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Biomedical subjects

J Boutin

Publications and source records attributed to J Boutin.

At least 19 recordsLinked to original sources

Respective contributions of alpha-adrenergic and non-adrenergic mechanisms in the hypotensive effect of imidazoline-like drugs.

The hypotensive effect of imidazoline-like drugs, such as clonidine, was first attributed to the exclusive stimulation of central alpha2-adrenoceptors (alpha2ARs). However, a body of evidence suggests that non-adrenergic mechanisms may also account for this hypotension. This work aims (i) to check whether imidazoline-like drugs with no alpha2-adrenergic agonist activity may alter blood pressure (BP) and (ii) to seek a possible interaction between such a drug and an alpha2ARs agonist alpha-methylnoradrenaline (alpha-MNA). We selected S23515 and S23757, two imidazoline-like drugs with negligible affinities and activities at alpha2ARs but with high affinities for non-adrenergic imidazoline binding sites (IBS). S23515 decreased BP dose-dependently (-27+/-5% maximal effect) when administered intracisternally (i.c.) to anaesthetized rabbits. The hypotension induced by S23515 (100 microg kg(-1) i.c.) was prevented by S23757 (1 mg kg(-1) i.c.) and efaroxan (10 microg kg(-1) i.c.), while these compounds, devoid of haemodynamic action by themselves, did not alter the hypotensive effect of alpha-MNA (3 and 30 microg kg(-1) i.c.). Moreover, the alpha2ARs antagonist rauwolscine (3 microg kg(-1) i.c.) did not prevent the effect of S23515. Finally, whilst 3 microg kg(-1) of S23515 or 0.5 microg kg(-1) of alpha-MNA had weak hypotensive effects, the sequential i.c. administration of these two drugs induced a marked hypotension (-23+/-2%). These results indicate that an imidazoline-like drug with no alpha2-adrenergic properties lowers BP and interacts synergistically with an alpha(ARs agonist.

Animals↗

Validation of French-language versions of the Visual Functioning Index (VF-14) and the Cataract Symptom Score.

OBJECTIVE: To produce and validate French-language versions of the Visual Functioning Index (VF-14), the Cataract Symptom Score (CSS) and two global measures of trouble and satisfaction with vision. DESIGN: Survey by means of telephone interviews conducted 2 weeks apart. SETTING: Ophthalmology clinic of a teaching hospital in Montreal. SUBJECTS: Subjects were recruited among patients with ocular media opacities, such as cataracts and corneal opacities. Of the 71 subjects recruited, 66 (41 French-speaking and 25 French- and English-speaking) completed the study. OUTCOME MEASURES: Visual acuity, scores on vision-related questionnaires and on the 36-Item Short-Form Health Survey (SF-36), a measure of perceived health status. RESULTS: The integral consistency of the French-language versions of the VF-14 and the CSS was high, with Cronbach alpha values of 0.96 and 0.82 respectively. The fidelity with regard to the English-language version, the test-retest reproducibility and the interrater agreement were high (intraclass correlation coefficients > or = 0.80). The correlation between the visual acuity of the better eye and the mean score on all four vision-related measures was statistically significant (p < or = 0.05). The VF-14 scores were also correlated with the score on five of the eight SF-36 subscales (p < or = 0.05). CONCLUSIONS: Our results show that French-language versions of the VF-14, CSS and global measures of trouble and satisfaction with vision are reliable and valid.

Adult↗

Interferon and ursodeoxycholic acid combined therapy in chronic viral C hepatitis: controlled randomized trial in 203 patients.

