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Biomedical subjects

P Goupille

Publications and source records attributed to P Goupille.

At least 19 recordsLinked to original sources
PubMed1992

Treatment of psoriatic arthropathy.

Psoriatic arthritis develops in 5% of patients with cutaneous psoriasis. Management is similar to that of other chronic inflammatory joint diseases, and the characteristic features of psoriatic arthritis should be considered: the disease is usually mild, with unpredictable flares and remissions, and skin disease is a concomitant feature. Nonsteroidal antiinflammatory agents are the mainstay of therapy and usually provide adequate control. Among long-term treatments, parenteral gold salts, methotrexate, and azathioprine have been shown to be effective. Retinoids are often used in patients with extensive skin lesions. Other treatments are currently being evaluated (auranofin, colchicine, D-penicillamine, sulfasalazine, cyclosporine, and gamma-interferon). Antimalarials are difficult to handle and may cause progression of skin lesions. Topical treatments are indicated in every case. Indications depend on the specific features of psoriatic arthritis, the clinical pattern, and the severity of the condition.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Discitis after lumbar disc surgery. Features of "aseptic" and "septic" forms.

Two major types of postoperative discitis have been previously described: septic discitis and "avascular" or "chemical" discitis. Percutaneous discal biopsy is an important way of distinguishing these entities. In a retrospective study of 25 cases of postoperative discitis, three groups have been analyzed with bacteriologic and histologic tests: a group of nine patients (group A) with positive discal bacteriologic cultures; a group of eight patients (group B) with typical septic histologic tests but negative bacteriologic discal procedures; and a group of eight patients (group C) in whom the histologic picture was reminiscent of a mechanical process. No group was unique in any clinical and radiologic parameter. Group A and group B were quite similar in biological features, but group C had erythrocyte sedimentation rate and C-reactive protein serum levels significantly lower than groups A and B (P less than 0.01). After 4 weeks, these differences were still present. This study confirms that there are two main features of postoperative discitis that can be recognized by histologic and biological tests, allowing for different treatments.

Biopsy↗
PubMed1992

Direct coronal computed tomography of the temporomandibular joint in patients with rheumatoid arthritis.

Direct coronal computed tomography (CT) of the temporomandibular joint (TMJ) was performed in 26 patients with rheumatoid arthritis (RA) and 26 control subjects. Erosions and cysts of the mandibular condyle had a significantly higher frequency in the RA group than in the control group (p < 0.05) but there was no significant difference in the incidence of other abnormalities. Bone changes were bilateral in RA. A wide range of CT abnormalities was present in patients with RA and in the control group. There are no CT abnormalities specific for RA, but the incidence of erosions and cysts of the mandibular condyle was significantly higher in the RA group and should suggest the diagnosis.

Arthritis, Rheumatoid↗
PubMed1992

[Long-term results of chymopapain chemonucleolysis].

Results of chemonucleolysis were evaluated (on the basis of residual pain, occupational activities, physical activities, and use of analgesics) in 125 of 162 consecutive patients with lower back pain and sciatica associated with documented vertebral disc protrusion who were managed and followed up for at least five years. Results were satisfactory in 62% of patients. Among 82 patients evaluated during a follow-up visit, 30% were free of symptoms, 38% had lower back pain, and 30% had radicular pain; however, among symptomatic patients, 67% had no limitations of activities of daily living. Results were significantly less favorable in power drill workers and in patients who had chemonucleolysis at the L4-L5 level. These data are evidence that chemonucleolysis provides good long-term results.

Adult↗
PubMed1992

[Temporomandibular joint and rheumatoid polyarthritis. Correlations between clinical and tomodensitometric abnormalities].

Clinical and CT scan abnormalities of the temporomandibular joint in rheumatoid arthritis have been little studied in the literature. The temporomandibular joint was examined clinically and by CT scan in 26 patients with rheumatoid arthritis and 26 controls. In the rheumatoid arthritis group, 61.2% of patients had physical signs of temporomandibular disease as compared with 42.3% of the controls. 88.4% of rheumatoid arthritis had erosive or geodic lesions of the temporomandibular joint by CT scan as compared with 57.6% of the controls (p less than 0.05). The temporomandibular clinical score was not correlated with CT scan score in rheumatoid arthritis. CT scan score was correlated with the number of basic drugs used, rheumatoid factor levels and radiological scores of the hands and cervical spine. The authors feel that the only CT scan abnormalities specific to rheumatoid arthritis consist of erosive and geodic lesions of the mandibular condyle, that there is no correlation between clinical and CT scan abnormalities of the temporomandibular joint in rheumatoid arthritis and that the extent of destructive lesions of the temporomandibular joint by CT scan in rheumatoid arthritis is closely correlated with the severity of the disease.

Arthritis, Rheumatoid↗
PubMed1992

[Temporomandibular joint and rheumatoid polyarthritis. X-ray computed tomographic aspects].

Direct coronal computed tomography (CT) examination of the temporomandibular joint (TMJ) was performed in 26 patients with rheumatoid arthritis (RA) and 26 control subjects. Changes in condylar shape, erosions and cysts of the mandibular condyle and condylar head resorption were more frequent among the RA group than the control group. Only the erosions and cysts of the mandibular condyle had a significantly higher frequency in the RA group than in the control group (p less than 0.05). Bone changes were bilateral in RA. Coronal view of the CT examination allow a clear visualization of the osseous elements of the TMJ but a control group is absolutely necessary to affirm with certainty the rheumatoid origin of the bone changes. The erosions and cysts of the mandibular condyle and their bilateral nature are the most specific features of RA on TMJ.

Arthritis, Rheumatoid↗
PubMed1991

[Breast hypertrophy and dorsolumbar spine. Prognostic influences of lumbar lordosis: preliminary results].

In a prospective study, the influence of a mammary hypertrophy on some clinical and radiological parameters of the lumbar and dorsal spine had been studied in 14 women comparatively to 14 control women, before and after a reduction surgery. Clinically, the frequency of the lumbar pain was identical in the two groups of patients before surgical treatment but a significant decrease of the frequency and the intensity of the lumbar pain was found after the surgery in the mammary hypertrophic group (p less than 0.01). Some radiological parameters of lordosis and the dorsal kyphosis were significantly higher in mammary hypertrophic patients than in control patients. After surgery, an increase of parameters of lordosis was observed associated with a significant decrease of the dorsal kyphosis (p less than 0.05). Nevertheless, by use of a radiological classification of the lumbar lordosis with the Ferguson's indice, two main groups of lordosis had been distinguished. The intensity of the lumbar pain and the dorsal kyphosis were significantly higher in patients with a low indice than in those with an high indice. More, the dorsal kyphosis has decreased only in patients with a low anterior lumbar indice. In conclusion, a mammary hypertrophy must be searched in women with a lumbar pain and an surgical treatment may be proposed.

Adult↗
PubMed1991

[Lumbar lordosis: radiological classification and biomechanical consequences].

Various radiological parameters were measured on a lateral film taken in erect position of the lumbar spine in 55 patient with low back pain. These various parameters had inter-, intra-observer and inter-study variation coefficients of less than 3%. In patients with a positive Fergusson index ("low" or inferior lordosis), mean values of the angle of lordosis and of obliqueness of the lower vertebral plateau of L5 in relation to the horizontal were higher than in patients with a negative Fergusson index ("high" or superior lordosis), this being statistically significant. In view of the correlations found between the various parameters measured and this classification, the biomechanical consequences, which have their role to play in the management of patients with low back pain, are discussed.

Adult↗