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Biomedical subjects

O Bletry

Publications and source records attributed to O Bletry.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Value of the cyclophosphamide bolus in severe systemic diseases. Preliminary results].

Twenty patients with severe systemic disease were treated intermittently with bolus intravenous injections of cyclophosphamide in doses of 0.5 to 1 g. The diseases were systemic lupus erythematosus in 9 cases, systemic necrotizing angiitis in 5 cases, Behçet's disease in 4 cases, Horton's disease in 1 case and dermatomyositis in 1 case. The rationale for this treatment was resistance to previous therapies in 9 patients, initial severity of the disease in 8 and the need for prompt reduction of corticosteroid dosage owing to side-effects in 3 other patients. No death or haemorrhagic cystitis was observed over a cumulative 120 month-patients period. Bacterial infection occurred in 6 cases, including pneumonia (3), and 1 case each of staphylococcal septicaemia, purulent meningitis and urinary infection: none of these infections were life-threatening, and all were cured without sequelae. The drug was well tolerated biologically, except for a moderate fall in neutrophils, lymphocytes and platelets. The systemic disease was stabilized or improved in 16 patients. It remained active and required corticosteroids at the same dosage level in 4 cases. It is concluded that bolus injections of cyclophosphamide are well tolerated in short-term treatments but that their effectiveness must be confirmed by controlled studies.

Adolescent↗
PubMed1988

[Prognosis and treatment of glomerulonephritis of periarteritis nodosa. The role of plasma exchange].

Fourteen patients with polyarteritis nodosa complicated by histologically confirmed glomerulopathies were included in a prospective multi-center study comparing corticotherapy (group 1, n = 8) with combined cyclophosphamide and steroids (group 2, n = 6). Plasma exchanges were associated on a routine basis. The two groups were comparable apart from initially more severe renal impairment in group 1 (p less than 0.05). Initial control of the disease was obtained in 11 patients (7 from group 1, 4 from group 2) including the patients with oligoanuria. Six patients recovered, 3 had recurrence requiring chronic hemodialysis and 5 patients died from group 1 (p less than 0.05). These preliminary findings suggest that plasma exchange can contribute to control of polyarteritis nodosa with renal complications.

Adrenal Cortex Hormones↗
PubMed1988

[Venous thrombosis in Behçet's disease].

Venous lesions in Behçet's disease (BD) were defined by Adamantiades and represent one of the most suggestive signs of the disease. They are occasionally the first sign of the disease and are frequently the basis for the diagnosis in a case of recurrent thrombosis in a young subject, the preferential context of BD. Involvement of superficial vessels is virtually constant. Venous vasculitis is responsible for non-specific hypersensitivity and erythema nodosa, which constitute some of the major diagnostic criteria. Ocular periphlebitis is one of the elements responsible for posterior uveitis. The originality of the venous involvement is due to the involvement of deep territories. Any vein may be affected, but the remarkable features are the size of the thrombosed vessels: superior and inferior vena cava, iliofemoral veins and the unusual site of the involvement: supra-hepatic veins, cerebral vessels, etc. Inferior vena cava thrombosis may be associated with aneurysms of the pulmonary arteries in the context of Hughes-Stovin syndrome. Cerebral phlebitis, which can now be identified more easily by means of digital angiography, is responsible for a typical picture: headaches, bilateral papilloedema and raised CSF pressure. The classical pictures of optic chiasmatic arachnoiditis and so-called benign intracranial hypertension actually correspond to unrecognised phlebitis. They may also be associated with other neurological lesions. In one half of cases, phlebitis cutaneous manifestations. However, they may precede the diagnostic signs or may occur very late in the course of the disease. They are recurrent and affect a number of different territories.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents↗
PubMed1988

[Wegener's granulomatosis. Clinical aspects, nosologic problems. Review of the literature apropos of 30 cases].

Thirty cases of Wegener's Granulomatosis are reported, 16 men and 14 women aged 49.3 +/- 14 years at the onset of their illness. The presenting symptoms were oto-rhino-laryngeal in 22 cases and pulmonary in 16 cases. Renal disease was initial in only 1 case. The complete picture comprised oto-rhino-laryngeal (29 cases), pulmonary (26 cases), renal (27 cases), articular (16 cases), muco-cutaneous (19 cases), ocular (15 cases), neurological (13 cases), and muscular (10 cases) involvement. An increased sedimentation rate, leukocytosis, anaemia and thrombocytosis were common findings. The treatment comprised steroid therapy associated with immunosuppressor drugs (28 cases) and plasma exchanges (8 cases). External radiotherapy was used in 5 patients, including 3 with bronchopulmonary lesions, but was not effective. The probability of survival after the initial symptoms was 84 p. 100 at 1 year, 69 p. 100 at 3 years and 59 p. 100 at 5 and 10 years. Eight patients died; infection and renal failure were the principal causes. Late relapse occurred in 3 patients justifying long-term follow-up and the necessity of using the term "cure" with reserve. The clinical and therapeutic aspects are described in the light of the authors' experience and a review of the literature. The concept of localised form of the disease and bordeline forms with atrophic polychondritis, periarteritis nodosa, Churg and Strauss syndrome and lymphomatous granulomatosis are also discussed.

