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J Cayla

Publications and source records attributed to J Cayla.

At least 55 records · Page 3Linked to original sources
PubMed1975

[4 cases of osteomalacia during anticonvulsant or sedative treatment].

The authors report osteomalacia in 3 cases of epilepsy and one case of coronary heart disease treated with phenobarbitone, either alone or associated with other anticonvulsants. There were clinical signs in all cases and typical radiological signs in 3 cases, a characteristic laboratory syndrome in 4 cases. In the 3 cases where it was estimated, serum levels of parathormone were high. Finally, in 3 cases where it was measured, daily urinary excretion of glucaric D acid was increased. The bony histological signs studied in 3 cases, were similar to those in deficiency osteomalacia. A study of Ca45 metabolism in one case, showed the characteristic changes found in osteomalacia. Finally, a study of the metabolism of tritiated vitamin D, or tritiated 25 OH CC, carried out in 3 cases, gave 3 different patterns; only one of them was characteristic of enzyme induction under the dependency of anticonvulsant. Started in 2 cases, treatment with 125 OH2CC, brought about a rapid fall in blood PTH levels which then rose again before falling progressively in one case, under treatment with 25 OH CC. The bony histological signs of hyperparathyroidism then regressed whilst serum PTH levels remained high. Phosphorous and calcium balance improved in only one case. Treatment with 25 OH CC in high dosage brought about clinical, radiological and laboratory cure of osteomalacia in both cases, reducing the frequency of fits in the epileptic patient.

Adult↗
PubMed1975

[Bone metastases of colonic and rectal neoplasms. Apropos of 11 cases].

The authors report 11 personal cases and discuss the characteristics of bony metastases in carcinoma of the colon and rectum. The frequency of these metastases is fairly low (1.3% of all cases of bony metastases) as tumours of the large intestine do not tend to migrate to the bones. Sometimes bony metastases are the presenting symptom but, usually the metastases occur within 5 years of the diagnosis of the primary tumour. The clinical picture shows no special characteristics. Radiologically, these bony metastases may be either single or multiple. Their distribution recalls that of other metastases in the bones with a few differences, however. The special frequence of pelvic involvement, distal localisations (hands or feet) are not exceptional. Metastases usually give rise to osteolysis. The mixed appearances are, however, not rare, and usually give a pseudo-sarcomatous appearance, with invasion of the soft parts and very marked periosteal reaction. Sometimes, bony condensation may be noted. The treatment of rectal and colonic cancer with bony metastases, is disappointing as the disease is always fatal within a relatively short period, usually less than one year after the diagnosis of the bone involvement. The histological appearances of the bony lesions depend on differenciation of the tumour and the characteristics of the neighbouring bony abnormalities which, in our experience, usually include both osteolysis and osteogenesis.

Age Factors↗
PubMed1975

[Myeloma and osteocondensation (apropos of 2 cases)].

The authors report two cases of multiple myeloma which were typical both clinically and in the laboratory but XRay examination, on the other hand, showed appearances of osteocondensation. In the first case, XRay showed both lesions of osteolysis in the cranial vault and homogeneous condensation of D11 and L1, together with the left iliac crest. In the other case, there was osteolysis of the acetabulum together with areas of osteocondensation distributed throughout the pelvis and upper ends of the femurs, with two areas of annular fibrosis circumscribing the area of osteolysis, finally, homogeneous condensation of the skull. In both cases, bone biopsy confirmed the diagnosis of multiple myeloma showing both osteofibrosis and plasma cell infiltration of the bone marrow. This also permitted the authors to note the absence of any myelofibrosis or metamorphic neo-osteogenesis. Illustrated by these two cases, condensing multiple myeloma is a rare entity, the special clinical characteristics of which reside in its fairly frequent coexistence with peripheral neuritis which is probably similar to a para-neoplastic syndrome. The radiological appearances are mainly of four types: 1) Focal areas of bony condensation. 2) Areas of annular fibrosis circumscribing osteolysis. 3) Appearances of radial spicules, or 4) Osteocondensation extending to a fairly large part of the skeleton. The laboratory signs are identical with those in other types of multiple myeloma with a few exceptions, such as, rareness of hypercalcemia, more frequent tendency to hypocalcemia, rise in alkaline phosphatase, in a few cases. Bone biopsy confirms the diagnosis. The osteofibrosis resulted here from thickening of the osteoid seams by laying down of successive layers of bony substance, irregularly calcified and, also secondarily, metamorphic neo-osteogenesis in a few rare cases which also included myelofibrosis.

