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Biomedical subjects

M Godin

Publications and source records attributed to M Godin.

At least 109 records · Page 6Linked to original sources
PubMed1983

Comparative nephrotoxicity of four aminoglycosides: biochemical and ultrastructural modifications of lysosomes.

In 1982, aminoglycosides still are widely prescribed and considered indispensable for the treatment of severe gram-negative infections. All the aminoglycosides are nephrotoxic, but both experimental works and clinical investigations indicate that they do not all have the same nephrotoxic potential. Within the renal tubular cell in several animal species and in man, the initial and the most extensive changes are those that occur in the lysosomes. We compared the effects of gentamicin, tobramycin, netilmicin and, amikacin on (a) lysosomal structural latency, (b) the activity of several enzymes, either lysosomal or those contained in the proximal tubular cell brush border, and (c) the accumulation of myeloid bodies in the lysosomes. From our results, it appears that gentamicin is the aminoglycoside that induces the greatest number of lysosomal changes whereas amikacin induces the least, with the effects of netilmicin and tobramycin quite close to those of amikacin. Other works comparing the nephrotoxicity of aminoglycosides reveal the same high nephrotoxic potential of gentamicin.

Amikacin↗
PubMed1982

[Pharmacokinetics of dibekacin in patients with chronic renal impairment].

The pharmacokinetics of dibekacin were studied in 23 patients with varying degrees of renal insufficiency. Creatinine clearance was between 4 and 51 ml/min. Chronic renal insufficiency did not affect maximum serum concentrations, nor the time required to reach a peak level after an intramuscular injection of 1 mg/kg of dibekacin. The maximum concentration was 4 to 5 mcg/ml and the peak obtained within the first hour. Renal insufficiency caused a very marked prolongation in the serum half-life of elimination. This rose from 6 hours in moderate renal insufficiency to 50 hours in a patient with a clearance of a few millilitres. Whatever the degree of renal insufficiency, it should be noted that urinary concentrations remained markedly higher than the MIC of organisms sensitive to the aminoglycoside. Dibekacin is highly dialysable, being virtually totally extracted during a 6 hours dialysis session using a membrane of 1 m2 surface area. An outline of dose adaptations in relation to the degree of renal insufficiency is suggested on the basis of these pharmacokinetic data.

Adult↗
PubMed1982

[Functional, histological, biochemical renal modifications. Comparative study of dibekacin, gentamicin, tobramycin, netilmicin and amikacin].

In this study, we evaluate the nephrotoxic potential of dibekacin (D) compared to gentamicin (G), tobramycin (T), amikacin (A) and netilmicin (N). The mean features of aminoglycoside nephrotoxicity are: a lysosomal membrane fragilization, a lysosomal phospholipidosis characterized by a decrease activity of sphingomyelinase, an increase lysosomal volume with both an increase of individual size and an increase number of lysosomes, a cell necrosis and renal failure. We have quantified these parameters biochemically and morphometrically. We can classify, considering doses and durations, the aminoglycosides as gentamicin greater than or equal to netilmicin greater than dibekacin = tobramycin greater than amikacin for decreasing nephrotoxic incidence.

Amikacin↗
PubMed1982

[Pharmacokinetics of cefotaxime and metabolites in uremic patients (author's transl)].

The study was done after a single dose in 6 normal subjects and 24 patients with varying degrees of renal insufficiency. In normal subjects, the results are similar whatever the assays are used. In uremic patients, the half-life for the terminal phase increased with renal failure with the microbioassay, but it is demonstrated that deacetyl cefotaxime has only a prolonged half - life with a more specific assay = HPLC method. After repetitive doses, the tendency for accumulation was only noted in patients with very severe renal failure (creatinine clearance less than 5 ml.min-1).

Adult↗
PubMed1981

[Pharmacokinetics of cefotaxime in patients with chronic renal impairment (author's transl)].

