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Biomedical subjects

M Krempf

Publications and source records attributed to M Krempf.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Role of imaging in the exploration of the adrenal glands].

Currently, the major method of adrenal gland imaging is computed tomography. This method allows demonstration of normal adrenals and the diagnosis of adrenal masses (if these are greater than 1 cm in diameter). The examination should be directed by clinical signs and known laboratory investigations. Computed tomography is therefore the first line investigation to perform. Certain lesions may be better demonstrated by other methods: MRI and MIBG scintigraphy offer a greater specificity in the investigation of pheochromocytomas. In addition, scintigraphy can identify possible ectopic tumours or recurrences. Selective catheterisation of the adrenal veins allows aldosterone and cortisone secretions to be assayed. There remains the problem of the incidental finding of adrenal masses in either an asymptomatic patient or in the context of investigation of spread of a know cancer. These lesions may benefit from diagnostic percutaneous guided biopsy.

Adrenal Gland Neoplasms↗
PubMed1990

Effect of long-acting somatostatin analog (SMS 201-995) on high glomerular filtration rate in insulin dependent diabetic patients.

Increased glomerular filtration rate (GFR) is considered to be a determinant factor in the pathogeny of diabetic nephropathy. In this study we analyzed the effect of a long-acting somatostatin analog (SMS 201-995) on high GFR in type I diabetes patients. Five subjects were involved in a cross-over double blind study. All the patients had a high GFR (205 +/- 18 ml/min/1.73 m2). They were randomly submitted to a 10-hour night i.v. infusion of SMS 201-995 at a rate of 8 g/min and placebo. GFR was measured using a blood 99mTc-DTPA decay curve during the last hour of infusion. After 10-hour SMS 201-995 treatment, no statistical change was observed in GFR. However, a slight decrease was noted in four of the five subjects (183.07 +/- 22.31 vs 202.83 +/- 13.23 ml/min/1.73 m2). GFR was higher only for the patient who presented with a mild hypoglycemic reaction during the infusion, which may increase glomerular filtration by itself. All the other parameters measured remained unchanged.

Adult↗
PubMed1989

[Bronchial hyperreactivity in non-asthmatic patients harboring a uterine fibroma].

One of the etiological factors of female late onset asthma lies in endocrine disorders and it often occurs during a period of hormonal instability (menopause or premenopause). Moreover various studies have shown increased allergic manifestations in women with gynecological problems (dysmenorrhea, premenstrual syndrome). Gynecological pathology is found in 30% of 67 women who suffer from late onset asthma. Prospective studies were carried out in 28 women with surgical uterine fibroma, to investigate bronchial hyperreactivity (BHR). The study included atopic research through questioning and allergy skin tests; spirographic respiratory function study, airway resistance, carbachol BHR with determination of the threshold dose (FEV1 20% decrease). Carbachol BHR was found in 8/28 persons (28%), but with no clinical manifestations. None of the patients smoke and only one suffers from mite-allergic rhinitis-conjunctivitis without asthma. BHR is often found in asymptomatic women with uterine fibroma. Is this BHR due to an autonomic dysregulation or to a hormonal malfunction? This hypothesis would require further studies to elucidate, since premenstrual asthma worsening is a well known phenomenon, which can be improved by progesterone. This may suggest a possible link between hormonal malfunction and BHR in women. A long term survey will facilitate detection of late onset asthma.

Adult↗
PubMed1988

[Lipid evaluation in cerebral infarction in its early phase and in the 4th month. Practical consequences].

Plasma lipid values studied in 30 subjects with stroke at days 1, 2 and 4 of the early phase indicated a significant decrease in total cholesterol, HDL-cholesterol and apolipoprotein A1 from day 1 to 4. However, there was no significant difference between values at day 1 and during the 4th month of convalescence. Since some patients admitted to hospital are never followed up later in a hospital environment, it would seem advisable, for practical purposes, to perform plasma lipid analysis on the first day of admission.

Adult↗
PubMed1987

[Microalbuminuria is not a marker of diabetic retinopathy].

Microalbuminuria is considered a good predictor of diabetic nephropathy. In this study over 50% of patients with retinopathy, whatever its severity, did not show microalbuminuria. However, among patients with microalbuminuria, the percentage of retinopathy was significantly increased (75%). It is concluded that with the exception of nephropathy, microalbuminuria is not a good parameter for the detection of other microangiopathic complications of diabetes.

Adult↗
PubMed1987

[Neurotoxicity of mitotane therapy of adrenocortical carcinoma (5 cases) and Cushing's syndrome (7 cases)].

Twelve patients were treated with op'DDD over a 9-year period. All presented with mild neurological symptoms, and half of them had major complications. There was no relation between the occurrence of these symptoms and the dose or duration of op'DDD therapy. The mechanisms of this neurological toxicity, both central and peripheral, are not well known, but they appear to be similar to those of certain op'DDD-related chemicals used in industry.

Adolescent↗
PubMed1987

Induction of ovulation in polycystic ovary syndrome with a combination of a luteinizing hormone-releasing hormone analog and exogenous gonadotropins.

