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D Bontoux

Publications and source records attributed to D Bontoux.

At least 19 recordsLinked to original sources
PubMed1992

[Unsatisfactory results of intradiscal injection of triamcinolone hexacetonide in the treatment of sciatica caused by intervertebral disk herniation].

Sciatica caused by intervertebral disc herniation can be treated with intradiscal injection of chymopapain. A search for a cheaper and less allergizing product led to triamcinolone hexacetonide, this procedure being known as "nucleorthesis". The first results at 6 months were encouraging. In 3 centres where triamcinolone hexacetonide was tested with a more than 2 years' follow-up 92 patients could be evaluated. The results obtained were considered satisfactory in 34 patients (36.9 percent), but they were poor in 19 patients (20.6 percent), and 39 patients (42 percent) had to be operated upon within 2 years. Return to surgery took place within the 6 months following nucleorthesis in 18 patients (19.56 percent) and beyond this period in 17 patients (22.8 percent) with degradation of the results. Moreover, calcifications were found in 19 out of 38 patients; they were of varying size, sometimes detected only at computerized tomography, and some of them appeared to produce symptoms. All considered, the failure rates, the number of patients who required surgery and the occurrence of large and sometimes symptomatic calcifications make triamcinolone nucleorthesis unacceptable compared with the recognized percentages of success with papain nucleolysis and surgical operations. For these reasons, we consider that this treatment should be abandoned.

Anti-Inflammatory Agents↗
PubMed1992

[Lumbar inter-apophyseal arthrosis and bone mineral content: prospective study versus controls with dual photonic absorptiometry and tomodensitometry].

Dual photon absorptiometry (DPA) is a non invasive and repeatable technique to measure vertebral bone mineral content (BMC). This method can be altered, in frontal incidence, by superposition of abnormal calcifications as calcified aorta or interapophyseal arthrosis. The authors studied nineteen females with lumbar apophyseal arthrosis compared with twenty one controls matched by age. Bone densitometry was performed by Am-Ba DPA and monoenergetic computerised tomodensitometry (CT) from L2 to L4. Arthrosis was studied by standard X ray radiographs and CT. Our results showed that inter-apophyseal arthrosis does increase BMC determined by DPA, especially when expressed as linear BMC (g/cm). The body mass index [weight (kg)/size (m2)] also increased these measures by DPA. CT results were, at the opposite, not influenced by osteo-arthrosis nor body mass index. Detailed analysis of DPA pictures allowed to recognize most of patients with osteo-arthrosis and to correct their results by using adjacent vertebral measures (L1) or abandoning pictures of unusual aspect. The authors mentionned necessity to match populations for age and body mass index and to include L1 in routine vertebral bone mineral content determination. By this way they supposed that osteo-arthrosis may not alter lumbar BMC measured with DPA technique.

Absorptiometry, Photon↗
PubMed1992

[Infectious spondylodiscitis. Analysis of a series of 105 cases].

Among 105 cases of infectious spondylitis diagnosed and treated from 1971 through 1990, 23 were due to tuberculosis (TS) and 82 to other causes (NTS). The annual number of cases of NTS rose over the study period, partly because of an increase in iatrogenic spondylitis, whereas the number of TS cases fell. In both groups, mean age of patients was higher than in earlier studies. The leading causative agents in NTS were staphylococci, followed by streptococci, then Escherichia coli. Diagnosis of spondylitis was dependent on the imaging techniques used; among available methods, the most reliable was magnetic resonance imaging which improved diagnostic performance by detecting early, specific changes. Except in patients with positive blood cultures and in TS patients with Koch bacilli recovered from other visceral foci, bacteriologic diagnosis rested on studies of samples taken from the spinal infection site. Half the subjects underwent discovertebral needle biopsy, with a success rate of 47.5%, a figure comparable with those reported in other studies. In 30% of patients, bacteriologic documentation of the infection was not obtained and diagnosis rested on a set of clinical, biological, and radiological criteria.

Bacterial Infections↗
PubMed1991

[Calcifications after intra-disk injection of triamcinolone hexacetonide in lumbar disk hernia. Evaluation of therapeutical results in 3 years].

