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Biomedical subjects

M Godin

Publications and source records attributed to M Godin.

At least 91 records · Page 5Linked to original sources
PubMed1986

[Acute systemic lupus erythematosus after thymectomy for myasthenia. Sequential study of lymphocyte subpopulations].

A 35 year-old woman developed severe systemic lupus erythematosus 9 years after thymectomy for myasthenia gravis. "Seric Thymic Factor" (STF) was low; T helpers subset, T helpers/T suppressors ratio and to a lesser extent T suppressors subset were decreased. Suppressor cell function investigated by Concanavaline A lymphocyte reactivity was low. Under cyclophosphamide, plasmapheresis and steroids all clinical and biological symptoms improved but STF remained low; T helpers, T suppressors subsets and T helpers/T suppressors ratio increased but did not reach the normal range. Statistical and immunological arguments suggest that the association between systemic lupus erythematosus and myasthenia gravis did not occur only by chance. Moreover, thymectomy might have played a role by decreasing the number and function of some subpopulations of lymphocytes.

Acute Disease↗
PubMed1986

[Renal complications of anti-cancer chemotherapy].

This review is not intended as a complete study of the nephrotoxicity of chemotherapy agents used in the treatment of cancer. The number of these drugs that are cytotoxic has considerably increased in the last few years and our information is incomplete for many of them. We therefore reviewed the observations reported in the literature. Cis-platinum, streptozotocin, methotrexate at high doses, mithramycin and mitomycin are highly nephrotoxic. Other drugs, such as nitrosoureas, celiptium are less nephrotoxic while some appear to rarely induce nephrotoxicity. Anticancer drug nephrotoxicity is characterized by its particular insidiousness, its time of occurrence and its evolution. Since no clinical manifestations accompany the lesions, nephrotoxicity must be sought routinely. It can occur early or late, may be constant as of the first course or appear only after a certain cumulative dose and even occasionally after such a long interval that its cause may appear to be in doubt. The severity of this nephrotoxicity ranges from the usual first minor urinary anomalies to terminal renal failure. The pathophysiogenic mechanisms of the nephrotoxicity remain in most cases obscure. The mode of penetration into the cells is not known. There are fewer data on the interaction between the toxic agent and the cellular metabolism. In most cases, the drug itself in unchanged form does not seem to be the causative agent, which appears rather to be its metabolite. These metabolites are not always identified. Thus nephrotoxicity of antitumoral agents has not been given sufficient attention. Only better knowledge of their action within the kidney will eventually lead to progress in preventing their harmful side effects.

Alkylating Agents↗
PubMed1985

Vegetating iodides after an intravenous pyelogram.

A 68-year-old woman treated by hemodialysis for chronic renal failure received 30.4 g iodine for an intravenous pyelogram. Three days later, she was covered by aseptic pustules which quickly evolved into vegetating masses on the face. Skin pathology showed dermo-epidermal necrosis with dermal polymorphonuclear infiltrates, sometimes pycnotic, and necrotizing vasculitis. Serum iodine was far above normal values. Hemodialysis and local care resulted in good healing within 1.5 month. Four similar cases occurring in patients with renal failure are mentioned in literature.

Acute Kidney Injury↗
PubMed1985

[Glomerulonephritis secondary to ventriculo-atrial shunts].

The authors report the case of a 45 year old man who had undergone a ventriculo-atrial CSF shunt procedure 5 years previously for normal pressure hydrocephalus and who had several unexplained episodes of infection over a 12 months period and has now developed a mixed nephrotic syndrome associated with a septicaemia. Corynebacterium commensale and Staphylococcus epidermis were isolated from the valve culture. Ablation of the valve resulted in clinical cure with minimal functional renal sequellae. The initial renal biopsy showed type I proliferative glomerulonephritis with subendothelial deposits of complement and immunoglobulins, which did not completely regress after 3 months' evolution. The serum complement fractions suggested activation of the alternate pathway and the possible pathogenic role of circulating immune complexes.

