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Biomedical subjects

P Camus

Publications and source records attributed to P Camus.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Busulfan-induced pneumopathy].

Busulfan or Misulban is considered by many the treatment of choice in chronic myeloid leukemia, for which it is used as a single agent. An interstitial fibrosing lung disease occurring after Busulfan was first described in 1961 and to date 56 cases have been published and are the object of this review. The clinical picture of this drug induced disease is well characterised. The disorder has an estimated incidence of 6% and begins gradually, marked by non-specific signs (dyspnoea, cough) and by an alteration in the clinical state, often severe, and is frequently accompanied by skin pigmentation. As a rule it occurs after prolonged treatment (on average 41 months, cumulative dose 2.900 mg). The respiratory function pattern is that of an interstitial fibrosis characterised by reduced volumes and hypoxaemia and hypocapnic respiratory failure. The radiology reveals interstitial and predominantly basal shadows. The histology is often obtained, either by lung biopsy or frequently at necropsy, because the prognosis is poor with an 84% mortality from respiratory failure. As for numerous interstitial pneumopathies, it poses questions as to the pathogenesis and early detection, problems which at present are imperfectly resolved.

Busulfan↗
PubMed1986

Pulmonary sequestration of amiodarone and desethylamiodarone.

We hypothesized that one of the reasons for the particular susceptibility of the lung toward the adverse effects from the antiarrhythmic agent amiodarone (A) could be a high pulmonary accumulation of this drug. This hypothesis was tested using the isolated perfused lungs of Fischer 344 and Sprague-Dawley rats and New Zealand White rabbits. Uptake of a 3 microM starting concentration of a mixture of A and [14C]A by the lung occurred rapidly in each species, and only 25.6, 19 and 16.4% of the initial concentration remained in the perfusate at the end (60 min) of the experiment in Fischer 344, Sprague-Dawley rats and rabbits, respectively. No metabolism of A was detected by the high-performance liquid chromatography technique. Raising the initial concentration of A from 0.3 to 120 microM (n = 26) in the Fischer 344 rats apparently did not saturate the uptake process, and the tissue/medium ratio averaged 122.5. The uptake of desethylamiodarone (DEA), the main metabolite of A in vivo, was more extensive (tissue/medium ratio = 506) than that of the parent compound. DEA also was not metabolized by the isolated perfused lungs. Lung homogenate incubations fortified with cofactors did not metabolize A or DEA. We conclude that in the isolated perfused lungs: A is extensively taken up by the lungs of rats and rabbits; the uptake is not saturated by raising the concentrations over a 400-fold range; DEA is taken up more readily than A; and metabolism of neither compound is observed.

Amiodarone↗
PubMed1985

[Tracheal intubation after maxillofacial reconstruction using a pectoralis major flap].

From 1979 to 1984, a pectoralis major musculocutaneous flap was used in 35 patients in order to cover a maxillofacial defect following either a gunshot wound or tissue loss after cancer surgery. In 50% of the cases, one or several operations were needed. 30% of the patients showed a fixed posture of the head preventing tracheal intubation by direct laryngoscopy. The measurement of the maxillopharyngeal angle helps to predict this impossibility. In such these cases intubation by fibroscopy was done to avoid tracheotomy.

Biomechanical Phenomena↗
PubMed1984

The diseased lung and drugs.

Among the numerous ways by which drug-lung relationships can be discussed we chose to examine three questions: Is the lung capable of directly modulating drug pharmacokinetics? Knowing that the pulmonary circulation can exert very selective and efficient clearance and catabolism of biogenic molecules such as serotonin (5-HT), norepinephrine (N.E.), prostaglandins PGE2 and PGF2 alpha, and bradykinin, as well as activation of angiotensin (A)I to AII, a similar behavior has been sought for drugs. Uptake of circulating drugs occurs clearance of biogenic amines, the significance of which remains to be fully evaluated, and iatrogenic phospholipidosis localization of which in the lung might result from the elevated drug concentration in the tissue. Lung cells contain enzymes, among them mixed function oxidases (MFO), which enables them to metabolize xenobiotics even in the intact organ. Although blood supply to the lung is higher than that to the liver, the comparatively low MFO content of the former organ predicts only a marginal pulmonary metabolic contribution in vivo. On the otherhand, enzymatic activity upon drugs can generate instable reactive metabolites which, even in minute amounts are toxic and can damage cells; furthermore, it is hypothesized that the relatively high bronchiolar Clara cell MFO content explains the striking susceptibility of the long to xenobiotics. Do lung diseases indirectly influence drug pharmacokinetics? Hindrance to blood flow is common in respiratory failure (R.F.), from both reduced area and hypoxic vasoconstriction, resulting in altered flow distribution to the liver and kidney.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1982

D-Penicillamine-induced severe pneumonitis.

We report the first histologically described case of severe D-penicillamine-induced pneumonitis. It occurred in a 73-year-old woman who suffered from rheumatoid arthritis and had previously demonstrated gold intolerance. Pathologic study disclosed marked interstitial and alveolar damage resembling that described with certain chemotherapeutic agents. We assess the drug's responsibility, discuss possible pathogenetic pathways, and provide suggestions regarding the patient on a D-penicillamine schedule.

Aged↗
PubMed1982

[The respiratory complications of D-Penicillamine therapy (author's transl)].

The literature is reviewed on patients developing respiratory symptoms while receiving D-Penicillamine, most of whom suffered from rheumatoid arthritis. The manifestations were (in decreasing frequency) bronchiolitis obliterans, interstitial pneumonitis, a Good pasture's like syndrome and bronchospasm. For each complication we discuss diagnostic criteria, the implication of the drug and the pathogenesis. In addition we make suggestions regarding patients on D-Penicillamine and emphasize the need for accurate reporting of adverse pulmonary effects to enlarge the epidemiological picture.

Anti-Glomerular Basement Membrane Disease↗
PubMed1980

Non-organic acute upper airway obstruction: description and a diagnostic approach.

We describe 3 cases of upper airway obstruction in which no organic cause could be identified. All 3 patients presented with severe dyspnea and stridor. Direct laryngoscopy and bronchoscopy failed to demonstrate any lesion. Flow-volume loops showed a pattern of severe variable extrathoracic airway obstruction with a decreased peak inspiratory flow and an increased ratio of the forced expiratory flow at 50% vital capacity to the forced inspiratory flow at the same lung volume. Plethysmographically measured airway resistance was normal in the 2 patients for whom it was obtained. We believe a functional etiology should be added to the possible causes of acute upper airway obstruction. This entity can readily be identified by the marked discrepancy between inspiratory flow limitation and airway resistance.

Adult↗