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Biomedical subjects

G Vidal-Trecan

Publications and source records attributed to G Vidal-Trecan.

11 recordsLinked to original sources
PubMed1989

[Hospital epidemiology of HIV infection in the Parisian public hospitals].

The evolution of hospitalization for patients with HIV infections in Parisian public hospitals (Assistance Publique de Paris) can be analyzed from the data base containing discharge diagnoses and from the results of a cross-sectional survey "on a given day". At present, the activity associated with HIV infection represents more than 2% of the total activity of this institution. From 1982 to 1987, HIV-associated activity increased extremely rapidly, treating patients in acute care hospitals and clinical departments and concomitantly developing home care and day hospitalizations. The latter were responsible for the substantial decrease in the average length of hospitalization. Home care and day care hospitalizations for HIV infection continued to increase during 1988, while longer-term hospitalizations decreased.

France↗
PubMed1989

[HIV infection in the Public Assistance Hospitals in Paris. Cross-sectional survey on a given day per trimester, a hospital indicator of morbidity].

Many patients with Acquired Immunodeficiency Syndrome (AIDS) and the other forms of human immunodeficiency virus infection are treated in the Assistance Publique hospitals of Paris (AP). A cross-sectional survey to be repeated on a given day of each trimester was designed to obtain rapidly and anonymously the number of inpatients treated. A questionnaire was sent to the head of every department treating acute inpatients, asking for the number of patients with AIDS, AIDS-related Complex, pre-AIDS... and asymptomatic carriers of HIV. In 1986, a regular increase was observed from 252 (139 AIDS patients) in March to 318 (170 AIDS patients) in December. On the average, approximately two-thirds of the AIDS patients were hospitalized in three hospitals; however, their number remained stable over the year so these three hospitals' proportion tended to decrease. An estimation of the annual number of inpatients with HIV infection was drawn from the mean of the cross-sectional survey's results. This survey makes it possible to evaluate on an almost continuous basis the impact of AIDS and related conditions on hospitalization figures.

AIDS-Related Complex↗
PubMed1988

[Human immunodeficiency virus infections and hospital structures: trends in the Public Assistance of Paris].

The evolution of the number of patients with the AIDS virus admitted to the Paris hospitals is monitored by two index systems, one based on the discharge diagnosis and the other a transverse inquiry on a given day, updated every three months since its conception at the beginning of 1986. This index also allows an evaluation of the number of patients consulting for this condition. In 1986, AIDS and AIDS related complexes (ARC) represented 1 p. 100 of the activity of the Assistance Publique Paris hospitals including all in- and outpatients. These conditions will probably account for 2 p. 100 of the activity in 1987. The duration of cumulated hospital stay is on average 30 days per year for AIDS and ARC, divided into roughly 3 admissions, with a tendency towards more under-24 hour stays and domiciliary care. The clinical departments looking after these patients are varied and increasing in number, but most of the work is carried out by Departments of Infectious and Parasitic Medicine.

AIDS-Related Complex↗
PubMed1984

[Rapid beta 1-24-corticotropin test in the exploration of the corticotropic axis. 71 cases].

The reliability of the beta 1-24 corticotropin test, which is both cheap and safe, in the assessment of the hypothalamic-pituitary-adrenocortical function was re-evaluated by comparing its results with those of the metyrapone test in 71 subjects: 30 controls and 51 patients with suspected pituitary-adrenal dysfunction. Response to a 500 micrograms intramuscular injection of beta 1-24 corticotropin was evaluated by measuring the 60 min plasma cortisol levels; 4.5 g of metyrapone divided into 6 doses were then administered orally and response was evaluated by measuring plasma 11-desoxycortisol levels. A highly significant correlation (r = 0.79; p less than 0.001) was observed between plasma cortisol and plasma 11-desoxycortisol levels. The results were best interpreted by expressing the values obtained as plasma cortisol concentrations which, in normal subjects are at least 21 micrograms/100 ml. The rapid beta 1-24 corticotropin test was found to be very reliable (sensitivity 90%, specificity 100%) to detect adrenal insufficiency, irrespective of the organs affected on the hypothalamic-adrenocortical axis.

