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Biomedical subjects

M Godin

Publications and source records attributed to M Godin.

At least 145 records · Page 8Linked to original sources

Right-sided endocarditis and ventricular septal defect.

Right-sided endocarditis occurred in a 40-year-old woman with ventricular septal defect. This association is uncommon in adults. Because of the changing and variable clinical patterns of this disease, it is difficult to make a prompt diagnosis. In this case diagnosis was delayed for almost a year. The occurrence of pneumonia due to Streptococcus viridans was the most important extracardiac manifestation.

Adult↗

Partial deficiency of the fourth component of human complement (C4) and autoantibody directed against C4 in a patient with SLE.

The finding of dramatically depressed levels of C4 in a 17-year old patient with severe systemic lupus erythematosus (SLE) prompted a genetic study of her family. This study revealed the existence of a partial C4 deficiency; we found the presence of a C4A3,C4BQo haplotype which was transmitted by the mother to each of her children. This patient possessed, in her serum, an autoantibody with anti-C4 specificity. The immunochemical characterization of this autoantibody revealed that it was IgM and belonged to the immunoconglutinin family. We have studied the effects of this autoantibody on the formation and dissociation kinetics of classical C3-convertase.

Adolescent↗

Pharmacokinetics of cefoxitin in normal subjects and in patients with renal insufficiency.

The pharmacokinetics of a single intravenous dose of 30 mg of cefoxitin/kg given to normal subjects and to patients with various degrees of chronic renal insufficiency were studied. The serum half-life of cefoxitin was correlated inversely with the rate of creatinine clearance, and the half-life increased exponentially when the creatinine clearance rate fell below 30 ml/min per 1.73 m2. The elimination of cefoxitin into urine was rapid and extensive in patients whose creatinine clearance was greater than 30 ml/min per 1.73 m2. In patients with more severe degrees of renal impairment, renal clearance of drug was diminished markedly (less than 20% of the administered dose was excreted in 4 hr as compared with greater than 60% in the former group). The clearance of cefoxitin can be increased fivefold by hemodialysis in patients with end-stage renal disease.

Adult↗

The pharmacokinetics of cefotaxime and its metabolites in subjects with normal and impaired renal function.

The pharmacokinetics of single doses (15 mg/kg) of cefotaxime and each of its metabolites were examined in six normal subjects and 24 patients who showed various degrees of renal insufficiency. An additional nine patients with renal failure were entered into a multiple-dose study in which cefotaxime (1 g) was given twice daily for five to seven days. After intravenous administration, the levels of cefotaxime in serum declined in two phases. The half-life for the terminal phase was 1.10 +/- 0.78 hr. Cefotaxime administered intramuscularly was well absorbed from the injection site (91% +/- 19%) and produced maximal levels of 25.5 +/- 3.5 microgram/ml in serum at approximately 0.5 hr after injection. The levels of the desacetyl metabolite in serum were comparatively low, and the half-life of this metabolite was 1.3 hr. Microbiologic measurements of cefotaxime showed that the half-life of the drug was lower in normal subjects (1.71 +/- 0.90 hr) than in patients with severe renal impairment (half-life, 10.20 +/- 3.43 hr). However, this difference was due primarily to desacetylcefotaxime. Specific measurement by high-performance liquid chromatography indicated only a slight increase in the half-life of cefotaxime, whereas the increase in half-life of desacetylcefotaxime was greater. The most pronounced increases in half-life of metabolites occurred when values for creatinine clearance in patients were below about 5 ml/min per 1.73 m2. When cefotaxime was administered repetitively, the ratio of maximal serum levels after the last dose to those after the first dose demonstrated minimal accumulation of intact drug. The average accumulation of desacetylcefotaxime in this group of patients was about twofold, and that for metabolites M2 and M3 was approximately fourfold. This accumulation of metabolites was observed only in those patients with severe renal impairment and was not excessive. Hemodialysis caused a significant reduction in the half-life of both cefotaxime and desacetylcefotaxime. Recommendations are made for the adjustment of dosing schedules in patients with renal failure.

Adult↗

Pharmacokinetics of aztreonam in patients with chronic renal failure.

The elimination kinetics of aztreonam (SQ 26,776), a new, completely synthetic, monocyclic beta-lactam antibiotic, were studied after the administration of a single 1g intravenous dose. Five healthy volunteers and 20 patients with various degrees of renal insufficiency were enrolled in this study. Concentrations of aztreonam in serum and urine were determined by both microbiological and high pressure liquid chromatography (HPLC) assays. The pharmacokinetic parameters for aztreonam were calculated on the basis of a 2-compartment open model. Serum concentrations of aztreonam at 10 minutes after administration were approximately 100 micrograms/ml in all subjects, regardless of renal function (HPLC assay). The mean serum half-life during the alpha-phase showed no important variation with renal function. The mean serum half-life during the beta-phase was 1.8 hours in normal subjects and 8.4 hours in haemodialysis patients (HPLC assay). There was a linear correlation between the serum clearance of aztreonam and creatinine clearance. The mean cumulative urinary recovery of aztreonam in 48 hours was 60 to 70% of the administered dose in normal subjects but this was reduced in the presence of renal insufficiency. SQ 26,992, the microbiologically inactive metabolite of aztreonam resulting from hydrolytic opening of the beta-lactam ring, was undetectable in the serum of normal subjects but was found in low levels in uraemic patients. Half of a 1g intravenous dose of aztreonam was eliminated during 4 hours of haemodialysis. Guidelines for administration of aztreonam in the presence of renal failure are given.

Adult↗

[Three cases of hereditary xanthinuria: review of the literature (author's transl)].

Xanthinuria is a rare hereditary disorder characterized by a gross deficiency of the enzyme xanthine oxydase resulting in hypouricemia, hypouricosuria and increased serum and urinary oxypurines. Three patients with this disease are presented and the pertinent literature is reviewed. We have demonstrated in one subject the absence of xanthine oxydase activity in a renal fragment. Genetic studies were performed but we do not find any relation between this deficiency of enzyme xanthine oxydase and HLA, Pl, Gm groups.

Adolescent↗

[Treatment of hypertension with Sotalol (author's transl)].

Sotalol is a new beta-adrenoceptor blocking drug without membrane stabilizing activity, without intrinsic sympathomimetic activity and with a low cardio-depressive effect. This beta-blocking agent has an half-life much longer than the other beta-blockers (T 1/2 from 10 to 13 hours). The antihypertensive effect and tolerance of 160 mg tablets of sotalol were studied in 35 hypertensive patients aged 18 to 60 years. The drug was administred once daily in the morning. Sotalol prescribed as the only antihypertensive drug lowered the blood pressure to normal values in 21 cases with a single daily of 1 to 3 tablets. In 8 patients a partial response was obtained (25 % reduction of the initial systolic and diatolic pressure). Six patients did not respond. The clinical and biological tolerances were good; Sotalol was only discontinued in three cases. Sotalol appears to be an effective and well tolerated antihypertensive agent, specially for the treatment of moderate and recent essential hypertension in young patients.

Adolescent↗