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Biomedical subjects

C Alexandre

Publications and source records attributed to C Alexandre.

At least 181 records · Page 10Linked to original sources
PubMed1982

Long term effects of dichloromethylene diphosphonate in Paget's disease of bone.

Dichloromethylene diphosphonate (Cl2MDP) is a diphosphonate which markedly inhibits bone resorption. We have tested Cl2MDP in Paget's disease, a disorder characterized by increased bone remodeling. Sixty-three patients with progressive Paget's disease were treated for 6 months with Cl2MDP at daily oral doses of 400, 800, 1600, or 2400 mg. Thirty-nine patients received calcium and vitamin D supplements during treatment. patients in all treatment groups had significant reduction in serum alkaline phosphatase, urinary hydroxyproline, skeletal uptake of 99mtechnetium-diphosphonate scintiscans, and resorption parameters on iliac crest biopsy samples as assessed by quantitative histomorphometry. Treatment was well tolerated and did not induce a skeletal mineralization defect. The reduction in alkaline phosphatase and urinary hydroxyproline persisted 1 yr after withdrawal of treatment. The biochemical remission was sustained in half of the patients 2 yr after the end of treatment and was accompanied by a marked reduction of bone pain. a daily dose of 800 mg is recommended as the best of control of clinical and biochemical symptoms. The transient increase in iPTH levels observed in patients treated with Cl2MDP alone did not occur when calcium and vitamin D were added. We conclude that Cl2MDP is effective in the treatment of Paget's disease of bone and provides a prolonged response. Dietary supplementation with calcium and vitamin D is desirable to prevent secondary hyperparathyroidism.

Alkaline Phosphatase↗
PubMed1981

Effects of ethane-1 hydroxy-1, 1-diphosphonate (5 mg/kg/day dose) on quantitative bone histology in Paget's disease of bone.

The effects of ethane hydroxy diphosphonate (EHDP) on quantitative bone histology have been studied in 43 pagetic patients treated for 6 months at a dose of 5 mg/kg/day. To determine the therapeutic effects on pagetic bone and to appreciate the side effects in non-pagetic bone, the patients were biopsied either in pagetic or non-pagetic areas of the ilium before the beginning of the treatment and at 3, 6 and 9 months (i.e. 3 months post-therapy) after the inception of treatment. Tetracycline double labelling of bone was performed before biopsies in each patient to measure the calcification rate. The results demonstrate that 5 mg/kg/day EHDP given for 6 months has a marked antiosteoclastic effect which is prolonged after the cessation of treatment. Pagetic osteoclasts appear more sensitive to EHDP than normal osteoclasts. The new bone formed during treatment has a regular lamellar texture. At the same time, the high appositional rate of pagetic bone is reduced to a normal value. Marrow fibrosis is reduced along with the reduction in the osteoclast population. Thus, pagetic bone changes to bone normal in quantity, quality and metabolism. Dynamically, in nonpagetic areas, a transitory decrease of calcification rate is noted at the end of the treatment, without morphological evidence of osteomalacia, except for 2 out of 43 cases. Histologically, EHDP given at a dose of 5 mg/kg/day for 6 months appears to be an effective and safe treatment for Paget's disease of bone.

Adult↗
PubMed1980

[Treatment of Paget's disease of bone with ethane-1 hydroxy-1, 1 diphosphonate at low dosage (author's transl)].

Fifty-one patients with Paget's disease were treated during 6 months with ethane-01 hydroxy-1, 1 diphosphonate (EHDP, etidronate) in doses of 5 mg/kg/day. The drug was most effective in relieving pain, at the same time diminishing the uptake of pagetic lesions on quantitative bone scans and lowering by almost 70% the abnormally high serum alkaline phosphatase levels and 24-hour hydroxyproline urinary levels. Histologically, the resorption surfaces and the number of osteoclasts per mm2 of bone tissue were significantly reduced. On follow-up, the improvement persisted for at least one year after treatment was discontinued. EHDP was well tolerated clinically and biologically, and on histological sections no accumulation of osteoid tissue due to impaired mineralization was seen. EHDP at the 5 mg/kg/day dose appears to be effective in the treatment of Paget's disease.

Adult↗
PubMed1980

[Osteoporosis at high remodeling and parathyroid function. Histo-biological confrontations (author's transl)].

In order to evaluate the relationship between apparently idiopathic osteoporosis and parathyroid hormone secretion, plasma immunoreactive parathyroid hormone (iPTH) was measured in 57 untreated osteoporotic patients using a carboxy-terminal specific antiserum, and sections of undecalcified iliac bone biopsies from these subjects, who had been previously doubly labelled with tetracycline, were quantitatively analyzed. Twenty one patients (36%) exhibited histological signs of a high remodeling similar to that which is present in primary hyperparathyroidism, but their osteoplastic oppositional rate values were lower. Among these 21 cases 8 had an increase of their iPTH levels. These data and those of the literature indicate that in a few cases high remodeling osteoporosis may be associated with parathyroid hypersecretion, but do not bring out the evidence that the increased circulating iPTH is the cause of osteoporosis. The authors draw from their results some practical consequences for the treatment of high remodeling osteoporosis.

