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Biomedical subjects

T Bardin

Publications and source records attributed to T Bardin.

At least 73 records · Page 4Linked to original sources
PubMed1992

Decrease of tumor-like calcification in uremia despite aggravation of secondary hyperparathyroidism: a case report.

Extraskeletal pseudotumoral calcifications generally develop in uremic patients with a high calcium x phosphorus (Ca x P) product and severe secondary hyperparathyroidism. In the present case report we describe a chronic hemodialysis patient presenting with a massive calcification of the left shoulder region, severe aluminum (Al) intoxication and moderate hyperparathyroidism. Her initial serum Ca x P product was only slightly elevated: 5.01 mmol2/l2. Under deferoxamine treatment during the subsequent 4 months, Al overload decreased. On the other hand, parathyroid overfunction worsened, as reflected by an increase of the serum immunoreactive parathyroid hormone [1-84] level from initially 690 to 1052 pg/ml (normal, 15-60 pg/ml) and an increase of alkaline phosphatase activity, and plasma calcitriol increased from undetectable to a low-normal value. Predialysis serum total Ca levels decreased rapidly from 2.9 to 2.5 mM but serum P concentrations remained elevated: 1.6-2.5 mM. Unexpectedly, the extent of the periarticular calcification diminished considerably during the same time period. The present observation shows that in a subset of uremic patients with Al overload, pseudotumoral calcifications may regress during Al chelation therapy despite progression of hyperparathyroidism. Since Al may predispose collagen to develop dystrophic or metastatic calcification, it is suggested that this process is reversible by correcting Al intoxication.

Aluminum↗
PubMed1992

Postvenereal Reiter's syndrome in Greenland.

Reiter's syndrome is very frequent in the Inuit of Greenland, because of high frequencies of venereal disease and HLA-B27. The authors report the results of the epidemiologic work and of the study of the effects of antibiotic treatment of venereal infection. In Reiter's syndrome patients, treatment of venereal infections by erythromycin or tetracycline was associated with a significant reduction in the rate of postvenereal arthritic flares.

Anti-Bacterial Agents↗
PubMed1991

[Bone involvement in primary oxalosis. Study of 20 cases].

The authors report 20 cases of primary oxalosis with bone involvement, late revealed in adults in 19 cases. They have studied the clinical, radiological and histological manifestations of this bone oxalosis. 19 cases had an end stage chronic renal failure, either treated by maintenance hemodialysis, or by renal (or liver-renal) graft. 17 patients complained of bone pain after starting hemodialysis; 3 had vertebral crush fractures, and 1 multiple spontaneous fractures. Diffuse bone sclerosis (with a homogeneous pattern on axial skeleton and a patchy appearance on the peripherical skeleton), bone translucency, subperiosteal phalangeal resorption were the main radiological symptoms. Oxalate crystals surrounded by a giant cells granuloma were always observed on bone biopsy (16 cases). Bone resorption was observed in 9 cases, hyperparathyroidism in 14 cases and osteomalacia in 7 cases. Hyperparathyroidism does'nt explain all the clinical and radiological manifestations (especially bone resorption). Bone resorption as other radiological and clinical manifestations can be found without hyperparathyroidism and can increase despite parathyroidectomy; so, bone resorption seems to be partly due to the granulomatous reaction around oxalate crystals rather than hyperparathyroidism.

Adolescent↗
PubMed1991

[Psoriatic rheumatism].

Five to seven per cent of patients with cutaneous psoriasis develop a seronegative inflammatory arthritis which is often erosive and frequently both peripheral and axial. The most common peripheral type of psoriatic arthritis is represented by asymmetrical oligoarthritis, the localisation most suggestive of psoriasis being distal interphalangeal arthritis. Symmetrical polyarthritis may also be observed. Severe and mutilating forms of the disease are fortunately rare. Te axial type of psoriatic arthritis consists of a usually bilateral sacroiliitis and/or spinal lesions which may result in ankylosing spondylitis. Most cases of psoriatic arthritis are treated with non-steroidal anti-inflammatory drugs alone and local treatments. Corticosteroid therapy must be administered with caution and restricted to the severe forms. A fairly large number of maintenance treatments for peripheral arthritis have been used, not always after controlled trials; the most commonly prescribed are gold salts, sulphasalazine and methotrexate.

Arthritis, Psoriatic↗
PubMed1991

[Hereditary chondrocalcinosis in Tunisia. Apropos of 3 families].

