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Biomedical subjects

J Pasquier

Publications and source records attributed to J Pasquier.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Subclavian and axillary arteritis in Horton's disease and rhizomelic pseudopolyarthritis. 10 cases].

Ten patients aged from 60 to 73 years presenting with Horton's disease or polymyalgia rheumatica had arteritis of the upper limbs. Asymptomatic abolition of pulse in the upper limbs (1 case) or claudication at rest or exercise (9 cases) and/or Raynaud's phenomenon (5 cases) preceded (4 cases) or accompanied (1 case) the discovery of giant cell arteritis, or complicated the reduction or discontinuation of corticosteroid therapy. Diagnosis rested on the regular association of an inflammatory syndrome with multiple arterial tapered stenoses and/or arterial thrombosis in the post-vertebral subclavian, axillary or brachial arteries and, chiefly, on the demonstration (in 7 cases) of a giant cell granuloma at biopsy of the temporal artery. Corticosteroid therapy (1 mg/kg/24 h in 8 cases and 0.5 mg/kg/24 h in 2 cases) initially combined with anticoagulants in 4 cases resulted in rapid regression of ischaemic and systemic signs in all patients, thus avoiding surgical revascularization of the upper limbs.

Aged↗
PubMed1987

[Re-permeation of deep venous thrombosis of the lower extremities: comparison between plethysmographic indices and phlebography scores. Preliminary results].

A prospective study, now pursued, has the aim of determining anatomical features (permeability of deep venous trunks and/or development of a collateral venous circulation) related to improvement in plethysmographic indices and comparing these with phlebographic data. Twelve patients have been investigated by occlusive plethysmography and bilateral phlebography of lower limbs on the day of diagnosis, after 10 days of heparin therapy and after 6 months of antivitamin K anticoagulant treatment started on the 11th day. Whereas a progressive improvement in plethysmographic indices and phlebographic scores exists during the course of treatment, no correlation has been observed between plethysmographic indices and degree of phlebographic obstruction. This suggests that the emptying rate indices cannot be considered as an absolute criterion for the decision to discontinue anticoagulant therapy.

Collateral Circulation↗
PubMed1987

[Involvement of arterial trunks of the upper limbs in giant cell arteritis. Apropos of 7 cases].

On 91 patients with temporal arteritis (TA) and/or polymyalgia rheumatica (PMR), we observed 7 females aged 62 to 73 years with upper extremities ischemia. Arm claudication and/or Raynaud's phenomenon were the initial manifestations of the disease in 2 cases, or appeared simultaneously with other symptoms in 2 cases, or complicated decreasing corticosteroid therapy in 3 cases. A temporal artery biopsy was performed on 6 patients with, in all of them, typical giant cell granulomatous arteritis pathology findings. Angiograms showed, in all cases, multiple bilateral smooth stenosis and/or obliterations of post vertebral subclavian arteries and/or axillary arteries. Symptoms always improved on corticosteroid treatment and no patient needed reconstructive surgery. In conclusion, large arteries involvement, which can occur in TA and/or PMR, affect in our experience most commonly the subclavian and axillary arteries, with female predominance as found in Takayasu's arteries. These disorders should be considered in cases of occlusive disease of the arms in elderly women and the response to steroids is usually adequate to eliminate the need for early surgical intervention. Early recognition of asymptomatic large artery involvement by Doppler evaluation, in all TA and/or PMR patients, and transient anticoagulant therapy might prevent vessels occlusions.

Aged↗
PubMed1986

[Long-term improvement of exercise performance in patients with activity-dependent pacemakers].

Exercise performance after implantation of the pacemaker with physical activity dependent pacing rate (Activitrax, Medtronic) was assessed by treadmill tests one month afterwards in 10 patients and a further 6 months later in 6 of them, who had long been VVI pacing dependent (reimplantation subgroup). In the 1 month test exercise performance had improved in 7 of 10 in activity pacing mode compared to VVI mode. After 6 months of physical activity dependent pacing the patients in the reimplantation subgroup showed an improved exercise test in VVI mode compared to the 1 month test in VVI mode. In activity pacing mode there was an additional improvement (increase of exercise duration from 12.1 +/- 2.5 to 14.5 +/- 2.7 min, p less than 0.005, and of accumulated work from 31.1 +/- 15.1%, p less than 0.002) compared to the VVI mode. Since Activitrax PM allows better exercise performance at longterm follow-up, it becomes a pacing mode of choice when double chamber pacing is impossible.

