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Biomedical subjects

D Mottier

Publications and source records attributed to D Mottier.

At least 91 records · Page 5Linked to original sources
PubMed1982

[Salivary lysozyme, immunoglobulins and beta 2-microglobulin in Gougerot-Sjögren syndrome].

Lysozyme (LZM), immunoglobulins and beta 2-microglobulin concentrations were measured in the saliva of 79 patients with primary (n = 29) or secondary (n = 50) Sjögren's syndrome and in a control population. beta 2-microglobulin and immunoglobulins A, G and M concentrations were higher, and LZM concentrations lower than in controls. A significant correlation was established between LZM and immunoglobulins, but no correlation was found between immunoglobulins and beta 2-microglobulin, nor between the latter and LZM. These results indicate that salivary LZM concentration may be of value in the diagnosis of Sjögren's syndrome.

Adult↗
PubMed1982

[Rheumatic manifestations in the presence of antibodies to Yersinia pseudotuberculosis. Apropos of 4 cases].

Rheumatic manifestations due to Yersinia pseudotuberculosis are apparently rare. We report four personal observations, including one of a patient with Reiter disease and significant titres of antibodies to Yersinia pseudotuberculosis. In all four patients a non-specific syndrome, with fever and digestive symptoms, preceded the onset of joint disease. Both peripheral and axial joints were affected. One patient had HLA B27; the brother of another patient had spondyloarthropathy with HLA B27. Stool cultures were negative but they were all done at least three months after the acute episode. These rheumatic manifestations have many features in common with those described in Yersinia enterocolitica infections. Studies of larger series could improve our knowledge of the part played by the patients' constitution and widen the scope of reactive arthritis.

Adult↗
PubMed1982

[Spontaneous peritonitis in a cirrhotic patient (author's transl)].

A case of spontaneous peritonitis in a cirrhotic patient is reported. Because of marked peritoneal and hemodynamic signs, exploratory laparotomy was decided on. Such cases of spontaneous peritonitis, which mimick surgical affections, are very uncommon. Onset is usually insidious with increasing hepatic fluid as the only sign. Bacteriologic examination of the peritoneal fluid is often negative. Diagnosis should be considered if cytology shows more than 75 polynuclear leukocytes per mm. When bacteriology is negative, association of an aminoside with penicillin G and metronidazole seems to be the most satisfactory combination.

Adult↗
PubMed1982

Analysis of criteria in staging in multiple myeloma.

One hundred and thirty patients suffering from multiple myeloma were reviewed for retrospective study of their classification according to Durie and Salmon's staging system. No significant difference was found in survival between patients in stage I, II and III. Since then, each criterion developed by Durie and Salmon was evaluated separately. Only the Hb level showed a significant influence; a Hb level under 8.5 g/dl or corrected calcaemia above 3 mmol/l were never found separately. When survival according to the number of criteria was considered there was no difference. These findings agree with the well-founded classification of Durie and Salmon but the real importance of each criteria is questionable.

Calcium↗
PubMed1981

[Myasthenia gravis and asymptomatic monoclonal gammapathy. Detection of autoantibody activity of the monoclonal immunoglobulin].

Simultaneous occurrence of "myasthenia gravis" and monoclonal "asymptomatic" gammapathy has been observed in a 83 years old patient. Antistriated muscle antibodies could be detected at a level of 1/1,000 but no antiacetylcholine receptors antibodies. The antibody activity is located both in the monoclonal IgG kappa and in the polyclonal IgG. This case illustrates the frequent occurrence of several auto-immune disorders in a same patient.

Aged↗
PubMed1978

[Acquired deficit in factor X associated with amyloidosis. One case (author's transl)].

A 75-year-old woman developed a haemorrhagic syndrome due to an acquired deficit in factor X whic resulted in death from gastrointestinal bleeding. This deficit was associated with primary amyloidosis. The relationship between the two conditions, the particular features of the haemostatic picutre and the ineffectiveness of replacement therapy are discussed.

Aged↗
PubMedDate not supplied

Early versus delayed introduction of oral vitamin K antagonists in combination with low-molecular-weight heparin in the treatment of deep vein thrombosis. a randomized clinical trial. The ANTENOX Study Group.

OBJECTIVE: To compare oral anticoagulant treatment (fluindione) started on either the 1st or the 10th day of a low-molecular-weight heparin (enoxaparin) treatment for deep vein thrombosis confirmed by venography. DESIGN: An open, multicenter, randomized study in two parallel treatment groups. INTERVENTIONS: All patients received enoxaparin, 1 mg/kg s.c. twice daily, and oral fluindione, 20 mg once daily, either beginning on day 1 or on day 10 of the enoxaparin treatment. Enoxaparin was discontinued once the international normalized ratio under fluindione was stable between 2.0 and 3.0 over 2 days. Fluindione treatment was maintained during a 3-month follow-up period. OUTCOME MEASUREMENTS: Specific examinations (venography and/or V/Q lung scanning and/or angiography) were performed only in the event of a clinically suspected recurrence of venous thromboembolism during the 3-month follow-up period. All cases were blindly assessed by an independent Reading Committee. RESULTS: A clinically suspected venous thromboembolism was confirmed by objective tests in 1 of 223 patients (group of delayed introduction of fluindione; n = 111). Equivalence was demonstrated between the two treatment schedules (p < 0.0001) for a maximal difference of 10% (90% confidence interval: -2.42 to 0.58). The mean duration of hospitalization was significantly reduced (p = 0.0001) in the group with early introduction of fluindione. The incidence of hemorrhage was comparable between the two treatment groups. CONCLUSION: Early and delayed introduction of oral anticoagulant treatment in association with subcutaneous enoxaparin in patients with deep vein thrombosis was shown to be equivalent in preventing the recurrence of venous thromboembolism. In patients with early introduction of oral anticoagulant, hospitalization was significantly reduced.

