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Biomedical subjects

R Montagnac

Publications and source records attributed to R Montagnac.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Myopathy in uremic patients].

Uremic myopathy seems unfrequently studied although it can be really inconvenient in daily activities for some patients. Its is a proximal and non specific myopathy that should be discriminated from uremic neuropathy. Several disturbances from renal insufficiency have been incriminated but they only play an adjuvant role in regard with renal osteodystrophy. Indeed the presence of myopathy in cases of severe osteodystrophy and its close similarity with myopathies accompanying the different forms of osteomalacia and/or hyperparathyroidism without renal failure suggest that the most important pathogenic factors come from calcium metabolic disorders: excessive parathyroid hormone, vitamin D deficiency, and/or impaired calcium transport. The treatment is subject to the predominant bone lesions: secondary hyperparathyroidism or osteomalacia; but the best attitude remains their prevention.

Humans↗
PubMed1989

[Myopathy in the uremic patient: apropos of a case].

Uremic myopathy is relatively unknown, despite the fact that it can be quite a severe handicap. It is a non-specific proximal myopathy which must be distinguished from uremic polyneuropathy. Several disorders linked to renal insufficiency have been implicated, but these only play an adjuvant role with regard to renal osteodystrophy. Indeed the presence of myopathy in cases of severe osteodystrophy, its similarity to the myopathies associated with different types of osteomalacia and hyperparathyroidism without renal failure, suggest that the most important pathogenic factor is related to disorders of the calcium phosphate metabolism: excessive parathyroid hormone, vitamin D deficiency and/or impaired calcium transport. Treatment will depend on the predominant bone lesions: secondary hyperparathyroidism or osteomalacia. However prevention remains the best course.

Aged↗
PubMed1989

[Ovarian vein syndrome].

After initial scepticism about its reality and despite a few disagreements, many authors now recognize the ovarian vein syndrome as a separate clinical entity, secondary to ureteral obstruction caused by dilation of the ovarian veins, which may cause lumbar pain, recurring pyelonephritis and/or lithiasic complications. The right side most frequently is affected because anatomical configuration of the right ureter is more susceptible to compression, and in fact, pregnancy appears to be an essential initiating or exacerbating factor. Thus, this anomaly might explain why painful and infectious manifestations and hydronephrosis so often develop on the right side (in over 95 p. cent of cases) during pregnancy. Its diagnosis thus must be known to be able to envisage its possible onset, by taking a careful history, and may be confirmed by certain radiological examinations. The latter, as well as treatment, depend on whether or not the patient is pregnant, its term, as well as severity of symptoms. Hence, erroneous diagnoses and incorrectly oriented surgical procedures may be avoided, while appropriate therapy is effective.

Female↗
PubMed1988

[Renal adenocarcinoma in a dialysis patient with acquired multicystic disease].

ACKD is frequent in chronic dialysis patients: its incidence is proportional to the length of time on dialysis. It occurs also in uremic patients before dialysis and persists, despite a tendency towards involution, in transplanted patients. ACKD is frequently associated with adenoma which can evolve into adenocarcinoma. Screening studies by sonography, eventually completed by CT, are essential to discover patients with ACKD, to follow them up and propose bilateral nephrectomy if ACKD evolves towards malignancy. ACKD should be considered as a pre-malignancy state.

Adenocarcinoma↗
PubMed1988

[Hypersensitivity reactions during hemodialysis. Role of high permeability, retrofiltration and bacterial contamination of the dialysate].

Since the more frequent use of highly permeable membranes and bicarbonate dialysate, hypersensitivity reactions are more often described during hemodialysis and raise the question of the entry of pyrogens from dialysate towards blood due to high permeability of membranes and to possible backfiltration. During dialysis sessions with such membranes, authors observed a severe collapse in a patient on bicarbonate fluid and a repeated Quincke's edema in another on acetate fluid. After exclusion of other causes of such hypersensitivity accidents, they discuss the role of bacterial contamination of dialysis fluid. They analyse the phenomenons of bidirectional high permeability and of backfiltration linked to these new membranes. They recall the different causes of dialysate contamination and give some means of avoiding these inconveniences which expose on one hand to acute severe reactions and on the other are prejudicial in the long term for the patients because of interleukin 1 production.

Adult↗
PubMed1987

[Comparison of 3 high-permeability dialysers].

Three capillary dialyzers, with highly permeable membranes, have been compared for their capacity of epuration of blood urea nitrogen, creatinine, phosphorus, uric acid and beta 2 microglobulin, and for their respective protein losses. There were very little differences between the dialyzers for epuration of small uremic molecules, with no benefit due to high permeability membranes in comparison with conventional dialyzers. Protein losses may be important and have to be known. About beta 2 microglobulin, filtered quantities are not correlated to changes in serum levels, suggesting the presence of other mechanisms (adsorption on the membrane and generation during hemodialysis) which influence, together with epuration, perdialytic changes of serum beta 2 microglobulin concentrations.

Blood Proteins↗
PubMed1987

[Colonic necrosis, an unusual extrarenal involvement in hemolytic and uremic syndrome].

A seventeen years old girl presented a HUS. The usual gastrointestinal symptoms of the prodromal phase involved secondary complications leading to emergency surgical treatment. Laparotomy exploration revealed segmental necrosis of the colon which was treated by colectomy: histological studies revealed its ischemic nature with specific lesions of thrombotic microangiopathy. Later course was uneventful with the exception of renal failure requiring maintenance hemodialysis. Review of literature confirms the rare and severe nature of gastrointestinal lesions requiring surgery. Great care should be taken on one hand, not to undertake a useless operation and on the other hand to operate in time colonic necrosis involving or not intestinal perforation or intussusception.

Adolescent↗
PubMed1987

[Extrarenal purification in severe salicylate poisoning in adults].

About a new case of severe salicylate intoxication, the authors wanted to confirm the advantages of extrarenal epuration in some circumstances. Besides of usual treatments, it decreases the severity of this intoxication and the delay in its treatment by reducing quickly blood salicylate level to a moderate or benign rate whose prognosis is really better. Of course, the choice among the most common treatments (hemodialysis, hemoperfusion, peritoneal dialysis) depends with technical disposals, but hemodialysis seems the most efficient with minor risks than the intoxication itself.

Adult↗