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Biomedical subjects

P Allain

Publications and source records attributed to P Allain.

At least 19 recordsLinked to original sources

[Chronic lead nephropathy. Epidemiology and diagnosis].

Chronic lead nephropathy has recently been rediscovered. Its usual manifestations are hypertension, gout and renal impairment. Retrospective epidemiological data suggest that prolonged exposure to lead increases the risk of hypertension and nephropathy. An increase in EDTA-induced urinary lead concentration (above 600 micrograms/72 hours), perfectly representative of lead concentration in bone, has been found with a 5 to 12 percent prevalence in chronic renal impairment irrespective of its cause. The origin of lead impregnation and its influence on the course of the renal disease have not yet been elucidated.

Chronic Disease

Evaluation of inductively coupled mass spectrometry for the determination of platinum in plasma.

Among the different analytical methods used for the determination of platinum in blood plasma from patients treated by platinum derivatives, inductively coupled plasma mass spectrometry appears to be the most sensitive (detection limit 0.05 microgram l-1) and the best adapted for measuring low concentrations. The preparation of the samples consisted only of a dilution. The recoveries were close to 100% and both within-run and between-days reproducibility were very good. The determination of free platinum which was only about 5% of total plasma platinum was chosen to illustrate the inductively coupled mass spectrometric method.

Cisplatin

Blood isoprene concentrations in humans and in some animal species.

The concentrations of isoprene, the main hydrocarbon of human breath, were measured in the blood of humans and of different animal species (rat, rabbit, dog, ewe, cow). In human blood, the concentrations of isoprene were between 15 and 70 nmol/liter (mean value of 37 +/- 25 (SD) nmol/liter). In the blood of the different animal species tested, traces of isoprene were unambiguously detected by mass spectrometry, but the levels were always lower than 1 nmol/liter.

Adult

[Iodoform poisoning. 3 cases].

Three cases of iodoform poisoning are described following dressings with 10% iodoform gauze (0.10 x 5 m) on extended wounds. Five, ten and sixteen days after the beginning of dressings, the patients became confuse, hallucinated, and one of them was subsequently comatose. Vomiting, fever, tachycardia with premature ventricular beats and shortening of P-R interval, slight increase of transaminases and proteinuria were observed. Within a few days (3 to 8) after the iodoform dressings were discontinued, the signs of iodoform toxicity disappeared. The toxicity of iodoform is probably unrecognized if the rarity of the observations published and the amount of iodoform gauzes annually sold are compared.

Adult

Effects of three chelating agents, EDTA, NTA, and TPP, on the concentration of elements in rat tissues.

Ethylene diamine tetraacetic acid (EDTA), nitrilotriacetic acid (NTA), and tripolyphosphate (TPP) sodium salts were given orally to rats at the dose of 1 mmol/kg/d for 35 d. The concentrations of Na, K, Ca, Mg, P, S, Fe, Sr, Cu, and Zn were determined in blood, plasma, brain, heart, muscle, liver, kidney, duodenum, and bone of control rats and of the rats receiving EDTA, NTA, and TPP. The main effect induced by EDTA, NTA, and TPP was a decrease of the concentrations of several elements Ca, Mg, Fe, P in the duodenum. Otherwise, EDTA induced an increase of Zn in the kidney (+ 20%), NTA, an increase of Fe in liver (+ 29%), and particularly an increase of Zn in bone (+ 44%). TPP induced a slight decrease of Zn and Cu in liver. In conclusion, EDTA, NTA, and TPP taken orally at the dose of 1 mmol/kg/d for 35 d induced moderate changes of the concentrations of some elements in rat tissues, but without signs of toxicity.

Administration, Oral

Diethyldithiocarbamate, copper and neurological disorders.

Diethyldithiocarbamate (DEDTC) given orally to rats without any addition of copper considerably increased the concentration of Cu in the brain without any change in the other tested tissues. Cysteine, comparatively studied, did not induce any change in the brain Cu level. Based on these findings and the literature data concerning DEDTC effects in animal and human, we put forward the hypothesis that the main effect of DEDTC is to provoke in the brain not a deficiency but an excess of Cu liberated from the lipophilic complex Cu-DEDTC. Cu is then engaged in an oscillatory oxido reduction giving a Cu++ cation radical able to induce deleterious effects on tissues in a similar way as paraquat. The practical consequences of this hypothesis are considered.

Administration, Oral

Effects of an EDTA infusion on the urinary elimination of several elements in healthy subjects.