The development of disk or epidural calcifications is a frequent possibility following intra-disk injection of triamcinolone hexacetonide. It was found 10 times in 26 follow-up CT scans obtained 2 to 3 years after the injection. These calcifications are often clinically silent, but they sometimes accompany a recurrence of the initial painful symptomatology. Furthermore, evaluation at 3 years of therapeutic results in a previously published series of patients who had received an intra-disk injection of triamcinolone hexacetonide showed a marked decrease in favourable results (30% vs 67% at 6 months). These two arguments: disappointing long term results and possibility of disk calcifications, are felt by the authors to justify abandoning the technique of triamcinolone hexacetonide by intra-disk injection in the treatment of lumbar disk prolapse.

Adult↗
PubMed1990

[How to evaluate the long-term course of osteoarthritis. Tests for trials of fundamental treatments (spine excluded)].

The best assessment tests for long term trials on osteoarthritis (OA) of the hip and knee are the following, in order of relevance value (consensus of french experts): 1) the loss of joint space thickness on successive radiographies; 2, 3) the indices of the severity for OA of the hip and knee; the investigator's overall opinion; 4) the patient's overall opinion (visual analogue scale of handicap); 5, 6, 7) the pain level (visual analogue scale); the time for going up and down a standard flight of stairs and the time of pain in this distance; the limitation of two articular movements; 8) the increase of either analgesics or NSAIDs consumption; 9) concerning OA of fingers, the number of joints newly involved on successive radiographies. At present, only the radiological tests 1 and 9 are validated. The clinical tests 2 to 8, valuable for short term trials, have yet to be validated for long term follow-up. Recommended duration of trials is three years. A rigorous organisation is necessary to avoid erroneous inclusions: all data recorded in the pre-inclusion visit have to be checked by the principal investigator. Since we have not yet a validated chondroprotective agent as a reference drug, the trial must be randomised, double blind, placebo controlled, parallel group study.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1990

[Definition of and diagnostic criteria for osteoarthritis. Application of anti-osteoarthritis agents to clinical experimentation].

The best definition of osteoarthritis is anatomical, but to be rigorous must include the biochemical characteristics of osteoarthritis cartilage. The most appropriate diagnostic criteria for clinical trials are those of Lequesne. However, radiological criteria assume that osteoarthritis had already developed and should be modified in order to permit the inclusion of early stages of osteoarthritis. The ACR classification criteria are less appropriate to the needs of clinical trials because of their lack of specificity. They are, nevertheless, of interest to the clinician in diagnosis and to the epidemiologist because of their simplicity. Diagnostic criteria of early-stage osteoarthritis proposed by Amor are of great interest to the clinician. However, their application to clinical trials still suggests certain difficulties. One can hope that such difficulties will be resolved with the development of M.R.I. and/or the discovery of novel biologic markers.

Humans↗
PubMed1989

[Hypo-uricemia].

Explore the source record for details and available documents.

Allopurinol↗
PubMed1989

[Post-traumatic reactive arthritis. Etiologic, clinical and diagnostic aspects. Apropos of 6 cases].

The relationship between trauma and reaction arthritis, although controverted must be interpreted in each specific cases, after chronological analysis of the events. The localizing role of a trauma occurring before the infectious episode and affecting, topographically, a specific joint, may be accepted. It is reasonable to admit that a trauma, following an infectious episode, may possibly trigger rheumatism, providing that one of these arthritis corresponds topographically to the trauma. On the contrary, it does not seem possible to accept, in the present state of our knowledge, that an isolated trauma occurring on a genetically predisposed individual, may generate, out of nothing, a Fiessinger-Leroy-Reiter syndrome.

Adult↗
PubMed1988

[Treatment by nucleolysis using chymopapain of disk hernias of purely lumbalgic form].

16 patients suffering from a herniated disc with purely lumbalgic manifestations were treated with chymopapain nucleolysis. The results were very good in 5 cases, good in 6 cases and poor in 5 cases. These data, along with those scattered in the literature, led us to consider nucleolysis as a treatment, probably valid, of a herniated disc in its purely lumbalgic form.

Adult↗