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Biomedical subjects

P A Uldry

Publications and source records attributed to P A Uldry.

At least 19 recordsLinked to original sources
PubMed2001

A phase II trial with new triptorelin sustained release formulations in prostatic carcinoma.

OBJECTIVES: The objectives were to assess if a single intramuscular (i.m.) injection of the GnRH agonist triptorelin, as pamoate Sustained Release (RS) 11.25 mg, was able to induce pharmacological castration and to maintain the plasma testosterone levels in the castrate range (< 1.735 nmol/l) up to 3 months in prostatic carcinoma. METHODS: Two different formulations of triptorelin pamoate 11.25 mg were assessed in 2 groups of 10 patients suffering from prostatic carcinoma. Each patient received one i.m. injection of triptorelin pamoate SR 11.25 mg. Triptorelin and testosterone levels were measured over 3 months. Pain, micturition difficulties, performance status, local and general tolerance, and the occurrence of adverse events were evaluated. RESULTS: Both formulations were able to induce castration levels (<1.735 nmol/l) of testosterone within 3 to 4 weeks post-injection, and to maintain levels below 1.735 nmol/l till the end of 3rd month. The bioavailability of one formulation (DLGSD-3-95-21) tended to be greater. This may explain the quicker onset of castration and the slight better maintenance of low testosterone levels during the 3rd month observed with this formulation. In terms of clinical end-points, the local tolerance of both formulations was excellent. No serious adverse events were recorded except transient hot flushes in 2 cases and slight bone pain in one. CONCLUSION: Triptorelin pamoate 11.25 mg given in microgranules is a 3-month sustained-release administration form which appears to be safe and effective in advanced prostatic carcinoma. Based on the findings of this study, the formulation with greater bioavailability (DLGSD-3-95-21) was selected as formulation of choice to be used for clinical treatments and further clinical investigation.

Aged↗
PubMed1993

[Neurologic polymorbidity in senescence: 467 cases].

In this paper we studied the neurological polymorbidity in a group of 467 hospitalized patients of more than 70 years of age. A disorder of the central nervous system (CNS) was of the principal mainly diagnosis in 393 cases, the peripheral nervous system (PNS) in 71 cases and in 3 cases a myopathy. In 77.9%, the various neurological disorders were within the CNS, including mainly cerebrovascular events (226 cases, 48%). Among 156 patients, there was an accompanying disorder of the PNS.

Aged↗
PubMed1993

Early symptoms and outcome of Listeria monocytogenes rhombencephalitis: 14 adult cases.

Listeria monocytogenes rhombencephalitis has never been studied in a significant group of patients. We describe 14 adult cases who were seen over a 10-year period. A biphasic illness was characteristic: (1) prodromes (5-15 days) with malaise, fatigue, headache, nausea or vomiting, and fever; (2) cranial nerve palsy with facial palsy, diplopia, dysphagia, dysarthria, usually multiple. Meningism and hemi- or tetraparesis were present in 11 patients and cerebellar dysfunction in 9 patients. In 4 cases, CT showed widening of the brain stem with disappearance of the surrounding cisterns. The cerebrospinal fluid was abnormal in all patients in whom this investigation was done (pleocytosis, elevation in protein content). The patients received antibiotic therapy for 2-6 weeks. In the 9 patients who recovered, the neurological dysfunction improved within 2 days to 1 week of the initiation of therapy. There were 5 deaths. At autopsy in 2 cases, there was severe purulent meningitis and rhombencephalitis with predominantly polymorphonuclear cellular infiltration in 1 case, while numerous microabscesses in the midbrain, pons and medulla were observed in the other. We conclude that L. monocytogenes infection should be considered in patients who develop fever and focal neurological signs particularly localized to the brain stem.

Adult↗
PubMed1993

Magnetic resonance imaging in patients with multiple sclerosis and spinal cord involvement: 28 cases.

