[Intrapulmonary round images in brucellosis].
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Biomedical subjects
Publications and source records attributed to H Allannic.
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This paper presents the baseline epidemiological data from 5548 patients with type 2 diabetes enrolled in a French observational study that aims to examine the safety, tolerability and use of acarbose as prescribed by general practitioners (GPs). Patients were recruited and monitored by a representative sample of GPs. Recruitment did not depend on a patient's suitability for acarbose treatment. The data revealed that the mean age of the patient population was 63 years, and that more than 50% of patients were over 65 years old. The population was markedly overweight [mean body mass index(BMI): males, 28.4 kg/m(2); females, 29.1 kg/m(2)] and the mean duration of diabetes was 10 (+/-7.3) years. Over 37% of patients had at least one diabetic complication, and the frequency of complications increased with both age and the duration of diabetes. The most frequently reported complications were cardiac (17.8%), vascular (14.5%) and ocular (12%). At recruitment, almost 90% of patients were being treated with oral antidiabetic agents (OADs). Sulphonylureas (74%) and biguanides (50%) were the most commonly prescribed agents. Acarbose was used to treat 17% of patients and 1% were receiving insulin. GPs set glycaemic treatment goals for 44% of patients in the study. Fasting glycaemia was the primary goal for 37% of the total study population, and HbA(1c) levels for 21% of patients. Postprandial glycaemia was generally given as a secondary or tertiary goal. In conclusion, this study provides the most up-to-date epidemiological data for patients with type 2 diabetes in France.
The authors relate a case of paraneoplasic Cushing's syndrome by mediastinal tumor, probably of thymic origin. All the clinical and biological signs recall similar cases previously related. An "ACTH-like" substance has been found by biological method in a lymphoide metastasis. The main interest resides in the anatomo-pathological findings and more especially in electronic microscopy. The abundance of the neurosecretory granules is a characteristic feature of the malignant cells observed. These granules appear to the authors identical to those observed in other secretory thymomas and various tumors.
Serum concentrations of Thyroxine (T4), triiodothyronine (T3) free thyroxine index (F.T.I.) and TSH response to TRH were evaluated in 55 Graves' diseases treated by Carbimazole. There is a good correlation between serum thyroid hormones and clinical state: 83,7% for T4; 79,5% for T3; on the other hand there is a discrepancy between T3 and T4 in many cases and between delta TSH and T4 (47%) or T3 (46%). The decrease of T4 occurs before that of T3: 46,6% normal at the 4th month and 72,5% at the 9th month for T4 against 41% and 50% for T3. At the end of the treatment 96,4% of patients are clinically normal but 20% of them remain with T3 and T4 values above normal.
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Persistence of a post-partum galactorrhea with an hyper-prolactinaemia leads to charge clonidin, an hypotensive-drug. When clonidine is stopped, galactorrhea and hyper-prolactinaemia case. Explanation of the role of the drug is uneasy.
The authors compared the nycthemeral variations of fructosamine levels in nineteen patients with diabetes to fluctuations in their glucose levels. Thirty-five other patients with poorly controlled diabetes were given an optimal treatment then followed up for 2 months (mean glucose levels, fructosamine and HbA1c assays). Mean nycthemeral variations in fructosamine levels did not appear to be correlated with glucose levels. However, intraindividual nycthemeral variability was greater than the analytic variability. After correction for total protein levels this variability was smaller but remained significative. In this longitudinal study, fructosamine and HbA1c levels decreased when control of glucose levels improved. However, decreases were notably greater in HbA1c than in fructosamine compared at 15, 45 and 60 days of follow up. Inversely, fructosamine was correlated better with the mean glucose levels of the preceding 7 days than was HbA1c. When mean glucose levels were calculated for the 15, 30, 45 and 60 preceding days, the results favored HbA1c. The findings presented in this study show that HbA1c remains the best criteria for monitoring medium term glucose levels. However, further word is needed before this conclusion can be confirmed.