Adolescent↗
PubMed1984

[Paraneoplastic hypercorticism].

Paraneoplasic hypercorticism results from ectopic corticolipotropic secretion. Its incidence remains underestimated because of the latent clinical forms of Cushing's disease. In some cases the primary tumour (bronchopulmonary, thymic, pancreatic or other) presents late. The variability of hormonal secretion makes it difficult to interpret dynamic tests. Measurement of ACTH and LPH are useful diagnostic aids; more specific markers of ectopic secretion have recently been reported. When the primary tumour cannot be directly treated, the quality of survival may be improved by the use of synthetic anticortisol drugs.

Adrenocortical Hyperfunction↗
PubMed1983

[Hypertension and Cushing's disease].

Over two thirds of patients with Cushing's disease suffer from hypertension. An analysis of 155 patients with Cushing's syndrome was undertaken to study its incidence and effects, and the biological profile and prognosis of the patients. The renin-angiotensin-aldosterone system was given particular attention in 5 patients. Serum angiotensin was raised and a positive correlation was observed with the serum cortisol. Serum aldosterone did not respond as normal to the usual stimuli and the normal plasma renin activity did not vary during the 24 hour period. The physiopathogenesis of hypertension in Cushing's disease is still not fully understood, especially with regard to the mode of action of the hypercortisolism, the essential factor. A mineralocorticoid type of behaviour, especially in the severe forms, may be associated with that of the ACTH-dependent precursors, a permissive action on certain pressor substances, the increase in secretion of angiotensin in parallel to that of the cortisol and finally, the increase in the risk factors probably play a role. The outcome of the hypertension after specific treatment of Cushing's disease is usually favourable. However, hypertension persists in a third of cases.

Adult↗
PubMed1983

[Therapeutic strategy in the hypertension of Cushing's disease].

The hypertension of Cushing's disease regresses in about two thirds of cases after specific treatment of this condition. The therapeutic possibilities available at present include the synthetic anticortisol drugs (OP'DDD, aminoglutethimide) adenomectomy and hypophyseal radiotherapy and, finally, bilateral adrenalectomy. The indications of one or the other forms of treatment depend on the presence of a patent hypophyseal tumour, the age of the patient and the stage of the disease. The hypertension requires treatment either because of its severity from the outset or its persistence after treatment of the Cushing's disease. Betablockers or central sympatholytic drugs like clonidine, are then used in monotherapy of first intention. Diuretics should be avoided whenever possible because of the risk of adrenal insufficiency after reduction of the hypercorticism.

Adrenal Glands↗
PubMed1982

[Results of surgical treatment of Basedow's disease].

Diffuse hyperthyroidism occurred in 88 patients (82 women and 6 men), aged 14 to 74 years, and was due to Graves disease in 65 cases and heteromultinodular goiter in 23 cases. After medical preparation, the surgical procedure was subtotal thyroidectomy for Graves disease and total unilateral with partial controlateral lobectomy for heteromultinodular goiter. The immediate postoperative course was uneventful except for two transient acute episodes of thyrotoxicosis. One to eight years after surgery, 53 patients are euthyroid, 34 are hypothyroid and one has recurrent hyperthyroidism. A TRH test was done in each of the 53 euthyroid patients. Three kinds of responses were demonstrated: a normal response in 22 cases, evidencing true euthyroidism; an excessive response in 24 cases, reflecting partial compensated hypothyroidism; an insufficient response in 7 cases.

Adolescent↗
PubMedDate not supplied

[Cushing's disease. Current data on its course and treatment].

Recent developments in the treatment of Cushing's disease, particularly the trans-sphenoidal microadenomectomy, have prompted a survey of the pathophysiological theories of ACTH hypersecretion in this condition. The results of the trans-sphenoidal approach are reported and the post-surgical evolution (success failure or recurrence) are discussed. It is emphasized that a long fellow up is essential to assess the efficacy of this therapeutic approach.

Adenoma↗