Ethylene diamine tetraacetate calcium disodium salt (EDTA Ca Na2), 1 g dissolved in 250 ml of 5% w/v glucose solution, was infused intravenously over 1 h into 10 healthy subjects (eight males and two females). Urines were collected over 24 h, the day before and on the day of the EDTA Ca Na2 infusion test. The elements Al, B, Ba, Cu, Fe, Mn, Si, Sr, Zn, Na, K, Ca, Mg, S and P were measured by inductively coupled plasma optical emission spectrometry. Pb was measured by inductively coupled plasma mass spectrometry. The EDTA Ca Na2 infusion increased the 24 h elimination of Al from 9.8 micrograms to 58 micrograms, of Fe from 66 to 121 micrograms, of Mn from 2.9 to 16.5 micrograms, of Pb from 9.8 to 56 micrograms and of Zn from 623 to 8847 micrograms. The ratio of the increase of urinary elimination induced by EDTA Ca Na2 was about 2 for Fe, 5 for Al, Pb and Mn, and 15 for Zn.

Adult

Effects of some chelating agents on bismuth absorption in the rat.

Bismuth encephalopathies appeared in the mid-seventies in France and concerned about 1,000 people and led to a fatal outcome in 70 cases. Responsibility of Bi was clearly confirmed by the disappearance of the intoxication after prescription of drugs containing Bi had been more tightly regulated. Since the implication of a substance increasing the intestinal absorption of Bi has been suspected, we studied the concentrations of Bi in the tissues of rats who had been treated with bismuth nitrate basic 400 mg/kg per d for one month with and without an intake of a chelating agent added to the drinking water at a concentration of 10 mmol/l. The chelating agents tested were ethylenediaminetetraacetic acid (EDTA), nitriloacetic acid (NTA) and tripolyphosphate (TPP), cysteine and diethyldithiocarbamate (DEDTC). Cysteine and DEDTC gave the highest increase of Bi in tissues but with a wide dispersion of levels. However, even in the rats with the highest levels of Bi, there were no behavioral problems. EDTA induced an increase of Bi in kidney, brain and bone and NTA in kidney but there was no obvious sign of toxicity. We did not succeed in reproducing in rats the Bi toxicity observed in patients some years ago.

Animals

Aluminium determination in the skin of patients with and without end-stage renal failure.

Aluminium (Al) concentration in the skin was determined by inductively coupled plasma optical emission spectrometry to look for a correlation between Al exposure and skin content in patients with end-stage renal failure. Skin Al concentrations were higher in dialyzed patients than in the nondialyzed group (1.02 +/- 0.30 vs. 0.26 +/- 0.10 micrograms/g; p less than 0.001). Moreover, in the dialyzed group, the patients treated for more than 100 months had a higher concentration of Al in the skin than the others (1.20 +/- 0.26 vs. 0.80 +/- 0.18 micrograms/g; p less than 0.05). Al skin content correlated better with the deferoxamine infusion test (DIT) than with Al blood plasma concentration. In conclusion, our data confirm that the DIT is a valuable tool for the evaluation of body Al content.

Adult

[Electroencephalographic silence after intoxication with a carbamate tranquilizer].

A case of acute meprobamate poisoning in a 43 year-old-woman is reported. Twenty five hours after admission in the intensive care unit, deep coma and cerebral electrical silence were observed whereas the meprobamate plasmatic concentration was 250 mg/l. The patient recovery was uneventful. Meprobamate analysis must be performed for unexplained coma with isoelectric EEG.

Adult

Toxicological screening of drugs by microbore high-performance liquid chromatography with photodiode-array detection and ultraviolet spectral library searches.

We use ultraviolet data, acquired with a photodiode-array detector coupled to a reversed-phase liquid-chromatographic system, to identify unknown drugs in plasma samples of acutely poisoned patients. Both retention time and spectra of the peaks obtained with a microbore Hypersil ODS column under gradient elution are compared with a library of approximately 350 compounds. We present our three-year experience with this system, which identifies drugs in less than 1 h, with a high degree of confidence.

Chromatography, High Pressure Liquid

[Dynamic bite block in fractures of the mandibular condyle and following surgery of temporomandibular ankylosis in children].

Early mobilization is the rule in cases of fracture and temporomandibular joint surgery. When prematurely discontinued, it may sometimes prove insufficient to prevent temporomandibular ankylosis in the child. Blockade in the open-mouth position is in keeping with an important general orthopedic rule, i.e., immobilization of joint fractures in position of function (ankylosis is loss of function, and is reflected by the child's inability or limited capacity to open his/her mouth). Continued night wear of re-habilitation devices, once consolidation is acquired, affords active joint mobilization during meals that is sufficient owing to the strength of the elevator muscles (five times than of the depressors).

Ankylosis

[Lingual-mandibular remodeling resection in prognathism].

