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Biomedical subjects

M Sibille

Publications and source records attributed to M Sibille.

31 records · Page 2Linked to original sources
PubMed1983

[Primary biliary cirrhosis and idiopathic thrombopenic purpura. A new association].

A case of primary biliary cirrhosis with stage III histological changes associated with an asymptomatic thrombocytopenic purpura with raised antiplatelet antibody levels is described. This new association of two conditions in which an autoimmune participation is generally accepted suggests a predisposition to this form of disease and/or the intervention of common trigger factors; however, an analysis of known etiological mechanisms does not exclude the possibility of a fortuitous association.

Autoimmune Diseases↗
PubMed1979

[Hypophosphatemia. A review (author's transl)].

Hypophosphatemia with or without phosphorus depletion can be observed in various diseases--particularly diabetic ketoacidosis, respiratory alkalosis, alcoholism, parenteral nutrition and hyperalimentation--and may cause serious neurologic, muscular, and hematologic disorders. This review summarizes the knowledges about hypophosphatemia--etiological mechanisms, pathophysiology and therapeutic modalities--and suggests that some place be reserved for serum phosphate in systematic and emergency panels of blood tests.

Alcoholism↗
PubMed1977

[Complication caused by abuse of alkalies in the treatment of ulcers].

The authors report the case of a 57 year old man who had taken for several years large quantities of alkaline drugs to relieve pain due to a gastric ulcer. This man presented acute digestive symptoms, and a confusional syndrome explained by various metabolic disturbance and especially hypercalcemia at 145 mg. Stopping the alkalis permitted within a few days the disappearance of the clinical symptoms and the correction of the laboratory disturbances. In the light of this case, the authors study the main clinical cases which have been described either in their acute form or in their chronic form (Burnett's syndrome). They discuss above all the physiopathology of these manifestations and it seems to them that the hypercalcemia is more important than the alkalosis. It remains to be explained why only a small number of subjects are exposed to these metabolic complications. There seems to be an individual hypersensitivity for under normal conditions, excess calcium is not sufficient to induce hypercalcemia.

Acute Kidney Injury↗
PubMed1977

[Hyponatremia and myxedamatous coma].

The authors report a case of coma due to peripheral myxoedema with severe hyponatremia (111 mq) and low urinary sodium. The clinical and metabolic disorders regressed within ten days under treatment with thyroid. The frequency of hyponatremia during myxoedema coma is recalled and the pathogenic mechanism discussed. Although the adrenal origin seems excluded, there is possibly some hypervasopresinism, but it seems finally that the thyroxin-dependent hyponatremia is of renal origin.

Coma↗
PubMed1976

[Fatigue fractures of the femoral neck and pubic rami. Analytical and critical study apropos of 97 case reports from the literature and 5 personal cases].

This investigation involved a study of fatigue fractures of the neck of the femur and of the pubic branches based on the one hand on 97 cases from the literature, which were diagnosed mainly on radio-clinical criteria, and on the other hand on 5 personal cases for which a quantitative histological analysis was undertaken by needle biopsy of the bone of the iliac wing. After describing these fatigue fractures in an unusual site, the authors undertake a critical study taking account of the histological information that was available. They show that only a histological study makes it possible to differentiate clearly fatigue fractures from insufficiency fractures, particularly when the later occur concurrently with a clinically and radiologically latent osteoporosis.

Adult↗
PubMedDate not supplied

[Diagnostic significance of low thyrotropin in internal medicine].

In an attempt to determine the significance of low plasma thyrotropin (TSH) concentrations in internal medicine and the usefulness of systematic TSH assays in hospitals, 732 consecutive TSH measurements were performed in first-admission patients. TSH concentrations below 0.15 mU/l were found in 33 patients (4.5%) divided into 4 groups: a) in 5 patients a second assay made within 10 days of the first one showed no fall in TSH levels; b) 5 patients had known endocrine disease; c) in 8 patients hyperthyroidism could be asserted; the diagnosis had not been suspected in 3 elderly women and 1 pregnant women; d) 15 patients remained with low TSH concentrations but had normal free T3 and free T4 levels; in this group a goitre was detected in 7 patients and 8 had a severe chronic disease. These results showed that a TSH concentration below 0.15 mU/l corresponded to hyperthyroidism in less than one out of three patients in this population and that the 0.07 to 0.15 mU/l range is particularly misleading. A second TSH assay, free T3 and free T4 measurements ant thorough investigations in search of a goitre must be made. Severe organic diseases and several drugs may induce a fall in TSH. All considered, the 1% prevalence of hyperthyroidism in this population does not justify systematic TSH assays, but in subjects over 60 years of age, the clinical manifestations of hyperthyroidism may be misleading or unrecognized, and TSH assays should be widely performed.

Adult↗
PubMedDate not supplied

[Early and unusual presentation of temporal arteritis. A report of 7 cases (author's transl)].

The authors report 7 cases of temporal arteritis, proved by biopsy, with unusual early symptoms. They emphasize dental extraction as a possible incitant of the disease. Diagnosis is very often overlooked when local symptoms of involvment of temporal arteries are lacking. Various head and neck pain, fever of unexplained origin, weight loss, when associated with erythrocyte sedimentation rate greater than 50 mm, should convince the physician to biopsy the temporal artery of people over the age of 60. Steroid therapy must begin as soon as diagnosis is made.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Critical value of bilirubin in the selection of healthy volunteers in for phase I].

10% of young male healthy volunteers have a total bilirubin value over 20 mumol/l; thus such a value appears not relevant as screening cut off point in clinical pharmacology. This study was intended to confirm if a 27 mumol/l cut off point previously defined by the authors does not support a risk. This study dealt with 487 subjects who had together measurements of total bilirubin value and lab. tests of liver cytolysis, cholestasis or hemolysis during the selection process. 48 subjects (9.8%) had a total bilirubin value over 20 mumol/l. Correlation tests do not provide arguments of cytolysis, cholestasis or hemolysis and there was no argument in favor of Gilbert's syndrome. Out of 48 hyperbilirubinemic subjects only 22 were included in clinical pharmacology studies. In more than 60%, the total bilirubin value returned to normal spontaneously and in no case appeared a significant clinical, biological, pharmacokinetic or dynamic abnormality. Except a possible increase of slow acetylor frequency, the medical literature analysis does not show any relevant modification in metabolism, pharmacokinetics or pharmacodynamics until a 40 mumol/l value of total bilirubin. Thus, the 27 mumol/l value of total bilirubin previously proposed is confirmed as a useful limit that does not lead to an additional risk.

Adult↗