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Biomedical subjects

A Prier

Publications and source records attributed to A Prier.

At least 37 records · Page 2Linked to original sources
PubMed1990

Stress fractures of the lower limbs in osteoporotic patients treated with fluoride.

We report clinical and bone morphometric findings in 18 osteoporotic patients who experienced stress fractures during fluoride therapy. Patients were treated with either sodium fluoride (n = 15), or sodium monofluorophosphate (n = 3). Oral calcium supplementation was given in 11 patients, and vitamin D in 13. Stress fractures occurred after 17.1 +/- 10.3 months of therapy (range: 5-41 months). Atraumatic sudden pain in a lower limb bone extremity, normal initial roentgenogram, high 99technetium uptake on early bone scan, and a 3 to 4 week delay in linear bone condensation area at the same site were characteristics of stress fracture. The most frequent sites were the tibial metaphysis (n = 13), femoral neck (n = 10), and calcaneus (n = 4). Biochemical data showed increased plasma alkaline phosphatase levels in 11 patients, and mild renal failure in 2. Bone histomorphometry was performed on an iliac crest specimen in 10 patients at the time of the stress fracture. Trabecular bone volume was normal, and formation parameters were increased. Features of osteomalacia were encountered in only 2 patients with decreased renal function. Trabecular resorption was increased, as assessed by the osteoclastic surface (1.01 +/- 1.15% bone surface), and the number of osteoclasts (0.44 +/- 0.49 per mm2 bone section). The clinical course was favorable in all patients who stopped fluoride, although 5 patients who continued the treatment had either completion of femoral neck stress fractures to hip fractures (n = 2), or recurrent stress fractures (n = 2), or both (n = 1). Fluoride appears to be a key factor in the pathogenesis of stress fractures, and may be associated with increased trabecular resorption in some treated patients.

Aged↗
PubMed1989

[Inflammatory arthropathies in patients with human immunodeficiency virus infection].

Articular manifestations were observed in 10 patients (8 men, 2 women, aged from 23 to 46 years) with human immunodeficiency virus (HIV) infection. All men were homosexuals, except for an intravenous drug addict. One woman was a native of Gabon and the other had multiple transfusions. The joint diseases were of the polyarthritis and acute oligoarthritis types, affecting mainly the knees and ankles but also the wrist and fingers; the spine was involved in one case. The synovial fluid present in 4 patients contained 5,000 to 27,000 cells per cubic millimeter, with a strong predominance of polymorphonuclears. In 3 cases, infective viral particles were found in the fluid with anti-HIV antibodies. In 2 patients biopsy of the synovial membrane provided evidence of non-specific subacute synovitis. All X-ray films, including those of the sacro-iliac joint, were and remained normal. The course of the joint disease was acute and regressive in 5 cases, chronic and prolonged in the remaining 5 cases. In 5 patients the arthropathies were the first clinical manifestations of the HIV infection. Three patients who had stage IV C AIDS died; the others were in stages II (5), III (1) or IV E (1) and did not progress to a more severe stage. This study shows that various types of inflammatory arthritis may occur in HIV positive patients. In most cases the arthritis is reactive, but certain data suggest that it may be directly related to the virus in some patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Acute, reversible, interstitial pneumopathy induced by melphalan].

A case of acute interstitial pneumonia with hypoxaemia is described; this occurred after the cessation of cortico steroids in a patient suffering from myeloma treated with melphalan. The absence of any microbes and the lymphocytosis in the bronchoalveolar lavage and the rapid and favourable improvement on cortico steroids led to a diagnosis of melphalan induced pneumonia. This acute form is probably due to a hypersensitivity mechanism and should be distinguished from the majority of cases of sub-acute fibrosing pneumonitis due to melphalan which have been published before. Urgent treatment with glucocorticoids is justified as well as the immediate and final cessation of the medication responsible, because it is this which will affect prognosis.

Acute Disease↗
PubMed1987

[Spontaneous fissures and fractures of the legs in patients with osteoporosis treated with sodium fluoride].

Thirteen cases of spontaneous fissure or fracture of the lower limbs observed in 8 patients under treatment with sodium fluoride are reported; 7 of these patients were being treated for osteoporosis. The fissures occurred after 20 months of treatment on average and were revealed by pain in the metaphysis with early high radionuclide uptake. Three to 4 weeks later, X-ray films showed a linear bone condensation area, involving in most cases, the tibial metaphysis, the femoral neck and the calcaneum. The prognosis was usually favourable, but 2 patients required surgery for fissure of the femoral neck with rupture of the cortex. Fluor seems to be responsible for the fissures which cannot be avoided by calcium and/or vitamin D intake. The main pathogenic hypotheses are excessive bone resorption, large amounts of poorly mineralized osteoid tissue and architectural abnormalities of the trabeculae. When such fissures occur, fluoride therapy must be discontinued and the limb put at rest, but since this side-effect is rare and usually benign the principle of a treatment that is beneficial in many cases of osteoporosis need not be revised.

Aged↗
PubMed1985

[Tumoral hypophosphoremic osteomalacia].