The combination of --hypoplastic upper jaw, with narrow soft palate, --glossoptosis (or low, propulsive tongue), associated with protrusion of lower jaw, is well known. Early, exclusively orthopedic management combines enlargement of the superior arcade; functional/postural re-education of the tongue. Surgical management comes in later; it associates modeling resection of the tongue intended to position the tongue against the palate, with Chevron's mandibular resection, suppression of the first premolar, and salvaging the mental nerve. This type of osteotomy is indicated whenever a 6 to 8 mm mandibular retrusion is required. Fixation is monomaxillar, via extemporaneous splinting, associated with low external cortical osteosynthesis. The latter allows for gain of motor activity as early as the second day post-surgery.

Adolescent

Concentration of bone elements in osteoporosis.

In aging and in osteoporosis, decreased bone density is associated with decreased bone mass. However, changes in the bone mineral phase remain a matter for investigation. In particular, it is unknown whether bone mineral loss is directly related to reduction in bone mass or associated with changes in the concentration of mineral elements in mineralized bone tissue. In this study, the cortical bone concentration of elements was determined in biopsies of the ilium from 33 subjects (12 controls and 21 individuals with untreated severe osteoporosis). Calcium and phosphorus concentrations were evaluated in cortical and trabecular bone using energy-dispersive x-ray (EDX) microanalysis and inductively coupled plasma optical emission spectrometry (ICPOES). Bone concentrations of Na, K, Mg, Cu, Zn, Fe, Sr, Al, B, and Si were also determined in cortical bone using ICPOES. Additionally, the concentration of F in cortical bone was measured with a specific ion electrode and the concentration of Pb was determined by atomic absorption spectrometry. In mineralized bone tissue there was no significant age-dependent variation in the concentration of Ca, P, or other elements either in controls or in osteoporotic subjects. Moreover, the concentration of elements in bone tissue did not differ in the two groups. These results suggest that the decrease in bone density in osteoporosis is directly related to evolution of the bone mass, without detectable changes in the concentration of elements in bone.

Adult

Determination of iodine and bromine in plasma and urine by inductively coupled plasma mass spectrometry.

The simultaneous determination of iodine and bromine in plasma and urine by inductively coupled plasma mass spectrometry, using a Nermag prototype instrument, is described. The sample preparation involves only a 10-fold dilution with a diluent containing europium as an internal standard followed by direct nebulisation in the plasma. The iodine, bromine and europium ions are measured at m/z = 127, 79, and 153, respectively. The sensitivity of the method, with detection limits of 1.6 and 52 micrograms l-1 for iodine and bromine, respectively, is satisfactory for clinical applications. The calibration graphs were linear over the ranges 0-400 micrograms l-1 and 0-40 mg l-1 for iodine and bromine, respectively, which are wide enough for most assays. The recoveries were close to 100% with coefficients of variation of less than 3%. The within-day and between-day reproducibility was about 5%. The concentrations of iodine and bromine in the plasma of 26 healthy individuals were 58 +/- 12 micrograms l-1 and 4.1 +/- 0.9 mg l-1, respectively. The amounts of iodine and bromine eliminated in urine were 94 +/- 97 micrograms per 24 h (range 27-403 micrograms per 24 h) and 3.6 +/- 1.7 mg per 24 h, respectively. These results are in agreement with reported values.

Adult

Plasma and urine aluminium concentrations in healthy subjects after administration of sucralfate.

1. Sucralfate (basic sucrose aluminium sulphate), a topical intestinal agent, was administered in suspension or granule form to 25 healthy subjects at a total dose of 4 g day-1 for 21 days. Aluminium in plasma and 24 h urine samples was assayed before, during and after administration of sucralfate by inductively coupled plasma optical emission spectrometry. 2. Sucralfate produced significant increases in plasma and urine aluminium concentrations. On average, plasma aluminium increased from about 2 micrograms 1-1 to more than 5 micrograms 1-1 and 24 h urine aluminium increased from less than 5 micrograms to more than 30 micrograms. Both plasma and urine aluminium concentrations decreased rapidly after sucralfate was stopped. However, urinary aluminium concentrations remained higher than normal 5 and 10 days after discontinuation of sucralfate administration. Moreover subjects receiving sucralfate granules had significantly higher average urinary excretion of aluminium than subjects receiving the suspension. 3. The small but significant increase in plasma and urine aluminium following sucralfate administration in therapeutic doses may reflect intestinal absorption of aluminium. Although such absorption would appear to be moderate in healthy subjects, it is suggested that aluminium-based treatments should be used only intermittently, especially in patients with renal disorders.

Adult