Adult↗
PubMed1980

[Should the pharmaceutical industry play an active part in pharmacosurveillance? (author's transl)].

The development of new drugs by pharmaceutical firms proceeds through different phases, i. e. pre-clinical studies and stage I, II and III clinical studies, which normally result in authorization to market. Once the drug is on the market, however, further research work is required to perfect its use and complete our knowledge of it. Stage IV clinical trials, which may be termed "pharmacosurveillance", fall as much as the previous ones within the responsibilities of the pharmaceutical industry, since reports on side-effects are collected and these may have practical applications. Thus, clinical research may be shifted towards possible new indications, or new pharmacological studies may be undertaken to elucidate the mechanism of some side-effects, develop them if they are beneficial, or find a way of preventing them if they are indesirable. With these considerations in mind, the authors have developed a protocol of pharmacosurveillance aimed at determining, through a preliminary in vitro study, the origin of some adverse reactions of anaesthetic drugs. Depending on the results of these studies, clinical applications are considered.

Anesthetics↗
PubMed1979

Effects of disodium dichloromethylene diphosphonate on Paget's disease of bone.

19 patients with Paget's disease were treated orally for 6 months with disodium dichloromethylene diphosphonate. 1600 mg/day (10 patients) significantly reduced urine hydroxyproline, serum alkaline phosphatase, urine calcium, and the number of pagetic bone osteoclasts. Tetracycline double labelling revealed undisturbed bone mineralisation. There was improvement on quantitative bone-scans and bone pain diminished. There was a transient increase in parathyroid hormone level in 13 of the 19 patients during treatment, which was associated with a high serum 1,25 (OH)2D3. No adverse clinical side-effects have been observed and biochemical remission has persisted for 9 months.

Administration, Oral↗
PubMed1979

[The hypocalcemia test, using human and salmon synthetic calcitonins. Paradoxical hypercalcemic responses. Responses in patients with Paget's disease treated with EHDP].

The hypercalcemia observed during the acute calcitonin test reflects the size and the activity of the osteoclastic population throughout the entire skeleton. Several calcitonins of animal origin (pork, salmon) have already been used for this test in human pathology, but the results can be flawed by the presence of anti-calcitonin antibodies. The authors demonstrate that human synthetic anti-calcitonin in man has a hypocalcemia effect identical to salmon synthetic calcitonin, with an equipotential dose for the rat. The systematic study of acute salmon calcitonin in various osteopathies makes it possible to note a certain number of paradoxical responses with prolonged hypercalcemia in the hours following injection. This is observed especially in the "hyperosteoidosis states" and the authors attempt to give it a physiopathological explanation. Finally, the acute salmon calcitonin test can be used as a mean of surveillance of the anti-osteoclastic activity of the disphosphonates in the treatment of Paget's disease.

Calcitonin↗
PubMed1978

[Study of 13 cases of ostensibly idiopathic male infertility treated successfully by HMG/HCG combination].

Amoung 95 cases of infertility due to oligo-asthenospermia with normal or low FHS, treated by the association HMG/HCG, 13 cases could be considered a success. From this particularly favourable slries, the author attempts to codify the indications of gonadotrophines in male sterilities. He suggests that such an indication, obvious in case of hypogonadotrophic hypogonadism could be expanded to some normoor hypogonadotrophic hypofertilities.

Adult↗
PubMed1977

[Indication for splenectomy and exploration of the abdomen in Hodgkin's disease (author's transl)].

Splenectomies were performed on 142 patients (86 men and 56 women). The majority of them (117) were stages III or IV. The purpose of the laparotomy was therapeutic and not exploratory. Surgery was indicated, either due to evolution of the disease suggesting splenic involvement or to symptoms of hypersplenism. Splenic involvement was confirmed in 71% and hepatic involvement in 40%. Despite the risk of mortality during the first month after surgery, proportional to the extent of the disease, the overall results are encouraging provided that surgical intervention is followed by aggressive polychemotherapy. Serious infections were observed, however, in 9 patients; they did not occur for several months or even several years after splenectomy.

Abdomen↗
PubMedDate not supplied

[Acute interstitial nephritis with uveitis. A case report].

Dobrin et al described in 1975 the first case report with acute renal failure due to tubulo-interstitial nephritis accompanied by uveitis and an inflammatory syndrome. The young adults are frequently involved and the complete resolution is usually obtained after corticosteroid treatment; this contrasts with the tendency towards relapse of the uveitis. The etiology and the pathogenesis of this syndrome remain unknown. We report the case of a woman which the renal function was incompletely reversible with corticosteroids.

Acute Kidney Injury↗