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Biomedical subjects

J Cadranel

Publications and source records attributed to J Cadranel.

At least 145 records · Page 8Linked to original sources
PubMed1990

Toxoplasma gondii pneumonia in patients with the acquired immunodeficiency syndrome.

PURPOSE: To perform a retrospective and descriptive study of Toxoplasma gondii pneumonia in patients infected with the human immunodeficiency virus (HIV). Clinical presentation, diagnostic procedures, results of therapy, and hypotheses on pathophysiology are discussed. PATIENTS AND METHODS: The study consisted of 13 HIV-infected patients who had developed T. gondii pneumonia. Eight had acquired immunodeficiency syndrome (AIDS) prior to T. gondii pneumonia and three of them had non-Hodgkin's lymphoma. Mean CD4 cell count was 32 x 10(6)/L. Serum anti-toxoplasma antibody titers were measured by an indirect hemagglutination assay and/or by an indirect immunofluorescence assay. RESULTS: All patients had fever and bilateral pulmonary infiltrates; two of them presented with septic shock. Mean arterial oxygen tension was 47 +/- 12 mm Hg. The diagnosis was established by bronchoalveolar lavage in 10 of 11 cases, open lung biopsy in one case, and postmortem biopsy in two cases. Serologic evidence of past infection was observed in 11 of 12 cases, while one patient presented with acute disseminated disease and absence of serum anti-toxoplasma antibody response. Extrapulmonary involvement was present in seven patients: liver (four), brain (three), bone marrow (two), heart (two), stomach (one). Ten patients recovered from T. gondii pneumonia. CONCLUSION: T. gondii pneumonia must be considered in AIDS patients with severe diffuse bilateral pneumonia, especially when associated with a very low CD4 cell count or non-Hodgkin's lymphoma. In most of these cases, disseminated disease was associated with reactivation of prior latent infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Hypoxemia in liver cirrhosis].

Hypoxaemia is observed in almost 30 per cent of patients with cirrhosis of the liver, irrespective of the cause of cirrhosis. Two main physiopathological mechanisms can be described: hypoxaemia may be secondary to intrapulmonary vascular abnormalities or due to a regional disequilibrium of the ventilation/perfusion ratio. In the first case, the severity of hypoxaemia often requires complex and invasive investigations, while in the second case, by far the most frequent, hypoxaemia is moderate, usually asymptomatic and in practice only needs a few investigations.

Arteriovenous Malformations↗
PubMed1989

Hypercalcaemia associated with chronic viral hepatitis.

A patient with long lasting non-parathyroid hormone mediated hypercalcaemia occurring within the context of hepatitis B virus chronic hepatitis is reported. Hepatocellular carcinoma and bone malignancy were carefully excluded. The biological pattern associated hypercalcaemia with normal phosphataemia, low nephrogenic cAMP level and high level of tubular reabsorption of phosphate. The usual causes of hypercalcaemia were ruled out. Hypercalcaemia may represent a rare biological feature of some advanced liver disease. The underlying mechanisms remain to be elucidated.

Calcium↗
PubMed1988

[Respective frequency and radioclinical features of 150 lung diseases observed in 125 patients with human immunodeficiency virus infection].

Seventy out of 125 patients with HIV infection had diffuse alveolo-interstitial pneumonia usually caused by an opportunistic infection, notably pneumocystosis. Nineteen patients had only localized lung opacities due either to usual or tuberculous bacterial infections or to Kaposi's sarcoma. In 10 patients with pleural effusion or mediastinal adenopathy, the condition was due to Kaposi's sarcoma (n = 4) or to mycobacteriosis (n = 3). An opportunistic or usual infection was demonstrated in 17 of the 51 patients with normal radiography of the chest. Finally, 37 patients free from infectious or tumoral pathology had isolated lymphocytic alveolitis.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Vitamin D metabolism in tuberculosis. Production of 1,25(OH)2D3 by cells recovered by bronchoalveolar lavage and the role of this metabolite in calcium homeostasis.

To investigate the extrarenal production of 1,25(OH)2D3 in tuberculosis, we extensively evaluated a patient with tuberculosis, hypercalcemia, and an elevated plasma concentration of 1,25(OH)2D3. Fresh total cells and cultured alveolar macrophages obtained by bronchoalveolar lavage were demonstrated to synthesize 1,25(OH)2D3 prior to and after nine months of successful antituberculous therapy. The continued capacity to produce 1,25(OH)2D3 was associated with a persistent lymphocytic alveolitis in this patient. This extrarenal production of 1,25(OH)2D3 probably contributed to the increased levels of plasma 1,25(OH)2D observed in our patient. Nevertheless, a close correlation between plasma 1,25(OH)2D and serum calcium was not observed. These findings suggest that although extrarenal production of 1,25(OH)2D3 occurs in tuberculosis, it need not be a predominant factor producing the abnormalities in calcium homeostasis observed in such patients.

