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C Mery

Publications and source records attributed to C Mery.

32 records · Page 2Linked to original sources

[Tiopronine, new anti-rheumatic drug, has slow action in rheumatoid arthritis].

2 mercapto propionyl glycine (tiopronine) has, like D-penicillamine, a thiol radicle; it is a powerful chelating agent of heavy metals. This analogy suggests that it may be used in rheumatoid arthritis. A preliminary double blind study lasting four months comparing 1g./day in 20 patients and a placebo in 10 patients showed slight (non significant) efficacy concerning all parameters. An open study using 1.5 g. daily is being carried out in 32 patients, and we note a beneficial effect on the morning stiffness, the joint index, the functional index, the prehension strength, the E.S.R., and the joint swelling. The side effects are similar to those of D-penicillamine: loss of taste, proteinuria, mucous ulceration, which required stopping treatment. The therapeutic effect within 4 months and was maintained for 18 months in the 15 patients under treatment. A new double blind trial comparing placebo and tiopronine at a dose of 1.5 g. daily is in progress.

Amino Acids, Sulfur↗

[Therapeutic approach in the rehabilitation of chronic lower back pain. Comparative study of 3 techniques of lumbar reeducation].

The short-term therapeutic effect of 3 techniques of rehabilitation of the lumbar spine (cyphosis gymnastics, kinebalneotherapy and differenciated rehabilitation) was studied out of 87 chronic lumbalgias selected at random and using one of the three techniques administered by 3 physical therapists. A comparison of these 9 couples (technique, technician) was based on criteria evaluated on a blind basis using the traditional unidimensional analysis and also multidimensional analysis. The cyphosis gymnastic reeducation gives less satisfactory results using 26 criteria out of 27. There is an underlying physical therapy factor. A certain number of prognostic factors with implications for any rehabilitation method and for all of the techniques, were disclosed. The comparative testing methods used in the study of drugs are applicable to rehabilitation techniques. However, it was not possible to carry out a comparative study of a reeducation method with a reeducation placebo.

Back Pain↗

[Criteria for the evaluation of the antirheumatic (antiinflammatory) drugs in man].

Comparison of 5 antiinflammatory drugs and placebo in a double blind, short term, cross-over trial conducted in patients suffering from rheumatoid arthritis. 15 measurements were used and studied. With classical unidimensional statistical tests it was not possible to discriminate active drugs between them. Multidimensional analysis (correspondance analysis and discriminant analysis) are more sensitive and allow us to distinguish active drugs with only 11 criterion.

Anti-Inflammatory Agents↗

Increased association of diabetes mellitus with capsulitis of the shoulder and shoulder-hand syndrome.

Sixty consecutive patients with capsulitis of the shoulder (including those with shoulder-hand syndrome) seen in our clinic since 1971 underwent an oral glucose tolerance test (5 with previously recognized diabetes were excluded from this test). Capsulitis was primary in 35, secondary to other factors in 25 subjects. Females (34) out-numbered males (26). Their ages ranged from 40 to 72 years (mean age: 54 years). Sixty control subjects matched for age and sex with the 60 "capsulitis" patients underwent the same OGTT (except one with previously recognized diabetes). We have found diabetes in 17 out of 60 patients with capsulitis according to Hayner's criteria (12 according to Jackson's criteria) versus 7 (2 according to Jackson's criteria) in the 60 control subjects. The difference is statistically significant by both methods, with a p value of less than 0.02).

Adult↗

Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc.

The findings are reported of a controlled clinical trial comparing in 66 rheumatoid arthritis patients 0 g (placebo), and 0.50 g a day and 1 g a day of penicillamine. Each of these groups has been subdivided into two, one part receiving 5 mg a day of zinc metal supplement, the other a placebo. The trial was planned to be double-blind, and for each patient to take part for 4 months. The results prove the effectiveness of penicillamine in rheumatoid arthritis. 0.50 g a day has the same effect as 1 g a day but gives less side effects. Zinc supplement inhibits the clinical effects of penicillamine but does not prevent the side effects.