Adult↗
PubMed1975

Pyogenic infection of the sacro-iliac joint. Report of thirteen cases.

Thirteen cases of infectious sacro-iliitis caused by pyogenic organisms are reported and compared with thirty-four cases in the literature. Staphylococcus was the commonest infecting organism (six cases). Two clinical patterns were noted, acute (nine cases) and subacute (four cases). Treatment was by antibiotics and bed rest in all patients. Surgery was indicated for diagnosis in three patients and for abscess in three patients. All of our patients had very good functional recovery.

Adolescent↗
PubMed1975

[Analysis of disorders of the principal pathways of calcium metabolism in Paget's disease. Effects of calcitonin administration. 26 cases].

Analysis of the principal routes of calcium metabolism by means of calcium-45 in 26 patients suffering from Paget's diseases sometimes showed, in agreement with data from the literature, a considerable increase in the common stocks of calcium in 25 cases, and an elevation in the anabolism (Vo+) in bone and in the catabolism (Vo-) in bone in all cases. The calcium balance was sometimes equal, but often clearly positive (10 cases) or negative (10 cases) and the level intestinal absorption of calcium was usually within the normal limits. An elevation in the endogenous fecal calcium (Vf) noted in half of the cases, although no value was below normal, seemed to represent an metabolic anomaly of abnormally high frequency in patients with Paget's disease, even though this fact has never been emphasized before. Statistically significant correlations were shown between the values of different kinetic and metabolic parameters in the group of patients studied. A second kinetic study carried out after several weeks of treatment with porcine calcitonin showed a statistically significant diminution in the values of Vo +, Vo -, endogenous fecal calcium, calciuria, hydroxyprolinuria, and in alkaline phosphatasaemia, as well as significant variations in the calcium balance in a positive direction. The common calcium stocks did not show a significant diminution, contrary to the findings of other authors. The level of intestinal absorption of calcium increased more often than it decreased, but the magnitude of the variations was slightly less than the level of statistical significance.

Aged↗
PubMed1975

[Thymoma and lupus disease (apropos of 2 cases].

Two new cases of association between a thymoma and a lupus illness are reported. The first was a women aged 42 years in whom were discovered simultaneously systemic lupus erythematosus (SLE) and a slowly invading thymoma, the histology of which was characterized by the predominance of epithelial cells; excision of this tumour did not appear to affect the evolution of the SLE. In the second case, a patient aged 60 years suffered from SLE ten months after the removal of a benign thymoma in which there was a predominance of lymphocytes. The SLE in this patient was easily controlled for more than a year by small doses of corticoids, but resulted in death after three years when anuria was associated with meningeal signs after the cessation of corticotherapy. The comparision of the data from these cases with those from eleven other cases in which there was association between a thymoma and SLE, brought to light several interesting facts. It is rare that SLE clearly precedes the discovery of the thymoma; it usually occurs afterwards or the two are discovered almost simultaneously. Collagenosis is of importance only when it coexists with a thymoma : starting later much more often than is usual in cases of SLE. The tumours were, in all but two cases, benign thymomas of different histological types, and their removal did not apparently influence the evolution of the SLE.

Adult↗
PubMed1975

[Paget's disease and vertebral blocks (apropos of 7 cases)].

The authors observed 10 blocks of from 2 to 8 vertebrae in 7 patients whose spines were affected by Paget's disease. The morphological characteristics of these blockages were for the most part similar to those of acquired synostoses, the corresponding articular apophyses appearing to be fused in the majority of cases. Even without a radiograph taken before the formation of the blocks, the fact that there had been progression of the synostosis between certain vertebrae indicates the probability of an acquired origin. The prevalence of these vertebral blocks in a group of 76 patients suffering from Paget's disease of the spine (12 percent, or 9 patients with 13 blocks) was significantly higher than that found in a population of 200 persons not suffering from Paget's disease, (3 percent, or 6 patients with 6 blocks) and among the 13 blocks discovered in the patients with Paget's disease only 3 were formed of vertebrae unaffected by deforming osteitis. These facts suggest that the formation of a vertebral block may be favoured by Paget's disease localized in the vertebral column. This is a little recognized idea even though it was formulated in Schmorl's work at the beginning of this century.

Aged↗