Adult↗
PubMed1988

[Immunological studies in hypersensitivity pneumopathies].

In immunological investigations in hypersensitivity pneumonia some have a diagnostic value for the clinician but many others are essentially of interest in research and in analysing the pathophysiology. Unfortunately, skin tests with the responsible antigens are often positive in patients but also in exposed subjects without the lung disease. Studies on peripheral blood require a search for IgE immediate hypersensitivity which is rarely positive and above all a search for precipitating antibodies by the different standard tests available: there again, positive findings occur often enough in exposed but asymptomatic subjects; the sensibility and specificity of cell-mediated hypersensitivity tests seem much more reliable. The study of cell populations in broncho-alveolar lavage fluid generally shows an inverted T4:T8 lymphocyte ratio; a functional analysis seems to show a high degree of lymphocyte activation, which may be of T4 or T8 phenotype whilst cytotoxic lymphocyte activity would be exclusively found in the patients and not in asymptomatic exposed subjects. The provocation test, as long as it is positive, is one of the firmest elements in a diagnosis, above all if one takes care to couple this with a study of the lavage. Finally, the satisfaction of the immuno-histological criteria is currently rarely required to confirm the presence of hypersensitivity pneumonitis.

Alveolitis, Extrinsic Allergic↗
PubMed1986

[Physiopathologic bases of the treatment of systemic scleroderma].

Numerous drugs have been suggested for the treatment of systemic scleroderma. They may be studied and classified according to their site of action on the chain of events that leads from vascular abnormalities to sclerosis of the skin. Thus, proline analogues, colchicine, lathyrogenic agents, D-penicillamine, coagulation factor XIII and oestrogens are thought to act on collagens and their metabolism. Ketanserin has been suggested by the discovery of tryptophan abnormalities. Corticosteroids exert an inhibitory effect on fibroblasts. The use of calcium antagonists, angiotensin-converting enzyme inhibitors, prostacyclin and anti-platelets rests on the presence of vascular abnormalities. The purpose of treatments with immunosuppressive drugs or plasma exchanges is to act on possible lymphocytic and/or macropageal factors.

Blood Platelets↗
PubMed1986

[Treatment of systemic scleroderma with ketanserin. Randomized, double-blind 6-months study of 27 cases].

Twenty-seven patients with systemic scleroderma and Raynaud's phenomenon underwent a randomised double blind therapeutic trial: monotherapy with Ketanserine (80 mg/day for 6 months) against Placebo. The secondary effects were comparable in both groups as were the withdrawals from the trial for aggravation of Raynaud's phenomenon (one in each group). No significant difference was observed between the two groups as regards the evolution of the Raynaud's phenomenon or skin changes. Dysphagia was improved in the Ketanserine group (p less than 0.05) but not in the Placebo group. Some patients in the Ketanserine group experienced an improvement in the Raynaud's phenomenon at the end of the trial period; there were no improvements in the Placebo group. Three haemorrheological parameters (total blood viscosity, plasma viscosity and thixotropism) were abnormal at the beginning of the trial and did not improve by the end in the Ketanserine group. The K infinity coefficient of Quemada's law was normal at the start of the trial and increased after treatment (p less than 0.05).

Clinical Trials as Topic↗
PubMed1985

[What should be done in the presence of isolated microscopic hematuria in man in the work environment?].

Microscopic haematuria was detected by the strip technique in 3.5% (normal: 1.8%) of 2100 men over 40 years of age, systematically examined at their place of work. Thirty-two agreed to undergo further investigations. Eight (25%) were found to have a urinary tract disease: kidney stones (2), prostatic adenoma (2), vesical diverticulum (1) and, notably, vesical tumour (2). Intravenous urography detected these abnormalities in 75% of the cases but missed the vesical tumours which were detected only at cystoscopy, urine cytology being also negative. The data obtained by cystoscopy were confirmed by vesical echography in 1 case. Thus, we believe that in the presence of even a single episode of microscopic haematuria in a man over 40, an intravenous urography should be performed. If the results are normal, and if the subject is a smoker or presents with an occupational or familial risk of cancer, this examination should be followed by cytology and vesical echography. If both are negative, then cystoscopy is necessary.

Adult↗