Adolescent↗
PubMed1986

[X-ray computed tomography in central pontine myelinolysis. 2 cases].

Two cases of central pontine myelinolysis were studied by computerized tomography (CT). One patient had chronic alcoholism, the other porphyria variegata; both initially presented with water-and-electrolyte disorders, notably hyponatraemia. The neurological disorders consisted of acute pseudobulbar syndrome which totally regressed within 15 days to 1 month. CT demonstrated a low density area in the pons, extending to the mesencephalon in one case. Despite clinical cure, this low density persisted for 16 and 20 months respectively, counting from the onset of neurological symptoms. In central pontine myelinolysis, CT images only are of diagnostic value in cases with suggestive neurological symptoms and aetiology. CT can recognize minor forms of the disease and confirms that in some cases severe forms may follow a regressive course.

Adult↗
PubMed1986

[Study of 2 markers, keratin and neuron-specific enolase, in bronchial cancers].

In an immunohistochemical study 31 patients with bronchial cancer (squamous cell 9, large cell 4, small intermediate cell 11 and oat cell 7) were investigated for keratin and NSE. Keratin seems to be a valuable marker since only oat cell cancers and 45% of small intermediate cell cancers were negative. In contrast, marking with NSE seems to be non-discriminating. The low value of NSE as marker was confirmed by 133 serum NSE assays performed in 39 bronchial cancer patients. Although NSE values were significantly higher in oat cell cancer, in any given patient serum assays can, at best, detect relapses.

Bronchial Neoplasms↗
PubMed1986

[Pulmonary metastases of a placental choriocarcinoma].

Pulmonary metastases of a placental choriocarcinoma are common but they are rarely the presenting factor, and whenever there are pulmonary metastases in a young woman a systematic search is required. We report on 7 cases and emphasize several important points. The diagnosis rests on the level of Beta H.C.G. One should be cautioned about transparietal aspiration or fibreoptic biopsy in view of the haemorrhagic nature of the lesion. An extensive work-up should be performed before classifying patients as low, medium or high risk as on this will determine the type of chemotherapy, either monotherapy with Methotrexate or polychemotherapy. The duration of treatment will depend on the clinical, radiological and biological outcome.

Adult↗
PubMed1985

Clinical comparison of 99mTc-HMDP and 99mTc-MDP. A multicenter study.

99mTc-Hydroxymethylene diphosphonate (HMDP) was compared to 99mTc-methylene diphosphonate (MDP) with respect to image quality, lesion detectability, and the uptake ratios of normal bone to soft tissue (B/S), metastatic bone to soft tissue (M/S) and bone metastases to normal bone (M/B) at 2 and 3 h after injection in the same subjects. Thirty-three patients with bone metastases were examined in six nuclear-medicine departments, with each center using its usual bone-scanning protocol which was identical for both compounds in the same patient. The uptake of 99mTc-HMDP in normal bone (B/S) was significantly higher than that of MDP at 2 and 3 h, but there were no significant differences between the two compounds with regard to the M/S or M/B ratios. The M/B of HMDP at 2 h was not significantly different from that of MDP at 3 h, the latter showing a significantly higher B/S and M/S ratio. All lesions were detected with both compounds, even at 2 h. The image quality was rated as follows (in decreasing order): HMDP (3 h), MDP (3 h), HMDP (2 h), and MDP (2 h). HMDP was shown to be a useful bone-imaging agent, especially when shorter intervals between injection and recording are required.

Adult↗
PubMed1985

[The fate of patients with carotid stenosis. Comparative study, based on the literature, of their natural history and evolution under medical treatment or following endarterectomy].

