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Biomedical subjects

J F Maillefert

Publications and source records attributed to J F Maillefert.

At least 37 records · Page 2Linked to original sources
PubMed2000

Primary hyperparathyroidism with normal serum intact parathyroid hormone levels.

To evaluate the features of primary hyperparathyroidism (HPT) with normal serum intact parathyroid hormone (iPTH) levels, we studied 271 consecutive patients undergoing surgery for primary HPT. In 20 patients, serum iPTH levels were within the normal range (10-65 ng/l). In their records, the most common clinical features were fatigue (n=13), polyuria (n=6), renal stone (n=5), and hypertension (n=5). Mean serum calcium and phosphorus were 2.78 and 0.85 mmol/l, respectively: 14 had serum phosphorus within the normal range. Mean serum iPTH was 48.5 ng/l, and was <45 ng/l in nine patients. Cervical ultrasound demonstrated a parathyroid adenoma in nine, and was normal in four. Tc sestamibi parathyroid scintigraphy always demonstrated an adenoma (9/9). In eight patients, normal iPTH values delayed diagnosis. Physicians should be aware of the possibility of HPT in patients with hypercalcaemia, even when serum phosphorus and iPTH levels are within the normal limits. Particularly, HPT cannot be excluded when serum iPTH levels are below the upper part of the normal range. In such cases, cervical imaging, which has the same sensitivity as in other HPT, should be undertaken. These explorations are useful, because many patients are symptomatic and can take advantage of surgery.

Adenoma↗
PubMed2000

Effects of cyclosporin at various concentrations on dexamethasone intracellular uptake in multidrug resistant cells.

BACKGROUND: The multidrug resistance phenomenon results from the expression of P-glycoprotein (P-gp), a drug-efflux pump. Corticosteroids are substrates for P-gp, whose function can be inhibited by cyclosporin. This study evaluates the ability of cyclosporin to modulate dexamethasone uptake in multidrug resistant cells. METHODS: The K 562 cell line, which does not express P-gp and a P-gp expressing clone, K562/ADM, were used. Cells were incubated with H3-dexamethasone in the absence or presence of cyclosporin at various concentrations. Then, cells were washed, lysed, and radioactivity was measured. RESULTS: The uptake of dexamethasone alone was higher in sensitive than in resistant cells. Addition of cyclosporin induced a dose dependent increase of dexamethasone uptake in resistant cells, whereas the drug did not influence dexamethasone uptake in parental cells. CONCLUSION: Cyclosporin, at therapeutic concentrations induces a moderate, but significant increase in dexamethasone accumulation in multidrug resistant cells. Thus, cyclosporin might increase the intestinal absorption of corticosteroids or their accumulation in mononuclear cells, or both, thereby increasing their therapeutic efficacy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2000

Numb chin syndrome.

Numb chin syndrome reflects an abnormality in the mental nerve or inferior alveolar nerve, or occasionally in a nervous structure located higher up in the body. It manifests as objective and/or subjective sensory disorders in the distribution of the mental nerve or inferior alveolar nerve, represented primarily by half of the lower lip and chin. Although numb chin syndrome falls mainly within the province of dentists and stomatologists, it can reveal a number of neoplastic or other diseases seen by rheumatologists. This article provides background information on numb chin syndrome, discusses its causes (including those seen mainly by dentists and stomatologists), and reviews numb chin syndrome due to generalized malignancies based on 144 cases from the literature and two personal cases.

Chin↗
PubMed1999

Rheumatic disorders developed after hepatitis B vaccination.

OBJECTIVE: To obtain an overview of rheumatic disorders occurring after hepatitis B vaccination. METHODS: A questionnaire was sent to rheumatology departments in nine French hospitals. Criteria for entry were rheumatic complaints of 1 week's duration or more, occurrence during the 2 months following hepatitis B vaccination, no previously diagnosed rheumatic disease and no other explanation for the complaints. RESULTS: Twenty-two patients were included. The observed disorders were as follows: rheumatoid arthritis for six patients; exacerbation of a previously non-diagnosed systemic lupus erythematosus for two; post-vaccinal arthritis for five; polyarthralgia-myalgia for four; suspected or biopsy-proved vasculitis for three; miscellaneous for two. CONCLUSIONS: Hepatitis B vaccine might be followed by various rheumatic conditions and might trigger the onset of underlying inflammatory or autoimmune rheumatic diseases. However, a causal relationship between hepatitis B vaccination and the observed rheumatic manifestations cannot be easily established. Further epidemiological studies are needed to establish whether hepatitis B vaccination is associated or not with an incidence of rheumatic disorders higher than normal.