In patients with clinically isolated spinal disease, magnetic resonance imaging (MRI) provides a non-invasive method of detecting surgically treatable causes and is also useful in detecting asymptomatic brain lesions where the cord syndrome is due to multiple sclerosis (MS). We report the findings of spinal and brain MRI in 28 patients with spinal cord disorder due to MS. It was possible to detect intrinsic plaques reliably in the majority of patients (60.7%) with clinical findings of spinal cord MS. The results of MRI are compared with the clinical status and with cerebrospinal fluid findings and evoked potentials.

Adult↗
PubMed1992

[Cerebrovascular accidents and surgery].

There are very few observations on the occurrence of stroke after general surgery; the incidence lies between 0.2 and 0.7%. On the other hand, cerebrovascular accidents are mainly seen after cardiac and carotid surgery, where the incidence is high (5%). Strokes are also an important cause of morbidity and mortality following orthotopic transplantations, particularly heart, heart/lung and liver transplantations.

Brain Ischemia↗
PubMed1992

[Magnetic resonance imaging in spinal cord diseases: 127 cases].

Acute or chronic spinal cord syndromes with or without evidence of cord compression are a common diagnostic problem in neurology. Magnetic resonance imaging (MRI) was performed on 127 patients to assess the sensitivity of this examination in detecting local spinal cord lesions. The most common location noticed in this study were the cervico-thoracic (40.9%) and cervical regions (33.8%). A total spine examination accounted for 14.9% of the examinations performed, and the lumbar spine was evaluated in 10.2%. An increased signal corresponding to plaques of multiple sclerosis was the most frequent diagnosis (25 cases), followed by cervical narrowing of the spinal canal and cervical disk diseases (23 cases), neoplasms (15 cases), spinal cord infarctions (12 cases), spinal infections (6 cases) and spinal cord injuries (3 cases). A myelopathy of undetermined etiology was diagnosed in 19 cases. MRI is very sensitive in multiple sclerosis, but it is not possible to diagnose the disease from abnormal scan only, other supportive laboratory results, such as oligoclonal bands, are necessary. MRI is very useful in evaluating intraspinal cord parenchymal lesions, such as neoplasms or congenital abnormalities.

Adult↗
PubMed1992

[Main involvement of the central nervous system in alcoholism].

The effects of alcohol on the central nervous system can be subdivided into three main categories: the effects of acute intoxication (drunkenness, acute encephalopathy, stroke), the effects of tolerance and ethanol withdrawal (delirium tremens, seizures) and the delayed manifestations of chronic alcohol consumption (cerebellar degeneration, Wernicke's encephalopathy, dementia).

Alcohol Amnestic Disorder↗
PubMed1992

[Value of bidirectional and transcranial Doppler studies in vascular insults of the vertebro-basilar area: 37 cases].

The examination techniques for identification of extra- and intracranial vertebral and basilar arteries are described. The clinical, Doppler sonographic and angiographic findings in 37 patients are presented and discussed. The vessels were recorded from a nuchal position via the posterior bone and/or the foramen magnum. A good correlation with the angiographic findings was found in 75.6% of cases but false-positive or false-negative results were observed in 9 patients. These results are good for Doppler evaluation of patients with vertebrobasilar circulation abnormalities, though angiography is still indicated when making a therapeutic decision.

Adult↗
PubMed1992

Chronic Mycobacterium avium complex infection of the central nervous system in a nonimmunosuppressed woman.

We report the case of a woman who developed chronic meningitis and a brain abscess due to Mycobacterium avium, without immunosuppressed state. She was treated with antituberculous drugs but the infection progressed and she died 4 years after first becoming ill. The occurrence of CNS infection with M. avium in the absence of acquired immunosuppression is rare. Its diagnosis is difficult, delaying clinical recognition and appropriate therapy.

Adult↗
PubMed1992

Herald facial numbness.

