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Biomedical subjects

L Guillevin

Publications and source records attributed to L Guillevin.

At least 379 records · Page 21Linked to original sources
PubMed1985

Treatment of progressive systemic sclerosis using factor XIII.

A double-blind, randomized crossover trial was carried out in 25 patients with progressive systemic sclerosis to compare the effectiveness and tolerability of treatment with Factor XIII with that of placebo. Patients received twice daily intravenous injections of either Factor XIII or placebo for 3 weeks and, after a wash-out period of 6 weeks, were crossed over to the alternative medication for a further 3 weeks. Assessments made by the physician and patients at the end of each treatment period indicated that Factor XIII was significantly better than placebo in improving the cutaneous manifestations of the disease and these opinions were supported by the significant improvement in the function index which was used to assess the degree of motor disability. Both local and general tolerability of Factor XIII treatment was good and there were no adverse reports.

Clinical Trials as Topic↗
PubMed1985

Hydergine pharmacokinetics in the elderly.

The pharmacokinetics of Hydergine was studied following intramuscular administration in a group of 6 subjects aged 76-86 and following oral administration in 6 subjects aged 66-86. Comparison with a control group of healthy volunteers (average age of 25) showed: --a marked reduction (- 50%) in renal clearance (p less than 0.001), related to the decrease in creatinine clearance in this population; --a lowering (- 30%) in metabolic clearance (p less than 0.02) in elderly subjects probably related to the decrease in hepatic blood flow observed with age; --a marked increase in bioavailability (X 2.5) following oral administration in elderly subjects, due either to increased absorption, or to a decreased hepatic first-pass effect. These results underline the value of studying the kinetics of geriatric drugs in the target population.

Administration, Oral↗
PubMed1984

[Necrotizing angiitis with or without asthma. Clinical, biological and etiological differences. Role of hepatitis B virus].

Sixty-five cases of necrotizing angiitis, including 20 with asthma (group A) and 45 without asthma (group B) were studied retrospectively. All patients were investigated for markers of hepatitis B, at least the HBs antigen. Skin lesions and arthralgias were more common in group B patients. Eosinophilia during angiitis was almost constant in group A and was observed in only 6% of group B patients. Renal involvement, hepatic lesions and arterial hypertension seemed to be more frequent in group B but the difference was not significant. The HBs antigen was present in 1/20 patients of group A and in 17/45 patients of group B (p less than 0.01). The anti-HBs antibody was found with equal frequency in both groups. The clinical and biological differences observed between these two groups of patients strongly suggest that necrotizing vasculitis with and without asthma are two separate nosological entities and in particular, that they have different causes.

Adolescent↗
PubMed1984

[Systemic periarteritis nodosa associated with monoclonal gammapathy. 4 cases].

Four cases of monoclonal gammopathy associated with polyarteritis nodosa are reported. In view of the chronology of events and course of the disease, the connections between protein peak and polyarteritis nodosa can be considered. Management of polyarteritis nodosa is discussed according to the existence of a peak which may originate in myeloma. The part played by plasma exchanges is debated.

Aged↗
PubMed1984

[Cushing's syndrome: a diagnostic strategy].

Biologic and radiologic investigations in the diagnosis of Cushing syndrome are evaluated. A two-step diagnostic procedure is propounded. The combination of absence of overnight suppression of plasma cortisol by dexamethasone and elevation of urinary free cortisol and midnight plasma cortisol levels establishes the diagnosis of Cushing syndrome in most patients. The next step is to determine the precise cause of Cushing syndrome by baseline plasma ACTH assays, the high-dose dexamethasone test and the visualization of the adrenals by iodocholesterol scintigraphy and/or computed tomography.

17-Hydroxycorticosteroids↗
PubMed1984

[Periarteritis nodosa and viral hepatitis B, conjugal forms. Apropos of 4 cases].

Four cases of periarteritis nodosa (PAN) associated with HB virus are reported in three couples. The spouse also had periarteritis nodosa (cases 1 and 2) or had hepatitis B (spouses of cases 3 and 4). These observations underscore the part played by conjugal transmission of HB virus and the risk of secondary PAN. Such observations are uncommon as the four reported cases occurred among a group of 95 PAN patients. Nevertheless, they are additional evidence in support of the role of HB virus which is associated with PAN in 45% of cases in this series.

Adult↗
PubMed1984

[Association of Horton's disease and periarteritis nodosa. Apropos of 3 cases].

Three cases of giant cell arteritis associated with periarteritis nodosa are reported. A review of the literature showed 16 similar reports. Giant cell arteritis features in temporal arteries were associated with periarteritis features in visceral or peripheral arteries in 5 cases only. Association of these two conditions seems to be uncommon and may be coincidental but does not justify including giant cell arteritis within the group of necrotizing angiitis. Awareness of this association nevertheless has practical implications as these cases should be treated as PAN patients.

Aged↗
PubMed1984

[Retroperitoneal seminoma without testicular lesion. A case report and review of the literature].

