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Biomedical subjects

P Michaud

Publications and source records attributed to P Michaud.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Unusual presentation of urinary tract infection in 6 cases].

Urinary tract infections may have different clinical presentations that may range from asymptomatic bacteriuria to purulent collections and severe sepsis. We report 6 diabetic patients, 3 presenting with a renal carbuncle and 3 with an emphysematous pyelonephritis. All required medical and surgical treatment and had a good evolution. Two carbuncles were caused by beta- hemolytic type B streptococcus. This is the second notification of this agent as causative of renal abscesses, probably reaching the kidney through hematogenous dissemination from cutaneous foci.

Abscess↗
PubMed1995

[Disseminated nocardiosis in 3 immunocompetent patients].

Nocardia asteroide infections, an aerobic actinomycete, have several forms and lungs, skin and brain are the organs most frequently involved. When the infection suspected, special staining methods must be ordered to identify the agent. We report three immunocompetent patients with disseminated nocardiosis, two presenting with nodular lesions of skin and lungs and one presenting with pulmonary involvement and brain abscesses. The importance of clinical suspicion and early diagnosis of nocardiosis is emphasized.

Adolescent↗
PubMed1994

Physicochemical properties of extracellular (1-->4)-beta-D-glucuronan produced by the Rhizobium meliloti M5N1CS strain during fermentation: evidence of degradation by an exoenzyme activated by Mg2+.

The mutant Rhizobium meliloti M5N1CS (NCIMB 40472) produced a partially acetylated (1-->4)-beta-D-glucuronan during fermentation. The polysaccharide (EPS) extracted from broth during fermentation by microfiltration and ultrafiltration (using a 100 kDa cut-off membrane) was characterized by size exclusion chromatography. The weight-average molecular weight (Mw) of the EPS decreased from 7.5 x 10(5) to 5 x 10(5) between 27 and 75 h of fermentation. When MgSO4.7H2O (0.8 gl-1 per day) was present in the medium during the same period, the Mw of the EPS decreased to 1.5 x 10(5). Since EPS degradation was detected after microfiltration of the fermentation medium supplemented with magnesium, the Mw decrease of the EPS extracted during fermentation may be explained by enzymic degradation of the polymer activated by Mg2+ ions.

Bacterial Proteins↗
PubMed1994

[Streptococcus pneumoniae septicemia. Analysis of 40 cases].

Sepsis due to Streptococcus pneumoniae has a high mortality. We report a retrospective review of 40 episodes of S pneumonia sepsis in adult patients during a two year period in a general hospital, that represented 11.3% of all sepsis observed in such hospital. Ninety two percent of infections were community acquired and in 95%, the portal of entry was the respiratory tract. Eighty five percent of patients had at least one risk factor such as alcohol abuse, unconsciousness or chronic pulmonary disease. Nine patients had suppurative complications (empyema in 4 cases, spontaneous bacterial peritonitis in 2, septic arthritis in 2 and meningitis in 1 case) and 12 (30%) died. The potential benefit of antipneumococcal vaccine as prevention should be considered in high risk subjects.

Adolescent↗
PubMed1994

[Hypothyroid myopathy. Communication of 4 cases].

We report four patients with primary hypothyroidism (3 female, aged 47, 46, 49 and 34 years old) whose principal manifestation was muscle involvement. The diagnosis was oriented by the finding of myoedema and a slow relaxation phase of tendon reflexes. In one patient, an electromyographic and histological study was performed. Thyroid substitution lead to an improvement in myopathy in all patients.

Adult↗
PubMed1993

[Major adverse reactions to propylthiouracil in 586 cases of hyperthyroidism].

Aiming to know the incidence and evolution of major adverse reactions to propylthiouracil in patients with hyperthyroidism, we performed a retrospective analysis of 586 patients treated between 1982 and 1992. All known complications associated to the use of propylthiouracil were considered major adverse reactions, when other causes were discarded. Eight patients (1.4% of the sample) had major adverse reactions: three had agranulocytosis, 3 hepatitis, 1 cholestasis and 1 vasculitis. All had a good evolution after discontinuing the drug. The patients with agranulocytosis were treated with antibiotics and the patient with cholestasis received prednisone. We conclude that major adverse reactions to propylthiouracil are infrequent, that they occur preferentially during the first months of treatment, earlier after reexposure and that there was no associated mortality.

