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M Gaudet

Publications and source records attributed to M Gaudet.

30 records · Page 2Linked to original sources
PubMedDate not supplied

[Current aspects of paraneoplastic acute polyarthritis].

Paraneoplastic acute polyarthritis (PAP) is a recognized rheumatological entity with semeiological features that are based only on a few published cases. We thought that it would be of interest to review the literature and present the current characteristics of PAP, taking into account only those cases where the acute polyarthritis and a neoplastic disease followed parallel courses. The clinical manifestations of PAP are extremely varied, making it difficult to distinguish this disease from some forms of rheumatoid arthritis, the RS3 PE syndrome or polymyalgia rheumatica. Clinicians must be vigilant when they are faced with a particularly progressive acute polyarthritis in a patient aged over 60, and particularly when this patient's general condition is altered and when fever and a clear-cut inflammatory syndrome are present. In such circumstances, it is mandatory to investigate for an underlying neoplasia.

Acute Disease↗
PubMedDate not supplied

[Humeral head necrosis during bismuth encephalopathy (author's transl)].

A further case of humeral head necrosis occurring in the course of a bismuth encephalopathy is reported. There was no apparent direct effect due to the bismuth as the lesion was quite different from those observed during typical bismuth osteopathy. The region affected by the bone lesion, its appearance, and the progressive anatomical and clinical changes noted are arguments in favour of a traumatic origin. The necrosis could be related to myoclonic movements which agitate the patients (usually elderly women) who are confined to bed because of the encephalopathy.

Aged↗
PubMedDate not supplied

Primary hyperparathyroidism in very old patients.

OBJECTIVES: To evaluate the clinical presentation and biological features of primary hyperparathyroidism (pHPT) in very old subjects. METHODS: Thirty patients aged 75 years or more, with pHPT were analyzed retrospectively. The diagnosis of pHPT was based on usual biological signs and was always confirmed by the finding of morphological abnormalities with parathyroid imaging or neck surgical exploration. RESULTS: At initial examination, recent general symptoms and neuromuscular symptoms were observed in 87% and 83% of the cases, respectively. Neuropsychiatric manifestations were noted in 73% of the cases. Confusion and depression were the most frequent findings, observed in 30% and 27% of the cases, respectively. In one of two patients with dementia like state, the mental status improved dramatically after surgery of the parathyroid adenoma. Serum calcium levels were in the normal range in 13% of the cases and equal or below 110 mg/L in 47% of the cases. There was no correlation between serum calcium level and the severity of mental changes. Serum parathyroid hormone determinations were abnormal in 93% of the patients. Thirteen patients underwent surgery with biological improvement in all cases. An ultrasonically guided percutaneous ethanol injection of parathyroid adenoma was performed in 10 patients with a biological cure rate of 50%. CONCLUSION: This study shows the major prevalence and potential severity of neuropsychiatric disorders in pHPT in very old patients. Because neuropsychiatric disturbances can respond favourably to surgical treatment, the clinician must systematically look for pHPT in elderly patients with cognitive impairment.

Acute Disease↗