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Biomedical subjects

S Herson

Publications and source records attributed to S Herson.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Pharmacokinetic parameters of prednisone and prednisolone in healthy volunteers].

A cross-over, double-blind, randomized trial with 8 healthy volunteers was undertaken to compare prednisolone and prednisone pharmacokinetics after a single oral dose (1 mg/kg) of prednisone (Cortancyl) and prednisolone sodium metasulfobenzoate (Solupred). Maximum prednisolone concentrations measured after ingestion of prednisone are higher (535 +/- 32 ng/ml) and occur earlier than after taking prednisolone sodium metasulfobenzoate (198 +/- 114 ng/ml) (p less than 0.001). The areas under the curve are significantly larger after prednisone than after prednisolone sodium metasulfobenzoate (p less than 0.02). These findings suggest a decreased systemic availability of prednisolone after prednisolone sodium metasulfobenzoate (Solupred) administration and show, from a strictly pharmacokinetic point of view, that equimolar doses of prednisone and prednisolone sodium metasulfobenzoate are not equivalent therapies.

Adult↗
PubMed1990

[Nailfold capillaroscopy. Comparison of 100 subjects over 65 years of age and of 100 young adults].

Nailfold capillary microscopy patterns in 100 patients aged more than 65 years and free from inflammatory diseases were compared to those of 100 young healthy adults. A higher prevalence of arteriovenous sludge (36% vs 7%, p less than 10(-6)), increase in capillary loop length (12% vs. 0%, p less than 10(-3)) and especially prominent subpapillary plexus (63% vs 12%, p less than 10(-9)) was found in the geriatric group. Such capillary patterns cannot be considered as abnormal in patients aged more than 65 years. Enlargement of capillary loops and loss of capillaries were never encountered. Bushy capillary formations and hemorrhages were very uncommon in both groups.

Adult↗
PubMed1989

Lack of HPA-23 antiviral activity in HIV-infected patients without AIDS.

A randomized study of 12 treated patients and seven controls was conducted in order to evaluate HPA-23 anti-HIV activity in HIV-infected patients. The antiviral activity was assessed by determining HIV p24 antigenemia. A persistence or even increase in antigenemia was shown in treated patients and thrombocytopenia was observed in nine out of the 12 patients. This suggests that HPA-23 should not be used in anti-HIV therapy.

Antimony↗
PubMed1989

[Cutaneous microcirculation in infectious endocarditis].

Nailfold capillary microscopy was used to study the microcirculation patterns in 26 adult patients with infective endocarditis. Abnormal patterns were found in 13 patients (50%). Enlargement of capillary loops was never observed. Significant correlations were found between the number of capillary abnormalities and both systemic involvement (cutaneous vasculitis, arthritis, splenomegaly and/or glomerulonephritis) and immunological disturbances (circulating immune complexes, rheumatoid factor and/or hypocomplementemia) (p = 0.02 and 0.003, respectively). Capillary abnormalities were significantly reduced in 14 patients studied 4 to 48 months after endocarditis was cured. However, due to the lack of specificity, nailfold capillary microscopy cannot be regarded as a useful tool for the diagnosis of infective endocarditis. Connective tissue disorders are not the sole diagnosis to be considered in patients with abnormal nailfold capillary microcirculation patterns.

Adolescent↗
PubMed1989

[Ungueal capillaroscopy in fasciitis with eosinophilia: a distinctive feature of systemic scleroderma. Apropos of 15 cases].

Eosinophilic fasciitis (EF) is a recently described disease whose distinction from progressive systemic sclerosis (PSS) is still being discussed. PSS has a characteristic microcirculation pattern. We performed nailfold microscopy on 15 patients with EF and compared the results to those of 98 PSS patients and 75 normal control subjects. EF patients have a normal microcirculation pattern (13/15) or discrete, non-specific anomalies: none had the typical capillary pattern associated with PSS and associated diseases. The findings of this study justify making a distinction between EF and PSS and demonstrate that nail fold microscopy can be a useful tool for an early differential diagnosis between these two disorders.

