significant change in creatinine clearance (32 to 38 ml/min). No adverse effects related to urea administration were observed. Urea intake seems to be useful in the management of hyponatremia in our patient with cardiac failure.

Aged↗
PubMed1986

Role of vagal neuropathy in the hyponatraemia of alcoholic cirrhosis.

The hyponatraemia common in decompensated cirrhosis arises in part from secretion of antidiuretic hormone attributed to a decrease in effective blood volume. Baroreceptors send inhibitory impulses to the midbrain and hypothalamus through the vagus and glossopharyngeal nerves. Since vagal neuropathy often occurs in chronic alcoholism, this might theoretically contribute to the inappropriate secretion of antidiuretic hormone, which might in turn induce hyponatraemia. In a prospective study including 34 patients with cirrhosis a high incidence of vagal neuropathy was found in the alcoholics (64%) and a clear cut increase in the incidence of hyponatraemia in patients with evidence of vagal damage and ascites (seven of eight patients (88%); p = 0.02). Results of a retrospective study of 64 patients with cirrhosis and ascitic decompensation showed hyponatraemia in 17 (50%) of 34 alcoholics but in only four (13%) of 30 patients with non-alcoholic disease (p = 0.006). Vagal neuropathy in alcoholic cirrhosis may contribute to the low serum sodium concentrations commonly found in these patients.

Ascites↗
PubMed1986

Relationship between aldosterone and sodium, potassium, and uric acid clearance in cirrhosis with and without ascites.

We have suggested that cirrhotic patients with high uric acid clearances had an increased effective vascular volume. This hypothesis was tested by studying the relationship between the excretion of uric acid, sodium, potassium, and aldosterone in cirrhosis. In 29 consecutive cirrhotic patients, of whom 17 had ascites, and in a control group, the logarithm of urinary sodium and aldosterone excretion highly correlated in control (r = -0.79, p less than 0.001) and cirrhotic patients without (r = -0.72, p less than 0.01) and with (r = -0.80, p less than 0.001) ascites. The regression line significantly shifted to the left in the cirrhotic patients (p less than 0.001). The urinary ratio K/K + Na also correlated with urinary aldosterone in controls (r = +0.66, p less than 0.001) and in cirrhotic patients (r = +0.77, p less than 0.001); this regression line shifted to the right in cirrhosis patients (p less than 0.02). The fractional uric acid excretion significantly correlated with urinary aldosterone only in cirrhotic patients (r = -0.76, p less than 0.001). These data confirmed the existence of hypoaldosteronism in many cirrhotic patients and are consistent with tubular hypersensitivity to aldosterone and emphasize the major role of the effective vascular volume in the control of urid acid clearance in cirrhosis.

Adult↗
PubMed1986

Treatment of hyponatremic cirrhosis with ascites resistant to diuretics by urea.

We have studied the efficacy of urea in the treatment of hyponatremia and hydrosaline retention in cirrhotic patients with ascites resistant to diuretics. In 5 patients with hyponatremia and ascites resistant to a major diuretic treatment (200-400 mg spironolactone combined with 40-160 mg furosemide/day for 4 of them), urea intake (30-90 g/day) induced the following changes: the daily weight changed from a gain of 0.01 +/- 0.06 kg/day to a loss of 1.03 +/- 0.12 kg/day (p less than 0.001) (mean +/- SEM), serum sodium concentration rose from 128 +/- 1.3 to 133 +/- 1.4 mmol/l (p less than 0.01), sodium output increased from 24 +/- 4 to 82.5 +/- 11 mmol/day, diuresis increased from 1.05 +/- 0.10 to 2.24 +/- 0.24 liters/day (p less than 0.01). Despite an important weight loss, the creatinine clearance did not change significantly (53.6 +/- 4.5 ml/min before and 70.0 +/- 8.2 ml/min during urea). In patients responding to classical diuretics, urea as a monotherapy was less effective. From the 6 patients with resistant ascites, only 1 developed prerenal uremia after urea treatment. In order to enhance urea efficacy, it is important to take it together with a long-loop diuretic. Intermittent urea intake seemed to be useful in cirrhotic patients with hyponatremia associated with ascites resistant to diuretics and with low or normal blood urea concentrations.

Adult↗
PubMed1985

Mechanisms of hypouricemia in the syndrome of inappropriate secretion of antidiuretic hormone.

Hypouricemia seen with hyponatremia related to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) results from an increase in uric acid renal clearance. We studied the mechanism of the increase of uric acid excretion in 6 SIADH patients through pyrazinamide (PZA), which decreases tubular secretion of uric acid, and sulfinpyrazone (SPZ) which decreases post-secretory reabsorption of uric acid. 3 g of PZA decreased the absolute uric acid excretion from 428 +/- 244 to 105 +/- 47 micrograms/min (mean +/- SD, p less than 0.01), and 300 mg of SPZ increased the uric acid to creatinine clearance ratio from 0.31 +/- 0.05 to 0.52 +/- 0.05 mg/dl glomerular filtration rate (mean +/- SEM, p less than 0.001), which represent an increment about half of that observed in the control group. The increase of uric acid clearance in SIADH seems to result from a decrease in the post-secretory reabsorption of uric acid. After SPZ, we saw a decrease of natriuresis from 5.6 +/- 1.4 to 1.8 +/- 0.3 mmol/h (p less than 0.001), without any change of urinary flow or urinary potassium excretion.

Glomerular Filtration Rate↗
PubMed1984

Hypouricemia in cirrhosis reflects hemodynamic alterations.

In a population of 27 consecutive patients with liver cirrhosis, systemic hemodynamics were investigated and correlated to uric acid concentrations, fractional uric acid excretion, and creatinine clearances. Mean serum uric acid concentration was lower than in normal controls, and this was related to abnormally high uric acid clearances. Uric acid concentrations correlated positively to total peripheral resistances and negatively to cardiac output. Fractional uric acid excretions correlated negatively to total peripheral resistances and positively to cardiac output. There was no correlation between creatinine clearances and any variable of systemic hemodynamics. Serum uric acid concentration and fractional uric acid excretion are dependent of the hemodynamic state in cirrhosis.

Bilirubin↗
PubMed1984

[Acquired immunodeficiency syndrome (AIDS) manifested as severe genital herpes. Apropos of 2 cases].

The authors present 2 cases of AIDS revealed by severe recurrent genital herpes simplex. The patients are 2 young, previously healthy, African women without histories of homosexuality or drug abuse. The first patient died after 5 months of follow-up (post mortem findings: viral bronchopneumonia with positive cultures for herpes and cytomegalovirus (CMV), viral colitis due to CMV). The second patient survived. She has been treated, during the last 11 months, for filariasis, buccal and vaginal candidiasis and cerebral toxoplasmosis.

Acquired Immunodeficiency Syndrome↗