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Biomedical subjects

G Lagrue

Publications and source records attributed to G Lagrue.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Proteinuria selectivity index: prognostic value in idiopathic nephrotic syndromes].

In INS, the histological appearance constitutes a classical prognostic element: minimal-change nephropathy (MCN) responds better to treatment than focal glomerulosclerosis (FGS) or IgM nephropathy (IgMN). However, this criterion is not consistent. We evaluated the prognostic value of the proteinuria selectivity index (SI): the ratio of IgG clearance to transferrin (Tf) clearance. Proteinuria was selective for an SI less than or equal to 0.01. In the 39 MCN, the SI ranged from 0.01 to 0.39 (median 0.10) and proteinuria was selective in 21 cases. In the 13 FGS and IgMN, the SI varied from 0.05 to 0.40 (median 0.22) and proteinuria was selective in 1 case (p less than 0.01 between these two groups). The SI ranged from 0.01 to 0.17 (median 0.07) for the 25 corticosensitive (CS) forms and from 0.08 to 0.40 (median 0.20) for the 27 corticoresistant (CR) ones (p less than 0.001). Twenty-four of the 30 MCN patients and 19 of 22 cases of selective proteinuria were CS. Multivariant analysis enabled the identification of variables predictive of the response to steroids. Age, sex and level of proteinuria had no such value. The predictive value of the SI was greater than that of the histological appearance (McFadden's R-square, 47 versus 22%, p less than 0.001). When the histological aspect was known, the SI provided additional precision, but the reverse situation was not true. The predictive curve of CS as a function of the SI was sigmoidal, therefore reflecting a homogeneous distribution, despite their different histological types.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Hereditary angioneurotic edema. Recent progress in diagnosis and treatment. Importance of a national registry].

The hereditary angioneurotic oedema is an exceptional disease of deadly risk from glottic oedema. The diagnosis is based on a very low serum C4, with collapsed C1 INH for a patient who has repeated attacks of Quincke's oedema or pseudo occlusive digestive crisis. These crisis are prevented by taking anabolic steroids and must be treated when they are serious by intravenous C1 INH. The recent contributions of the immunogenetic and the interest of a national registry are underlined.

Angioedema↗
PubMed1990

Peripheral action of spironolactone: improvement in arterial elasticity.

Arterial elasticity, which can be assessed by means of a piezogram, is thought to be involved in the development of hypertension. In hypertensive patients (and with aging in normal subjects), arterial elasticity is reduced. Long-term administration of spironolactone, beta blockers, or a beta-blocker/dihydralazine combination to hypertensive patients sufficiently reduced systolic and diastolic blood pressure to about the same extent; however, only spironolactone had any effect on piezoelectric indexes of arterial elasticity.

Adrenergic beta-Antagonists↗
PubMed1990

[Idiopathic nephrotic syndrome. Effect of oral cromoglycate].

The occurrence of idiopathic nephrotic syndrome may be due to environmental antigens, and in particular to the ingestion of certain foods, as indicated by the result of food eviction tests. This led us to prescribe oral cromoglycate (800 mg/day for 2 weeks) combined with the avoidance of specific foods. Twelve patients with corticosteroid-dependent (n = 6) or corticosteroid-resistant (n = 6) idiopathic nephrotic syndrome with proteinuria greater than 1.50 g/24 h were thus treated without modification of steroid dosage. In 3 of these patients hypersensitivity to certain foods had previously been demonstrated. In 5 of the 12 patients, proteinuria was reduced by more than 50 percent; these 5 patients had received cromoglycate for 2 weeks with a free diet. After evictions were stopped, 3 patients relapsed; in 2 cases proteinuria remained absent. In 3 of the 12 cases, we subsequently used cromoglycate and evictions in corticosteroid-dependent patients in complete remission by gradual reduction of steroid dosage in the hope of lowering the dependence threshold. In one patient, the corticosteroid therapy could be discontinued during 3 months without relapse; in the other 2 patients no effect was observed. Thus, oral cromoglycate could be used together with food eviction in certain cases of idiopathic nephrotic syndrome, this being a therapeutic approach as well as a diagnostic test.

Administration, Oral↗
PubMed1990

Presence of antibodies against endothelial cells in the sera of patients with episodic angioedema and hypereosinophilia.

