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Biomedical subjects

M C Eveleigh

Publications and source records attributed to M C Eveleigh.

10 recordsLinked to original sources
PubMed1987

[Isotypes of rheumatoid factors and cellular immunity anomalies in rheumatoid polyarthritis. Apropos of 61 cases].

In 61 patients with rheumatoid polyarthritis, we studied the rheumatoid factors isotypes, class IgM, IgG, IgA and the abnormalities of the ratio CD4/CD8 (lymphocytes with membrane phenotype "helper"/lymphocytes with membrane phenotype "suppressor") determined by monoclonal antibodies. We found a statistically significant increase of the rate of IgM rheumatoid factors (p less than 0.0001), IgG (p less than 0.004), IgA (p less than 0.008), in patients with rheumatoid polyarthritis whose ratio exceeded that of the control population. On the other hand, the percentage of rheumatoid factors detected by agglutination was not significantly increased in this group. This increase seemed linked to a specific abnormality of the control of lymphocytes B which synthesize rheumatoid factors.

Adult↗
PubMed1986

[D-penicillamine in the treatment of rheumatoid polyarthritis. 104 cases with a 5-year follow-up].

104 patients with rheumatoid arthritis were treated by D-penicillamine and were followed for 5 years after the start of treatment. At the end of the 5th year, 27 patients (26 per cent) are still taking the treatment with satisfactory results; 47 patients (45 per cent) had to stop treatment because of intolerance; 15 patients (14.5 per cent) stopped treatment because of escape or because of a poor therapeutic result and 15 patients (14.5 per cent) could not be evaluated. In the patients treated for 5 years with a satisfactory result, there was a regular decrease in the articular index which was statistically significant during the first two years of treatment. The variations in the erythrocyte sedimentation rate were less spectacular: it only decreased significantly during the first year. The variations in the serum levels of rheumatoid factor were irregular. Systemic corticosteroid therapy was able to be stopped in 6 out of 7 cases. The authors did not observe any significant correlation between the results of treatment and the age of onset of the rheumatoid arthritis, the articular index, or the initial erythrocyte sedimentation rate. In contrast, the mean history of the disease was significantly shorter in the patients with a satisfactory result at the 5th year. The majority of suspensions of treatment took place during the first 2 years of treatment and were motivated by intolerance reactions, in particular renal intolerance. Whatever the reason for the suspension of treatment, it was not influenced by the history of the rheumatoid arthritis, the rheumatoid serology, the sex of the patient or the maximal dosage of D-penicillamine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Bone scintigraphy in multiple myeloma].

The results of bone scintigraphy were compared with those of plain skeletal X-rays in 26 patients with multiple myeloma who all presented radiological and/or scintigraphic skeletal lesions. 364 bone sites were studied: 135 of them were abnormal, 64 on the plain X-ray alone, 21 on scintigraphy alone and 50 on both examinations. The sensitivity of the bone scintigraphy was only greater than that of plain X-rays for the thoracic lesions (sternum and ribs). The skeletal lesions detected by scintigraphy in addition to those detected on the X-ray would have changed the clinical staging of the patient in only 3 cases. Purely lytic lesions of the thoraco-lumbar spine were never detected by bone scintigraphy. More than one third of the compression fractures were also missed by this examination. The radiological course of 13 sites initially abnormal only on the bone scintigraphy was followed for 6 to 24 months; after this period of time, 9 of these lesions were still radiologically normal. In 6 patients, the radiographic and scintigraphic course could be compared to the clinical and laboratory data on 14 occasions: both pain X-rays and scintigraphy were only concordant with the clinical and laboratory course in no more than one half of cases. The number of abnormal sites on scintigraphy was no different in the patients who responded to treatment. In multiple myeloma, bone scintigraphy only detects a little more than half of the skeletal lesions. When performed in addition to plain X-rays, it detects about 16 per cent of additional lesions, particularly in the ribs and sternum.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

Venous admixture in human septic shock: comparative effects of blood volume expansion, dopamine infusion and isoproterenol infusion on mismatching of ventilation and pulmonary blood flow in peritonitis.