The aim of therapy of carotid artery stenosis is to reduce the number of cerebral ischemic accident complications, but marked uncertainty exists at the present time as to the spontaneous course of these stenotic lesions and the efficacy of the different treatments proposed. After a transient ischemic accident (TIA) there is a 37% risk of a vascular accident (CVA) of a more definite type occurring within 5 years but only 1/4 of these patients die of cerebral complications, death in half of the cases being of coronary origin. Very rapid treatment with anticoagulants after TIA slightly diminishes the number of established cerebral ischemic accidents, but increases the risk of cerebral hemorrhage. Among the anti-aggregant agents, only Aspirin at high dosage (1 to 1.3 g/24 h) appears to be effective in preventing relapses of TIA and/or of CVA and/or on mortality which results from it. Carotid endarterectomy after TIA does not alter long-term survival, dependent on the increased cardiac mortality, but appears to reduce markedly the long-term recurrence rate of TIA and/or CVA. Globally, however, benefits of surgical treatment can be obtained only if post-operative cerebral mortality and morbidity are extremely low, conditions obtained in highly specialized centers only. Spontaneous course of angiographically detected asymptomatic stenosis shows, for a mean 4-year survival, a relatively low level of TIA (3,3 to 19%) and of CVA (0 to 12%) whatever the anatomic type of the stenosis. Prophylactic endarterectomy in practised hands has a low operative mortality (0 to 2%), a limited perioperative cerebral morbidity (1.3 to 4.5%) and a satisfactory later relapse rate of CVA (less than 5% at 4 years). These findings indicate comparable courses for spontaneous and treated cases globally, as well as with respect to cardiac mortality. In the absence of randomized trials it is a controversial point as to whether carotid surgery is superior to a spontaneous course in cases of asymptomatic stenosis.

Anticoagulants↗
PubMed1984

Bacterial endocarditis presenting as acute vertebral osteomyelitis: 14 cases.

Association between bacterial endocarditis (BE) and vertebral osteomyelitis (VO) has infrequently been noted. In a retrospective analysis of BE (280 cases) and VO (150 cases) 14 cases were found to have this association. There were 12 males and 2 females, ages ranging from 39 to 72 years, mean age 56.6. Blood cultures were positive for Streptococcus viridans (6 cases). Str. faecalis (4 cases), staphylococcus (2 cases), Gram negative bacteria (1 case). Organism was not isolated in one case. Fever and severe back pain antedate the diagnosis of VO 3.5 and 2.5 months. X rays films of the spine and bone scans (4 cases) revealed lumbar (6 cases) or cervical (4 cases), or dorsal (3 cases) or combined cervical and dorsal (1 case) locations. History of murmur (4 cases) and development of mitral (8 cases) or aortic (4 cases) or combined mitral and aortic (2 cases) insufficiencies were consistent with concomitant BE. Echocardiogram revealed vegetations in 6 out of 9 cases. Patients received antibiotic therapy for 3.5 months. Ten patients were cured with antibiotics only, 4 required valve replacement. One died. Thus age, sex, history of heart disease, valvular involvement, duration of symptoms prior to admission and bacteriological pictures are the same in BE with VO as in BE without VO. Survival rates are also the same if early recognition of BE and VO with prompt and prolonged antibiotic therapy may prevent severe haemodynamic or vertebral problems.

Acute Disease↗
PubMed1982

[Recurrent paroxysmal myoglobinuria with acute renal insufficiency caused by muscular carnitine (palmitoyltransferase deficiency. A case].

A 45-year-old man was hospitalized on 3 occasions for recurrent myalgias with paroxysmal myoglobinuria resulting in two episodes of acute renal failure. The second episode was fatal: the patient died of shock and hyperkaliaemia during haemodialysis. The predominant signs and symptoms were muscle pain with functional deficit, signs of renal failure and a rise in serum enzymes. All examinations were negative between attacks. Muscle biopsies showed a major degree of myolysis, and biochemical tests demonstrated severe muscle palmityl transferase deficiency associated with partial deficiency of muscle carnitine. The diagnostic features and physiopathology of the disease are reviewed.

Acute Kidney Injury↗