We reported three additional cases of a newly described syndrome called episodic angioedema with hypereosinophilia. In order to investigate its pathophysiological mechanisms, four parameters were concurrently investigated, including blood eosinophil density, serum chemoattractant activity, serum major basic protein (MBP) levels and the presence of anti-endothelial cell antibodies. Distribution of eosinophils through a metrizamide density gradient showed a preferential sedimentation of blood eosinophils in intermediate layers, clearly different from the hypodense cells (low-density layers) identified in a group of seven patients with idiopathic hypereosinophilic syndrome (HES). In two of the three patients with cyclic angioedema, a chemotactic activity towards eosinophils was detected in the serum (30 +/- 6 and 42 +/- 12 eosinophils per high-power field; P less than 0.05 compared with a control group). Serum MBP levels were at 1524, 619 and 1200 pg/ml. All three patients had circulating anti-endothelial cell antibodies, predominantly of the IgG isotype, in contrast to controls (P less than 0.01) or to patients with HES (P less than 0.01). Specificity of the antibody for endothelial cells was demonstrated in the three patients studied by the absence of binding to various blood cells, including monocytes, lymphocytes, eosinophils and platelets. In one case (patient 2), the levels of anti-endothelial cell antibodies, as well as the serum chemoattractant activity to eosinophils varied according to the successive acute phases of the disease. Although further investigations are needed to clarify the exact pathophysiology of this syndrome, and especially the possible participation of the anti-endothelial cell antibodies in the cutaneous lesions, these data suggest that angioedema observed in this syndrome could result from the combined effects of activated eosinophils and of immunologically induced endothelial lesions.

Adult↗
PubMed1990

Mucosal immunity in adult primary glomerulonephritis. I. Evaluation of salivary IgA subclasses and components.

Salivary components (proteins, albumin, IgA1, IgA2, IgG, IgM, beta 2-microglobulin, neopterin and peroxidase) were investigated in 3 adult types of primary glomerulonephritis (PGN): IgA mesangial glomerulonephritis (IgAGN; n = 14); idiopathic membranous glomerulonephritis (n = 8); idiopathic nephrotic syndrome (INS; n = 14), and a control group (n = 11). Salivary IgA1 levels were significantly increased in all these PGN whereas salivary IgA2 levels were only higher than controls in INS. Albumin and proteins did not differ between PGN and controls, while the IgA1 + IgA2/protein ratio was significantly increased in these 3 PGN. Salivary neopterin levels were enhanced in the 3 types of PGN, whereas beta 2-microglobulin levels were not. The other salivary components did not differ from controls. These results demonstrate the nonspecificity of the IgA increase at mucosal sites previously found in IgAGN and raise the hypothesis of an activation of mucosal immunity of PGN or of a disturbed isotypic network or lymphokine secretion in these diseases.

Adult↗
PubMed1990

Indirect evaluation of blood oximetry by digitized conjunctival capillarography: effects of naftidrofuryl.

Microcirculatory disturbances are essential elements in peripheral and visceral oxygenation. Microcirculation can be studied by conjunctival angioscopy with morphological studies (arterioles, veinules, and capillaries appearances) and blood flow dynamics by digitized photographies (indirect oxymetric measurements in vivo). We studied the effects of naftidrofuryl on 20 atherosclerotic patients (mean 70 years old). After 3 months' treatment some parameters were significantly improved: interstitial edema, arteriolar sludge, and mainly vascular oxymetry. This means better microcirculatory hemodynamics and thus a better tissular oxygenation.

Aged↗
PubMed1990

[Proteinuria selectivity: description of a new index].

An improved simple method for determination of selectivity index has been described. This new index (Creteil index) has been compared to Cameron index. The correlation between both indexes has been 0.949 (R-squared). Creteil index is a less expensive method because only two determinations are requisited in serum and urine: albumin and IgG. In Cameron index, transferrin and IgG are detected and albumin has to be measured in addition in the blood to appreciate the nephrotic syndrome.

Albumins↗
PubMed1989

[How to prevent vascular risk related to smoking: an aid to discontinue smoking].

In addition to hypertension and hypercholesterolemia, the third major risk factor in vascular diseases such as atherosclerosis and acute thrombosis is nicotinism, particularly that involving the smoking of cigarettes. Each cigarette smoked, with inhalation, is followed by increases in blood pressure and heart rate due to release of catecholamines and vasopressin. In addition, nicotine intake modifies the metabolism of certain drugs, such as beta-blockers, diminishing their antihypertensive action and hence nullifying the therapeutic benefit. Hypertension in smokers therefore constitutes a real "model" for the pharmacologic study of certain antihypertensives. Clearly the essential aim with any hypertensive subject is discontinuance of smoking, which is difficult to achieve with heavy smokers since genuine drug dependence is involved. There is no "miracle" treatment. It is necessary in each case to study the characteristics of dependence, which is both psychologic and pharmacologic (nicotine being the principal drug). Appropriate, and hence more effective therapies can then be proposed in light of the results obtained.

Humans↗