The pharmacokinetics of cefotaxime were investigated in 6 healthy subjects and in 22 uraemic patients with various degrees of renal insufficiency. After i.v. bolus injection of a single 15 mg/kg dose, pharmacokinetic data were calculated using a two compartment model. Serum and urine concentrations were determined by microbiological (M.A.) and HPLC assays. With microbiological assay, the elimination serum half-life (T 1/2) increased in patients according to their degree of renal insufficiency and reached 10 hours when creatinine clearance fell below 10 ml.min-1. When concentrations of cefotaxime and its derivatives (desacetyl cefotaxime, M2 and M3) were determined by HPLC assay, the elimination serum half-life of cefotaxime (T 1/2) was not modified in severe uraemic patients; however the elimination half-life of the metabolites increased when creatinine clearance decreased. Cefotaxime can be administered at a dose of 1 g i.v., twice daily in patients with stable chronic renal insufficiency when creatinine clearance is above 5 ml min-1. In cases of more severe renal failure, the dose should be halved and given i.v. every 12 hours.

Adult↗
PubMed1981

[Diclofurime: a new antihypertensive agent. Effectiveness and kidney tolerance].

Diclofurime is a non-inotropic arterial vasodilator and an antagonist to calcium transport. We studied its antihypertensive effect in 16 hypertensive subjects. When given alone at an average dose of 240 mg/day, it induced an overall significant diminution of systolic and diastolic arterial pressure. Among the 16 subjects studied, diclofurime lowered arterial pressure below 150/90 mm Hg in seven, induced an improvement in arterial pressure in six, and showed no effect in three. When hypertension is not controlled with 450 mg diclofurime in 3 doses/day, it may be given in association with acebutolol. Diclofurime is well tolerated. The most troublesome side effects noted were headache, cardiac erethism, asthenia and edema in the lower limbs. These clinical signs were usually transient. Among these 32 patients side effects required interruption of treatment in three. Laboratory follow-up was made on day 78 and 180 after initiation of treatment. No significant change in results was noted. Renal function was studied in seven patients having normal renal function and in six chronic renal failure patients whose inulin clearance was about 30 ml min-I. It was observed that in the normal subject, the injection of a loading dose of 40 mg diclofurime followed by a maintenance dose of 80 mg during one hour induced a slight increase in glomerular filtration and a greater increase in renal blood flow; the filtered fraction was thus diminished. Diclofurime induced a clear and sustained increase in excretion of water and sodium chloride without modifying urinary excretion of potassium. In severe renal failure, no significant changes in glomerular filtration, renal blood flow or electrolyte excretion were observed with diclofurime.

Adult↗
PubMed1980

[Mixed idiopathic cryoglobulinemia and glomerulonephritis (author's transl)].

Mixed idiopathic cryoglobulinemia may be associated with renal failure. When this occurrence appears some characteristic lesions may be observed on renal biopsies. The authors describe a case of mixed idiopathic cryoglobulinemia with nephrotic syndrome and hypertension. Histologic data and immunofluorescence study of renal biopsies are similar to those described in the published literature. If antigen-antibody complex seems to be for all authors the etiological feature of renal disease, the treatment to apply is not well known. The related case had been treated by plasmapheresis and the authors give their results to short and mean term.

Antigen-Antibody Complex↗
PubMed1980

Sarcoidosis. Retroperitoneal fibrosis, renal arterial involvement, and unilateral focal glomerulosclerosis.

In one patient with pulmonary sarcoidosis, hypertension occurred during the course of the disease. Aortography showed extensive narrowing of the right renal artery. Surgical exploration disclosed extensive periaortic and perirenal fibrosis. This fibrosis encircled the right renal artery and caused extrinsic compression. Pathological examination disclosed a large amount of histiocyte epithelioid infiltration in various samples of the fibrosis and particularly in the adventitia of the renal artery, highly suggestive of sarcoidal angiitis. Surgical biopsy was performed on both kidneys. The right kidney, protected by arterial stenosis, was little altered, while the left kidney showed extensive interstitial, tubular, and glomerular lesions. The glomerular lesions were focal and segmental hyalinosis.

Adult↗