[Physiopathology and treatment of dysnatremia].
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Biomedical subjects
Publications and source records attributed to G Schaison.
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Ondansetron, a highly selective 5-HT3 receptor antagonist, is available in an intravenous (IV) formulation and tables, but syrup would be particularly useful in children. As chemotherapy can affect taste perceptions, this study was undertaken to determine the preference between two flavors of ondansetron syrup in children undergoing chemotherapy. Fifty-nine children, randomized into a multicenter, double-blind, crossover study, each received 5 mg/m2 of IV ondansetron daily before chemotherapy. The syrup was then randomly given in two doses, one of each flavor, strawberry and grape, 30 minutes apart. The preference was assessed 30 minutes after the second dose of syrup had been administered. Taste was assessed by the child against a panel of five faces. Of those children expressing any preference, 70% preferred the strawberry flavor. Overall, 59% of children preferred the strawberry flavor, whilst 25% preferred grape (P = 0.005) and 15% expressed no preference. The only adverse event assessed as drug related by the investigator was constipation, which occurred in one patient. In conclusion, a strong preference was found for the strawberry formulation. The ondansetron syrup was safe and well tolerated.
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A new case of 17 beta hydroxysteroid deshydrogenase deficiency is reported. In venous blood, dehydroepiandrosterone (DHA) level is normal, but the level of basal testosterone (T) is low, and delta 4 androstenedione (delta 4 A) is ten times higher than the normal level. The increase of delta4AT is characteristic after chorionic gonadotropin stimulation and over more in spermatic venous blood. Estrone (E1) produced from delta 4 A is high but estradiol (E2) level is equally low in systemic circulation and spermatic venous blood. This increase of plasmatic E2 is the witness of disturbance of E1 conversion into E2 as well as delta 4 conversion into T. It is an explantation of the lack of gynecomastia in this case. Serum gonadotropins LH and FSH are increased. This report contrast with other cases of 17 beta hydroxysteroid deshydrogenase deficiency and with the testicular feminization in which E2 and FSH levels are normal. This underline the importance of T in the LH regulation and the one of E2 in FSH control.
The hypopituitarism and the diabetes insipidus are often idiopathic. A retrospective study of 6 cases of diabetes insipidus and 8 cases of partial or total idiopathic antehypophyseal insufficiency has shown the value of MRI to demonstrate anomalies of the infundibulum or hypothalamic-hypophysis "stages". MRI allows to bring together some cases of idiopathic hypopituitarism in a new entity which is the hypopituitarism due to a newborn section of the infundibulum.
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