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Biomedical subjects

J Pourel

Publications and source records attributed to J Pourel.

At least 19 recordsLinked to original sources

Functional disability in rheumatoid arthritis: two different models in early and established disease.

A hypothesis that the development of functional disability in rheumatoid arthritis (RA) would be more rapid at the beginning than in established disease was studied in a group of 82 patients with RA referred to the Rheumatology Unit of Nancy, France. The relationship between disease activity, articular destruction and functional disability indicated a significant interaction (moderating effect) of disease duration. Two different models are proposed to explain functional disability. A model for early RA (less than 5 years duration) includes biological activity, and a model for established disease (more than 5 years) includes disease duration, extraarticular lesions and radiographic damage. These models could be useful in designs of therapeutic trials.

Arthritis, Rheumatoid

Lack of adjuvanticity of human recombinant interleukin-1 beta in collagen induced arthritis in rats.

We investigated the influence of human recombinant interleukin-1 beta (hrIL-1 beta) on the time-course of collagen induced arthritis (CIA) when injected concomitantly with the arthritogenic emulsion. Three sensitizing procedures were compared. The control group received type II collagen only. The other groups differed by the adjunction of demonstrated (MDP) or potential (IL-1 beta) adjuvant. No adjuvant effect of IL-1 was observed as judged on clinical or radiological scores. On the contrary, MDP significantly worsened the lesions of the injected right hindpaw, and increased the incidence of CIA. Surprisingly, humoral response to type II collagen was decreased in the group receiving IL-1 beta. This might be explained by a non specific increase of antigen clearance.

Acetylmuramyl-Alanyl-Isoglutamine

[Measurement of the functional capacity in rheumatoid polyarthritis: a French adaptation of the Health Assessment Questionnaire (HAQ)].

The ability in performing daily life activities, as assessed with self-administered questionnaire, measures the functional severity of rheumatoid arthritis (RA). The HAQ Disability Index, designed to explore RA, was translated by 3 francophone teams. Three anglophones gave a back-translation. The latters were compared with the original HAQ under the control of 2 bilingual individuals, allowing to the adjustment of the French version. The validity of this measurement tool was studied in a group of recent RA (n = 40, mean disease duration: 2.4 years), longstanding RA (n = 32, mean disease duration: 8.4 years) and controls (n = 59). The construct validity was assessed in a principal component analysis, which showed the contribution of each item of the questionnaire. The intra-subject reproducibility was satisfactory. The HAQ score correlated well with usual clinical and radiological parameters. It differed significantly in the groups, showing a high discriminant ability. A validated instrument for measuring functional ability in French RA patients is now available for the follow-up and therapeutic assessment.

Activities of Daily Living

Long-term disability and prolonged sick leaves as outcome measurements in ankylosing spondylitis. Possible predictive factors.

Prognostic factors for the occurrence of longterm disability and prolonged sick leave were determined in 182 patients with ankylosing spondylitis. A significant relationship appeared between functional disability (determined by the Stanford Health Assessment Questionnaire) and sex, age at disease onset, and the number of peripheral joints involved. Using a life-table approach, the probability of prolonged sick leaves was associated with peripheral joint involvement and work that involved carrying heavy loads. Long-term disability was more frequent after work involving exposure to cold conditions (relative risk [RR] = 2.01) and prolonged standing postures (RR = 1.34), while sedentary work (RR = 0.35) and formal vocational rehabilitation programs (RR = 0.57) seemed to protect against long-term disability.

Adult

Pre-B lymphocytes with intracytoplasmic mu chains in the peripheral blood of rheumatoid arthritis patients.

A dysregulation of B-cell differentiation and activation has long been evidenced in rheumatoid arthritis (RA). Such analyses have, however, usually focused on the latest stages of B-cell development. Using a classical technique of immunofluorescence labeling on cytospins, we investigated the presence of peripheral pre-B lymphocytes in 92 RA patients and 23 controls. Cells with intracytoplasmic mu chains were evidenced in 58.7% of the RA patients studied, ranging between 0 and 30%, while small numbers of c-mu cells, never exceeding 6% of peripheral blood lymphocytes, were observed in 9 controls. Relationships between this feature and clinical or laboratory data were investigated, showing a negative correlation between the percentage of c-mu + lymphocytes and Ritchie's index (P = 0.05), the number of tender or swollen joints (P = 0.05), erythrocyte sedimentation rate (P = 0.005), seropositivity (P = 0.05), and disease duration (P = 0.01).

Adult

[Fractures caused by bone insufficiency of the proximal femoral epiphysis. Contribution of MRI].

The fractures by bony insufficiency are particularly well seen on MRI. On T1 weighted images they are detected as a very hypointense line surrounded by a hypointense area. On T2 weighted images, the hypointense line is also recognized and represents the fracture surrounded by a hyperintense area due to oedema or hemorrhage. Five cases of bony insufficiency fracture of the femoral head are reported. The features of the superior subchondral locations of these fractures and some primary and limited epiphyseal osteonecrosis are similar and consistent with a common pathogeny.

Aged

Clinical pharmacokinetics of nonsteroidal anti-inflammatory drugs in the cerebrospinal fluid.

The pharmacokinetics of nonsteroidal anti-inflammatory drugs (NSAIDs) in the cerebrospinal fluid (CSF) is of clinical interest as it may be related to some of their properties and side-effects. Two types of NSAIDs can be described with respect to their concentration and time course in CSF: in the first type, the transfer across the blood-brain barrier seems to be controlled by simple physico-chemical factors. These drugs (oxyphenbutazone, indomethacin, ketoprofen) are characterized by a high lipophilicity. At steady state, their free plasma concentrations correspond to their CSF concentrations. The second group consists of more hydrophilic compounds (salicylates); there is no correlation between plasma concentrations and CSF concentration. Further investigation needs to be carried out on CNS side-effects and the antialgesic activity of salicylates in relation on their CSF distribution.

Anti-Inflammatory Agents, Non-Steroidal

[Familial articular chondrocalcinosis].

Articular chondrocalcinosis is a well-defined radiological entity with or without clinical manifestations. A familial form was described by Sitaj and Zitnan in 1957. Attention has mostly been paid to chondrocalcinosis associated with metabolic diseases and to "sporadic" chondrocalcinosis, usually due to ageing of the joint. Familial chondrocalcinosis, of which more and more cases are reported, is increasingly under study and is used as a model for pathogenic research. It already appears that familial chondrocalcinosis, of dominant autosomal transmission, is a new metabolic disease.

Calcium Pyrophosphate