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T Vial

Publications and source records attributed to T Vial.

90 records · Page 5Linked to original sources
PubMedDate not supplied

[Cardiotoxicity of 5-fluorouracil: report of 6 cases].

5-fluorouracil (5-FU), a fluoropyrimidine antimetabolite, is widely used in the treatment of cancers of the digestive tract and breast. The clinical cardiotoxicity of 5-FU was first reported in 1975. Adverse cardiac effects include coronary disorders, heart failure and sudden death of suspected cardiac origin. Six new cases are reported, including 5 cases of angina and one of heart failure. The patients, 4 males and 2 females, were 26 to 71 years of age (mean: 56.2). They had no medical history of heart failure, myocardial ischemia or electrocardiographic anomalies prior to 5-FU treatment. Three patients had hypertension of whom one had had type-II diabetes mellitus for the past 20 years. Clinical symptoms included chest pain in 4 patients and heart failure in one, whereas the last patient had ECG changes with no associated clinical symptoms. Clinical symptoms of angina totally disappeared after the cessation of 5-FU administration, but heart failure was alleviated only after the introduction of digitalis, a converting-enzyme inhibitor and a diuretic. It has been estimated that 1.6% of patients treated with 5-FU develop adverse cardiac effects. Patients at greater risk are those with a history of ischemic cardiac disease, thoracic radiotherapy or high-dose 5-FU therapy. The mechanism involved is not clearly elucidated. Spasms of the coronary arteries or toxic inflammation of the myocardium have been suspected. These 6 new cases confirm the potential for cardiotoxicity of 5-FU and the need for careful cardiac monitoring of treated patients.

Adult↗
PubMedDate not supplied

[Vasculitis after anti-influenza vaccination. Report of 5 cases].

We describe five cases of vasculitis noted a few days after influenza vaccination. This complication has occurred in four women, and the mean age was 76 years. Although cutaneous biopsy has confirmed leucocytoclasic vasculitis in only one case, the clinical characteristics were evocative in the other cases. No systemic complication were noted. Spontaneous retrocession was noted in four patients and following corticosteroids once. To our knowledge only few cases of vasculitis has been previously reported after influenza vaccination. The mechanisms are unknown but preservatives may have some responsibilities.

Aged↗
PubMedDate not supplied

[The Stevens-Johnson syndrome from maprotiline and propranolol?].

A wide variety of agents have been associated with erythema multiforme, particularly drugs and infectious agents. We describe a typical Stevens-Johnson's syndrome developing 15 days after initiation of propranolol and maprotiline therapy. Other etiologies have been excluded by appropriate investigations and the responsibility of each drug is discussed.

Adult↗
PubMedDate not supplied

[Neuropsychic effects of cimetidine and ranitidine. Apropos of 1 case].

The incidence of neuropsychiatric complications is very low in patients receiving conventional doses of cimetidine or ranitidine. In this case report, the same patient presented with psychiatric symptoms successively following treatment with both histamine H2-receptor antagonists, suggesting the involvement of histamine-mediated CNS modulation.

Cimetidine↗
PubMedDate not supplied

[The monitoring of teratogens. The methodology of a follow-up study].

The assessment of risks following drug exposure during pregnancy is of major concern to Drug-Information Centers. A computer-based management is helpful. The authors describe a computerized system to follow pregnancy outcomes and discuss their first results, stressing the merits of automatized recalls.

Decision Making, Computer-Assisted↗
PubMedDate not supplied

[The caffeine test].

The inhibition of oxidative drug metabolism is a major cause of clinically significant drug interactions. Among the possible modalities for exploring the enzyme inhibiting potential of drugs, the caffeine test is a valuable addition to the antipyrine test in man. Indeed, microsomal enzymes explored by the caffeine test differ from those attainable by the antipyrine test. After a short overview of caffeine pharmacokinetics, the features of the caffeine test are tentatively described. The results of published studies indicate the usefulness of this simple test for detecting those new drugs endowed with an enzyme inhibiting potential.

Animals↗
PubMedDate not supplied

[Follow-up of 151 pregnant women exposed to antidepressant treatment (MAOI excluded) during organogenesis].

The Pharmacovigilance and Poisons Center in Lyon undertook an analysis of their data on antidepressant (MAOI excluded) exposure during the first trimester of pregnancy. From 1986 to 1991, 151 prospective enquiries were collected of which 145 exposures occurred during the first trimester of pregnancy. The outcome of pregnancy was known for 114 of these cases. Voluntary or medical abortion was decided in 24 cases, spontaneous abortion occurred in 11 patients and fetal death, unrelated to drug exposure, was noted in one case. Delivery was reported in 78 cases including 69 (88.5%) normal infants, with obstetrical complications not related to the treatment in 7 of these cases. Neonatal complications were noted in 5 (6.4%) cases, including withdrawal symptoms possibly related to the treatment in 3 cases. Congenital abnormalities were identified in 4 cases (5.1%) with one case of major malformation (membranous ventricular septal defect). Such a study is not an exhaustive survey of antidepressant exposure during pregnancy, but a collection of inquiries received by our centre. Even though our study's ability to detect an overall increase in the risk of malformations is too low and limited the extent of our conclusion, our results are in agreement with the literature data as no important increased in major birth defect was observed.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[Neutropenia during treatment with fusidic acid: analysis of 5 cases].

Two cases of moderate neutropenia and 3 cases of severe neutropenia in the course of fusidic acid treatment for sepsis related to a hip prothesis or septic osteitis are reported. Neutropenia was always observed following routine blood cell count, after a mean of 21 days' treatment (16 to 27 days). Moderate fever was observed only once, in a patient with profound neutropenia. A complete recovery of blood cell count was noted in all cases, 5 to 9 days upon discontinuation of fusidic acid. A sternal bone-marrow aspiration was performed in 4 cases, showing normocellularity or hypercellularity in two cases, and moderate hypoplasia of granulocytic cells. The respective roles of other treatments are discussed. Overall, these five cases suggest that reversible granulocytopenia can be caused by protracted treatment with fusidic acid. Although nine different associated drugs could also have been involved in four patients, the causal relationship was less suggestive for three of them due to chronological events. In other cases, the drugs never or very rarely caused neutropenia. Finally, the possibility of vancomycin-induced neutropenia cannot be excluded in one case.

Aged↗
PubMedDate not supplied

[Acute drug-induced agranulocytosis: experience of the Regional Center of Pharmacovigilance of Lyon over 7 years].

Sixty-two cases of drug-induced agranulocytosis, spontaneously reported to the regional drug monitoring centre in Lyon from 1988 to 1994, have been analysed. The mean age of patients was 58.6 years, and sex ratio was 1:1. The mean delay of onset was 46.2 days and absolute neutrophil counts (ANC) dropped below 0.1 x 10(9)/l in 73 per cent of patients. Bone marrow aspirates disclosed absence of myeloid series in 28 per cent of investigated cases. Neutrophil recovery occurred after a mean of 9.3 days, and the overall fatality rate was 6.5 per cent. Haematopoietic growth factors (HGF) were used in 11 patients with an ANC below 0.1 x 10(9)/l and/or a hypoplastic bone marrow. We have found no clear indication for a potential benefit of HGF treatment, but HGF were usually administered late during the course of neutropenia, i.e., after a mean of 6 days. The incidence rate estimated for people living in the Rhône administrative division was 3.3 per million per year, similar to that found in epidemiological studies. Drugs most frequently involved were anti-infective agents and psychotropic drugs.

Acute Disease↗