Search PubMed⌕ Search

Biomedical subjects

M Audran

Publications and source records attributed to M Audran.

173 records · Page 10Linked to original sources
PubMedDate not supplied

[Cortisone-induced osteoporosis: from physiopathology to treatment].

Corticosteroid-induced osteoporosis, the principal cause of "secondary" osteoporosis, is usually observed in patients under prolonged systemic corticosteroid therapy and results from the multiple effects exerted by these drugs on bone cell metabolism. Corticosteroids reduce the intestinal absorption of calcium and its tubular reabsorption, thereby negativating the calcium balance and inducing a parathyroid reaction. This reaction is responsible for an increase in bone cell remodelling, but the main manifestation of the direct effect of corticosteroids on bone is osteoblast depression, so that there is disparity between bone resorption and formation, which in turn is responsible for bone tissue deficit. Sex hormone deficiency (due to menopause or treatment) and lack of physical activities (due to the causal disease or to iatrogenic myopathy) amplify bone rarefaction. By quantifying the bone loss, modern densitometry methods provide an early risk evaluation. Osteoporosis of varying intensity exposes some 20% of patients to fractures, vertebral collapse and rib fractures. Preventive measures are always recommended, including minimal effective dose corticosteroid therapy, sodium-free diet, calcium and vitamin D supplement, sex hormone replacement and pursuance of physical activities. Once the stage of fractures by osteoporosis has been reached, the "curative" treatment aims at reducing the incidence of new fractures, either by slowing down osteoclast resorption, or by restoring the bone tissue reserve through stimulation of the osteoblasts. The usefulness of these therapeutic measures in the preventive treatment of corticosteroid-induced osteoporosis remains controverted.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[The natural development of osteoporosis. 30 patients with a median follow-up of 11 years].

The authors present a sketch of the natural development of osteoporosis based on a retrospective study over a mean period of eleven years of 30 osteoporotic subjects (23 females, 7 males) who had received little or no treatment. Development was rapid during the three years following diagnosis, as was shown by the annual number of attacks of acute spinal pain, months of functional handicap and vertebral compression fractures, as well as by changes in size and the two vertebral radiologic indices used. Development slowed after the fourth year, but subsequent deterioration was unaffected. This spontaneous change seemed to depend less on etiological factors than on a decrease in bone mass to below the threshold at which fractures may develop. Slowed development of osteoporosis after the fourth year appeared to be due to an adaptation of the subject's way of life to the fragility of the spine. The results of treatment and monitoring of three years or less should be viewed in light of this slowed osteoporotic development.

Activities of Daily Living↗
PubMedDate not supplied

[The effects of synthetic 1-34 fragment of human PTH on kidney and bone receptors in man. Use of the Ellsworth-Howard test].

The authors propose to study parathyroid hormone receptors in humans by means of a test "inspired by the Ellsworth-Howard test" using the active synthetic 1-34 fragment of the hormone PTH-1-34. The use of this test in 44 patients (29 healthy subjects, 7 patients with idiopathic hypercalciuria 5 cases of Paget's disease, 1 patient with idiopathic hypoparathyroidism, 2 cases of basal cell nevus syndrome) who received different doses of this substance intravenously, revealed a marked dose-dependent stimulation of adenyl-cyclase as objectified by an increase in urinary excretion of cyclic AMP (AMPcU). Distal tubular calcium reabsorption was also significantly affected as demonstrated by a decrease in urinary calcium in the first hours following administration of the 1-34 fragment even in the case of idiopathic hypercalciuria. In comparison to the "classical" Ellsworth-Howard test, however, no significant urinary phosphate response was observed during the present test. Similarly, urinary hydroxyproline and phosphate and calcium blood levels remained stable. As the results obtained for the case of hypoparathyroidism demonstrate, this easily performed test is useful for valuating parathormone receptors in kidney by means of two sensitive parameters (AMPcU and the ratio of fractional urinary calcium to urinary creatinine). In addition to its action, synthetic fragment h PTH-1-34 offers the advantage of being totally innocuous.

Bone and Bones↗
PubMedDate not supplied

Inhospital management of common lumbosciatic syndrome. An opinion survey among French rheumatologists.

To determine which treatments are most commonly offered to patients younger than 70 years of age admitted for uncomplicated lumbosciatica suggestive of disk herniation, we sent a 43-item questionnaire to 106 rheumatology departments in France. The questionnaire collected information on hospital stay duration, modalities of rest, drug treatments, local glucocorticoid injections, physical treatments, sick leave duration and advice given to the patients. The response rate was 77% (84 questionnaires). Substantial variations were found across departments. Hospital stay duration ranged from five to 20 days and nonsteroidal antiinflammatory drug treatment duration from five to 30 days. Local glucocorticoid therapy was given as one to four injections at intervals of two to seven days. Spinal traction was used in 38% and a corset in 50% of study centers. Neither was there any consensus regarding immediate or delayed physiotherapy. Most respondents recommended bedrest for no longer than 15 days, a nonsteroidal antiinflammatory drug, a level I or II analgesic, local glucocorticoid injections and, in the event of persistent pain at the end of the hospital stay, a lumbar corset.

Aged↗