Adolescent↗
PubMed1993

[Basedow-Graves disease development in 2 patients with primary hypothyroidism: exceptional development of the autoimmune thyroid disease].

Autoimmune thyroid disease has multiple manifestations and its presentation may change with time. We report two patients with primary hypothyroidism due to Hashimoto's disease that unexpectedly, developed a hyperthyroidism due to Basedow-Graves disease. This phenomenon may be explained by variations in the types and proportions of anti TSH receptor antibodies, that can stimulate or block thyroid gland function and growth. It is deducted that the hypothyroidism of these patients was not due to a definitive gland destruction, but to the action of function blocking antibodies.

Adult↗
PubMed1993

[Autoimmune thyroid pathology of pregnancy and puerperium. Prevalence in a zone of endemic goiter and its impact on the newborn].

The aim of this work was to study the prevalence of thyroid disease in pregnant and puerperal women and newborns in Pirque (Chile) and its possible relation to iodine intake or autoimmune disease. Two hundred twenty eight women with 13.4 +/- 3.4 weeks of pregnancy were examined initially and in 223, laboratory tests were performed. Goiter was found in 107 women. Although all women were euthyroid, those with goiter had higher serum levels of T3 and T4. Nineteen women had positive anti-thyroid antibodies and urinary iodine excretion was > 100 micrograms/g creatinine in 87.2%. Within 2 and 57 weeks after delivery (mean 13.5 weeks), 183 women were reexamined and in 175 laboratory tests were performed. Serum T3 continued to be higher in those with goiter. Fifteen women with positive anti-thyroid antibodies during pregnancy continued to have positive titres; of these, two had a post partum thyroiditis and one a graves disease. Two hundred three newborns were examined and no one had goiter or elevated TSH. It is concluded that there is a high frequency of goiter among pregnant and puerperal women from Pirque, that iodine intake is normal and that there is a low frequency of post partum thyroiditis.

Adolescent↗
PubMed1992

[Treatment of severe rhesus isoimmunization by repeated transfusions in utero].

Repeated transfusions in utero by umbilical cord puncture enable the treatment of severe forms of rhesus incompatibility. The two cases reported, including one involving seven transfusions between twenty and thirty seven weeks since the LMP, form the basis of a review of the literature defining the advantages and results of this technique.

Blood Transfusion, Intrauterine↗
PubMed1991

[Surgical treatment of vulvar stenosis. Technic description].

A surgical technique for the treatment of vulvar stenosis is described. The recto-vaginal space is approached by the cutaneous route, starting with incisions for resection of 2 skin triangles arranged as butterfly wings on either side of the midline. The sclerous cicatricial tissue between rectum and vagina is widely exposed and incised so that the lower part of the posterior vaginal surface can be dissected and mobilized without any risk of damaging the mucosa, since the tractions required for cleavage are exerted on the cutaneous side of the bridle. It is only at this stage that a median sagittal cutaneo-mucosal incision of the bridle is carried out, followed by a transverse suture without tension. This easily performed technique has been used in 11 cases without complication and with satisfactory long-term functional results.

Constriction, Pathologic↗
PubMed1991

Tissue effects of methotrexate injected into the uterine horn of pregnant female rats.

Methotrexate has been proposed as a treatment for unruptured extra-uterine pregnancy, but its effects on the tubal wall remain unknown. In order to analyse these effects, an experimental study was carried out on two groups of pregnant female rats, one receiving methotrexate (n = 8) and the other sodium chloride (n = 6). In both groups, a single intra-embryonic injection was performed in the uterine horn. The genital tract was prepared for histological examination. In all rats which received a single dose of methotrexate (5 mg per 100 g body weight) six days after mating and were killed nine days later, the labyrinthine part and the junctional zone of the placenta were necrotic at the site of the injection, with no embryonic development. The other parts of the genital tract were not visibly altered. In rats receiving sodium chloride and killed under the same conditions, necrosis of the placenta was observed at the site of injection in three animals. In the other three rats, a focal necrosis of the placenta was found, which was probably of mechanical origin. From this study, we conclude that methotrexate is efficient in killing normally implanted embryos and is, at least under light microscopy, non-toxic to the adjacent portions of the genital tract.

