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J Pourel

Publications and source records attributed to J Pourel.

At least 37 records · Page 2Linked to original sources
PubMed1995

Development of a criterion for response to therapy at 6 months in multiple myeloma.

UNLABELLED: To investigate the prognostic value of therapy at 6 months on survival in multiple myeloma, to develop a new criterion assessing response to initial therapy at 6 months, and to compare it to a current criterion. The types of initial and 6-month therapy were considered in a prognostic factor analysis in 70 patients treated in routine practice. Using the response to initial therapy defined by the clinician's decision as grouping variable in this group, a discriminant analysis identified the characteristics of responder patients. The validity of the resulting criterion was tested in another test group. Its prognostic ability was compared to the CLMTF criterion (50% M-component reduction from baseline). The therapy at 6 months, reflecting the clinician's appraisal of response to initial therapy, predicted survival significantly. A criterion combining two variables (M-component change and haemoglobin level at 6 months) classified 70% and 72.4% of patients correctly regarding response status in the training and test groups respectively. This criterion was shown to perform better than the CLMTF criterion in predicting survival. CONCLUSION: A new criterion for response to therapy at 6 months, also presented in a nomogram, combines M-component change and haemoglobin level at 6 months.

Aged↗
PubMed1995

Diagnosis of Lyme disease. Current difficulties and prospects.

Articular manifestations of Lyme disease may be less common in Europe than in the United States, perhaps because European strains of Borrelia burgdorferi are characterized by greater genetic diversity and different organotropisms as compared with American strains. The diagnosis rests on clinical symptoms. A history of erythema migrans is pathognomonic. Isolated articular manifestations with no history of erythema migrans raise difficult diagnostic problems. Monoarthritis and asymmetric oligoarthritis is the most characteristic pattern; enthesitis can occur, a clinical feature shared with spondylarthropathy. Serologic tests (indirect immunofluorescence, Western blotting) have not been standardized and should be used only to confirm the diagnosis in patients with suggestive clinical manifestations. The interpretation of serologic test results is made difficult by the high seroprevalence rates seen among the general population in endemic areas, where subclinical Borrelia burgdorferi infection probably occurs. Detection of Borrelia burgdorferi DNA using polymerase chain reaction amplification is a potent tool both for diagnosis and for gaining insight into the pathophysiology of Lyme disease. However, difficulties subsist (risk of contamination of the specimens, inhibitory effects). Continued work is needed to determine which targets (chromosomal DNA, plasmidic DNA) and specimens (joint fluid and/or synovial membrane) provide optimal results.

Blotting, Western↗
PubMed1994

Low incidence of rheumatoid arthritis in France.

The incidence of rheumatoid arthritis (RA) was estimated in the Lorraine district, eastern France, over the period 1986-1989. Cases were identified from in- and outpatients at the district Rheumatology Hospital Centre, private rheumatologists, general practitioners and by regional media announcements. Supplementary cases resident in the area were sought by extending the procedure to adjacent districts. The population count was obtained from the national Census. An overall age-adjusted incidence rate of 8.8/100,000 was found using the 1987 ACR criteria (12.7/100,000 in females, 4.7/100,000 in males; sex ratio = 2.65) and 9.5/100,000 using the 1958 ARA criteria (definite and classic RA). These rates were compared, using the same standard population, with the age-adjusted incidence rates in other incidence studies mainly conducted in Caucasian populations. The RA incidence rates appeared lower in France than in any other country in Europe, USA and Japan.

Adult↗
PubMed1994

Experimental articular toxicity of aluminum compounds in vivo.

OBJECTIVE: To investigate the articular toxicity of 2 aluminum derivatives, one insoluble (hydroxide) and/or the other soluble (lactate), after a single administration in rabbits and rats. METHODS: First, aluminum levels in plasma, urine, synovial tissue, liver and kidney were measured in saline treated rabbits and 1 to 2 days after an articular injection of 75 mg of aluminum compounds into their right knee. The methodology used was argon plasma emission spectrometry. Thereafter, the joint toxicity of aluminum lactate at the same dose regimen was evaluated for 2 days by a qualitative histological examination of synovial tissue and articular surfaces and a colorimetric assay (1,9-DMB) of patellar articular cartilage proteoglycan content. Secondly, the single injection of 50 mg of aluminum derivatives as an inducer of inflammation was studied in the rat subcutaneous air pouch, a model for a synovial-like space. Leukocytes and eicosanoids levels were measured in pouch washout fluids from 1 to 72 h after injection. RESULTS: After injection into rabbit knee, aluminum lactate largely distributed within the body while hydroxide remained locally. However, aluminum lactate resulted in perivascular edema, sparse infiltration of inflammatory cells in the synovium and a hemorrhagic effusion. Proliferation of the synovial cell layer coexisted with an apparent loss of proteoglycan in superficial zones of tibial and femoral cartilages when patellar proteoglycan content remained unchanged. Aluminum hydroxide did not affect joint structures. In the air pouch experiment, aluminum lactate increased prostaglandin E2 (PGE2) levels from 3 to 10 h after its injection and less intensively leukotriene B4 (LTB4) levels after 6 h, in the absence of leukocytes migration into the cavity. In contrast, aluminum hydroxide increased leukocytes count in pouch-washout fluid from 3 to 24 h after its injection when PGE2 and LTB4 levels were little modified. CONCLUSION: Although some differences attributable to dissimilarities in the experimental model used, aluminum compounds, even in a soluble form, may damage joint structures either directly or through stimulating the secretion of eicosanoids by synovial-like cells.

Aluminum Compounds↗
PubMed1993

[Scanning electron microscopy and microcrystals in articular diseases].

The value of scanning electron microscopy (SEM) in the study of crystals in articular diseases is underlined in several cases of examination of joint fluid, or crystal deposits in articular or periarticular tissues obtained by percutaneous or surgical treatment with chemical and crystallographic correlations. Apatite crystals. Two deposits of hydroxyapatite of the rotator cuff were studied by SEM, crystallographic techniques and chemical analysis. SEM study showed spherical aggregates of various size. Urate crystals. Three tophi were observed by SEM, with crystallographic techniques and chemical analysis. Their needle-shape and their great size (20 m) were characteristic. Calcium pyrophosphate crystals. In a case of typical clinical and radiological features, examination of joint fluid, with chemical correlation showed shorter and thicker crystals than those or urate. The precise identification of crystals is based on sophisticated crystallographic techniques such as X-ray diffraction, although SEM allows an accurate and quite simple morphologic study, most often sufficient.

Apatites↗
PubMed1993

[Abnormalities of the muscular bioenergetics in Steinert's disease].

The thenar muscles and gastrocnemius of a patient with myotonic dystrophy were investigated, at rest, by phosphorus nuclear magnetic resonance spectroscopy. A decrease in phosphocreatine level and an increase in inorganic phosphate and phosphodiester levels were found in the gastrocnemius, which was clinically spared, whilst the thenar muscles, which were wasted and affected by myotonia, exhibited only an increased inorganic phosphate level and an elevated pH. These findings were comparable with those found in other muscular disorders, such as Duchenne's and Becker's dystrophies, as well as in limb girdle dystrophy. They suggested that the abnormalities observed were unrelated to myotonia or wasting, and the possibility of a secondary mitochondrial disorder in myotonic dystrophy, is to be considered.

Adult↗
PubMed1992

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↗
PubMed1991

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↗
PubMed1991

[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↗
PubMed1990

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↗
PubMed1990

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↗
PubMed1990

[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↗
PubMed1989

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↗