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Biomedical subjects

J C Renier

Publications and source records attributed to J C Renier.

At least 19 recordsLinked to original sources
PubMed1992

Ankylosing spondylitis and monoclonal gammopathies.

From 1960 to 1990, 557 patients with ankylosing spondylitis (428 men, 129 women) were diagnosed and indexed in the department of rheumatology. Monoclonal gammopathies were found in seven (five men, two women) patients (1.3%). With one exception, ankylosing spondylitis preceded monoclonal gammopathies by many years. The distribution of the isotypes of the mIg found in these seven patients was striking when compared either with previous reports of an association between ankylosing spondylitis and monoclonal gammopathies or with local data on the epidemiology of monoclonal gammopathies: five patients with IgG, four of them of the lambda (lambda) type, and two IgM, both of the kappa (kappa) type were found; no patients with mIgA were recorded. Two patients were HLA-B27 positive and had slight and transient monoclonal gammopathies, whereas three subjects were HLA-B27 negative and had important spikes, corresponding in two subjects to malignant diseases. This observation raises the question of whether the coexistence of HLA-B27 and ankylosing spondylitis might provide a protective action. Epidemiological studies are required to clarify such points.

Adult↗
PubMed1992

[Lower back pain in physicians. Epidemiological aspect and risk factors].

The purpose of this study was to evaluate as accurately as possible, in a well-defined population subgroup, the prevalence and incidence of lower back pain, the impact of this symptom on professional activities and personal life, and the influence of risk factors. Members of the medical profession were considered particularly apt to accurately and reliably report their personal experience with lower back pain and were therefore selected for this survey. Five hundred 93-item questionnaires were sent to a representative sample of physicians in the Maine-et-Loire district, France. Response rate was 93%. Prevalence of lower back pain at the time of the survey was 32% and cumulative prevalence was 62%. Static spinal disorders (exaggerated lordosis, scoliosis, unequal length of lower limbs) and injury to the spine were found to be risk factors. Occupation-related stresses to the spine reported as being responsible for lower back pain included bending forward for prolonged periods, lifting weights, driving, and prolonged sitting.

Adult↗
PubMed1992

[Anti-centromere antibodies. Study of 67 positive sera].

From a series of 67 sera containing anticentromere antibodies we endeavoured to determine the principal clinical or biological peculiarities of these antibodies. The titers of anticentromere antibodies were usually high, with few differences between patients. Humoral immunity was frequently perturbed, with antinuclear autoantibodies (without anti-Scl 70), anti-mitochondria antibodies, rheumatoid factors, circulating immune complexes, etc. The disease predominated in women (97%) whose age and duration of symptoms varied considerably. The most frequent clinical manifestation noted in the 47 reports analyzed was Raynaud's phenomenon (93%) which in most cases (90%) was part of a complete or incomplete CREST syndrome. Telangiectasias, calcinosis and acrosclerosis were the main witnesses to the duration of these sclerodermas. Our findings were concordant with those of previous studies. However, the frequency of sicca syndrome (76%) was unexpected, and must be related to 2 laboratory results: the quasi-absence of anti-SSA and anti-SSB antibodies in our patients and the presence of two monoclonal immunoglobulins (IgM kappa and IgG lambda). There may be some degree of independence between the sicca syndrome and the sclerodermal manifestations.

Adult↗
PubMed1992

[Investigation of phosphorus calcium metabolism after oral phosphorus supplementation].

Effects of oral administration of phosphorus on phosphorus and calcium parameters and on bone metabolism hormones were investigated in two studies: in the first, 12 young female adults and 8 females over 50 years of age took a single oral load dose of 780 mg elemental phosphorus, whereas in the second study assays were performed 5 and 15 days after initiation of twice-daily phosphorus supplements in 19 young adults, 14 subjects above 50 years of age who were free of osteoporosis, and 12 patients with osteoporosis also over 50 years of age. The phosphorus load was associated with an increase in intact parathyroid hormone levels (iPTH 1-84), which was more marked in subjects above 50 years of age than in younger adults. On the 15th day of phosphorus supplementation, there was no significant increase in baseline iPTH and no change in baseline dihydroxyvitamin D or osteocalcin levels; during the Nordin tests, the fractional calcium excretion index (CaU/CrU) and the fractional hydroxyproline excretion index (OH Pro/CrU) remained unchanged. In contrast, the phosphorus load was followed by a decrease in the maximum phosphorus reabsorption threshold (TMP/DFG), which was more marked on the 5th day than on the 15th day; a slight fall in serum phosphorus levels was also seen on the 15th day. These findings suggest that phosphorus supplementation should be intermittent rather than continuous. Analysis of subjects aged 50 to 69 years failed to disclose any significant differences between patients with and without osteoporosis.

Administration, Oral↗
PubMed1992

[Weismann-Netter and Stuhl toxopachyosteosis. Apropos of 30 cases].

Toxopachyosteosis, a rare bone disease, was described in 1954 by Weissmann-Netter and Stuhl. This congenital osteopathy, which may be familial, is defined by an anteroposterior curvature (toxon = arc) and thickening (pachus = thick) of the shafts of both leg bones. Other bones may be affected. Short stature and delayed walking are other important special features of the disease. It is most often diagnosed late and by chance because of the minimal functional consequences of the deformities. Sequelae of vitamin D-deficient rickets are the main differential diagnosis. The aim of this study undertaken by the Bone and Calcium/Phosphorus Metabolism Section of the Société Française de Rhumatologie (French Society of Rheumatology) was an overall assessment of the disease. The authors report 30 cases of toxopachyosteosis and evaluate their main characteristics on the basis of data from the literature.

