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Biomedical subjects

L Guillevin

Publications and source records attributed to L Guillevin.

At least 415 records · Page 23Linked to original sources
PubMed1982

[Clinical aspects, outcome and prognosis of Horton's disease. Retrospective study of 47 cases].

The authors report their experience of Horton's disease in 47 histologically confirmed cases treated between 1966 and 1979. The symptomatology is recalled with the incidence of the various clinical and biochemical signs. The actuarial survival curve shows a 71.2 p. cent three year and a 61 p. cent five year survival rate. There was no statistically significant difference at three years with a control population. The duration of maintenance therapy was, on average, of 24.8 months, never less than 15 months and sometimes reaching 60 months. The average maintenance dose was 12 mg. Specific and non-specific complications are discussed. The incidence of refractory and cortico-dependent forms shows that the optimal treatment for this disease has yet to be found; the often brilliant initial results of corticotherapy do not reflect its long-term efficacy.

Adult↗
PubMed1981

[Cardiac involvement in systemic lupus erythematosus. 103 cases (author's transl)].

One hundred and three cases of systemic lupus erythematosus (SLE) were reviewed after a period of up to 10 years. The pericardium was involved in 27%, the endocardium in 23% and the myocardium in 14.5% of the cases. Arrhythmia was rare and usually accompanied pericardial or myocardial lesions. Conduction disorders were present in 14.5% of the patients. Atrioventricular block often occurred long after the acute phase of SLE, and synthetic antimalarial drugs appear to be responsible for their development. Whether or not SLE affects the heart, the prognosis is the same during the first ten years of the disease.

Adult↗
PubMed1981

[Efficacy of captopril in periarteritis nodosa with arterial hypertension and renal failure (author's transl)].

In a patient with periarteritis nodosa failure of antihypertensive treatment with beta-blockers and diuretics encouraged the authors to use captopril in doses of 150 mg per day. Blood pressure rapidly returned to normal levels. The hypotensive effect of captopril is ascribable to its action on the renin-angiotensin system, since plasma renin activity was particularly high in this patients.

Angiotensin I↗
PubMed1981

[Periarteritis nodosa associated with hepatitis B virus. 42 cases (author's transl)].

HBs antigen was detected by immunodiffusion or radioimmune assay in the blood of 19 out of 42 patients with periarteritis nodosa examined between 1970 and 1978. Histological or biochemical signs of hepatitis were present in 6% of HBs--positive patients and 1% of HBs-negative patients. The incidence of clinical symptoms was similar in both groups, except for multiple neuritis, which was much more frequent in HBs-positive patients (89%) than in HBs-negative patients (52%; p less than 0.001), suggesting a close relationship between neuritis and HBs and HBs antigen. There was a negative correlation between myalgias and skin lesions and the presence of the antigen. The prognosis of periarteritis nodosa was similar in both groups. The course of the disease seemed to be more prolonged in HBs-positive patients, but there was no significant difference in mortality rate.

Adult↗
PubMed1981

Effects of captopril on blood pressure, electrolytes, and certain hormones in hypertension.

Short-term hypertensive and hormonal effects of captopril were studied in 26 hypertensive patients. Blood pressure (BP) and heart rate were recorded in subjects in the supine position 1 hr before and 3 hr after an oral dose of 1 mg/kg. Urinary, plasma electrolytes, plasma renin activity (PRA), and plasma aldosterone (PA) were determined before and after the test. It was verified, in a preliminary investigation involving 5 patients, that a placebo did not alter the measured parameters. Captopril decreased mean arterial pressure (mean ABP +/- SD) from 128 +/- 2.5 to 108.5 +/- 2.6 mm Hg (p less than 0.001); the maximum decrease was between 30 and 180 min. No changes in heart rate or plasma electrolytes were noted. PRA increased after captopril from 2.29 +/- 0.96 to 3.13 +/- 1.25 and to 4.11 +/- 1.87 at 1 hr and 3 hr (p less than 0.05). There was a correlation between PRA in standing subjects before captopril and decrease in mean ABP (r = 0.59, p less than 0.01). The best correlation was between the decrease in mean ABP and the maximum increase in PRA after captopril (r = 0.69). A good correlation was found between mean ABP and PRA 3 hr after captopril (r = 0.62). Correlation coefficients between decrease in mean ABP and either precaptopril PA or decrease in PA were not significant. In 14 patients, captopril (5.1 +/- 0.61 mg/kg/day) for 4 mo induced the same decrease in mean ABP that was observed during the test. After short- and long-term captopril, mean ABP correlated (r = 0.76, p less than 0.01).

