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Biomedical subjects

D Lauque

Publications and source records attributed to D Lauque.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Evaluation after 2 years of substitutive treatment of PiZZ emphysema with alpha-1 antitrypsin. 9 cases].

Homozygous PiZZ individuals with a serum deficiency due to a defect in the secretion of the alpha 1-antitrypsin protein are at risk of developing severe panlobular emphysema. Tobacco smokers are particularly exposed to the disease which begins at an earlier age. Treatment by substitutive therapy with alpha 1-antitrypsin concentrates seems to be the only possibility. A two years' clinical trial was performed in 9 PiZZ patients, with more than 1,500 infusions being administered weekly. Serum AAT levels were used as guidelines to follow biochemical changes in the protease-antiprotease balance. From 0.16 g/l initially, the AAT level rose to 0.57 g/l after 7 months. No adverse reaction was observed during the trial; the concentrated protein was well accepted, ant the antielastase activity of the protein recovered after injection was equivalent to the activity injected. An attempt to administer the infusions monthly was stopped when we observed a dramatic decrease of the serum AAT level. Clinically, stabilization of the symptoms was noted. No degradation was observed in the patients who took part in the trial, even if no real improvement was detected.

Adult↗
PubMed1990

Bronchoalveolar lavage in liquid paraffin pneumonitis.

We evaluated cells and lipids recovered in the bronchoalveolar lavage fluid from seven patients with liquid paraffin pneumonitis. For each patient, the BALF was whitish with oil droplets on the surface. Alveolar macrophages contained numerous, large vacuoles that did not react with May-Grunwald-Giemsa, Papanicolaou, or periodic acid-Schiff but were stained in black with Sudan B, orange with Sudan III and red with oil Red O. Liquid paraffin was identified on thin layer chromatography of BALF-extracted lipids as a very hydrophobic compound migrating on the solvent front as control liquid paraffin. This abnormal spot was definitely identified as liquid paraffin by infrared spectroscopy and gas liquid chromatography for the first patient. The number and percentage of AMs were largely decreased in the BALF of each patient, whereas the number of neutrophils, eosinophils and lymphocytes was increased. These findings suggest that this cell-mediated inflammatory response plays a role in the development of interstitial fibrosis at late stages of liquid paraffin pneumonitis.

Aged↗
PubMed1989

[Natural history of bronchiolo-alveolar cancer. Apropos of 38 cases].

Thirty-eight cases of bronchioloalveolar carcinoma were selected on anatomico-pathological criteria and analysed both radioclinically and histologically. At histology, this type of carcinoma is characterized chiefly by the growth of malignant cells along the alveolar walls. Cytology, which determines the nature of these cells (pneumocyte II or Clara cell), is not specific but remains important as regards phylogenesis. The course of bronchioloalveolar carcinoma gives a better understanding of its mode of propagation. Actuarial curves show that all patients with a diffuse carcinoma die very rapidly, whereas the survival rate of those who have localized lesions is 60% at 5 years. Moreover, the time required for dissemination to take place is long in assessable cases. This means that the condition should be diagnosed at an early stage on the presence of crepitant rales, on their air bronchogram at CT and on transparietal needle biopsy under CT. The chances are that early excision will result in cure.

Actuarial Analysis↗
PubMed1987

[Pulmonary calcinosis].

Interstitial pulmonary calcinosis was discovered after finding hypercalcaemia in a man of 56 who had been treated for several months with Hydrochlorthiazide. This was a secondary hyperparathyroidism due to the formation of parathyroid adenomatous cysts. This illness had been quiescent until then and was probably revealed as a result of the hydrochlorthiazide therapy.

Calcinosis↗
PubMed1986

[Thoracic puncture guided by x-ray computed tomography. Apropos of 125 cases].

A series of 125 CT-guided thoracic punctures performed over a 20-month period is reported. The only complications were pneumothorax in 14 cases, 5 of which were drained, and 1 case of hemomediastinum. For the diagnosis of malignancy the sensitivity of the method was 82%, its specificity 100% and its effectiveness 74%. The level of sensitivity rose to 86% in the last 90 cases. This method is an additional contribution to exploration of the lungs. In trained hands it gives rise to few complications and should result in a histological diagnosis in a large number of cases.

Adult↗
PubMed1985

Effect of oral N-acetylcysteine on mucus clearance.

Oral N-acetylcysteine has been advocated as a mucolytic agent for use in chronic bronchitis. We have investigated the effects of regular use of this drug at a dose of 200 mg thrice daily for 4 weeks in nine patients with chronic bronchitis on lung function, lung mucociliary clearance and sputum viscosity in a controlled, double-blind, crossover study. No significant differences were found in lung function, mucociliary clearance curves or sputum viscosity following treatment with N-acetylcysteine compared to control or placebo measurements.

Acetylcysteine↗
PubMed1985

[Computerized tomography of pleuropulmonary pathology due to asbestos].

28 patients presenting with proven pleuro-pulmonary pathology due to asbestos underwent conventional radiography and also computed tomography (TDM). It is evident that TDM was more sensitive in detecting the presence of pleural plaques which were either hidden or invisible on standard radiographs. False parietal images were often eliminated. With a mesothelioma it can guide the biopsy approach and by visualising contra-lateral plaques that the origin is asbestos. It should enable irregular plaques to be monitored more easily.

Adult↗
PubMed1985

[Alveolar paraffinosis: cytologic and biochemical study of bronchiolo-alveolar lavage fluid].

