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Biomedical subjects

J P Rémi

Publications and source records attributed to J P Rémi.

3 recordsLinked to original sources

Endocrine function in 98 HIV-infected patients: a prospective study.

Endocrine function was prospectively evaluated in 98 patients (73 men and 25 women) infected by HIV in various stages of illness: Centers for Disease Control groups II (19), III (20), IVA and IVC2 (27), IVC1 and IVD (32). Testing included baseline and post-stimulation evaluation of gonadal, thyroidal, and adrenal axes. Although adrenal function was within normal values in most cases, with no differences between patient groups, nine out of 98 patients had either a low baseline or post-stimulation serum cortisol, cytomegalovirus adrenalitis being suspected in two cases. Mineralocorticoid response was normal in all individuals. The main abnormalities were sick euthyroid syndrome with low tri-idothyronine and/or thyroxine in 16% of patients and hypotestosteronemia in 29% of men with AIDS. These abnormalities, related to a functional deficiency of the hypothalamic-pituitary axis, were highly correlated with the degree of illness, i.e. weight loss and low CD4+ cell count. It was concluded that endocrine dysfunction in HIV-infected patients is rarely of clinical significance, that it is related more to cachexia and advanced disease than to HIV or opportunistic infections, and that it could serve as a prognostic marker.

Acquired Immunodeficiency Syndrome↗

[Should the assay of serum free thyroxine and triiodothyronine replace the other methods of evaluating thyroid function?].

Total T4, total T3, free T4 and free T3 were measured at the same time in 633 subjects. These subjects were classified according to the clinic state and the hormonal results in 426 euthyroid, 145 hyperthyroid and 62 hypothyroid cases. The results permitted to define the sensitivity, specificity and predictive value of the different tests. When each measure was considered alone, free T4 was the most useful test for all the hormonal states. In association, FT4 + FT3 is more useful than T3T + T4T for all the diagnostic parameters and for all the clinical situations. To measure FT4 with an adequate kit appears to be in 1985 the key method for evaluating the thyroïd function. To associate FT3 is useful in some difficult cases.

Humans↗

[Alcoholic neuroacropathy. Recent diagnostic and pathogenic attainments].

The authors report the results of a prospective study of 28 patients with alcoholic neuroacropathy or the Bureau and Barrière syndrome. The investigations included biochemical analysis of the alcoholism, electrophysiological studies and, in 4 cases, electron microscopy of the musculocutaneous nerve biopsy. Bone scintigraphy with foot and hand scans was carried out in all cases for a more exact and above all, earlier diagnosis of the neurological osteoarthropathy. The clinical syndrome was attributed to a polyneuropathy with a large sensory component of the alcoholic "dying back" variety in all cases. High VGM levels associated with high serum IgA levels appears to be a biochemical diagnostic criteria of this condition. The latter parameter was not closely related to the hepatocytic status of the patient but suggests a direct or indirect effect of the neuropathy on humoral immunity. All cases had characteristic bone scans with high uptake at points of mechanical stress of the anterior part of the foot (first metatarsophalangeal joint). This finding, which is also observed in alcoholic sensory neuropathy without trophic disturbances prompts the authors to define a preacropathic state and an evolutive and pathogenic outline of the disease.

Alcoholism↗