AIMS: This prospective randomized trial was carried out in order to determine whether the long-term administration of ursodeoxycholic acid after discontinuation of interferon had any beneficial effect on the clinical course of hepatitis C virus infection. METHODS: Enrolled in the study were 203 patients with chronic active hepatitis C. They were all given: interferon alpha-2a (3 MU subcutaneously thrice a week) and ursodeoxycholic acid (10 mg/kg/day) for 9 months. At month 9, biochemical responders only were randomized into ursodeoxycholic acid treatment or placebo for 12 additional months (double blind study). RESULTS: At the end of interferon therapy, 71 patients (37%) were virological responders and 107 (56%) patients were biochemical responders and were randomized: 54 into the ursodeoxycholic acid group and 53 into the placebo group. Sustained response was evaluated 12 months after withdrawal of interferon. Sustained biochemical and virological responses were, respectively, 30% and 22% in the ursodeoxycholic acid group and 46% and 32% in the placebo group, which did not significantly differ. Histological evolution of fibrosis and necrotic inflammatory activity were similar in the two groups. CONCLUSION: Continuation of ursodeoxycholic acid therapy after withdrawal of interferon in patients with end-of-treatment response did not result in any significant improvement either in the maintenance of response to interferon or in liver histology.

Adolescent↗

Patients' preference regarding portable pumps.

The growing number of home parenteral nutrition patients has encouraged the development of portable infusion pumps. The authors found that the individual who meets the criteria for home therapy is also the same individual who welcomes independence. The portable pump further enabled these individuals, who have already undergone a major lifestyle change, to achieve the desired independence. Twenty-three home parenteral nutrition patients were surveyed regarding pump satisfaction and operation. The distinct psychological advantage provided was the final motivating factor.

Humans↗

[Glomerular disease associated with myelofibrosis (author's transl)].

The authors report the case of a 46 year-old patient presenting with membranous-proliferative glomerular disease, megakaryocytes present in the glomerular capillaries, evolving concomitantly with myelofibrosis. There are two possible explanations for this unusual association: the glomerular disease and the myelofibrosis may both result from the same etiologic and pathogenic factor, or the glomerular disease may be the consequence, thrombocytosis existing, of platelet activation, either direct or after deposition of immune complexes. The formation of immune complexes after antigenic stimulation in myelofibrosis is theoretically compatible with immunitary anomalies found in the evolution of this disorder as described in the literature.

Humans↗

[Renal lesions in myelofibrosis (author's transl)].

In 26 cases of myelofibrosis, the authors investigated for possible renal impairment that can be appraised from the usual clinical, laboratory, and roentgenographic signs. No anomalies were demonstrated in 12 of these cases. In 14 (or 53%) of the patients, some anomaly was discovered : essentially proteinuria with minor alteration of renal function, but also, two cases of poorly functioning left kidney evidenced on intravenous urograms, one case of acute anuric renal failure connected with hyperuricemia, one case of hypokalemic tubulo-interstitial nephritis, and one case of glomerulonephritis with, nephrotic syndrome. This study, when compared to the literature, indicates that besides nephropathy specific to myelofibrosis and attributed to myeloid metaplasia in the kidney, serious consideration must be given to lesions due to (1) compression of the left kidney by the enlarged spleen, (2) urate precipitation in the urinary passages, and (3) a possible glomerular disorder whose mechanism remains undefined.

Adult↗

[Hyperacute periarteritis nodosa complicating Basedow's disease].

The symptoms and the evolution of necrotizing vasculitis vary greatly. The authors illustrate the case of an 18 year old patient with a history of frequent allergic manifestations (urticaria and others) who was found to have, in septembre 1975, a typical case of Grave's disease. During the following 2 months she was treated with an iodide derivative. One year later the clinical signs increased to the point where a treatment associating lugol, carbamizole and propanolol was deemed necessary. Less than 2 months later there developed a polyvisceral disease with oscillating fever, polyarthralgia and necrotizing vasculitis. The plurivisceral nature of the illness was further illustrated by the presence of a hyperreflexia, a glomerulopathy and retinal exsudats. A muscle biopsy revealed the necrotizing vasculitis with granulomas typical of periarteritis nodosa. Cardiac, neurologic and renal complications were responsable for a rapid down-hill course and despite corticoïdes and immunosuppresive drugs, the patient died after a few weeks of treatment. That periarteritis nodosa should complicate the evolution of Grave's disease suggests a connection between the two, very probably immunologic in nature. The role of drugs capable of inducing vasculitis must be explored, especially the iodide derivatives, the antithyroïd medications or their association. Such cases, even though they may be rare, should incite special care in the prescription of antithyroïd drugs in the allergic patient.

Acute Disease↗