Adolescent↗
PubMed1999

Bone mineral density in men treated with synthetic gonadotropin-releasing hormone agonists for prostatic carcinoma.

PURPOSE: We evaluate the relationship between the use of synthetic gonadotropin-releasing hormone (Gn-RH) agonists and bone loss in men. MATERIALS AND METHODS: Bone mineral density and parameters of mineral metabolism were evaluated in 12 patients with stage C prostatic carcinoma before and after 6, 12 and 18 months of treatment with 3.75 mg. triptorelin intramuscularly every 4 weeks. RESULTS: Of the 12 patients 9 were evaluated after 6, 7 after 12 and 6 after 18 months of therapy. In comparison with month 0, the lumbar and femoral neck bone mineral density tended to decrease at month 6 (-3 and -2.7%, p = 0.31 and 0.17, respectively), at month 12 (-4.6 and -3.9%, p = 0.13 and 0.13) and at month 18 (-7.1 and -6.6%, p = 0.12 and 0.027). A second analysis revealed that the lumbar and femoral neck bone mineral density was significantly decreased on the last evaluation compared to month 0 (p = 0.05 and 0.028, respectively). The serum osteocalcin was increased during treatment, suggesting an accelerated bone turnover in men treated with Gn-RH agonists. CONCLUSIONS: The use of Gn-RH agonists in men may induce an accelerated bone loss. Further studies are needed to confirm these results and to evaluate the incidence of osteoporotic fractures in men treated with Gn-RH agonists.

Adenocarcinoma↗
PubMed1999

Bone metastases from a paraganglioma. A review of five cases.

Paragangliomas are infrequent, usually benign tumors developed from neuroectoderm cells. The neck is the most common location, although some cases arise within the abdominal cavity, usually in the retroperitoneal space. We report five cases with bone metastases. In three patients, convincing evidence was obtained that the primary was in the retroperitoneal space. Clinical manifestations of metastatic bone disease occurred up to 17 years after the diagnosis of paraganglioma. Useful data were obtained from plain radiographs, magnetic resonance imaging, serum and urine catecholamine assays, and above all meta 123iodobenzylguanidine scintigraphy. Histologic and immunohistochemical studies of the lesion yielded the definite diagnosis. Surgery and radiation therapy are the two mainstays of therapy. Although rare, metastatic forms of paraganglioma should be borne in mind. This diagnosis should be entertained in patients with bone lesions and recent-onset arterial hypertension, irrespective of whether they report a history of surgery for a tumor, and even if this tumor was removed many years earlier and labeled benign.

Adult↗
PubMed1999

Refractory arthropathy after intravesical bacillus Calmette-Guérin therapy. Usefulness of isoniazide.

BACKGROUND: Arthritis associated with bacillus Calmette-Guérin immunotherapy usually responds dramatically to nonsteroidal antiinflammatory drug therapy. Isoniazid is generally reserved for other complications such as granulomatous hepatitis. CASE-REPORT: A 73-year-old man was admitted for fever, arthritis of the knees and right temporomandibular joint, an inflammatory swelling over the left Achilles tendon and bilateral conjunctivitis. The symptoms started in the wake of a course of intravesical bacillus Calmette-Guérin immunotherapy. Laboratory tests showed evidence of severe inflammation. Cultures of blood, urine and joint fluid specimens were negative, as were tests for autoantibodies and serologic tests for organisms known to cause reactive arthritis. Nonsteroidal antiinflammatory therapy was ineffective and glucocorticoid therapy produced only a partial response. All the symptoms resolved under isoniazid therapy in a dosage of 300 mg/day for three months. CONCLUSION: Use of antituberculous agents may be required in some cases of arthritis associated with bacillus Calmette-Guérin immunotherapy, most notably those with severe pyrexia.

Adjuvants, Immunologic↗