The case of a 54-year-old man with a retroperitoneal seminoma and normal testes is reported. Diagnosis was established late, when the tumor had become large and inoperable and produced symptoms of subocclusion. Onset of gynecomastia, an uncommon occurrence, had been recorded two years earlier and should have given rise to suspicion. The tumor was a histologically unmixed seminoma with very significant beta-HCG secretion. A chemotherapy-radiotherapy combination produced dramatic improvement. From data from a review of the literature, pathogenesis, diagnosis and management of this uncommon type of seminoma are discussed.

Chorionic Gonadotropin↗
PubMed1984

[Mesenteric and retroperitoneal fibrosis. A case report. Review of the literature].

The authors report a case of combined mesenteric and retroperitoneal fibrosis resulting in vascular and digestive compressions. Diagnosis was established by laparoscopy and biopsy. No etiologic factors were found. Such an association is exceptional and suggests that the disease is systemic. The possibility of fibrosis arising far from the mesenterium (mediastinum, extrahepatic biliary tract, thyroid, orbit) has led some authors to suggest that this condition be termed Idiopathic Systemic Fibrosis. An immunologic origin has been speculated in the literature.

Colonic Diseases↗
PubMed1984

[Treatment of human brucellosis with rifampicin].

Rifampin, which exhibits good intracellular diffusion and in vitro bactericidal activity on brucella, is effective in experimental brucellosis in mice, without selection of resistant strains. It was therefore legitimate to use rifampin in man since conventional treatment of acute brucellosis is followed by recurrence in 15% (tetracycline alone) or 3.7% (streptomycin-tetracycline combination) of cases. Rifampin was given to 13 patients with brucellosis (acute brucellosis in 8, osteoarticular brucellosis in 3 and chronic brucellosis in 2). Rifampin was given as sole therapy in a daily dosage of 600 to 1 200 mg. A tetracycline was subsequently needed in three cases, in combination with rifampin in two, and as replacement therapy in one. Treatment lasted 20 to 60 days in acute brucellosis and 2 to 15 months in other forms. Only one failure was recorded among the 11 cases of acute or localized brucellosis. Conversely, effectiveness of rifampin proved incomplete (1 case) or null (1 case) in chronic forms. The satisfactory effectiveness of rifampin is confirmed by a review of the literature which found 17 reports addressing the subject. These include 324 cases of brucellosis treated by rifampin, as sole therapy in 255 patients, with only 24 failures ascribable to faulty dosage. Indeed, rifampin must be given for at least 30 days, in a minimal daily dosage of 600 mg or 10 mg per kg, in a single dose. Cotrimoxazole is an antagonist and should not be associated with rifampin. Conversely, tetracyclines are synergistic and their association, which is useless in acute brucellosis, is helpful in localized and chronic forms.

Acute Disease↗
PubMed1984

[Arterial hypertension in periarteritis nodosa. 37 case reports].

Hypertension in periarteritis nodosa poses the problem of aetiology, prognostic significance and treatment. Thirty seven cases of periarteritis noda with hypertension were analysed with à follow-up of over 10 years. These cases were taken from a series of 91 patients with polyarteritis nodosa admitted to the Department of Internal Medecine at the Pitié Hospital, between 1960 and 1980. Hypertension was observed on admission in 40% of the patients and developed during the first year of the disease in another 40%. The prognosis of patients with polyarteritis nodosa and hypertension is not significantly different from those without hypertension during the first six years. The overall prognosis depends mainly on the degree of renal involvement. The hypertension is renovascular in a number of cases due to ischaemia of the renal cortex. This was demonstrated by renal arteriography or by evaluating plasma renin activity in the renal veins. In some cases, especially those in which the hypertension preceded the periarteritis nodosa, the hypertension seemed to progress independently. In some cases, however, it was not possible to determine the relationship between the periarteritis nodosa and the hypertension or confirm that this association was coincidental. The use of angiotensin I converting enzyme inhibitors is an important advance in the treatment of the hypertension of periarteritis nodosa with high plasma renin activity as it counteracts the exact mechanism of the hypertension. Their use is justified in high plasma renin activity hypertension of periarteritis nodosa; patients who fail to respond may be treated with betablockers or other antihypertensive drugs.

Adolescent↗
PubMed1984

[Peripheral nervous system and panarteritis nodosa. Review of 27 cases].

Twenty-seven cases of panarteritis nodosa (PAN) with peripheral neuropathy are reported. Diagnosis was based on pathological criteria of necrotizing vasculitis in 20 patients (group I) and on clinical, biological and sometimes arteriographic data in 7 (group II). The 27 patients (18 women and 9 men), aged between 30 and 78 years (mean: 53.4 years), presented either a mono- or multineuropathy (8 cases), a polyneuropathy (17 cases), or sensory symptoms (2 cases). A neuropathy was the initial feature of the PAN in 15 cases. The CSF, examined in 16 cases, was always normal, and results of electrophysiological investigations constantly suggested the presence of an axonal neuropathy with normal motor nerve conduction rates. Other signs of PAN included fever (81 p. 100 cases) and loss of weight (74 p. 100). The ESR was increased in 70 p. 100 cases and hypereosinophilia was present in 33 p. 100. Quantitative pathology in 13 cases from group I revealed typical findings, and associated microvasculitis in 4 cases. The outcome was fatal in 13 cases while 12 recovered and have been followed up for from 1 to 14 years.

Adrenal Cortex Hormones↗