Adult↗
PubMed1989

[Histopathologic aspects of polymyositis and dermatomyositis. Correlation with the clinical course. Study of 57 cases].

Muscle biopsies from 57 patients with dermatomyositis or polymyositis were histologically evaluated and compared with the disease's clinical course. Perifascicular atrophy, perivascular infiltrates and tubular inclusions in endothelial cells were significantly more frequent in young patients with dermatomyositis. On the other hand, in adult polymyositis, which evolves more slowly, necrosis with slight muscular atrophy and perinecrotic infiltrates was observed. This division into two groups was clear when the clinical evolution and histological patterns were compared. The mean age of each group was different, but there was a large overlap. Two different pathogenetic mechanisms can be envisaged: primary involvement of muscle capillaries with muscle ischemia in young patients with dermatomyositis and primary involvement of muscle fibers in adults afflicted with polymyositis.

Adolescent↗
PubMed1989

[Plasma exchange in dermatomyositis and polymyositis. Retrospective study of 38 cases of plasma exchange].

In order to evaluate the efficacity of plasma exchanges (PE) in dermatomyositis and polymyositis, the case histories of 38 patients, who had undergone plasma exchanges between 1980 and 1986 in 10 French plasmapheresis centers, were studied. Large volume PE were performed in 34 patients after failure of conventional therapy and were part of the initial regimen for the 4 others. The initial activity of the muscle disease was acute in 27 patients and subacute or chronic in 11 cases. Clinical results were evaluated on a functional scale based on changes in muscle force: 24 patients improved (10 appreciably and 14 moderately) and 14 remained unchanged. PE were well tolerated in 23 patients. But side effects occurred in 15 patients, necessitating treatment withdrawal in 4 cases. PE seem to be more effective when the dermatomyositis is acute and evolutive than when it is chronic and insidious. The encouraging results of this exhaustive retrospective study prompt us to set up a prospective randomized trial.

Adolescent↗
PubMed1989

[Plasma exchange in dermatomyositis. A retrospective study of 21 cases].

We have reviewed the results obtained in 21 dermatomyositis patients who were treated with plasma exchanges (PE) in 8 french centres between 1980 and 1986. Patients and methods. Seven of the 21 patients studied were male and 14 were female; 16 were children under 15 years of age. The disease was initially acute in 17 cases, subacute in 3 cases and chronic in 1 case. Plasma exchanges were performed as first-line therapy in 13 patients and after failure of the usual treatments in 18 patients. The decision to use PE therapy was prompted by an increase in muscle weakness in 14 of these 18 patients and by a lack of improvement despite treatment in the remaining 4 patients. PE therapy was started 17 months on average after the beginning of treatment. At the time 10 patients were under systemic corticosteroid therapy (prednisone or prednisolone greater than 1 mg/kg/day in 7 cases); 7 patients were receiving immunosuppressants jointly with corticosteroids (prednisone or prednisolone greater than 1 mg/kg/day in 5 cases); and 1 patient had systemic corticosteroids (3 mg/kg/day), methotrexate and antilymphocyte serum. In 3 patients, 2 of whom had severe muscle weakness. PE's were performed from the start. Our 21 patients underwent a total of 234 plasma exchanges. Each patient had a mean series of 11 +/- 6 PE's spread over 11 +/- 3 weeks. In addition to PE therapy, 12 patients received corticosteroids (greater than 1 mg/kd/day in 7 cases) and 8 had corticosteroids (greater than 1 mg/kd/day in 5 cases) together with immunosuppressants. One patient who was put on TE therapy from the start received no other treatment. It must be noted that in 12 patients the introduction of PE was accompanied by another therapeutic change.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Subacute infectious endocarditis in the elderly. Retrospective study of 33 cases].

