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Biomedical subjects

F Archambeaud-Mouveroux

Publications and source records attributed to F Archambeaud-Mouveroux.

41 records · Page 3Linked to original sources

[Treatment of prolactinoma].

Prolactinomas rank first in frequency among hormone-secreting pituitary adenomas, but their management remains controversial. The authors present a review of the literature concerning the various therapeutic methods used and their results. As regards microadenomas, opinions are divided since the results obtained with bromocriptine and with selective adenomectomy are about the same. As regards macroadenomas, surgery exposes to more frequent complications and above all to recurrences. The majority of authors is in favour of bromocriptine first followed, if necessary, by surgical excision. Pregnancy may accelerate the development of prolactinomas. This risk is minimal with microadenomas and more real with macroadenomas, requiring more radical treatment before pregnancy and close monitoring.

Bromocriptine↗

[Developmental adrenal tuberculosis. Value of x-ray computed tomography].

Two cases of Addison's disease secondary to active adrenal tuberculosis are reported. Computed tomography showed hypertrophy of the adrenal gland, which was bilateral in one case and unilateral in the other. Repeat computed tomography scans during antituberculous chemotherapy demonstrated a progressive change of the adrenals toward atrophy and calcification, while the adrenal function remained impaired. The authors recall that adrenal tuberculosis may be unilateral first, then bilateral, and that the gland is initially hypertrophic before hormonal deficiency appears; later on, adrenal atrophy and calcification develop. Computed tomography seems to be useful in the aetiological diagnosis of Addison's disease. Moreover, it helps in determining whether or not antituberculous therapy is indicated, which is not always easy to decide in the absence of "active" focus. The finding, with or without positive tuberculin skin tests, of an adrenal hypertrophy unexplainable by any other pathology (e.g. metastasis, histoplasmosis) should call for antituberculous treatment, especially since it sometimes results in recovery of adrenal function.

Addison Disease↗

[Sulfasalazine or salazosulfapyridine in the treatment of rheumatoid polyarthritis. An open study of 46 patients. Review of the literature].

The SASP was studied in 46 patients with rheumatoid arthritis. The efficacy criteria which were selected (decrease of the sed rate by more than 50 p. cent during the first hour, morning stiffness under 20 minutes, Ritchie's index inferior to 10 and decreased cortisone and NSAID doses), explain that 25 p. cent of the patients are considered as satisfied after 12 months of trial. The patients selected, present severe forms of the disease or forms resistant to other treatments. The improvement appears significant after the first month. Half of the patients left the trial either because of ineffectiveness, or evolutive relapse (21.73 p. cent) or because of side-effects (28.26 p. cent). The most frequently observed disorders and intolerances are of digestive nature. No serious accident is to be deplored. Such results are in accordance with the data from the literature. The SASP must therefore be considered as the fundamental treatment of rheumatoid arthritis. The new galenic forms, dissolving in the gastro-intestinal tract, have enabled to markedly improve the digestive tolerance.

Arthritis, Rheumatoid↗

[Prolonged hyperthyroidism and recurrent atrio-ventricular block].

The authors report the case of a patient with hyperthyroidism who had three episodes of grade 2 and 3 atrio-ventricular block over a 6-year period. After he recovered from hyperthyroidism, the atrio-ventricular conduction returned to normal and remained so throughout a 5-year follow-up. A grade 1 atrio-ventricular block is found in 6 to 8 p. 100 of hyperthyroid patients, but grade 2 and 3 blocks are rare in such patients. Case reports in which thyrotoxicosis alone seemed to be responsible for disorders of conduction are exceptional; frequently, other factors likely to induce such disorders were present. In 90 p. 100 of the cases hyperthyroidism was due to Graves' disease; it lasted for more than one year and thyrotoxicosis was often severe. These facts suggest the possibility of a thyrotoxic myocarditis and/or an autoimmune focal myocarditis. Although rare, atrio-ventricular block in hyperthyroid subjects is a possibility that warrants electrocardiographic monitoring, notably when negative dromotropic drugs are prescribed.

Adult↗