Administration, Oral↗
PubMedDate not supplied

Assessment of the risk and prophylactic treatment of venous thromboembolism in the elderly.

Numerous large randomized controlled trials have assessed the benefit of prophylactic anticoagulation for venous thromboembolism in selected patients. However, few trials were conducted in elderly patients, as this issue was not addressed in this specific population,or as elderly patients were excluded of these studies. Therefore, as the risk of a first episode of venous thromboembolism (in surgical and in medical setting) and the risk of a major anticoagulant-related bleeding are both increased in elderly subjects, the results of the main available studies can not be extrapolated to this population. Consequently, in practice, the balance between expected benefit and risk of prophylactic anticoagulation should be carefully assessed for each individual elderly patient taking in account the specific risk of venous thromboembolism in elderly in the absence of anticoagulation, the risk of anticoagulant related bleeding according to the type of anticoagulant treatment and the intrinsic risk of bleeding of elderly subjects and, lastly, the available guideline recommendations. In order to improve such evaluation, it is anticipated that further prophylactic studies are needed in elderly patients. In addition, the development of anticoagulation clinics and new oral anticoagulants should help to reduce anticoagulant related bleeding for an equivalent, or an increased, benefit.

Aged↗
PubMedDate not supplied

[Current status of anticoagulants].

INDICATIONS: Direct inhibitors of thrombin, such as hirudin, are directed against the active site and the recognition site of thrombin. Because of their low-molecular-weight, they can inactivate thrombin bound to fibrin. Prevention of thromboembolic complications in patients undergoing primary total hip or knee replacement is now an authorized indication of desirudin in France. The recommended treatment for heparin-induced thrombocytopenia is lepirudin when there is a clinically evident thrombosis and danaparoid sodium, a mixture of anticoagulant glycosaminoglycans in an antithrombotic prophylaxis setting. LMWH: Low-molecular weight heparins are not yet authorized in France for the treatment of pulmonary embolism. However, deep venous thrombosis can be securely treated with one daily fixed dose of nadroparin or tinzaparin. ORAL ANTICOAGULATION: The duration of anticoagulation therapy in patients with venous thromboembolism remains controversial. Three to six months of therapy is recommended after a first episode of venous thromboembolism; the shorter regimen may be chosen when there is an identifiable and transient risk factor, and the longer when the thrombosis is idiopathic. In the context of primary prevention of ischaemic heart disease low intensity oral anticoagulation could be recommended in men at high risk.

Administration, Oral↗
PubMedDate not supplied

[Anticoagulants in the elderly. Age-related factors].

HEPARINS: For unfractionated heparins, certain studies have demonstrated increased hemorrhage rates correlated with age and with renal function. Subcutaneous injections every 12 hours are as effective and less uncomfortable for the patient than continuous intravenous infusions. Low-molecular-weight heparins are currently contraindicated for curative treatment and their use is not recommended for prevention when the creatinine clearance is below 30 ml/min. OTHER ANTICOAGULANTS: The dosage of sodium daparanoid should be adapted to the renal function with regular surveillance of anti Xa activity. With hirudin, there is a risk of product accumulation in case of renal failure. For oral anticoagulants the relationship between old age and the frequency of hemorrhagic complications is still a subject of debate. ORAL ANTICOAGULANTS: The starting dosage should be reduced to one-half or one-quarter of the usual dose. The INR should be measured regularly, particularly since elderly subjects are highly susceptible to wide variations in INR irrespective of the cause. It is also advisable to carefully determine appropriate situations when oral coagulants should be used.

Age Factors↗
PubMedDate not supplied

[Anticoagulants in the elderly. Indications].

UNLABELLED: RISK AND BENEFIT: The beneficial effect of anticoagulant treatment is well established by numerous therapeutic trials demonstrating its usefulness in two main indications (venous thromboembolism and complete arrhythmia due to atrial fibrillation) in selected populations. Very few trials have been specifically conducted in elderly subjects and the increased risk of thrombosis and anticoagulant related bleeding cannot be used to extrapolate the results to elderly subjects. For this reason, a careful assessment of the initial risk and expected benefit must be made for each individual patient using a validated and systematic global evaluation system adapted for elderly subjects in order to better discern the indications and the risk of hemorrhage. PERSPECTIVES: The development of anticoagulation clinics, based on the method initiated by Professor Boneu at Toulouse, together with clinical trials designed to produce results transposable to the diverse and complex geriatric population, and finally the development of new oral compounds not requiring laboratory tests under the same conditions should help reduce the therapeutic risk for an equivalent benefit.

Age Factors↗
PubMedDate not supplied

[Genetic polymorphism of acetylation and hydroxylation in the Briton population].

Genetic-controlled drug oxidation and acetylation were studied using dextromethorphan and caffeine as test compounds respectively in white Briton subjects (41 Britons and 27 Bigoudens considered as an ethnic group). Phenotyping was performed using the metabolic ratio (MR) calculated as the urinary output dextromethorphan/dextrorphan ratio and the urinary output of 5-acetylamino-6-formylamino-3-methyluracil (AFMU)/1-methylxanthine (1-MX) ratio in subjects given 40 mg of dextromethorphan and 150 mg caffeine respectively. Frequence distribution of hydroxylator and acetylator status in Briton and Bigouden groups showed no significant difference relatively to the French population. However the frequence distribution of the intermediate acetylator group in the Bigouden population was significantly different from that observed in the Briton population (7.4% vs 31.7%). The signification of this latter result was discussed on the basis of genetic transmission.

Acetylation↗