Antigen-Antibody Complex↗
PubMed1984

[Pharmacokinetics of azlocillin in chronic renal failure and hemodialysis patients].

The pharmacokinetics of azlocillin were studied in 16 patients with varying degrees of renal impairment (creatinine clearance Ccr ranging from 0 to 52 ml/min/1.73 m2) and on and off sessions in 4 of these patients on periodical haemodialysis. A single dose of azlocillin 80 mg/kg was given by intravenous infusion over 30 min. Maximum concentrations in the sera of patients with renal impairment were the same as in normal subjects, ranging from 300 to 400 micrograms/ml. The elimination half-life (t 1/2) increased as renal function deteriorated, with values of 1.11 h in subjects with healthy kidneys to 5.66 h in patients with Ccr less than 15 ml/min (maximum 8.38 h). The apparent volume of distribution (Vd) was unchanged in patients with renal impairment but was significantly increased in patients on haemodialysis. The mean percentage of the dose administered excreted in the urines decreased from 60-70% in normal subjects to about 11% in patients with severe renal failure, but urinary concentrations remained above therapeutic levels. The extra-renal elimination of azlocillin was unmodified by renal impairment. Azlocillin is easily removed by dialysis: t 1/2 values between and during 6 h sessions of haemodialysis were 6.55 h and 2.81 h respectively, corresponding to a 45.8% extraction on the dialyser. These results are comparable to those found in the literature and can be used as a basis for adjusting azlocillin dosage to the degree of renal function.

Adolescent↗
PubMed1983

Pharmacokinetic aspects of guanfacine withdrawal syndrome in a hypertensive patient with chronic renal failure.

The unusual observation of a withdrawal syndrome due to guanfacine in a hypertensive patient with chronic renal failure led to a study of the kinetics of the drug in this patient. The principal pharmacokinetic parameters of guanfacine were greatly altered, with extended biotransformation and a decrease in the half-life compared to the values observed in other cases of severe renal insufficiency. Associated treatment with phenobarbital had had a considerable effect, as shown by the results of a further kinetic study 2 months after withdrawal of the phenobarbital. The findings then were in good agreement with reference values which strongly suggests a consequence of the enzyme inducing effect of phenobarbital. Advice about the dosage regimen in such cases is given.

Female↗
PubMed1983

Pharmacokinetics of temocillin (BRL 17421) in subjects with normal and impaired renal function.

The pharmacokinetics of temocillin were investigated in five normal subjects and in 20 uraemic patients. Normal subjects were given single intravenous doses of 3.75, 7.5 and 15 mg/kg of temocillin and a single intramuscular dose of 7.5 mg/kg. Patients with renal impairment were given 7.5 mg/kg of the antibiotic intravenously. A three-compartment open model was used to calculate kinetic data after iv administration. Pharmacokinetic parameters of temocillin were similar both for the three iv doses and for the im dose. The terminal serum half-lives (T1/2 beta) averaged 4.75-5.88 h. The central distribution volume (Vc) and the apparent volume of distribution (Vd area) were 0.093-0.111 and 0.268-0.303 l/kg, respectively. Renal and total body clearances were within 27.4-34.1 and 40.2-47.8 ml/min/1.73 m2, respectively. 67.4-71.5% of the dose was recovered unchanged in urine over 24 h. Intramuscular dosing of 7.5 mg/kg gave a mean peak level of 26.71 mg/l at 1.67 h. In uraemic patients, similar maximum serum concentrations were found after a single 7.5 mg/kg iv dose. The terminal half-life increased according to the degree of renal failure, from 5 h in normal subjects to about 30 h in severe uraemic patients. Renal impairment did not significantly modify Vd area, fractional clearance (Cr/GFR) and non renal clearance. 65.2% of the antibiotic was removed during haemodialysis. Dosage adjustments of temocillin in uraemic patients are proposed.

Adult↗