A case report of a diffuse alveolar lipoid pneumonia occurring in a patient incapable of giving a proper history underlines the diagnostic difficulty of lipoid pneumonias. Till now, unless the diagnosis was made at necropsy, one relied on a history of prolonged consumption of medications containing mineral oil, with evidence on open lung biopsy of excess fatty material in the pulmonary parenchyma. Chromatography on thin slices of the lipid extract of bronchiolo-alveolar lavage liquid fixed in silica gel, a simple technique, should rapidly give the diagnosis. In the alveolar form of the disease bronchopulmonary lavage returns a significant quantity of paraffin oil and may be considered as a therapeutic method.

Bronchi↗
PubMed1983

The frog palate for studying mucus transport velocity and mucociliary frequency.

The palate of the frog possess a pseudostratified epithelium with mucus secreting cells and numerous ciliated cells covered with a continuous mucus blanket of 4 to 8 micron thickness. This palate can be used as a simple model for studying mucus transport and giving rapid information on the transportability of pathological bronchial secretion by the ciliary mechanism. The analysis of the relationship between the rheological properties of sputum an their transport rates on the frog palate showed that the highest transport rates were obtained with sputum samples characterized by a high spinability (Sp greater than 70 mm) and an intermediate range of viscosity (25-180 P) and elasticity (SR = 4-12 units). The mucociliary frequency (Fm) of the frog palate was measured by a photoelectric method and analyzed as a distribution function of the ciliary frequencies by the Fast Fourier Transform method. Fm decreased significantly after mucus depletion and was restored when adding a drop of frog mucus collected on a freshly excised frog palate. On the other hand, it remained about 20% lower than the original predepleted value, when adding purulent sputum collected in patients with chronic bronchitis and cystic fibrosis. The frog palate appears as a valuable model for analyzing the mucociliary transport rate and also for studying the effect of pathological secretions on the ciliary beating frequency.

Animals↗
PubMedDate not supplied

[Pneumorenal syndrome induced by d-penicillamine: Goodpasture's syndrome or microscopic polyarteritis?].

Diffuse alveolar haemorrhage associated with glomerulonephritis is a rare but serious complication of d-penicillamine therapy. A case is reported which illustrates the usefulness of bronchoalveolar lavage and kidney needle biopsy for the early diagnosis of this condition. A search for antiglomerular basement membrane antibodies in serum was negative, whereas antigranulocyte cytoplasmic antibodies were present. These immunological results differentiated the disease from Goodpasture's syndrome to which it is clinically related and placed it in the same category as microscopic polyarteritis. After treatment with corticosteroids, cytostatic drugs and plasmapheresis, the outcome was favourable in contrast with the usually poor prognosis.

Aged↗
PubMedDate not supplied

[Alveolar hemorrhage, glomerulonephritis and anti-cytoplasmic polynuclear antibodies].

The value of antineutrophilic cytoplasmic antibodies (ANCA) was assessed in the diagnosis and chronic treatment of 7 patients with microscopic polyarteritis or Wegener's granulomatosis. All patients had oligoimmune glomerulonephritis with segmental and focal necrosis and presented with anaemia. Five of them had alveolar haemorrhage with haemoptysis and infiltrates at radiography. ANCA were assayed by indirect immuno-fluorescence on ethanol-fixed neutrophils and were strongly positive, with a cycloplasmic aspect in 5 cases and a perinuclear aspect in 2 cases. Initial remission with fall in ANCA titres was obtained with corticosteroids, cyclophosphamide and sometimes plasmapheresis (5 patients), but frequent relapses with re-elevation of ANCA titre occurred when treatment was reduced. It is concluded that ANCA are very helpful in the diagnosis of systemic vasculitis, notably in cases with first-time alveolar haemorrhage. They also facilitate monitoring and therapeutic decisions, since relapses are frequent.

Aged↗
PubMedDate not supplied

[An intensive survey of drug surveillance in a medical admissions department].

An intensive survey of pharmacovigilance was carried out in a medical admission department over a 4-month period. Out of 2,017 admissions to hospital, 23 (1,1 p. 100) were motivated by adverse reactions to drugs. Questioning brought out allergy and multiple drug therapy as important factors. Lesions of the skin and mucosae predominated, notably after treatment with antibacterial and non-steroidal anti-inflammatory agents. The categories of drugs involved were, in decreasing order of frequency: cardiovascular (6/23), anti-bacterial (5/23), neuropsychiatric (4/23) and non-steroidal anti-inflammatory drugs (4/23). The fact that the patients had taken several products rendered evaluation difficult. Using imputability scales made it possible to reduce the cause-effect relationship in 26 p. 100 of the cases.

Admitting Department, Hospital↗
PubMedDate not supplied

Descriptive analysis of emergency hospital admissions of patients with Alzheimer disease.

The aim of this project was to study the underlying reasons for emergency hospital admission of patients with dementia of the Alzheimer type (DAT) and their characteristics. This prospective 4-month study identified 118 patients with DAT, most of whom were referred to the two emergency departments of the Toulouse University Hospital. The two main reasons for admission were behavioral problems (26.3%) and falls (18.6%). Patients were generally at an advanced stage of the disease process and had substantial evidence of poor nutritional status and loss of activities of daily living ability. About one third of patients had already been admitted to the hospital for the same reasons in the preceding months. Psychotropic drugs predominated (71%) among the current medications taken by the patients and were mainly anxiolytics and neuroleptics. Finally, the discharge report indicated that medications were a contributing factor in the disorders of 25% of patients. We believe that improved information for caregivers and early management and treatment are essential to respond adequately to the problems raised by this population.

Activities of Daily Living↗