Adult↗
PubMed1988

[Behcet's disease in France. Apropos of 60 autochtonous subjects].

Based on a retrospective study of a series of 196 patients followed up from 1974, to 1986, 60 cases of Behcet's disease are reviewed in autochthonous French patients, defined as born of French parents in Metropolitan France. The group included 36 men and 27 women (sex ratio 1.45) age range 32 +/- 7 years at time of diagnosis. Semeiology and outcome were compared with those of North African patients, the bias related to their female under-representation being eliminated by analysis of findings in males only. No significant difference was noted between the two groups, particularly with respect to ocular, neurological and vascular lesions. Neither the sex nor the existence of HLA B5 (28/40 tests) had any influence on semeiology. Three deaths related to the disease were reported two pregnancies were conducted to term without neonatal effects despite maternal acute ocular episodes. Treatment was with corticoids (n = 33), immunodeppressants (n = 15), colchicine (n = 29) and anticoagulant and/or anti-aggregant therapy (n = 31). Lasting disappearance of aphthosis was obtained in 34 cases, of cutaneous signs in 27, articular signs in 26 and vascular signs in 16. The ocular lesions present initially in 41 patients had disappeared over long periods in 29 cases, and presented a satisfactory prognosis since less than 39 p. 100 of the patients had any significant handicap at 5 years. Among the relapses, 5 appeared after too hasty withdrawal of colchicine. The diagnosis of Behcet's disease should be evoked in autochthonous subjects if necessary, and confirmed on the basis of usual clinical criteria alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Is Behçet's disease associated with characteristic abnormalities of coagulation and fibrinolysis? Apropos of 70 case reports].

The frequency of thrombotic episodes in patients with Behçet's disease prompted us to study their hemostasis. Seventy patients were investigated and 27 of them (38%) had history of venous thrombosis; they were compared to 27 healthy subjects and to 16 hospitalized patients in whom the diagnosis of Behçet disease was ruled out. Fibrinolytic activity after a 10 minute venous occlusion was significantly decreased while fibrinogen, factor VIII and von Willebrand factor was increased as well as the tPA inhibitor (PAI-I): the last 3 proteins are synthetized by the endothelial cell. No significant difference was observed between patients with or without history of thrombosis. Coagulation and fibrinolysis changes observed are not specific of Behçet disease since they were also found in a population of patients without Behçet disease and without history of thrombosis.

Adolescent↗
PubMed1987

Systemic necrotizing angiitis with asthma: causes and precipitating factors in 43 cases.

Causes and precipitating factors for systemic necrotizing angiitis (NA) with asthma were sought in 43 patients, focusing on a history of vaccination and desensitization. Mean age of patients was 43.2 years. Diagnosis was based on histopathologic findings in 25 patients, arteriography in 2, and clinical criteria in 16. History of allergic manifestations (asthma, rhinitis, eczema, urticaria) was present in the family of 19 patients. Forty-two patients presented with asthma before development of NA and 23 of them were treated with steroids. Nineteen subjects gave a history of desensitization and 5 of vaccination in the 4 weeks preceding the disease. The main symptoms of NA were asthma in 43, fever in 25, weight loss in 31, peripheral neuropathy in 29, cutaneous signs in 25, digestive signs in 16 (abdominal pain, digestive bleeding, bowel perforation), noninfectious pneumopathy with pulmonary infiltrates in 33. Eosinophilia was 8,212 +/- 6,214/mm3. Antigen HBs was found in 2 of 30 patients. Prognosis of NA with asthma was good in 15 patients who recovered completely from the disease. Seven patients died and the other patients improved but remained under treatment. The survival curve showed that 75% of patients were alive after 60 months. Our findings suggest that different causes can be considered responsible for NA, and that, in cases of NA with asthma, there is reason to consider vaccination and desensitization as precipitating factors.

Adolescent↗
PubMed1987

Antiphospholipid antibodies: a disease marker in 25 patients with antinuclear antibody negative systemic lupus erythematosus (SLE). Comparison with a group of 91 patients with antinuclear antibody positive SLE.

Twenty-five antinuclear antibody (ANA) negative patients with systemic lupus erythematosus (SLE) or lupus-like disease were compared to 91 ANA positive patients with SLE for clinical and biological symptoms. Cutaneous symptoms were infrequent in ANA negative patients (p less than 0.03). Thrombocytopenia (p less than 0.001), venous or arterial thrombosis (p less than 0.02) as well as cerebral infarction (p less than 0.001) were more frequent. Three types of antiphospholipid antibodies were determined by different methods; the VDRL, the lupus anticoagulant and an ELISA for IgG anticardiolipin antibody (aCL). The frequency of a positive VDRL test was significantly higher in the ANA negative group (p less than 0.05). Correlation studies suggest that the 3 methods are not redundant and detect overlapping but not identical antibodies. Of the 3 antiphospholipid antibody assays, only the IgG aCL test was significantly associated with thrombosis in the ANA negative group (p less than 0.02).

Adolescent↗