Hereditary chondrocalcinosis was reported in three Tunisian families. The clinical manifestations appeared early in life and extensive radiologic involvement was apparent. The mode of inheritance seemed to be autosomal with incomplete penetrance. In one family HLA typing revealed that all affected subjects had the haplotype A1 B12 DR3.

Adolescent↗
PubMed1990

[Objectives to be assigned to the various proposed treatments (NSAID, analgesics, preventive or curative fundamental treatments). Which type of patients for which type of clinical trials].

Short term symptomatic treatment concerns, above all, painful, active osteoarthritis. Long term treatment prevents or slows down the destruction of cartilage and is assessed by radiological measurement of the joint space in the hip and knee. This must also be combined with a clinical criterion based on a functional pain index and the quality of the patient's life. Interphalangeal osteoarthritis, excluding root arthrosis of the thumb, is a good model and the preventive effect of treatment can be assessed from the extension of interphalangeal involvement. In the lower limbs, osteoarthritis of the hip in its idiopathic form (with overall superior or supra-external narrowing) and minor dysplasias were selected. Internal femorotibial osteoarthritis is suitable for evaluating a drug's effect in protecting cartilage. Other varieties are reserved for symptomatic treatments.

Analgesics↗
PubMed1990

[Rheumatologic complications and amyloidosis in dialysis patients].

Articular complications seem to be very common in patients under chronic dialysis, where they currently constitute the main limitation to the long-term functional prognosis. Carpal tunnel syndrome is often bilateral and severe; after 8 to 10 years of haemodialysis, it is usually associated with local deposits of amyloid substance. Treatment must be undertaken early and it is surgical. Arthropathies due to microcrystalline deposits take various forms, the most frequent being acute periarticular attacks related to apatite crystals. Septic arthritis is a frequent complication, dangerous in such patients, and which must be considered in every case of acute or subacute arthritis. Chronic arthropathies affect more than one half of the patients who have been under dialysis for more than 10 years. The most common are arthralgias of the shoulders often associated with pain in other joints, restricted joint movements and synovial thickening notably in the wrists, small finger joints and knees; radiology shows subchondral cavities betraying the presence of the cervical spine, are fairly frequent in patients under long-term haemodialysis. The pathogenesis of these complications is not yet fully understood, and several factors may be involved. Anatomically, carpal tunnel syndrome and chronic arthropathies are associated with articular deposits of a very special amylose consisting of beta-2 microglobulins.

Amyloidosis↗
PubMed1990

Pseudotumor of the craniocervical junction during long-term hemodialysis.

A systematic study of the upper cervical spine was performed using magnetic resonance imaging in 25 patients (15 men and 10 women) who had been undergoing hemodialysis for more than 10 years. Seven pseudotumors of the periodontoid soft tissue were disclosed, which were similar to the pannus recently described in rheumatoid arthritis. Bone cystic radiolucencies were observed in association with these pseudotumors in 5 patients. The radiolucencies were located in the atlas (1 in the lateral mass and 1 in the anterior branch) and in the axis (3 in the odontoid process and 1 in the vertebral body). No horizontal or vertical atlantoaxial subluxation was demonstrated. These features were observed only in patients who had amyloid arthropathy. They could be a frequent, yet thus far little-recognized, feature of beta 2-microglobulin amyloidosis.

Adolescent↗
PubMed1990

Beta 2-microglobulin amyloidosis: a sternoclavicular joint biopsy study in hemodialysis patients.

The incidence of beta 2-microglobulin deposits appears to increase with time on dialysis. However, the precise prevalence of the disease is not known at present because adequate, noninvasive diagnostic procedures are still lacking. We performed systematic synovial biopsies of the sternoclavicular joint during surgical parathyroidectomy in 22 chronic hemodialysis patients with severe hyperparathyroidism. Nine of the patients proved to have beta 2-microglobulin amyloid deposits as demonstrated by Congo red staining and by immunofluorescence. They had undergone dialysis for longer time periods (12.6 vs 8.5 years, p less than 0.02) and tended to be older than the 13 amyloid-negative patients. They also had a significantly higher body aluminum overload, as demonstrated by a higher increase of plasma aluminum after desferrioxamine infusion. Finally, the presence of Congo-red-positive deposits correlated well with clinical and x-ray findings suggestive of dialysis amyloidosis.

Amyloidosis↗