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Biomedical subjects

R Marechaud

Publications and source records attributed to R Marechaud.

33 records · Page 2Linked to original sources
PubMed1984

[Chronic atrophic polychondritis. Critical analysis of the therapeutic efficacy of dapsone. 2 cases].

Dapsone has been used since 1976 in the treatment of relapsing polychondritis. A critical analysis of its therapeutic effectiveness based on 2 personal cases and 14 cases reported in the literature, all treated with dapsone alone, showed that treatment had to be discontinued in 4 on account of side effects (haemolytic anaemia, erythema multiforme, somnolence, headache, nausea); 1 patient showed no improvement and 5 relapsed; 6 responded favourably and without relapse during a 3 months' to 4 years' follow-up. Considering the unpredictable course of relapsing polychondritis and the fact that some of its clinical manifestations, notably auricular chondritis, may spontaneously resolve, the response of the disease to dapsone is difficult to establish and requires to be confirmed by a controlled clinical trial.

Aged↗
PubMed1984

[Remission induced at the early stage of insulin-dependent diabetes: do predictive factors exist?].

The induction of a remission has been attempted in 28 patients with insulin-dependent diabetes of less than 3 months' duration by strictly normalizing glycemia either with a period of external artificial pancreas followed by continuous subcutaneous insulin infusion (22 patients) or with continuous subcutaneous insulin infusion alone (6 patients). HLA A, B and DR antigens were determined in every patient. Residual beta-cell function was evaluated by measuring C peptide and the ratio of C peptide to glycemia, and by testing the response to a glucagon stimulation before initiating and after withdrawing insulin treatment. Oral treatment with 15 mg glibenclamide and 840 mg metformin daily was administered when insulin had been stopped. A remission was obtained in 17 of the 28 cases. The likelihood of a remission was greater if: (1) the patient was older (mean age was 25.6 years in case of success and 16.6 Years in case of failure); (2) initial daily needs for insulin were smaller (0.88 v. 1.23 U/kg); and (3) stimulated secretion of C peptide was larger (0.22 v. 0.11 mmol/l).

Adolescent↗
PubMed1983

[Arterial hypertension with secondary hyperaldosteronism, reversible by nifedipine, in systemic scleroderma].

A case of severe hypertension with secondary hyperaldosteronism developing in a 71 year old woman affected by "Crest" syndrome is reported. The patient was treated by nifedipine, which led to the correction of blood pressure, plasma renin activity and serum aldosterone. The role of renal arteries vasospasm and renin-angiotension system in the genesis of scleroderma is discussed.

Aged↗
PubMed1982

[Nephrotic syndrome associated with chronic lymphoid leukemia. Review of the literature apropos of a case].

A case of chronic lymphoid leukaemia complicated by a nephrotic syndrome is reported. There was no evidence of amyloidosis or renal vein thrombosis. Percutaneous renal biopsy disclosed lobular membranoproliferative glomerulonephritis with subendothelial deposits of IgG, C3, C4 and C1q. Circulating immune complexes, IgG lambda cryoglobulin and low CH50 levels due to activation of the classical pathway were demonstrated in serum. Immunosuppressive treatment of the leukaemia resulted in complete regression of the nephrotic syndrome.

Aged↗
PubMed1982

[Blood sugar control in diabetics with the insulin pump. Comparison with discontinuous injections].

Eighteen insulin-dependent diabetic patients received insulin in a continuous subcutaneous infusion delivered by a portable pump. Short-term glycemic control was evaluated on the average glycemia (serum glucose was assayed seven times per 24 hours for three to five days), on the MAGE coefficient which gives an estimate of glycemic lability, and, in eight patients, on serum C-peptide concentrations. Results were compared to those recorded with two daily subcutaneous injections of a combination of regular and intermediate insulin. The average glycemia and the MAGE coefficient were 1.32 + 0.05 milligram (m + SEM) and 1 + 0.05 milligram respectively under continuous infusion, compared to 2.05 + 0.12 and 1.76 + 0.12 milligram respectively under insulin injections. Insulin requirements were significantly lower under continuous infusion (0.99 + 0.08 U/kg versus 1.35 + 0.11 U/kg). In three patients with brittle diabetes the use of the pump ensured rapid metabolic control. The advantages and drawbacks of portable insulin pumps are discussed in the light of this experience.

Adolescent↗
PubMed1982

[Viral etiology of aseptic lymphocytic meningitis. Twenty-four cases seen over a nine-year period (author's transl)].

Among 208 cases of aseptic lymphocytic meningitis seen over a nine-year period, 24 were diagnosed as viral infections. Diagnosis was established by both isolation of the virus from one or several specimens (feces, pharyngeal mucus, CSF) and significant rise in specific antibody titres. The usual clinical and epidemiological characteristics of these benign infections were demonstrated in our series: prevalence in males; recrudescence in summer; infectious syndrome associated with an unequivocal, though moderately severe, meningeal syndrome, and occasionally with various visceral manifestations (exanthema, pharyngitis, acute respiratory disease, myalgia); clear CSF usually with pleiocytosis (relative but not absolute predominance of lymphocytes) and normal chemical findings. All the cases in our series were due to enteroviruses, Echo or coxsackie. Isolation of a poliovirus (type III) in one case deserves mention. Cases where clinical examination led to unequivocal diagnosis of mumps or herpes zoster were not included in our study.

Adolescent↗
PubMed1979

[Paraneoplastic hypercalcaemia in a case of carcinoma of the bladder. Demonstration in the tumour of a substance with parathormone activity (author's transl)].

Hypercalcaemia accompanied a bladder tumour in a 77-year-old woman. Immuno-reactive parathormone (IPTH) in the tumour being high, the hypercalcaemia could thus be attributed to secretion by the tumour of a substance with parathormone activity. The rarity of bladder tumours at the origin of paraneoplastic hypercalcaemia is recalled. The mechanism of the metabolic disturbance and the disagreement between serum and tumour levels of IPTH are discussed.

Aged↗
PubMedDate not supplied

[Pharmacokinetics of sulindac in aged patients presenting with inflammatory joint disease].

The kinetic of sulindac and its two metabolites (sulfide and sulfone) was investigated in twelve elderly patients, following multiple oral dose administration of 400 mg/d. Data were compared to those obtained previously in ten healthy volunteers who received the same dosage regimen. Following multiple dose administration, accumulation ratios indicate that sulindac do not accumulate either in elderly patients (R = 1.35; R = AUC0-24 J8/AUC0-24 J1) or in healthy young subjects (R = 1.38; R = U0-24 J1). No significant modification of sulindac and sulfide kinetic parameters was observed. The apparent bioavailability of the inactive metabolite, sulfone, was found to be doubled in elderly patients (p less than 0.05). We conclude that there is no need to modify the dosage regimen of Arthrocine (400 mg once a day) in elderly patients.

Administration, Oral↗
PubMedDate not supplied

[Blink reflex and stimulus detection by the facial nerve in 21 diabetics. Testing before and after precise blood sugar normalization by the artificial pancreas].

Study of the blink reflex and stimulodetection of the facial nerve in 21 diabetics with chronic hyperglycemia (HbA1C: 12.17 +/- 2.34%) shows normal or slightly prolonged R1, R2 and M latent periods in most cases. Forty-eight hour metabolic correction by artificial pancreas produces an overall improvement in the latent periods of the blink reflex, while the motor latent period of the facial nerve remained unchanged. The improvement, also observed in studies of limb responses, points towards a metabolic process directly related to the hyperglycemia.

Blinking↗