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Biomedical subjects

P Godeau

Publications and source records attributed to P Godeau.

At least 379 records · Page 21Linked to original sources
PubMed1985

[Psychic disorders in systemic lupus erythematosus. Prospective study of 35 cases].

In the prospective study reported, 35 patients with systemic lupus erythematosus underwent thorough psychiatric examination. They were divided into three groups according to whether their psychiatric symptoms were acute (10 patients), subacute (9 patients) or non-existent (16 patients). Particular attention was paid to such factors as obstetrical events (pregnancy, spontaneous or induced abortion), history of psychiatric disorders, emotional traumas and treatment with corticosteroids. The overall incidence of psychiatric symptoms was high (54%), mainly due to isolated depressive states (37%). The only significant contributing factors were a personal history of psychiatric disorders (p = 0.001) and emotional traumas (p = 0.0004). There was no difference between the three groups as regards the distribution, dosage and duration of corticosteroid therapy.

Adrenal Cortex Hormones↗
PubMed1985

[Recklinghausen's disease with hypophosphoremia and osteomalacia. Apropos of 2 cases].

The authors report two cases of osteomalacia due to phosphate diabetes in patients with Recklinghausen's disease. In one case abnormalities of vitamin D metabolism were identical with those described in cases of phosphate diabetes associated with mesenchymal tumours. The abnormalities found in the second case were different. The physiopathological mechanism of osteomalacia due to phosphate diabetes in mesenchymal diseases generally and in Recklinghausen's disease in particular is discussed.

Adult↗
PubMed1985

[Trial treatment of severe Raynaud's phenomenon with prostacyclin (PGI2)].

Severe forms of Raynaud's phenomenon are very disabling. In a randomized, single-blind trial, we have evaluated the effects of PGI2, a natural compound with strong vasodilator and anti-platelet activities, in 14 patients presenting with Raynaud's phenomenon. The patients received a 24-hour infusion of either PGI2 in doses of 10 mg/kg.min, or only the solvent (glycine buffer). All patients recorded the frequency and severity of the attacks before and after treatment, and 7 of the 8 patients who received the solvent benefited from a PGI2 infusion 30 to 60 days later. Among the 14 patients (6 men, 8 women), 10 had underlying collagen disease. The number of attacks per week was initially 15.9 +/- 5.3 (mean +/- s.e.). The resulting impairment was pronounced (+ + on a + to + + + scale). Radioimmunoassays of prostaglandins showed a strong increase in 6-keto PGF1 alpha levels during the infusion, without changes in thromboxane levels. A significant (p less than 0.05) reduction was observed in the number of attacks (2.6 +/- 2.5 per week) and in impairment (+ on average after PGI2 but not after the buffer). Improvement after PGI2 lasted from 0.5 to 12 months, and all but one patient regarded the treatment as effective in long-term, despite undesirable side-effects (flush, hypotension) which occurred regularly during PGI2 infusion. In all patients with ulcerations of the finger tips, these healed more rapidly after PGI2. It is concluded that in spite of immediate discomfort, PGI2 in 24-hour infusions seems to be of value in the treatment of severe Raynaud's phenomenon.

Drug Evaluation↗
PubMed1985

[Superior caval syndrome. Diagnostic and therapeutic management. Apropos of 20 cases].

Superior vena cava obstruction (SVCO) is an infrequent syndrome. Clinical diagnosis is often late. 20 cases of SVCO collected in 7 years are being reported. In 17 cases, SVCO revealed the underlying disease. It was mostly neoplastic (12 times), especially pulmonary cancers (5 times) and lymphomas (twice). Among benign causes (5 times), mediastinal fibrosis was the most often recognized (twice). Prognosis depended on etiology: when it was malignant, mortality rate was 50 p. cent (actuarial survival rate after one year: 40 p. 100); when it was benign, there was no mortality (follow-up: 21 months). Thrombo-embolic complications (25 p. 100) were seen during the end-stage of neoplasms and were responsible in 4 out of 7 deaths. Surgery was interesting for diagnosis (histology) and treatment (bypass surgery, the result of which was good only in the 3 operated benign causes). A simple model is proposed for treatment.

