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Biomedical subjects

P Godeau

Publications and source records attributed to P Godeau.

At least 487 records · Page 27Linked to original sources
PubMed1979

Fate of circulating immune complexes in infective endocarditis.

To examine the role of circulating immune complexes (CIC) in infective endocarditis, we studied 64 patients with infective endocarditis for the presence of CIC by the polyethylene-glycol (PEG)-precipitation test and the Clq binding test. This study was repeated during the course of the disease in 23 patients. CIC were found in 84 per cent of patients (66 per cent with acute infective endocarditis, 89 per cent with subacute infective endocarditis) during the active phase of the disease. Higer PEG precipitates were associated with typical cutaneous signs, cryoglobulins and nonstreptococcic culture-positive infective endocarditis. Under appropriate antibiotic treatment, the PEG precipitate levels of 17 patients fell within 1 month to the normal range, with a concomitant drop in cryoglobulinemia and rheumatoid factor. Conversely, uncontrolled sepsis always (six of six) yielded a rising level of CIC. These findings support the hypothesis that CIC may be important in the pathogenesis of peripheral lesions in infective endocarditis.

Adolescent↗
PubMed1979

[Fiessinger-Leroy-Reiter syndrome with non-obstructive cardiomyopathy treated with methotrexate].

The case of a 50 year old male with the Fiessinger-Leroy-Reiter syndrome, ankylosing spondylitis and generalised pustular psoriasis is reported. This condition wax complicated by non-obstructive cardiomyopathy, congestive cardiac failure and first-degree atrioventricular block, the site of which was localised by electrophysiological studies (nodal block with an infrahisian conduction defect). After failure of several therapeutic regimes, a spectacular improvement was obtained with Methotrexate associated with a diuretic; the signs of heart failure regressed and the cardiomyopathy stablised. A parallel improvement was seen in the skin, cardiac and articular lesions and has been maintained with an 18 months follow-up. Left ventricular performance was studied by echocardiography. The mechanism of the beneficial effect of Methotrexate is unclear; this therapeutic trial is to be extended to include other cases of primary cardiomyopathy without obstruction.

Arthritis, Reactive↗
PubMed1979

[Glomerulopathy during Behçet's syndrome. Immunofluorescent and electron microscopy studies (author's transl)].

Full renal investigation were conducted in 11 patients with Behçet's syndrome. Biological tests revealed the presence of mild proteinuria in 5 of them. Needle biopsy showed extra-membranous or mesangial fibrinoid deposits in 6 cases, associated in 1 case with segmental and focal glomerulitis lesions. Immunofluorescence studies demonstrated glomerular deposits of mesangial and extra-membranous C3, sometimes with immunoglobulins (IgA-AgG). Ultrastructural examination was carried out in 7 cases and showed "hump" deposits attached to the external face of the basal membrane and rounded nodules of 7 to 15 mu included in the mesangium. The presence of immune complexes in the renal glomeruli, therefore, is not all unusual in this disease, which is probably auto-immune in nature, and in fact appears to be a quite frequent occurrence. These deposits, which were probably well-tolerated by most of the patients in this series, might be involved in the production of progressive glomerulopathies in chronic cases, as observed in one of the cases studied.

Adolescent↗
PubMed1978

[The association of a digestive carcinoma and subacute endocarditis. 4 cases (author's transl)].

Attention has recently been drawn to the association of digestive carcinoma and streptococcus bovis endocarditis. The authors studied 130 records of patients with endocarditis and an association with a digestive tumour (3 neoplasms, one villous tumour) was found in four. Streptococcus bovis was demonstrated in one case, streptococcus faecalis in two and streptococcus durans in one. The association of carcinoma and subacute endocarditis would thus seem to not solely relate to digestive commensual organisms. The question of common factors favourising carcinoma and endocarditis is raised.

Adenocarcinoma↗
PubMed1978

Surgical correction of chronic postembolic obstructions of the pulmonary arteries.

Following episodes of pulmonary embolism, the presence of thrombi in the pulmonary arteries leads to severe respiratory insufficiency and chronic right heart failure. We have operated upon 16 such patients, nine men and seven women from 23 to 68 years of age. All had severe dyspnea, 14 had chronic cor pulmonale, six had mental disturbances with syncope, and four had severe cardiac failure. The presence of clots was demonstrated by pulmonary angiography, and the permeability of the distal arterial bed was ascertained by selective injection of the bronchial arteries. In all cases but two a lateral thoracotomy was used so that the obstructed arterial branches could be approached distally. The inferior vena cava was always ligated to prevent recurrences. There were six operative deaths, three from cardiac failure, one from acute pulmonary edema, one from hemothorax, and one following a pyothorax. Ten patients are surviving after 6 months to 10 years. One is still limited because of significant pleuropulmonary sequelae. Six are enjoying good results with marked improvement in their functional limitations, a significant drop in the pulmonary artery pressure, and radiological permeability of previously obstructed arteries. Three are excellent condition--completely asymptomatic.