Arthritis, Rheumatoid↗

[4 cases of osteomalacia during anticonvulsant or sedative treatment].

The authors report osteomalacia in 3 cases of epilepsy and one case of coronary heart disease treated with phenobarbitone, either alone or associated with other anticonvulsants. There were clinical signs in all cases and typical radiological signs in 3 cases, a characteristic laboratory syndrome in 4 cases. In the 3 cases where it was estimated, serum levels of parathormone were high. Finally, in 3 cases where it was measured, daily urinary excretion of glucaric D acid was increased. The bony histological signs studied in 3 cases, were similar to those in deficiency osteomalacia. A study of Ca45 metabolism in one case, showed the characteristic changes found in osteomalacia. Finally, a study of the metabolism of tritiated vitamin D, or tritiated 25 OH CC, carried out in 3 cases, gave 3 different patterns; only one of them was characteristic of enzyme induction under the dependency of anticonvulsant. Started in 2 cases, treatment with 125 OH2CC, brought about a rapid fall in blood PTH levels which then rose again before falling progressively in one case, under treatment with 25 OH CC. The bony histological signs of hyperparathyroidism then regressed whilst serum PTH levels remained high. Phosphorous and calcium balance improved in only one case. Treatment with 25 OH CC in high dosage brought about clinical, radiological and laboratory cure of osteomalacia in both cases, reducing the frequency of fits in the epileptic patient.

Adult↗

[Radiographic study of the hand in 50 cases of primary articular chondrocalcinosis. Comparison with a control series of 100 subjects].

The authors analysed radiograms of the hands of 50 patients suffering from primary articular chondrocalcinosis (ACC) and compared them with those of 100 control subjects of similar sex and age. There were 40 women and 10 men, with an average age of 69.6 years (plus or minus 9.82). A chalky incrustation of the semilunar pyramidal interspace was observed in 40 percent of cases. The frequency of this incrustation was next in order of importance to incrustation of the triangular ligament which occurred in 52 percent of cases. The difference from the controls was highly significant (p less than 0.001). Voluminous geodes affecting one or more of the bone of the wrist were present in 20 percent of the patients with ACC and in 5 percent of the controls. The difference was significant (p less than 0.01). Chalky deposits were found in the soft tissues immediately next to a metacarpo-phalangeal articulation in 22 percent of the ACC patients but not in any of the controls. The difference was highly significant (p less than 0.001). These chalky deposits next to metacarpo-phalangeal articulations were always associated with chalky incrustation of the radio-carpal joint. As regards the radiological lesions, considered as being typical images of arthrosis and affecting the trapezo-metacarpal, metacarpo-phalangeal, and interphalangeal articulations, the chondrocalcinosis patients appeared to be more frequently affected than the controls, but the difference was not significant. On the other hand, a type of arthropathy occurs in ACC patients which also resembles an arthrosis radiologically but which was 5 times more frequent in them than in the controls and which in this series occurred without nearby trapezo-metacarpal arthropathy only in ACC patients (16 percent as against 0 percent in the controls: p less than 0.001); this was scapho-trapezial arthropathy. The finding of this kind of radiological lesion, particularly when it is not associated with lesions in the trapezo-metacarpal articulations should indicate the possibility of a diagnosis of ACC and should lead to radiological investigation of other sites.

Adult↗

Autoantibody formation in D-penicillamine-treated rheumatoid arthritis.

One hundred and two rheumatoid arthritis patients were tested before treatment for the presence of 16 autoantibodies. Low titers of antinuclear factors appeared, but there were no antitissue antibodies. At different intervals during the treatment of a 2nd series of 176 patients, elevations of antinuclear factors were observed that correlated slightly with either autoimmune or toxic side effects. Antitissue antibodies were seen only in pemphigus and myasthenia after the onset of these complications. The practical value of systematic evaluation for autoantibodies in penicillamine-treated rheumatoid patients is questionable.

Adult↗