The authors reviewed 33 cases of infectious endocarditis in patients over 65 years of age and classified according to Von Reyn's diagnostic criteria. Twenty-four patients had organic valvular disease, 4 had a prosthetic valve, and in 4 cases the diagnosis of the murmur was uncertain. Positive blood cultures were obtained in 79 p. 100 of cases. The commonest infecting organism was the streptococcus (21 out of 26). In 11 patients, it was a Group D streptococcus and a recto-sigmoid colonic tumour was found in 3 cases. A dental portal of entry was suspected in 55 p. 100 of patients and this should guide the choice of prophylactic antibiotic therapy. The initial choice of antibiotic had to be changed in 19 patients, usually because of poor tolerance. Eight patients died and one underwent valve replacement within two months of hospital admission.

Aged↗
PubMed1987

Severe lactic acidosis as a presenting feature of pheochromocytoma.

High plasma concentrations of epinephrine and norepinephrine have the potential for generating substantial hyperlactatemia by virtue of their metabolic and vasoconstrictor effects; both these influences affect lactate metabolism in the direction of overproduction and underutilization. Nonetheless, lactic acidosis is not a recognized presenting feature of pheochromocytoma. In this report, we describe a patient with pheochromocytoma in whom the endogenous outpouring of epinephrine and norepinephrine resulted in severe lactic acidosis that featured prominently in the clinical presentation. Pheochromocytoma should be listed among the clinical entities associated with or predisposing to lactic acidosis.

Acidosis, Lactic↗
PubMed1986

Study of elastase-type activity in blister fluids of recessive dystrophic epidermolysis bullosa.

Recessive dystrophic epidermolysis bullosa (RDEB) is characterized clinically by blister formation due to minor trauma and ultrastructurally by a progressive disappearance of anchoring fibrils at the dermoepidermal junction and of the oxytalan-type fibers which belong to the elastic fiber system. In this study, we determined the elastase-type activity in blister fluid obtained from 8 patients suffering from RDEB as compared to the suction fluid of experimental blisters in a healthy person and to the blister fluid of a patient suffering from epidermolysis bullosa simplex. One patient with dominant dystrophic epidermolysis of the albopapuloid type was also studied. Seven of the eight children with RDEB showed highly elevated values. The eighth child, treated with etretinate, as well as the patient suffering from dominant epidermolysis bullosa had moderately increased values. The determination of elastase-type activity in the blister fluid could therefore be useful to establish the differential diagnosis of recessive dystrophic epidermolysis bullosa.

Blister↗
PubMed1986

[Caval thromboses and systemic diseases].

Sixty-five patients presenting with a vena cava syndrome have been examined over a 7 years period; incidence of systemic diseases as an etiologic factor has thus been studied. A systemic disease was diagnosed in 17 cases, that is 25 p. 100 of cases. This incidence is higher in inferior vena cava syndromes (15 cases out of 45). Two diseases appear as the main factors: on one hand, Behçet disease, liable for 8 vena cava thrombosis, 7 inferior and 8 superior thrombosis; on the other hand, severe disseminated erythematous lupus liable for 5 cases of inferior vena cava thrombosis. Other etiologies are mentioned such as: Churg and Strauss disease (1 case), Horton disease (1 case) and hemorrhagic rectocolitis (1 case). In the patients presenting with lupus, two died from various pulmonary embolisms; a vena cava clip was required in 3 cases. As for lupus, the immuno-hepatologic exploration did demonstrate a thrombopenia in 5 cases, an hemolytic anemia with a positive Coombs test in 2 cases, and a circulating anti-coagulant (antiprothrombinase type) in one case. Though high frequency of systemic diseases in this series may depend on the patients' recruitment, systemic lupus as well as Behçet diseases are to be researched in case of vena cava thrombosis, above all if diagnosed in a young patient and failing to be explained by a congenital abnormality of hemostasis.

Adult↗