A hemodynamic study with blood gas analysis was performed so we could observe changes induced by blood volume expansion, dopamine infusion and isoproterenol infusion in 20 adult patients suffering from peritonitis complicated with septic shock and acute respiratory failure. Blood volume expansion increased cardiac index (from 2.6 +/- 1.21/min/m2 to 3.4 +/- 1.31/min/m2; p less than 0.001), but also enhanced venous admixture (QS/QT) from 27 +/- 14% to 36 +/- 13%; p less than 0.01). Dopamine infusion increased cardiac index (from 2.6 +/- 0.9 1/min/m2 to 3.4 +/- 1 l/min/m2; p less than 0.001), but also enhanced venous admixture (from 25 +/- 11% to 31 +/- 12%, p less than 0.001). Isoproterenol infusion increased cardiac index (from 2.6 +/- 0.9 l/min/m2 to 3.6 +/- 1.1 l/min/m2; p less than 0.001), but also enhanced venous admixture (from 27 +/- 12% to 33 +/- 11%; p less than 0.001). This worsening in mismatching of ventilation and blood flow is correlated with the enhancement in pulmonary blood flow obtained by these three therapeutic procedures.

Adult↗
PubMed1978

Pulmonary gas exchange during venoarterial bypass with a membrane lung for acute respiratory failure.

In patients with fulminating pulmonary edema not responsive to conventional therapy, venoarterial membrane lung bypass can provide assistance if decreased systemic blood pressure prevents use of high-level positive end-expiratory pressure ventilation. In 10 patients with acute respiratory failure, partial venoarterial bypass provided a rapid and marked improvement of systemic oxygenation. Measurement of pulmonary blood flow (PBF) and intrapulmonary shunting (QS/QP) during bypass via prolonged left heart catheterization showed that left ventricular PaO2 was increased through a rapid and profound reduction of QS/QP. During the first days of bypass, derecruitment of pulmonary vessels is probably the mechanism of improved pulmonary oxygenation. When low pulmonary arterial pressures (PAP) are sustained, resorption of pulmonary edema is favored. Despite the beneficial effects of bypass, death occurred in every case due to diffuse interstitial fibrosis and/or parenchymal damage. The absence of healing, due to prolonged circulatory exclusion, may be detrimental despite immediate improvement. Because of this possibility, venovenous or mixed perfusion should be more extensively explored.

Acute Disease↗
PubMedDate not supplied

[Chemonucleolysis in the treatment of disk lumbo-radiculalgia. Cooperative study of 333 cases].

A retrospective study was carried out of 333 patients who had been treated by chemonucleolysis with chymopapain. The efficacy and safety of this treatment were evaluated and factors exerting a statistically significant effect on the quality of the results were selected from clinical and radiological data and the conditions of chemonucleolysis. Results were satisfactory in 70.5% of cases. Complications were seen in 2.8% of cases, all of which developed favorably; three of four started work again within four months, without change of job in 84% of cases. 11% of patients underwent surgery after failure of nucleolysis. There was no statistically significant evidence that results were influenced by age, sex, duration of painful episode justifying nucleolysis, the duration of the first lumbar pains or radiculalgia, the radiographic condition of the treated disc before nucleolysis or the radiographic condition of the lumbar section of the spine. There was also no significant effect of the extent of discoradicular interaction (as seen by radiography), the number of levels treated or the site of nucleolysis. In contrast, the frequency of satisfactory results was significantly higher when nucleolysis was carried out for mono-radicular sciatica, when Lasègue's sign was noted and when marked discal degeneration was seen by discography.

Adult↗
PubMedDate not supplied

[Postero-lateral arthrodeses in spondylolisthesis and lumbosacral disk arthroses. Study of 11 cases with follow-ups exceeding 5 years].

The retrospective study of 111 patients having undergone a postero-lateral arthrodesis for lumbar disc degeneration or spondylolisthesis has enabled to evaluate functional results according to the clinical criteria of Stauffer and Coventry with a mean follow-up of 9.5 years, and to examine among clinical and socio-professional elements, X-rays data and technical conditions of the graft, those which seem to influence in a statistically significant fashion the quality of the results. The long term result was estimated satisfactory (very good and average) for 70% of spondylolisthesis, and stable in time; 3/4 of the patients resumed work, after rehabilitation 2 out of 3 times. Concerning disk arthroses, we have observed 50% of satisfactory results, with degradation of average results one year after surgery occurring 4 out of 10 times, most often more than 5 years after the graft; 58% of the patients resumed work, half of them after rehabilitation. 25 complications were noted and they all evolved favorably. Among factors capable of influencing the quality of the result, no statistically significant influence was found concerning the pre-operative site of the pain, the possible past history of spine surgery, a pre-operative risk profession for the spine, a pre-operative inter-apophyseal arthrosis, the number of levels grafted and a possible associated discal curettage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