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Biomedical subjects

M Bernat

Publications and source records attributed to M Bernat.

At least 37 records · Page 2Linked to original sources
PubMed1981

Osteoarticular complications in bismuth encephalopathy.

The authors have observed 59 cases of bismuth encephalopathy between 1972 and 1979. Eight female patients in this group showed osteoarticular lesions confined exclusively to the thoracic vertebrae and the humerus. These lesions included six cases with fractures of the surgical neck of the humerus, bilateral in two patients, three cases with spine fracture, and osteonecrosis of the humeral head in five cases. These lesions were seen predominantly in the severe and chronic myoclonic and convulsive forms of the disease. Intraspongy microfractures due to the intense and repeated myoclonia could explain osteonecrosis. It has been suggested that bismuth facilitates the modification of the bony tissue; however, the evidence remains inconclusive as there are few anomalies of phosphocalcic metabolism.

Adult↗
PubMed1981

[Correlation between osteoporosis and discarthrosis. Comparative frequency of spinal osteophytosis and thickness of intervertebral disk in 50 patients with osteoporosis confirmed by bone biopsy and in 50 controls. Study of lordosis in 50 osteoporotic patients].

Comparative radiological study of the spine in 50 osteoporotic subjects selected on double criteria, radiological and histological, and 50 control subjects of the same age and same sex, confirmed the lesser frequency and the mildness of the osteophyte formation, and the disk degeneration in osteoporotic subjects. The vertebral radiological index, which measures both the number and importance of the vertebral body surface concavity and vertebral collapse, and has no significant correlation with age. A study of the degree of lordosis and of the index of bending of the trunk was carried out in 50 osteoporotic patients. Only one third of them had lumbar hyperlordosis. Owing to its inconstancy, lumbar hyperlordosis cannot be considered as responsible for the mildness of the osteophyte formation in osteoporotic patients. It seems reasonable to admit that the mildness of the osteophyte formation and of the osteoporosis are linked together and are probably the result of a reduced capacity of bone formation.

Aged↗
PubMed1980

Anabolic effect of human parathyroid hormone fragment on trabecular bone in involutional osteoporosis: a multicentre trial.

After baseline studies, 21 patients with osteoporosis were treated with human parathyroid hormone fragment (PTH 1-34) given as once-daily subcutaneous injections for 6-24 months. The dose used did not cause hypercalcaemia even in the first few hours after injection. Calcium and phosphate balances improved in some patients, but there was no significant improvement in the group values. There were, however, substantial increases in iliac trabecular bone volume: the mean increase, confirmed by repeat blind measurements, was 70% above mean baseline volume. The new bone was histologically normal. Those patients who had the largest increases in 47Ca-kinetic and histomorphometric indices of new bone formation showed the greatest increases in trabecular bone volume, suggesting that treatment with human parathyroid hormone fragment caused a dissociation between formation and resorption rates that was confined to trabecular bone. Since vertebrae are four-fifths composed of trabecular bone, this hormone fragment may prove useful in treating patients with the crush fracture syndrome.

Aged↗
PubMed1980

[Hyperparathyroidism secondary to cirrhosis. Arguments supplied by ionized calcium, urinary cyclic AMP and blood N-terminal parathyroid hormone].

A laboratory study including estimation of 25 OH vitamin D, terminal parathormone (PTH) C and N fractions, urinary cyclic AMP (AMP cU) and ionised calcium, was carried out in 25 patients, 10 cases of alcoholic cirrhosis without decompensation (group 1) and 15 cases of decompensated cirrhosis (group 2) in order to seek evidence in favour of hyperparathyroidism secondary to cirrhosis. The results show: 1) The existence of hypovitaminosis D which seems to be independent of the liver failure. 2) A very definite increase in terminal PTH N in group 2 compared with group 1 (p < 0.01), without any increase in terminal C fraction. 3) An insignificant increase in urinary cyclic AMP in group 2 compared with group 1. 4) A low serum ionised calcium in group 2 compared with 14 controls (p < 0.05). The terminal N PTH was correlated significantly with urinary cyclic AMP and ionised calcium. The evidence is in favour of secondary hyperparathyroidism where the ionised calcium plays a role, but one wonders whether other factors do not intervene, e.g. serum iron, owing to the discovery of a significant link between serum iron and terminal N PTH levels.

Adult↗
PubMed1980

[Calcium metabolism study performed by means of Ca-45 in bone diseases and idiopathic hypercalciuria].

The authors analyse the results obtained during 54 radioisotope investigations using 45Ca in 13 cases of idiopathic hypercalciuria, 12 cases of osteoporosis, 3 cases of Paget's disease, and 2 cases of osteomalacia including one of Fanconi's disease in an adult. In 12 patients, repetition of the radio-isotope test two, three or four times; permitted the authors to study the effects of the treatments administered: calcitonin, phosphate, vitamin D, parathormon, oestrogen. Calcitonin increases intestinal absorption and reduces bone reabsorption and also accretion. Phosphate greatly increases accretion and bone reabsorption in vitamin-resistant osteomalacia of adults. The synthetic fragment 1--34 of human parathormone increases accretion and reabsorption but does not modify the calcium balance. The addition of estrogen reduces reabsorption and slightly increases accretion in two osteoporotic patients producing a positive calcium balance. This method of investigation is of great interest to assess the effects of a drug on calcium metabolism and on the two processes of bone remodelling.

Aged↗
PubMed1979

[Contribution of dynamic isotopic tests in the study of algodystrophies].

The authors studied 20 patients suffering from algodystrophy (23 localizations) by triple scintigraphy with technetium, using pyrophosphate to study the importance of bone changes, marked red blood cells to measure the vascular volume, and pertechnetate to measure the interstitial compartment. These tests were done on the average 1.4 months after the outset of the disease. This work made it possible to demonstrate in the algodystrophy: a pronounced bone hyperfixation that was uneven according to the patients; a frank increase in the vascular volume, notably on the capillary level, and a reduction of the circulatory output (calculated on 4 distal localizations), and an increase of the interstitial compartment higher than that of the vascular volume and corresponding to the edema. These results demonstrate a circulatory stasis. In 4 patients treatment with calcitonine reduced the vascular volume but not the bone hyperfixation. In 1 patient, treatment with pindolol reduced the bone hyperfixation and the vascular volume. The authors underline the advantage of such methods in creating a better knowledge of the physiopathology of algodystrophies and effective means of treating them.

Blood Volume↗
PubMed1979

[Scapular and vertebral osteopathies during acute myoclonic bismuth encephalopathies. Apropos of 8 cases].

Among 59 cases of bismuth encephalopathy, 8 patients were observed to have osteo-articular lesions of the shoulders and dorsal vertebral. These included osteonecrosis of the head of the humerus, which has been reported previously, uni- or bi-lateral fractures of the upper end of the humerus, and vertebral fractures. Severe and repeated myoclonic spasms appear to be capable of causing fractures; microscopic fractures in the spongy bone could explain the osteonecrotic images observed.

Adult↗