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Biomedical subjects

G Nouvet

Publications and source records attributed to G Nouvet.

At least 73 records · Page 4Linked to original sources

[Respiratory function disorders during hepatopathies with immunity involvement].

A respiratory functional test was done systematically on 24 patients with chronic hepatitis and was found normal in only 2 cases. It showed an alteration of the transfer in 14 patients and a syndrom of hyperinflation in 8 others. Despite the histopathological proof it seems that the transfer alteration could be attributed to diffuse interstitial pulmonary lesions. They have already been noted in chronic hepatitis by several authors. The pathogeny of this interstitial involvement probably implied immunity phenomenons including the participation of the antigen Australia or others. As for the hyperinflation syndrome observed in 4 patients in the absence of any bronchopulmonary history, it could reveal an emphysema, which, so far, had not been seen associated to chronic hepatitis.

Adult↗

[Study of P50 and 2,3-diphosphoglycerate in 23 bronchoemphysema patients as a function of hypoxia and hemoglobin concentration].

2,3-DPG and P50 were measured in 23 patients with chronic obstructive lung disease. All patients had a chronic hypercapnia (PaCO2 greater than or equal to 45 Torr). They are shared in 3 groups, according to hemoglobin content [Hb] and hypoxia : group I(PaO2 = 48.0 +/- 2.4 Torr ; [Hb] = 15.9 +/- 0.3 g. 100 ml-1; n = 9), (M +/- 1 SE); group II (PaO2 = 46.4 +/- 5.0 Torr; [Hb] = 11.6 +/- 0.7 g. 100 m[-1; n = 7); group III(PaO2 = 61.4 +/- 2.4 Torr; [Hb] = 13.3 +/- 0.4 g. 100 ml-1; n = 7). 2,3-DPG (group I : 1.05 +/- 0.06 mole.moleHb-1; group II : 1.02 +/- 0.08; group III : 1.11 +/- 0.08) was not significantly different of 2,3-DPG value of 12 control subjects (0.96 +/- 0.04). P50 of group I (26.9 +/- 0.9 Torr) and group III patients (28.1 +/- 1.6 Torr) was not significantly different of control value of P50 (27.4 +/- 0.5 Torr). P50 of group II patients (29.6 +/- 0.8 Torr) was significantly higher than P50 control and group I values (p less than 0.05). All the patients of group II died. These results suggest that in patients with chronic obstructive lung disease : 1) P50 value is different with various clinical conditions; 2) P50 increase is a compensatory mechanism in severe hypoxemia with anemia, but is not sufficient; 3) [Hb] is the best data for clinical prognosis.

Acid-Base Equilibrium↗

[Respiratory function tests in epidermoid cancers of the bronchi].

The results of functional tests are analyzed in 50 cases of epidermoid bronchial cancers. Severe disorders take place in almost every patient. In one patient out of two, there is an old distension already existing prior to the cancer; in other patients gas exchange disorders can be improved by the intervention. Moreover, from some results a spreading of cancer towards the mediastinum is to be feared.

Adult↗

[Methotrexate for the treatment of patients with chronic cutaneous sarcoidosis: 4 cases].

INTRODUCTION: Pathogenesis of sarcoidosis remains partially unknown. Cutaneous lesions are frequent (20 to 35% of cases). Their clinical features and follow-up data are highly variable. Numerous treatments have been proposed. The clinical features and follow up data of four patients with chronic cutaneous sarcoidosis treated with methotrexate are reported. CASE REPORT: Mean age of patients (3 female, 1 male) was 40 years old (34-49 years). One patient presented with a lupus pernio, two patients with papules and nodules, and the last with an annular lesion of the face. All patients had been previously treated with topical corticosteroids and/or hydroxychloroquine without any success. Patients were treated with methotrexate at doses ranging from 12.5 mg to 30 mg per week for at least 6 months. Complete remission of cutaneous lesions was observed in 3 of 4 patients after a mean treatment duration of 29 months (16 to 36). Methotrexate side effects were observed in one patient (elevated liver enzymes) leading to methotrexate discontinuation. DISCUSSION: Methotrexate seems to be an effective treatment of cutaneous sarcoidosis. It should be used namely in patients who failed to respond to previous treatments with topical corticosteroids or antimalarial drugs.

Adult↗

[Information obtained by liver biopsy in 100 tuberculous patients].

