Biomedical subjects
P Marland
Publications and source records attributed to P Marland.
[Conduction disorders during cardiac sarcoidosis (author's transl)].
The authors report 2 observations of auriculoventricular blockage developed during a mediastino-pulmonary sarcoidosis, requiring a heart pacer in the first case and corticosteroid treatment in the second. The frequency of the disorders of intracardiac conduction was evaluated by a retrospective study of 412 cases of mediastino-pulmonary sarcoidosis. Seventy two ECG were considered abnormal, a frequency of 17.2%. The disorders of auriculo-ventricular and intra-ventricular conduction represented a third of cases. What is known on the risk of lethal evolution of cardiac sarcoidosis in which those abnormalities are significant, justifies an electrophysiological investigation. The indications for a definitive cardiac stimulation and corticosteroid treatment are debated. On this final point, it seemed necessary to plan a prospective study to confirm the merits of the treatment and to define its modalities.
[Management in pollinosis and false pollinosis].
Typical cases of pollen allergen (hayfever, allergic asthma), together with isolated non-respiratory "equivalent" manifestations (urticaria, eye conditions, headache, etc.), are easy to detect on the basis of skin tests and the clinical history. Such manifestations may also occur in "false pollen allergy", related in most instances by atmospheric moulds (Dematiaceae), sometimes by house dust or dermatophytes (Candida Albicans, Trichophyton sp), by food or by a bacterial infection or allergy. A combination of pollen allergy and false pollen allergy is common. In cases of false pollen allergy the proportion of negative skin reactions would appear to worsen with the repeated use of prolonged action corticosteroid injections, given on a preventive basis. Similarly, these disorders, initially seasonal, change to more chronic manifestations throughout the year. Desensitization with aqueous extracts of allergens ensured the most complete protection against the causes of pollen allergy and false pollen allergy. Allergen extracts percipitated with alun (semi-retard extracts), more effective than tyrosine adsorbates (Pollinex) have the advantage of offering more rapid treatment without the risk of dangerous reactions. The best therapeutic results have obtained over the course of the last ten years, by the authors, combining on each occasion a semi-retard allergen with an aqueous allergen, thereby acquiring the benefit of the adjuvant effect of the first, in a course of ten to fifteen injections per year. Non specific therapy (antihistamines, cromoglycate, theophylline, etc.) retains all of its symptomatic indications. Oral corticosteroid therapy is better metabolized in the organism and has less of a disturbing effect on the circadian rhythm of cortisol, and is hence to be preferred to injections of delyaed action corticosteroid suspensions.
[Pollinosis and false pollinosis].
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