Three unusual patients who developed subacute facial numbness as the heralding symptom of an expanding tumor that involved the trigeminal nerve fibers are reported. The first patient had clinical and electrophysiological evidence of an isolated mental neuropathy as a result of metastatic lesions with bone destruction from a renal cell carcinoma. The second patient had a sensorimotor trigeminal neuropathy caused by a direct compression of the semilunar ganglion by a cavernous hemangioma of Meckel's cave. The last patient experienced facial numbness as the unusual presenting manifestation of a primary brainstem lymphoma. Patients 1 and 3 died a few weeks after the admission, whereas patient 2 poorly recovered. Despite the availability of new techniques for early diagnosis, this report demonstrates how difficult it can initially be to differentiate a 'benign' trigeminal neuropathy from serious conditions and underscores the poor prognosis of fifth nerve fibers involvement by an expanding mass. Early referral with clinical and electrophysiological evaluation appears to be of crucial importance.

Adult↗
PubMed1992

[Pseudoradicular syndrome in multiple sclerosis. 4 cases diagnosed by magnetic resonance imaging].

Four patients with multiple sclerosis presented with pseudoradicular limb pain. There was a limb weakness with sensory loss and areflexia. Magnetic resonance imaging showed a demyelinating plaque in the cervical cord with a characteristic T2 relaxation time. A direct relationship between the plaque and the clinical troubles was established in all cases. Treatment with corticosteroids was helpful, and other treatments (carbamazepine) were not necessary. The mechanisms of such pain are unknown but some of the symptoms may be the result of lesions in the endogenous pain control system.

Adrenal Cortex Hormones↗
PubMed1991

[Modifications in and prognostic value of the EEG in anoxic encephalopathy: 75 cases].

The use of new cardiopulmonary resuscitation techniques has considerably increased the possibility of survival after cardiopulmonary arrest. It is of considerable interest to evaluate the extent of any anoxic brain damage. The EEG has proven very informative in the assessment of cerebral function in patients with anoxic encephalopathy. Its role is unchanged despite advanced imaging techniques. In 75 patients, the value of EEG recorded on the days after the onset of disturbances has been compared with the initial Glasgow coma scale (GCS) as a predictor of short-term prognosis. The EEG patterns were classified into 6 major grades and 12 sub-grades which were defined on the basis of the morphology of dominant activities, distribution and reactivity to external stimuli. A favorable outcome occurred with grade I to IIB associated with a GCS of 5 above. A bad prognosis was suggested by grades IVA to VC, particularly when epileptiform discharges were present, and the GCS was always below 5 in these patients. With new EEG grading scales in anoxic encephalopathies, the accuracy for predicting survival (or death) is now 90%.

Adult↗
PubMed1991

[Neurological examination of the elderly. Principle modifications and most-frequent abnormalities].

This article will review age-related changes in the neurological examination. The involutional process is a diffuse one, affecting all levels of the neuraxis simultaneously. Most of the numerous little manifestations distinguishing them so sharply from the youthful are really features of the neurology of the elderly. Some signs are characteristic: attitude of general flexion, general poverty of movement, gait, minor extrapyramidal signs, primitive reflexes. However, these features may also be caused by neurological diseases common in the elderly, such as dementia or cervical myelopathy, which is very common after 75 years.

Aged↗
PubMed1991

[Alpha coma: rectrospective presentation of 20 cases].

Alpha coma is a relatively rare variety of EEG resulting from diffuse cerebral anoxia, focal brainstem lesions, metabolic disturbances or intoxications. It is a monotonous, unreactive and anteriorly predominant activity of less than 50 microV and of 8 to 13 Hz. Twenty cases of alpha coma are reported: 16 resulting from anoxic encephalopathy, 2 from brain stem strokes, and 2 from metabolic encephalopathy. Cardiac arrest was the main cause of alpha coma (10 cases); a large number of patients (7 cases) died, or have survived with severe neurologic deficits (2 cases). In 2 cases there was a metabolic-toxic cause (benzodiazepines and parathion intoxication). The 2 patients with pontomesencephalic haemorrhage died. The physiopathogenicity of alpha coma, which remains obscure, is also discussed.

Adult↗