Animals↗
PubMed1991

A prepubertal surge of thyrotropin precedes an increase in thyroxine and 3,5,3'-triiodothyronine in normal children.

The variations in plasma levels of TSH, T4, T3, and rT3, during the pubertal period, were studied in 647 school students from the urban area of Santiago in Chile (47% males and 53% females) with ages ranging between 7.5 and 15 yr. The subjects were grouped by age in consecutive intervals of 6 months each, and pubertal development was determined in every subject. TSH showed a significant increase, reaching a peak in the 9- to 9.5-yr interval. The same was found for T3 and T4, which reached a peak by 10 and 11 yr. The T4/T3 ratio did not show any significant variation with age. After 9.5 yr, a decrease in rT3 and increase in the T4/rT3 ratio was found. The TSH peak preceded the onset of clinical pubertal development, while the T3 and T4 peaks coincided with this onset. The variations in rT3 suggest an increase of peripheral conversion of T4 to T3. These transient events, not described until now, could be termed thyroidarche and could have a significant effect on pubertal growth and development.

Adolescent↗
PubMed1991

[Catheterization of petrous sinus and selective determination of ACTH: usefulness in the management of Cushing's syndrome in 2 cases].

Two patients with Cushing's syndrome are reported. The syndrome was the consequence of relapse after transphenoidal resection of a pituitary tumor in one and due to occult ACTH secretion in the other. Determination of ACTH after bilateral petrosal sampling in both cases and after systemic venous sampling at different sites in one, allowed localization of the source of hormone secretion which was confined to one side of the hypophysis in one case and to the thorax in the other. Hypophyseal resection in the first case and bilateral adrenal resection in the other were performed successfully. The value of this diagnostic test is analyzed.

ACTH Syndrome, Ectopic↗
PubMed1991

[A comparative study of properties of paracetamol tablets of the matrix type].

Our study was to compare the quantitative and qualitative effects of 2 polymeric agents (méthylcellulose, hydroxypropylmethylcellulose) and of 2 diluants (lactose and dicalcic phosphate) on the compression properties and sustained liberation of acetaminophen matrixes. Three experimental plans were permitted the experimentation; regression equations were used for our analysis of the results. The results we obtained show the superiority importance of the effect of the diluant/acetaminophen ratio over the liberation of the drug, as well as the better efficiency of méthylcellulosic matrixes. Thence to its solubility, the lactose helps to a faster liberation.

Acetaminophen↗
PubMed1991

[Placental villitis].

Placental villitis, which is defined by the presence of lymphocytic or macrophagic inflammatory cells within the villosities, constitutes a recently-described histopathological entity. This condition is the consequence of an immune response of the feto-placental unit towards a non-specific, multiple aggression and the incidence is very low. The extent of the inflammatory reaction may culminate in placentitis, resulting in miscarriage. Although a large number of infecting agents are known to be responsible for the pathogenesis of villitis, in most cases the etiology remains unknown. The hypothesis of a failure of the mechanisms of immunotolerance during pregnancy is suggested by many authors to explain their origin.

Chorionic Villi↗
PubMed1991

[Epithelialization of a new vagina after nymphoplasty and salpingoplasty].

The association of salpingoplasty to the previously described nymphoplasty improves the result of the vaginoplasty of the Rokitansky-Kuster-Hauser syndrome. The pediculate mucous flaps obtained by cleavage of the labium minus are linked with the vascularized tubal flaps from the lumbo-ovarian ligament. In the present observation, this dressing up technique of the new vagina has enabled a quick and complete epithelialization, avoiding a progressive obturation from inwards towards the surface, without the use of a mandrin in the long run.

Adult↗