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Biomedical subjects

P Godeau

Publications and source records attributed to P Godeau.

At least 397 records · Page 22Linked to original sources
PubMed1985

[Collagen diseases and microcirculation].

The microcirculation (terminal vessels with a calibre of less than 30 mu) was examined by means of capillaroscopy which was correlated with histological studies. According to the classification of vasculitis, microvasculitis is a pathological process involved in a number of collagen diseases. The study of the cutaneous lesions of leukocytoclastic angiitis is one of the best method for approaching the study of these microangiopathies, especially in the context of hypersensitivity vasculitis. The study of the microcirculation may also be valuable in other connective tissue diseases (various forms of necrotic vasculitis, lupus, scleroderma, polydermatomyositis) and in Behçet's disease. However, this study is only in its preliminary stages and the data of capillaroscopy need to be interpreted critically.

Capillaries↗
PubMed1984

[Incidence of antinuclear antibodies during treatment with acebutolol. A 1-year prospective study in 45 hypertensive patients treated by monotherapy].

Determinations of antinuclear antibodies (ANA) were performed before treatment, then every 3 months for one year, in 45 hypertensive patients treated with acebutolol alone in daily doses equal or superior to 800 mg. Non significant ANA titers (1/10 to 1/40) were detected before treatment in 8.8% of the patients. After one year of treatment, 15.5% of the patients were found to have antinuclear antibodies. In 4 (8.8%) female patients (3 of whom were ANA-negative before treatment) the ANA titers were above 1/40. Treatment was discontinued in one of these due to the occurrence of bronchospasm. No lupus-like syndrome was observed during the course of the study. Prolonged prospective studies with acebutolol alone would be required to determine whether in the long term the incidence of significant ANA titers remains at the 8.8% level or increases.

Acebutolol↗
PubMed1984

[Necrotizing angiitis with or without asthma. Clinical, biological and etiological differences. Role of hepatitis B virus].

Sixty-five cases of necrotizing angiitis, including 20 with asthma (group A) and 45 without asthma (group B) were studied retrospectively. All patients were investigated for markers of hepatitis B, at least the HBs antigen. Skin lesions and arthralgias were more common in group B patients. Eosinophilia during angiitis was almost constant in group A and was observed in only 6% of group B patients. Renal involvement, hepatic lesions and arterial hypertension seemed to be more frequent in group B but the difference was not significant. The HBs antigen was present in 1/20 patients of group A and in 17/45 patients of group B (p less than 0.01). The anti-HBs antibody was found with equal frequency in both groups. The clinical and biological differences observed between these two groups of patients strongly suggest that necrotizing vasculitis with and without asthma are two separate nosological entities and in particular, that they have different causes.

Adolescent↗
PubMed1984

[Systemic periarteritis nodosa associated with monoclonal gammapathy. 4 cases].

Four cases of monoclonal gammopathy associated with polyarteritis nodosa are reported. In view of the chronology of events and course of the disease, the connections between protein peak and polyarteritis nodosa can be considered. Management of polyarteritis nodosa is discussed according to the existence of a peak which may originate in myeloma. The part played by plasma exchanges is debated.

Aged↗
PubMed1984

[Periarteritis nodosa and viral hepatitis B, conjugal forms. Apropos of 4 cases].

Four cases of periarteritis nodosa (PAN) associated with HB virus are reported in three couples. The spouse also had periarteritis nodosa (cases 1 and 2) or had hepatitis B (spouses of cases 3 and 4). These observations underscore the part played by conjugal transmission of HB virus and the risk of secondary PAN. Such observations are uncommon as the four reported cases occurred among a group of 95 PAN patients. Nevertheless, they are additional evidence in support of the role of HB virus which is associated with PAN in 45% of cases in this series.

Adult↗
PubMed1984

[Association of Horton's disease and periarteritis nodosa. Apropos of 3 cases].

Three cases of giant cell arteritis associated with periarteritis nodosa are reported. A review of the literature showed 16 similar reports. Giant cell arteritis features in temporal arteries were associated with periarteritis features in visceral or peripheral arteries in 5 cases only. Association of these two conditions seems to be uncommon and may be coincidental but does not justify including giant cell arteritis within the group of necrotizing angiitis. Awareness of this association nevertheless has practical implications as these cases should be treated as PAN patients.

Aged↗
PubMed1984

[A case of purpura, or the return to natural diseases].

With reference to a case of vitamin C deficiency in a strict vegetarian, the authors recall the clinical findings and current diagnostic procedures in scurvy. Serum and urine ascorbic acid assays are now available and established the diagnosis. Management rests upon vitamin C given in a curative dosage of 1 to 2 g per day for 15 days followed by a preventive dosage of 10 mg per day.