Eight clomiphene citrate (150 mg/day for 5 days)-resistant anovulatory women with polycystic ovary were included in this study. A luteinizing hormone-releasing hormone (LH-RH) analog, D-Trp-6-LH-RH, 100 micrograms subcutaneous-per day, induced a hypogonadotropic state within varying periods but at most within 3 weeks, after an initial flare-up effect characterized by slight increase in ovarian size in four patients and in the other four by cysts that disappeared rapidly. On the 28th day or 15 to 20 days after menstruation for subsequent cycles, during maintenance of D-Trp-6-LH-RH therapy, a usual gonadotropin regimen was carried out in 33 cycles. Human menopausal gonadotropins obtained follicular maturation in all cycles. However, there was never the growth of a single dominant follicle but always of several follicles. Human chorionic gonadotropin then induced ovulation in 31 cycles (94%). Luteal phase was normal in 28 and inadequate in 3 of the 31 ovulatory cycles. Hyperstimulation, generally mild to moderate but rather severe in 2 cycles, was constant. Five pregnancies were obtained. The overall pregnancy rate was 15% per cycle and 17.8% per normoovulatory cycle. This study showed that an associated treatment with an LH-RH analog enables gonadotropins to achieve ovulation regularly with an encouraging number of pregnancies but at a risk of hyperstimulation.

Adult↗
PubMed1987

[Microalbuminuria in diabetics. I--Definition, significance and physiopathology].

The term "microalbuminuria" qualifies an albumin excretion rate above the upper limit of normal individuals but below values giving positive results with conventional test strips. Its predictive value has been established for diabetic nephropathy in type I Diabetes, and for an excessive risk for mortality in type II Diabetes. Microalbuminuria is of glomerular origin in diabetes. It is secondary both to intra-renal haemodynamic changes and to altered permeability of the glomerular basement membrane. The various parameters involved in its genesis are reviewed.

Albuminuria↗
PubMed1987

[Microalbuminuria in diabetics. II--Methodological aspects and therapeutic perspectives].

The screening for microalbuminuria in diabetic patients has been made possible by means of sufficiently sensitive and reproducible techniques. Threshold values of albumin excretion rate must be defined according to the type of urine collection and by taking into account the high variability of this parameter. The high variability of albumin excretion rate required that repeated measurements must be considered. The prevalence of microalbuminuria depends on the type of diabetes, the degree of micro- and macrovascular complications, and the presence of associated arterial hypertension. Current attempts to reduce microalbuminuria in the diabetic patients through strict glycaemic control, lowering of high blood pressure and other means, are discussed.

Albuminuria↗
PubMed1986

[Methodological problems in the determination of microalbuminuria].

We have performed 7 different urinary collections to assess albumin excretion rate in insulin-dependent diabetics. The night and the 24 hours urine collections were more accepted than the others. For albumin excretion rate there was no correlation among the different collections. So, the albumin excretion rate must be done always on the same sample for one patient and be repeated to confirm pathological values.

Adult↗
PubMed1985

[Radioimmunoassay of urinary albumin: early indicator of diabetic nephropathy?].

Microalbuminuria is now considered a good biological marker predictive of diabetic nephropathy. The degree of microalbuminuria was determined by radioimmunoassay in 23 controls and 50 insulin-dependent patients with poor control of glycaemia. Higher levels were found in diabetics, whatever the duration of the disease. At the moment, this difference, which is reversible with good metabolic control, can be explained by blood glucose balance. Several authors have established the existence of a microalbuminuria threshold predictive of nephropathy, but its level is controversial, chiefly on account of the urine collection methods.

Adolescent↗
PubMed1985

[Cardiac tolerance of a beta-2-sympathomimetic spray: fenoterol. Apropos of 37 patients followed using a Holter monitor during a brief treatment protocol].

37 subjects with stable asthma and a mean age of 50.3 undertook a protocol to study the cardiac tolerance to a spray B2SM. A Holter monitor was performed before and 48 hours after the institution of a Fenoterol spray in 4 daily doses of 600 micrograms at fixed times. Before starting treatment with a beta 2 sympathomimetic spray (B2SM) 11 subjects had abnormal traces with significant auricular extra-systoles in 4, ventricular extra-systoles in 5 and both in one subject: one patient had a run of ventricular tachycardia without symptoms. On Fenoterol, a worsening of pre-existing extra systoles was noted thrice, one was auricular the other two ventricular. Two patients had brief runs of ventricular tachycardia but the role of Fenoterol was uncertain; one of the patients was very elderly and hypoxaemic. In the second and elevated theophylline level of 20 micrograms/l was noted. The arrythmogenic power of a B2SM seems weak, but in certain situations such as hypoxaemia, metabolic acidosis and overdosage of theophylline, over consumption of B2SM in association with the above factors could contribute to serious arrhythmias. Also in this study in which there was a protocol limited in time, no premature conclusion should be made on the crucial problem of the cardiovascular risks of B2SM in the basic treatment of asthma but raises the problem of the arrythmogenic potential of the drug association of Theophylline + B2SM.

Adult↗
PubMed1985

[Correlation between the assay of glycosylated hemoglobin A1c and fructosamine in diabetic patients submitted to a systematic control visit. Establishment of reference values].

The plasmatic glycosyl proteins levels were measured in fifty non diabetic volunteers and thirty five patients with diabetes mellitus by the fructosamine test. The upper limit for healthy volunteers was estimated to 25 mumoles/g protein. A higher fructosamine concentration and greater spread of values were observed in the diabetic group. A very good correlation was noted in the diabetic group between A1C hemoglobin and fructosamine concentrations. This test is very reproducible, inexpensive and should be a good alternative to the A1C hemoglobin determination in some physiologic or pathologic disorders.

Diabetes Mellitus, Type 1↗