[New developments of anti-inflammatory therapy].
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Biomedical subjects
Publications and source records attributed to C Bregeon.
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An electron microscope study of 35 bone biopsies from patients with Paget's disease confirmed the constnat presence of intra-nuclear and intracytoplasmic inclusions, which seemed to be the most specific anomalies of the osteoclasts. The presence of these inclusions leads to their comparison with other inclusions described in certain affections for which the viral etiology is at present under discussion.
The authors report clinical, laboratory, and radiological results obtained by immunodepresant treatment of 78 patients suffering from rheumatoid polyarthritis, over a period of more than 4 years. In 27 of the patients the treatment had been followed for 4 to 8 years. Clinically the results were excellent in 36 cases, reasonably good in 23 cases; in 19 cases therapy was unsuccessful or had to to be stopped. There was a reduction in the sedimentation rate in cases with good results and in half the cases there was a reduction in the titre of the Waaler-Rose reaction. Studies on the evolution of radiological signs in 34 patients showed definite deterioration in only 2 cases out of 19 subjects having very good clinical results and definite deterioration in 7 of 15 subjects with less good clinical results or failure. Thus the immunodepressant treatment appeared capable of stopping or slowing down the osteoarticular destruction. The cessation of treatment in 28 patients was followed by a relapse in 14 patients (7 within 6 months, and 7 within 6 months to 2 years). In 14 patients there was no relapse and in 8 of these the improvement has lasted for more than 3 years. With the doses used, there were few short-term complications of treatment. Haematological tolerance appeared to vary according to the patient ; for prolonged treatment the dose should be adapted to the individual.
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The use of iodinated contrast agents is associated with adverse drug reactions (ADRs) (mainly allergic). Data from the literature suggest a frequency of ADRs ranging from 5 to 8 per cent for the whole group of iodinated contrast agents. The present systematic prospective study performed over a period of six months investigated ADRs in a Radiology Department of the University Hospital in Toulouse. After 1480 injections of iodinated contrast agents, only five ADRs (i.e. 0.34 per cent) were observed. However, the frequency remained higher in patients with a history of allergy (1.5 per cent). The low frequency of ADRs can be explained both by the use of mainly low osmolality contrast agents (75 per cent) and by systematic preventive management of risk (detailed questionnaire, choice of the contrast agent according to risk).
The authors report a case of Gaucher's disease in an adult. This is a rare disease due to the accumulation of a glucoceramide in the reticulo-endothelial cells and may remain for long clinically symptomless, as in this case. The diagnosis suggested by the biological disturbance, viz. moderate thrombopenia, hypergammaglobulinemia, increase in SGPT, was conformed by the presence of Gaucher's cells in the liver and in the bone marrow, and by the existence of an intraleukocytic glucosidase deficiency. The authors recall the clinical forms of this disease, and recent clinical trials.