Adult↗
PubMed1984

[Inferior caval syndromes. Apropos of 45 cases].

The authors report their experience with 45 cases of inferior vena cava thrombosis. Diagnosis was delayed for an average of 55 days. One-third of cases were revealed by an embolic complication. Inflammatory diseases were the most common causes (Behcet disease: seven cases, systemic lupus erythematosus: 5 cases). Malignancies accounted for 20% of cases. Abnormalities of coagulation were uncommon: antithrombin III deficiency in one patient and protein C deficiency in another. Estrogen-progestogen combinations could be incriminated in 4 cases. Outcome was fatal in 20% of cases, usually as a result of the underlying disease. Functional status was good in two-thirds of patients without malignancy followed up for an average of 27 months. In 14 patients a clip was inserted to ensure total (3 cases) or partial (11 cases) interruption of vena cava blood flow because of a free thrombus and/or recurrent pulmonary embolism. Three patients had thrombectomy. After clip insertion two embolisms were recorded, one of which occurred in the immediate post-operative period.

Adolescent↗
PubMed1984

[Treatment of human brucellosis with rifampicin].

Rifampin, which exhibits good intracellular diffusion and in vitro bactericidal activity on brucella, is effective in experimental brucellosis in mice, without selection of resistant strains. It was therefore legitimate to use rifampin in man since conventional treatment of acute brucellosis is followed by recurrence in 15% (tetracycline alone) or 3.7% (streptomycin-tetracycline combination) of cases. Rifampin was given to 13 patients with brucellosis (acute brucellosis in 8, osteoarticular brucellosis in 3 and chronic brucellosis in 2). Rifampin was given as sole therapy in a daily dosage of 600 to 1 200 mg. A tetracycline was subsequently needed in three cases, in combination with rifampin in two, and as replacement therapy in one. Treatment lasted 20 to 60 days in acute brucellosis and 2 to 15 months in other forms. Only one failure was recorded among the 11 cases of acute or localized brucellosis. Conversely, effectiveness of rifampin proved incomplete (1 case) or null (1 case) in chronic forms. The satisfactory effectiveness of rifampin is confirmed by a review of the literature which found 17 reports addressing the subject. These include 324 cases of brucellosis treated by rifampin, as sole therapy in 255 patients, with only 24 failures ascribable to faulty dosage. Indeed, rifampin must be given for at least 30 days, in a minimal daily dosage of 600 mg or 10 mg per kg, in a single dose. Cotrimoxazole is an antagonist and should not be associated with rifampin. Conversely, tetracyclines are synergistic and their association, which is useless in acute brucellosis, is helpful in localized and chronic forms.

Acute Disease↗
PubMed1984

[Arterial hypertension in periarteritis nodosa. 37 case reports].

Hypertension in periarteritis nodosa poses the problem of aetiology, prognostic significance and treatment. Thirty seven cases of periarteritis noda with hypertension were analysed with à follow-up of over 10 years. These cases were taken from a series of 91 patients with polyarteritis nodosa admitted to the Department of Internal Medecine at the Pitié Hospital, between 1960 and 1980. Hypertension was observed on admission in 40% of the patients and developed during the first year of the disease in another 40%. The prognosis of patients with polyarteritis nodosa and hypertension is not significantly different from those without hypertension during the first six years. The overall prognosis depends mainly on the degree of renal involvement. The hypertension is renovascular in a number of cases due to ischaemia of the renal cortex. This was demonstrated by renal arteriography or by evaluating plasma renin activity in the renal veins. In some cases, especially those in which the hypertension preceded the periarteritis nodosa, the hypertension seemed to progress independently. In some cases, however, it was not possible to determine the relationship between the periarteritis nodosa and the hypertension or confirm that this association was coincidental. The use of angiotensin I converting enzyme inhibitors is an important advance in the treatment of the hypertension of periarteritis nodosa with high plasma renin activity as it counteracts the exact mechanism of the hypertension. Their use is justified in high plasma renin activity hypertension of periarteritis nodosa; patients who fail to respond may be treated with betablockers or other antihypertensive drugs.

Adolescent↗
PubMed1984

[Sarcoidosis in internal medicine. A cooperative study of 554 cases].

