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Biomedical subjects

J Pourrat

Publications and source records attributed to J Pourrat.

31 records · Page 2Linked to original sources
PubMed1990

Treatment of progressive systemic sclerosis by plasma exchange: long-term results in 40 patients.

The efficacy of plasma exchanges (PE) during the course of scleroderma has only been investigated for short periods. The aim of this study was to follow patients over a long enough period to observe the course of the clinical and paraclinical symptoms in the short, medium, and long term. Forty patients, 24 women and 16 men, were treated by PE and observed for 1-3, 3-12 and over 12 months. Immunological, biological and clinical course and any undesirable side effects were evaluated using a detailed questionnaire. Concomitant therapies were reported and most frequently consisted of corticosteroids, colchicine, factor XIII or vasodilators (nifedipine, captopril). The therapeutic effectiveness of PE was assessed on the basis of improvements in cutaneous, digestive, joint, muscular, lung, cardiovascular and renal lesions. Our findings confirmed the effectiveness of short-term PE on scleroderma (52% of the patients improved during the first 3 months). However, this improvement was transient (5% improvement between 3 and 12 months and only 2.5% over 12 months) and limited to the cutaneous and muscular lesions. Thus, PE cannot be recommended for the treatment of progressive systemic sclerosis.

Adolescent↗
PubMed1984

[Gynecomastia and chronic renal insufficiency in periodic hemodialysis. Demonstration of a decrease in the free fraction of testosterone].

Gynecomastia is frequently observed in male patients undergoing hemodialysis; however, its mechanism is still unclear. Hormonal studies were performed in a group of 39 men, aged 50 +/- 14 years, dialysed for 2.8 +/- 2 years. 23 (59 p. 100) of them had gynecomastia. Peripheral hypogonadism and hyperprolactinemia were found in all the hemodialysed patients. Whether gynecomastia was present or not, no significant difference was observed for gonadotropins, prolactin, testosterone, estradiol 17 beta and testosterone-estradiol binding globulin levels. In contrast, the urinary output (p less than 0,05) and free testosterone (p less than 0,05) were significantly lower in the group with gynecomastia. Gynecomastia occurring in hemodialysed patients is probably due to a decrease of the testosterone/estrogen ratio. If so, percutaneous treatment with 5 alpha dihydrotestosterone might improve this type of gynecomastia.

Adult↗
PubMed1984

Metastases of human tumor xenografts in nude mice.

In the present study, using systematic microscopic examination, we tried to determine the true incidence of metastases in nude mice bearing a wide variety of human tumors. A total of 63 malignant tumors were successfully transplanted subcutaneously and 831 nude mice bearing tumors were examined. It appeared that 17 of the 63 tumors (26.9%) retained their metastatic ability in nude mice. Most of these tumors were adenocarcinomas (11/17 cases). Generally the metastatic deposits in the lungs and, to a lesser extent, in the lymph nodes were small and thus only detectable on microscopic examination. We also found a positive correlation between the presence of metastases and neoplastic infiltration of the lymphatic and/or blood vessels around the subcutaneous tumors. Metastatic human tumors, including neoplastic cells from effusion, exhibited higher metastatic ability than primary tumors (p less than 0.005). However, the expression of this metastatic potential depends on several factors including tumor volume, survival time after inoculation and murine hepatitis infection. Thus, animals with metastases bore larger tumors (9.56 cm3) than those without metastasis (6.35 cm3; p less than 0.0001). Moreover, survival time after inoculation was longer in mice with metastases (104 days) than in mice without metastases (81 days; p less than 0.0001). A negative influence of viral hepatitis on the incidence of metastases was observed. This may simply be related to the shortened life span of the animals. Death due to this infection may precede the expression of the metastatic potential.

Animals↗
PubMed1983

[Effects of the PETN-piridoxylate combination in the long-term treatment of cardiac failure in the aged patient].

Vasodilator treatment with long-activity nitrate derivatives intensifies the effects of treatment with digitalis and diuretics in left ventricular insufficiency. The object of this study was to evaluate, in an open comparative trial, the clinical effects of a prolonged adjunctive treatment with Mycoril, which is composed of a sustained-release nitrate derivative (pentaerythrityl tetranitrate: PETN) and an antianoxic agent (piridoxilate). The study was conducted in 90 patients with cardiac insufficiency who were treated and followed-up for at least one year. Study patients were divided into two groups matched for age, sex and etiology. The control group (42 patients) received digitalis and diuretics; the treatment group (48 patients) was given digitalis, diuretics and Mycoril in a daily dose of 4 to 6 capsules. The results show a significant improvement of symptoms in patients with ischemic cardiac insufficiency treated with Mycoril (83%) compared with the control group (52%) (p less than 0,03). Diuretics were needed in lower doses or withdrawn in a significantly higher number of patients in the Mycoril group (67%) than in the control group (38%) (p less than 0,01). This study provides clinical confirmation of the value of adjunctive treatment with a product such as Mycoril in patients under digitalis and diuretic therapy.

Aged↗
PubMedDate not supplied

[Renal microscopic hematuria in rheumatoid polyarthritis].

In a retrospective study of 162 cases of rheumatoid arthritis we found that 24 patients (14.8%) had presented with microscopic haematuria with or without proteinuria. Renal biopsy had been performed in 15 of these 24 patients. Apart from the classical lesions of extramembranous glomerulonephritis, amyloidosis and interstitial nephritis, 60% of histological results showed lesions of mesangial glomerulonephritis. These lesions seemed to be independent of maintenance treatments, but they might have been facilitated by the chronic inflammation kept going by the rheumatoid disease itself.

Adult↗
PubMedDate not supplied

[Pneumorenal syndrome induced by d-penicillamine: Goodpasture's syndrome or microscopic polyarteritis?].

Diffuse alveolar haemorrhage associated with glomerulonephritis is a rare but serious complication of d-penicillamine therapy. A case is reported which illustrates the usefulness of bronchoalveolar lavage and kidney needle biopsy for the early diagnosis of this condition. A search for antiglomerular basement membrane antibodies in serum was negative, whereas antigranulocyte cytoplasmic antibodies were present. These immunological results differentiated the disease from Goodpasture's syndrome to which it is clinically related and placed it in the same category as microscopic polyarteritis. After treatment with corticosteroids, cytostatic drugs and plasmapheresis, the outcome was favourable in contrast with the usually poor prognosis.

Aged↗
PubMedDate not supplied

[Alveolar hemorrhage, glomerulonephritis and anti-cytoplasmic polynuclear antibodies].

The value of antineutrophilic cytoplasmic antibodies (ANCA) was assessed in the diagnosis and chronic treatment of 7 patients with microscopic polyarteritis or Wegener's granulomatosis. All patients had oligoimmune glomerulonephritis with segmental and focal necrosis and presented with anaemia. Five of them had alveolar haemorrhage with haemoptysis and infiltrates at radiography. ANCA were assayed by indirect immuno-fluorescence on ethanol-fixed neutrophils and were strongly positive, with a cycloplasmic aspect in 5 cases and a perinuclear aspect in 2 cases. Initial remission with fall in ANCA titres was obtained with corticosteroids, cyclophosphamide and sometimes plasmapheresis (5 patients), but frequent relapses with re-elevation of ANCA titre occurred when treatment was reduced. It is concluded that ANCA are very helpful in the diagnosis of systemic vasculitis, notably in cases with first-time alveolar haemorrhage. They also facilitate monitoring and therapeutic decisions, since relapses are frequent.

Aged↗