Various tumoral diseases may induce hypophosphataemic osteomalacia. This is the case, in particular, with mesenchymal tumours and sclerosing metastases of prostatic cancer; much less common causes are diffuse connective tissue dysplasias and non-prostatic epitheliomas. Depending on whether osteomalacia results from a mesenchymal tumour or from osteitis of prostatic origin, the practical problems encountered are quite different. In the first case, the important point is not to miss a mesenchymal tumour when confronted with an acquired and apparently idiopathic hypophosphataemia; repeated examinations at regular intervals are sometimes necessary to detect the tumour which is usually benign; osteomalacia can then be cured by its removal. In the second case, the difficulty is to detect an osteomalacia which may be masked by bone metastases and to recognize its tubular origin in order to prescribe the appropriate treatment. Little is known about the pathogenesis of tumoral hypophosphataemic osteomalacia. The renal diabetes and low 1,25 (OH)2 D plasma levels frequently associated with the disease reflect a complex enzymatic disorder thought to be caused by a humoral mediator secreted by the tumour. Studies carried out in this field have already shown that 1,25 (OH)2 D is therapeutically useful when the tumour cannot be excised.

Bone Diseases↗
PubMed1985

[Vitamin D deficiency in long-stay geriatric patients. Study of a therapeutic protocol adapted to the institutional milieu].

A vitamin D deficiency was observed in 22 women and 6 men aged 66 to 94 years, hospitalised in a long-stay department in the Paris region for an average of 5 years and incapable of going out. The diagnosis was confirmed by measuring serum 25 (OH) D: 1.89 +/- 0.18 ng/ml during the month of June (11.5 +/- 4.2 ng/ml at the same period in II healthy young adults). The patients were randomly divided into two groups of 11 (Group I) and 17 patients (Group II). The first group was given an improved diet in calcium and Vit. D; the second group received, in addition, an intramuscular supplement of 30 mg of Vit. D3 in monthly injections of 5 or 10 mg. The serum 25 (OH) D levels were measured each month in both groups. Patients with intramuscular supplements showed a slow rise until the total injected dose exceeded 20 mg, followed by a sudden rise to values greater than 30 ng/ml. Eight months after the last injection, mean serum 25 (OH) D was still 24.7 +/- 4.6 ng/ml compared to only 3.6 +/- 3 ng/ml in Group I. Vitamin D deficiency in geriatric patients cannot be corrected by dietary supplement alone, but parenteral Vit. D3 using an easily applicable therapeutic protocol is effective and well tolerated at the suggested dosage.

Aged↗
PubMed1985

[Vertebral and thoracic osteoarticular manifestations in palmoplantar pustulosis].

Two cases of inflammatory joint disease during attacks of aseptic palmo-plantar pustulosis are reported. Both patients had vertebral involvement: disco-vertebral erosions at several levels in one case and spondylitis and intersomatic ossification in the other. One patient also had sacroiliitis and involvement of the anterior thoracic skeleton (costoclavicular joints, costal cartilages ans xiphoid) confirmed by bone scintigraphy. The relation between this cutaneous-articular syndrome and other inflammatory joint diseases, especially ankylosing spondylitis and psoriatic arthropathy are discussed. The very unusual involvement of the anterior thoracic skeleton, the coexistence of aseptic palmo-plantar pustulosis and absence of antigens HLA B27, B13 and B17 suggest a similarity to the pustular osteoarthritis recently described by Japanese workers who grouped this condition with other spondylarthropathies.

Adult↗
PubMed1983

[Double-blind comparative study of Bi-Profenid tablets and Profenid capsules in inflammatory rheumatism].

The effectiveness of Bi-Profenid tablets and Profenid capsules was studied comparatively in patients with inflammatory joint disease. 43 patients with rheumatoid arthritis or various chronic inflammatory joint diseases were given 300 mg of Bi-Profenid in 2 daily oral doses and 300 mg of Profenid in 3 daily oral doses, for two consecutive 7 day periods. This double blind cross-over study was carried out in two rheumatology centers. Effectiveness of the two forms of ketoprofen on morning stiffness and pain scale was found to be comparable. However, patients more often preferred Bi-Profenid (15 cases) to Profenid (10 cases); 12 patients reported no difference. Tolerance was excellent in 92.7% of cases under Profenid capsules and in 94.8% of cases under Bi-Profenid tablets.

Adolescent↗
PubMed1983

[Treatment of gout].

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Combined Modality Therapy↗
PubMed1983

[Physiology and main implications of magnesium in osteo-articular pathology].

The role of magnesium in the constitution, metabolism and hormonal control of bone tissue can be deducted from what is known of its physiology. Magnesium deficiency may result in vitamin-D resistant hypocalcaemia or even biochemical signs of hypoparathyroidism, which only regress after the deficiency is corrected. Measurements of magnesium levels in blood and urine are justified when such abnormalities occur in patients with digestive disorders, predominantly alcoholism, liver diseases or malabsorption. In all other circumstances, magnesium therapy is very rarely indicated for osteo-articular diseases.

Animals↗
PubMed1983

[Articular manifestations of Whipple's disease. A case of sacroiliitis and destructive coxopathy].

Whipple's disease is a systemic illness whose pathogenesis, which is still poorly understood, implies an infectious agent accessible to antibiotic therapy. The authors report a case which is made unusual by the manifold systemic manifestations, important eosinophilia and destructive nature of the joint lesions of the hips. The physiopathological mechanisms of ocular and cutaneous manifestations are considered. A dramatic improvement is obtained with tetracyclin.

Adult↗
PubMed1983

[Destructive non-tumoral osteoarthropathies of the shoulder].

Destructive arthropathy of the shoulder is reviewed and the indications of total prothesis are briefly considered. It seems that the long term functional tolerance of destructive arthropathy of the shoulder is better than would be expected considering the radiological damage which is often substantial. The indications of shoulder prosthesis are dominated by rheumatoid polyarthritis and are infrequent in the other forms of these arthropathies.

Arthropathy, Neurogenic↗