The authors report the results of a retrospective cooperative study of 554 cases of sarcoidosis admitted to departments of internal medicine. The condition is more common in women (57 p. 100) than men (43 p. 100), but the onset is earlier in men. The clinical presentation is very variable and includes a wide variety of extra-thoracic localisations. "Guided" biopsy of early accessible lesions (skin, subcutaneous lymph nodes) is positive in 92 p. 100 of cases: the sensitivity of "blind" biopsy is less impressive, ranging from 49 to 69 p. 100 according to the tissue biopsied (bronchial mucosa, accessory salivary glands, liver). Alveolar lavage is positive in 65 p. 100, and angiotensin converting enzyme is positive in 58 p. 100 of untreated cases. There is a clear correlation between the results of these investigations and the radiological stage of the mediastino -pulmonary disease. Steroid therapy was instituted in 68 p. 100 of cases. The outcome with or without therapy was favourable in 82 p. 100 of cases, confirming the usually benign course of sarcoidosis when the heart is not involved.

Adolescent↗
PubMed1984

[Cardiac manifestations of the hypereosinophilic syndrome. The value of 2-dimensional echography (12 cases)].

The prognosis of the hypereosinophilic syndrome (HS) depends mainly on the development of endomyocardial fibrosis (EMF). This complication may be overlooked at an early stage, although its presence is an indication for steroid or antimitotic therapy of the HS. Even at an advanced EMF and associated intracardiac thrombi may not be visualised by angiography. This study was undertaken to assess the diagnostic value of 2D echocardiography in 12 patients. The patients were all men (12 of them) aged 22 to 64 years with unexplained eosinophilia 1 500/mm3 for over 6 months, and visceral lesions. The patients were divided into 3 clinical groups. Group A comprised 4 "allergic" patients with chronic asthma and a significant elevation of IgE; Group B comprised 5 "myeloproliferative" patients with splenomegaly and/or hepatomegaly and a significant elevation of serum B12 levels. The 3 remaining patients who could not be allocated to either Group A or B formed the third group (Group C). 2D echocardiography was carried out on average 30 months after diagnosis of the HS and six planes of examination were used systematically (two parasternal, two apical, one extreme apical and one subcostal). Right and left ventriculography was performed in 6 patients (less than one month before or after 2D-echo). Anatomical studies were obtained in 4 cases (2 operations, 3 autopsies). Echocardiographic signs of EMF were observed in 8 cases. Four patients had a restrictive cardiopathy associated to a large LV thrombus in 2 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Periungual capillaroscopic aspects in Behçet's disease. Apropos of 30 cases].

Nailed capillaroscopy was systematically performed in 30 patients with Behcet's disease to search capillary dystrophies with paradoxal normal number of capillary loops; some indirect signs of microvascular disease were noted: pallor of the background; petechiae; sludge; abnormal visibility of the venous plexus and of irregularly arranged venules. Eight patients had a normal capillaroscopy: thirteen had direct signs of microvalvular abnormalities (nine cases with two direct signs and at least two indirect signs; and four cases with two direct and one indirect, or one direct and three indirect signs). Nine patients had only sludge and/or petechiae. We never observed any abnormality in the number of the capillaries, in the sweat droplets nor in the circulatory speed. Two patients had megacapillaries resembling those seen in scleroderma. The petechiae were observed in 50 p. 100 of the cases. We found no correlation between the capillaroscopic abnormalities and the age, sex, duration of the disease, or ethnic background. However, the presence of aphthosis the day of the capillaroscopy seems to be correlated with the cutaneous microvascular abnormalities. Thus, there exist frequent capillaroscopic abnormalities in Behcet's disease. Although aspecific, they point out the vascular tropism of this disease, resembling that of the vascularite. The prognostic importance of the capillaroscopy in Behcet's disease is under study.

Adult↗
PubMed1984

[Recurrent abortions and circulating anticoagulant. Relation to lupic disease: 6 cases].

Six women, aged 16 to 27 years old at the beginning of their illness suffered recurrent spontaneous abortion (two to eight episodes) and three of them had arteriolar venous thrombosis. These symptoms led to the finding of an antiprothrombinase type of circulating anticoagulant. In two cases, positive dissociated syphilitic serology was observed and all patients presented other haematological abnormalities: thrombocytopaenia and/or autoimmune haemolysis. The diagnosis of disseminated lupus erythematosis was established after an average period of 11 years (range 1 to 27 years) based on at least 4 of the ARA criteria (five out of six cases) and/or characteristic immunological abnormalities (five out of six cases). Thrombosis is more common in lupus when there are associated haematological abnormalities. It is probably directly related to the presence of circulating anticoagulant which inhibits the production and/or secretion of prostacyclin by the endothelial cells.

Abortion, Habitual↗