Adult↗
PubMed1992

[Coexistence of monoclonal IgM and ankylosing spondylitis. Apropos of 2 cases].

Two cases of the association of monoclonal IgM and ankylosing spondylitis are reported. Their presentations are in accordance with local epidemiological data (monoclonal IgM, both kappa, one of them malignant, discovered in 71 and 79 year-old men). Ankylosing spondylitis does not appear as either favouring the incidence of monoclonal immunoglobulins or, in our opinion, having a major influence on their isotype. Conversely, while each member of this association could have its own story, the possible role of the coexistence of HLA B27 together with ankylosing spondylitis should be considered.

Aged↗
PubMed1991

[Bone density in 20 black African young adults of the Bantu race is identical to that in subjects of white race].

Bone mineral content (BMC in g) as well as bone mineral density (BMD in g/cm2) were measured by dual photon absorptiometry in 20 black africans and 20 white individuals of the same age and sex. The BMC of african males, as well as their body mass index (BMI), were significantly less than those of the whites. In contrast, neither BMD nor the ratio of BMC to BMI differed between the two groups. These results suggest that morphotype plays a greater role than the ethnic factor in the determination of bone mass in the young adult.

Adult↗
PubMed1990

[The development of bone mass during a lifetime].

The authors present a reminder of the methods used to evaluate the bone mass and density and, with population studies, specify the profile and significance of the physiological osteopenia in both sexes. Analysis of these studies shows that the age of onset of the bone loss and its percentage vary markedly between the various sites of the skeleton, according to the type of bone, cortical or trabecular. It seems that the "smooth" aspect of the physiological osteopenia curves obtained is women during population studies, essentially results from the disparity between the times of menopause. A general protocol of the physiological osteopenia, synthesizing all data collected with nine different methods of measurement of the mineral bone content, is presented for educational purposes.

Adult↗
PubMed1979

[Acute leukaemias after treatment using cytotoxic agents for rheumatological purpose. 19 cases among 2006 patients(author's transl)].

The authors undertook a retrospective study to determine the number of acute leukaemias developing amongst 2006 patients suffering from chronic inflammatory rheumatic conditions and connective tissue disorders, treated with cytotoxic agents. The follow-up period ranged from 1 to 13 years. Nineteen leukaemias were found, essentially granulocytic, with a latent period of 5.7 +/- 2, 8 years after the beginning of treatment. This incidence of almost 1% of leukaemias is probably less than the actual percentage since a number of patients were lost on follow up and since the period of observation is as yet too short. The majority of patients has been treated for more than one year. No cases were seen amongst patients treated for less than six months, or with less than 1g of chlorambucil or 50 g of cyclophosphamide. The risk would seem to be the same for both alkylating agents. No patients treated with azathioprine developed leukaemia, but few patients received this drug. Amongst 35 patients treated for severe psoriatic arthropathy with chlorambucil, 4 developed leukaemia. This particularly high percentage is such that all trials of alkylating agent in this condition should be stopped. The prevalence of leukaemia seen in the series as a whole is comparable to that found in mass studies carried out in various malignant diseases treated by cytotoxics. Awareness of this risk should, lead to even stricter limitations before the use of cytotoxic drugs in rheumatological conditions.

Acute Disease↗
PubMed1979

[Contribution of dynamic isotopic tests in the study of algodystrophies].

The authors studied 20 patients suffering from algodystrophy (23 localizations) by triple scintigraphy with technetium, using pyrophosphate to study the importance of bone changes, marked red blood cells to measure the vascular volume, and pertechnetate to measure the interstitial compartment. These tests were done on the average 1.4 months after the outset of the disease. This work made it possible to demonstrate in the algodystrophy: a pronounced bone hyperfixation that was uneven according to the patients; a frank increase in the vascular volume, notably on the capillary level, and a reduction of the circulatory output (calculated on 4 distal localizations), and an increase of the interstitial compartment higher than that of the vascular volume and corresponding to the edema. These results demonstrate a circulatory stasis. In 4 patients treatment with calcitonine reduced the vascular volume but not the bone hyperfixation. In 1 patient, treatment with pindolol reduced the bone hyperfixation and the vascular volume. The authors underline the advantage of such methods in creating a better knowledge of the physiopathology of algodystrophies and effective means of treating them.

Blood Volume↗
PubMed1979

[Idiopathic hypercalciuria. Correlative study of bone tissue and phosphocalcium investigations].

The authors report on the clinical, biological and radiological anomalies observed in a series of 42 cases of idiopathic hypercalciuria. An histological bone study showed "osteomalacia" type changes (an increase in the osteoid volume and a decrease in the mineralization speed). The Ca45 isotope studies showed that there was an exchangable pool of calcium and a turnover, which was generally low. A study of the kidney functions revealed a decrease in the tubular reabsorption of calcium, while that of phosphorous remained within normal limits. There was no case of hyperparathyroidism in this series. The authors pose the question of whether the failure of calcium to settle on the tissues and the lack of tubular reabsorption of calcium, does not result from the relatively ineffective action of the endogenous circulating parathyroid hormone.

Adolescent↗