Aldosterone↗
PubMed1981

[Disorders of conduction in lupus erythematosus : frequency and incidence in a group of 112 patients (author's transl)].

A retrospective study of 112 cases of lupus erythematosus, 103 acute disseminated lupus erythematosus (ADLE) and 9 chronic discoid lupus (CDL), was conducted to determine the incidence of disorders of conduction (DC), and to study their prognosis and discuss their pathogenicity. The mean age of the group was 38 +/- 16 years, and the mean follow-up period after discovery of the DC was 53 months. Cardiac lesions were present in 49.5 p. cent of the 103 patients with ADLE : pericarditis in 27 p. cent, murmur from lupus endocarditis or cardiomyopathy in 23 p. cent, heart failure in 4.8 p. cent, and hypertension in 17 p. cent. Disorders of conduction were present in 18 (17.5 p. cent) of the 112 patients studied. These included 5 partial right bundle-branch blocks (no complete right bundle-branch block), 2 complete and 3 partial left bundle-branch blocks, 5 complete, 2 first degree, and 1 second degree atrioventricular blocks (AVB). The atrioventricular blocks were usually located in the truncal or fascicular regions, but in 2 cases they were nodal in origin. The 5 complete AVB were associated with ADLE in two cases and CDL in the three other cases. The AVB in the ADLE cases appeared 9 to 20 years after the onset of the lupus, these two patients developing pericardiomyocarditis unaccompanied by disorders of conduction. The three complete AVB occurring during CDL were detected 9 to 18 months after the diagnosis. A fatal outcome was noted in 13 (12.5 p. cent) of the ADLE patients and one of the 9 cases of CDL. Ten-year survival curves showed no difference in prognosis for the groups with or without disorders of conduction, but mortality increased in patients with DC after 10 years. As disorders of conduction were more frequently observed in patients with lupus than in a control population, they can be attributed to either a lupus myocarditis or prolonged administration of synthetic antimalarial agents. Disorders of conduction, and particularly complete AVB are, in fact, observed in patients without pericardiomyocardial lesions, and when they exist usually develop a long time after the onset of the cardiac lesion. All patients had been treated with antimalarials, however, and the onset of the DC was associated with a chloroquine myopathy in some of them. Three of the five complete AVB were observed during the course of CDL in patients without cardiac lesions, this being a supplementary argument for implicating synthetic antimalarials.

Adult↗
PubMed1980

[Treatment of neurogenic orthostatic hypotension by an association of tyramine and a monoamine oxidase inhibitor (author's transl)].

Metabolic and hormonal tests to assess plasma renin, aldosterone, and catecholamine activity were conducted in three patients with idiopathic orthostatic hypotension. Blood pressure readings were then taken in decubitus and orthostatism during treatment with 10 to 15 mg of tyramine and 30 mg of tranylcypromine. Marked functional improvement was observed, with an increase in mean blood pressure in decubitus and a less marked reduction in orthostatism avoiding the onset of severe discomfort. Therapeutic indications are limited, however, because of a possible hypertensive response.

Aged↗
PubMed1979

[Polyarteritis nodosa with ureteric stenosis. Two cases (author's transl)].

In two cases, surgical exploration fully confirmed that ureteric stenosis was related to PAN. There are four cases of this association in the litterature but it is probable that the frequency of such stenosis is underestimated: amongst 75 patients being treated for PAN in our department, only 11 underwent intravenous urography, 10 being abnormal.

Adult↗