Adult↗
PubMed1985

[Periarteritis nodosa: clinical and therapeutic study of 126 patients followed-up during 23 years].

A hundred and twenty-six patients with systemic polyarteritis nodosa (PN) were studied over a 23 year period. The clinical symptoms and paraclinical data of PN are reviewed, and the results obtained by the different therapeutic approaches used during this period are presented: steroids alone and then associated with immunosuppressors and, in the most recent cases, associated with plasma exchange. The actuarial survival of patients in this retrospective and unrandomised series was comparable whether steroids were used alone or with immunosuppressors. The different therapeutic approaches in PAN are discussed especially with respect to the role of immunosuppressor therapy and plasma exchange.

Adrenal Cortex Hormones↗
PubMed1985

[Digestive manifestations of periarteritis nodosa in a series of 120 cases].

In a series of 120 patients with periarteritis nodosa (PAN), 50 had gastrointestinal manifestations; 34 had transient abdominal pain which regressed spontaneously or in response to corticosteroid therapy and required no further investigation. Thirty one more serious episodes occurred in the remaining 26 patients. Eight of these were in fact the initial signs of PAN and 13 required laparotomy. There were 20 episodes of abdominal pain (peritonitis: 9, pancreatitis: 4, acute cholecystitis: 2, duodenal ulcer: 3, intestinal infarction: 1, unexplained pain without diagnosis at laparotomy: 1) and 11 of gastrointestinal hemorrhage (melaena or hematemesis: 4; hematochezia: 5). Clinical and biological features of patients with and without gastrointestinal manifestation were not significantly different except for cardiac involvement which was significantly more frequent (p less than 0.05) in the second group. Corrected survival rates were significantly lower (p less than 0.05) in patients with gastrointestinal manifestations. These results show that, in patients with PAN, digestive manifestations, particularly perforations, carried a poor prognosis. Nevertheless exploratory laparotomy and surgery unrelated to PAN (eg appendicectomy) were well tolerated.

Abdomen↗
PubMed1985

[Corticotherapy and surgery. Apropos of 73 cases].

The authors reviewed the outcome of 73 operations performed on 60 patients on long-term steroid therapy: Eighteen operations were carried out for gastro-intestinal perforation but the causal role of steroid therapy was only established in 6 cases (4 gastric and 2 colonic perforations). In the other 12 cases there was intercurrent pathology or a recrudescence of the underlying disease process. More selective indications for steroid therapy and the protective action of new drugs on the gastro-intestinal mucosa are probably responsible for the low incidence of iatrogenic complications compared with previously published series. However, steroid therapy did affect the postoperative course: the risk of infection was 20 to 30 p. 100 higher than normal, very common after emergency surgery (75 p. 100) and a major cause of mortality (60 p. 100); the risk seems to be high when the steroid dose exceeds 0.5 mg/kg/day, the disunion of an anastomosis was observed in 6 cases, including 5 "dirty" operations with a mortality of 60 p. 100, healing was slow: 2 cases of evisceration and 2 of abdominal hernia were observed. It was not possible to assess the threshold dose of steroids with regards to this complication, metabolic complications, especially adrenal failure were much less common. Of the diseases requiring steroid therapy the problem of angiitis seemed particularly prominent. Although the prognosis of the intercurrent surgical condition was not aggravated; mortality from a relapse of the angiitis was nearly 100 p. 100. Therefore, medical control of the relapse would seem to be the first priority and should be taken into account when assessing the surgical indications.

Adult↗
PubMed1985

Treatment of progressive systemic sclerosis using factor XIII.