The results of liver biopsy in 100 patients with tuberculosis are reported. In 8 patients, biopsy only occurred secondarily, during liver disease which appeared during antituberculous treatment. In five cases, the association of rifamycin and isoniazid was probably responsible and the mild histological signs noted suggested a favourable course after stopping one of the drugs or simply reducing the dose. The 3 other patients had virus hepatitis and biopsy was of prognostic interest by revealing the onset of post-hepatic cirrhosis. In 92 cases, liver biopsy was carried out before treatment. In 34 cases the liver was normal, in 38 patients there were hisotlogical changes which did not suggest tuberculosis but, probably, alcoholism. These were : steatosis, in 21 cases, cirrhosis in 8 cases, a mixture of steatosis and cirrhosis in 4 cases, and acute alcoholic hepatitis in 5 cases. Finally, in 20 cases, biopsy revealed an appearance of granulomatous hepatitis. Although this lesion is significant in the development of the disease, it is not characteristic of tuberculosis unless there is caseous necrosis, as in 2 cases, and unless culture of the biopsy material is positive, as in one case out of 9, i.e. the diagnostic interest of liver biopsy is not very great compared with prognostic interest. By determining the anatomical condition of the liver, often not obvious when simple liver function tests are carried out, it permits one to forsee to some extent the tolerance of the liver to antituberculous treatment, especially in alcoholics.

Alcoholism↗

[Contribution of functional respiratory exploration to the etiological study of spontaneous pneumothorax (author's transl)].

In order to specify the etiology of primary spontaneous pneumothorax, lung function studies were performed on 14 patients after one pneumothorax without any set. All the patients showed at least one disturbance. 4 patients revealed a decrease of maximal expiratory flow, a decrease of lung recoil, a hyperinflation and a reduction of lung transfer factor. In 6 other patients decrease of elasticity, hyperinflation and decrease of transfer factor were observed, but maximal expiratory flow was normal. One patient showed an obstructive syndrome. It is difficult indeed to connect physiological findings and anatomy, but these disturbances are often observed in lung dystrophy. Perhaps, these disturbances are in connexion with the proximity of accident; so, a long term study is required in order to know the etiopathogeny of this disease.

Adolescent↗

[Study of adult morbidity and mortality from pneumococcus in hospital (author's transl)].

The authors report the retrospective study of 333 cases of pneumococcal infection recorded in in-patients at the Rouen CHU (University Hospital Centre) from january 1974 to december 1978. Pneumococcal infection involves mainly the lungs (210 cases) according to different features. Pleural involvement is found in 70 cases only. Extra-respiratory localizations are less frequently encountered; they are represented mainly by meningitis (43 cases). Prognosis depends more on diathesis factors such as age and associated pathology than on the site of infection (cases with isolated respiratory involvement being usually less severe). The authors insist on the necessity of prevention especially by vaccination, of which indication is discussed.

Adolescent↗

[Gastroesophageal reflux and pulmonary disease].

Gastroesophageal reflux (GER) is a functional entity which is defined as "the involuntary reflux of the gastric contents in the oesophagus, without vomiting and without the involvement of either the gastric, abdominal or diaphragmatic muscles". It is therefore a question of a syndrome which is independent of the anatomical abnormalities in the cardio-tuberositic region (i.e. hiatal hernia). It may also show itself through digestive symptoms, thoracic pains, ENT symptoms and breathing complications. The presence of the latter has been clearly established in certain circumstances: --in infants, GER can cause obstructive apneas, which are responsible for sudden inexplicable deaths (SID): GER and SID have very similar epidemiological characteristics; polygraphic recordings showed that a reflux may immediately precede the onset of obstructive apnea; the instillation of 0.1 N hydrochloric acid in the oesophagus of children with GER causes an apnea. Medical or surgical treatment of the reflux prevents the recurrence of these accidents; --in adults, and older children, GER is responsible for coughs, recurring bronchopneumopathies and asthma; long-term recordings of the oesophageal pH have proved that there is a time-relationship between the two events. Scintigraphic studies have shown the pulmonary contamination by a radioactive isotope placed in the stomach the previous evening. GER has been equally suspected for conditions such as lung abscess, bronchiectasis and hemoptysis, but here it is more difficult to prove. With certain pulmonary fibroses, histological lesions have been compared with those observed during inhalation bronchopneumopathies, but it is difficult to establish a link with a reflux; --functional respiratory studies have not produced a specific functional entity for patients with GER; --careful medical treatment or surgical correction of GER lead to the sedation of respiratory symptoms (RS) in the majority of cases; --the association frequency of a GER and of RS is difficult to establish because of the diversity of the means of diagnosis employed in the past and also because of the heterogeneity of the studied populations, but the frequency is nevertheless high, indeed significantly higher than the prevalence of GER in the general population. The mechanisms which link GER and RS are not well known: first of all, there is the failure of normal antireflux mechanisms and also certain hormonal, alimentary (coffee, alcohol, tobacco, etc.) and therapeutic (theophylline, betamimetics) factors, which facilitate the reflux.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