Adult↗
PubMed1977

[Scleroderma presenting as oedema (authors transl)].

The authors report 8 cases of scleroderma with oedema in the initial stages which could be divided amongst three groups on the basis of their clinical, biological, histological characteristics and course: normal systemic scleroderma, mixed connective tissue disease, Shulmans syndrome. The relationship between one of these cases and Buschke's scleroderma is discussed. These cases of scleroderma are characterized by diagnostic difficulties in the initial phase and by their relatively favourable vital prognosis (one death only). Corticosteroids may be effective to some extent in the presence of mixed connective tissue disease of Shulman's syndrome.

Adrenal Cortex Hormones↗
PubMed1977

[Diagnosis of a fibrosarcoma of the psoas presenting with fever only by gallium citrate scintigraphy (author's transl)].

A fibrosarcoma of the psoas in a 62-year-old woman manifested itself essentially by a febrile syndrome for approximately one year. It would appear that the first manifestation of the lesion occurred three years previously (lumbar pain). Careful clinical examination, numerous radiological studies and two exploratory laparotomies failed to reveal the site of the lesion. The latter was finally demonstrated by GaC67 gammagraphy. This case thus confirms the great value of this radioactive tracer in the diagnostic study of a febrile syndrome as a tumour syndrome. It would appear to be perhaps desirable, in this pathological context, to request a whole body study using GaC67 before proceeding to exploratory laparotomy.

Back Pain↗
PubMed1977

[HLA markers and periodic disease [familial Mediterranean fever (F.M.F.)] (author's transl)].

Thirty-one unrelated patients, 15-52 years old, were typed by microlymphocytotoxicity for 27 alleles of the HLA system. In addition, 12 families including 1 or more patient were also analysed. This criteria for diagnosis were those of Sohar et all. (Am. Intern. Med., 1967, 43, 227-253). All patients were of Israelite-Sephardin origin except two (Armenian and French); they were from North-Africa (Tunisia, Morocco and Algeria) and Israël. The results were compared to the antigen frequencies of 3 reference normal populations. The frequencies of the studied alleles do not differ from those of controls, except for HL-A28 and B14 slightly increased when compared to the normal frequencies. The study of 7 families with at least two sibs suffering from FMF shows a random distribution of the genotypes : 2 HLA identical, 6 different and 10 haploidentical diseased sibs. This distribution differs significantly (p less than 0.01) from that expected in the case of a recessive inheritance. These data do not support the hypothesis of a linkage between genes controlling FMF and HLA genes.

Adolescent↗
PubMed1977

[Treatment of hypercalcemia].

Hypercalcemia may have various causes. I should nevertheless be rapidly treated. Among recent treatmens, we may quote diuresis with furosemide, calcitonin, mithramycin, which are the most effective. More recently indomethacin has been used and may be more specific for neoplastic hypercalcemia. These various treatments should be proposed depending on the level of serum calcium, the rapidity of onset and the presumed cause.

Calcitonin↗
PubMed1977

[Hypokalemia and hypomagnesemia in a cirrhotic patient. Correction of metabolic disorders by magnesium].

The authors report the case of a cirrhotic with severe hypokalemia (2 mEq/l) responding incompletely to attempts at correction by classical treatments. The findings of a serum and red cell magnesium deficiency led to administration of this electrolyte which proved efficacous. They then recall the mechanism of hypokalemia and hypomagnesemia in alcoholics, study the possible relationship between these abnormalities, their noxious effects and suggest a treatment.

Humans↗
PubMed1977

[Periarteritis nodosa and Australia antigen. Comparative study apropos of 25 cases].

The authors compared two series of 27 cases of périateritis over a period of 5 years. The determined the frequency of the nodosa HBs+ (series B) and HBs-- (series A) collected clinical and laboratory signs in both series. There resulted that apart from the hepatic signs constant in series B and absent in series A, the only statistically significant differences were the joint sings and the hypertension more common in series B and the respiratory signs more common in series A. Furthermore, the course of HBs+ cases appears much mote severe than that of HBs-- cases which emphasises the importance of the hepatic involvement but this finding should be interpreted with circumspection for the mode of selection of the patients and the treatment were different in the two series.

Adolescent↗
PubMed1977

[Coagulation and acute disseminated lupus erythematosus. Apropos of 25 cases].

It is important to study coagulation during lupus disease, not only to detect circulating anticoagulants, which may be the cause of hemorrhage, but also in order to seek chronic hypercoagulability, which is more dangerous as it may favour the development of thrombosis on inflammatory arteritis or aggravate the development of glomerular lesions. We have thus explored in this way 25 patients with systemic lupus of which 17 had histologically confirmed renal disease. 25% had hypocoagulability, but 50% had hypercoagulability which justitied treatment with heparin.

Blood Coagulation↗