Biomedical subjects
Publications and source records attributed to P Roblot.
Results of a prospective trial showed that 7.9% of patients in an internal medicine department were affected by a drug-induced pathology (DIP). Reasons for this include non respect of contra-indications or to non supervision of treatment such as anti-hypertensive drugs. DIP affected more often elderly patients, and reflected superconsummation of medication.
A retrospective study of ten cases of intoxication due to Datura were reported. Clinical symptoms were those of atropinic intoxication, associated with hallucinations and aggressiveness. The diagnostic is supported by clinical examination. Laboratory examinations are useful only for differential diagnosis.
Forty-seven patients were included in a prospective trial to define the interest for searching immunologic abnormalities during endocarditis. No specific abnormalities were found, aside some patients with endocarditis who have a high levels of immune complexes. These results suggest that the interesting immunologic abnormality is the presence of an high level of immune complexes could be of interest in endocarditis.
The authors report the results of a study concerning 90 patients admitted to an Internal Medicine Unit for transient loss of consciousness. The cause of this event was found in 74 cases (82%), including 73 where the initial evaluation had been simple, consisting of physical examination, electrolytogram, blood glucose level, electrocardiogram and test for postural hypotension. Patients and physicians reported different frequencies of recurrence (17 and 51% respectively) and complications (27 and 96% respectively). Recurrences were usually multiple and appeared soon after the initial event. A 4% mortality rate was recorded over 21 months, but only one death was due to a cardiovascular cause. No death was observed in the group of patients without initial aetiological diagnosis. Apart from cardiac syncopes, the consequences of transient loss of consciousness seem to be psychological rather than physical. A simple initial evaluation is often sufficient.
Leukaemia inhibitory factor (LIF) is a cytokine which possesses a wide range of biological activities including, like IL-6, the capacity to stimulate acute phase protein (APP) synthesis. We have developed a sensitive and specific ELISA for human LIF, and tested the circulating cytokine levels in various disease states, some of which are associated with inflammation. LIF was detected in 11/20 sera from patients with giant cell arteritis (GCA), a vasculitis syndrome affecting particularly the temporal artery, characterized by panarteritis with inflammatory cell infiltration. LIF levels were considerably elevated in some patients who also displayed elevated levels of IL-6 and C-reactive protein (CRP); however, no correlation was observed between the levels of circulating LIF and levels of IL-6 or CRP. Furthermore, LIF levels were not affected by corticosteroid therapy, whereas IL-6 and CRP decreased rapidly, as clinical symptoms resolved. A putative role for LIF in the persistence of histological lesions is discussed. This is the first report of the presence of circulating LIF in sera. These results are in agreement with the complexity of induced inflammatory cytokines and corticoid regulation of APP synthesis observed in vitro and in vivo.
A case of ankylosing spondylarthritis in which retroperitoneal fibrosis developed 16 years after onset is reported. The patient also had aortic incompetence and cardiac conduction disorders. Eight other cases of ankylosing spondylitis with retroperitoneal fibrosis have been published. Potential relationships between the two conditions--including the possible role of indomethacin used by the patient for 16 years--are discussed.
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The value of serum bactericidal activity (SBA) determination for assessing the effectiveness of antibiotic therapy was evaluated in a retrospective open study in 168 cases of septicemia. Outcomes in a first group (I) of 67 patients with a SBA of at least 1/4 were compared with outcomes in a second group (II) of 101 patients with a SBA below 1/4 or non-determined. Within these groups, outcomes of 37 septicemias due to Gram negative bacilli (subgroup Ia) and 22 staphylococcal septicemias (subgroup Ib) with a SBA greater than or equal to 1/4 were compared with outcomes in 26 septicemias due to Gram negative bacilli (subgroup IIa) and 22 staphylococcal septicemias (subgroup IIb) with a SBA less than 1/4. Statistical analysis of distribution of age, sex, underlying disease, biologic parameters and antibiotics given demonstrated no significant difference between the various groups. 56 patients (86.1%) recovered in group I, against 76 (79.1%) in group II; corresponding figures are 34 (91.1%) and 21 (84%) in subgroups Ia and IIa respectively. These differences are not significant (p greater than 0.05). Our findings suggest that an "effective" SBA fails to correlate with favorable outcome of septicemia.
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