A double-blind, randomized crossover trial was carried out in 25 patients with progressive systemic sclerosis to compare the effectiveness and tolerability of treatment with Factor XIII with that of placebo. Patients received twice daily intravenous injections of either Factor XIII or placebo for 3 weeks and, after a wash-out period of 6 weeks, were crossed over to the alternative medication for a further 3 weeks. Assessments made by the physician and patients at the end of each treatment period indicated that Factor XIII was significantly better than placebo in improving the cutaneous manifestations of the disease and these opinions were supported by the significant improvement in the function index which was used to assess the degree of motor disability. Both local and general tolerability of Factor XIII treatment was good and there were no adverse reports.

Clinical Trials as Topic↗
PubMed1985

[Fasciolar hepatic abscesses: value of hepatic ultrasonography. Apropos of 3 cases].

Hepatic abscess is a rare complication of fasciolasis. The ultrasonographic appearances of these abscesses are not well known. The finding of nodular echodense images in the hepatic parenchyma may cause diagnostic confusion. We report three cases in which abdominal ultrasonography demonstrated hepatic abscesses complicating fascioliasis. Follow-up examination showed regression of these lesions after treatment.

Adult↗
PubMed1985

[Unusual muscular involvement in ankylosing spondylitis].

Muscle involvement in ankylosing spondylitis has been little studied. The authors report two cases with marked muscular atrophy and functional impotence, which had directed the diagnosis towards a myopathy over a period of several years in the first case, and a suspected primary muscular disease associated with ankylosing spondylitis in the second. Muscle biopsies eliminated the diagnosis of myopathy in both cases, with rapid functional recovery with proper treatment. Following a review of the literature, two hypotheses can be considered to explain the muscular involvement in ankylosing spondylitis: one mechanism which appears well-established is a radiculitis with involvement of the paravertebral muscles: other authors suggest that there is nonspecific, generalized muscular involvement in this disorder.

Adult↗
PubMed1985

[Uveitis in acquired syphilis].

Syphilis is a well-established cause of uveal disease and is thought to be responsible for several distinct types of intraocular inflammation. Four cases of acquired syphilitic uveitis are reported. The diagnosis was essentially based on the clinical picture, the elimination of other possible causes, the results of reliable blood immunologic tests eg, the TPHA, FTA and Nelson tests, and the rapid response to penicillin therapy. Evaluation of anti-Treponema pallidum antibodies in the aqueous humor does not contribute to the diagnosis of syphilitic uveitis. Two cases needed large amounts of penicillin (total dosage, 440 million units). Oral steroids were used to control the associated inflammatory reaction and to prevent a Herxheimer reaction. All the patients responded well to therapy.

Adolescent↗
PubMed1985

[Nerve and muscle microvasculitis: 50 cases].

Fifty consecutive cases of nerve and muscle microvasculitis (MV) seen on nerve and muscle biopsies were studied. These were observed in a 5 years period, among 1076 nerve and/or muscle biopsies performed in adult patients in the Laboratoire de Neuropathologie Charles Foix. The systemic necrotizing vasculitides, in which the arteries of diameter greater than 70 microns are involved, acute polymyositis, sarcoidosis and acute polyneuritis were not considered in this study. Mononuclear cell infiltration was the rule. It was associated to leukocytoclasis in 2 cases. No fibrinoid necrosis was seen. These changes were highly diagnostic when seen in the nerve or the connective tissue of the epi or perimysium. The etiology of these microvasculitides was mainly connective tissue diseases (42 p. 100) and, overall, panarteritis nodosa (16 p. 100), or malignancies (28 p. 100) which comprise 7 solid tumors and 4 lymphomas. Other cases were related either to systemic diseases (thromboangiitis obliterans, monoclonal dysglobulinemia, cholesterol embolus) or to local trauma. The relationship between MV and peripheral neuropathy was less obvious in 3 cases of mononeuritis multiplex associated with diabetes mellitus and in 3 cases of acute idiopathic and regressive mononeuritis multiplex. In 5 cases, no cause was found.

Adult↗