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P Thieblot

Publications and source records attributed to P Thieblot.

At least 19 recordsLinked to original sources
PubMed2000

Response of leucine metabolism to hyperinsulinemia in hypothyroid patients before and after thyroxine replacement.

We have investigated the effect of hypothyroidism and insulin on protein metabolism in humans. Six hypothyroid patients were studied in a postabsorptive state before and after 5 months of regular treatment for hypothyroidism (153 +/- 17 microg/day of L-T4). The effect of insulin was assessed under hyperinsulinemic euglycemic and eukalemic conditions. Insulin was infused for 140 min at 0.0063 +/- 0.0002 nmol/kg x min. An amino acid infusion was used to blunt insulin-induced hypoaminoacidemia. Whole body protein turnover was measured using L-[1-13C] leucine. When compared to L-T4-induced subclinical thyrotoxic state, hypothyroidism induced a significant decrease (P < 0.05) in leucine endogenous appearance rate (a reflection of proteolysis; 0.89 +/- 0.09 vs. 1.33 +/- 0.05 micromol/kg x min), oxidation (0.19 +/- 0.02 vs. 0.25 +/- 0.03 micromol/kg x min), and nonoxidative disposal (a reflection of protein synthesis; 0.87 +/- 0.11 vs. 1.30 +/- 0.05 micromol/ kg x min). Insulin lowered proteolysis during both the subclinical thyrotoxic and hypothyroid states. Hypothyroidism impaired the antiproteolytic effects of insulin. Thyroid hormones are, therefore, essential for the normal antiproteolytic action of insulin.

Adult↗
PubMed1999

[Carbimazole and leukocytoclastic vasculitis: apropos of a case].

INTRODUCTION: The authors describe the case of biopsy-proven cutaneous leukocytoclastic vasculitis secondary to treatment with carbimazole. EXEGESIS: A 78-year-old white female developed erythematous macules on the lower limbs which cleared after discontinuation of her current treatment and implementation of oral steroid therapy. Causal explorations (lack of systemic disorder or infectious disease) remain negative, except for positive immune complexes. This case clearly differs from the two cases of microvasculitis (myositis and nephritis) secondary to treatment with carbimazole previously mentioned in the literature. CONCLUSION: To our knowledge this is the first report of biopsy-proven cutaneous leukocytoclastic vasculitis associated with this antithyroid agent. Its widespread use makes awareness of the side-effect important.

Aged↗
PubMed1998

[Vitiligo in multiple autoimmune syndrome: a retrospective study of 11 cases and a review of the literature].

PURPOSE: The occurrence in the same patient of three or more autoimmune diseases defines multiple autoimmune disease. Multiple autoimmune disease is an unusual condition in which dermatological autoimmune diseases and especially vitiligo have an important place. METHODS: We examined retrospectively 11 cases of multiple autoimmune diseases associating vitiligo. We studied the clinical characteristics of vitiligo and those of the associated autoimmune disorders. RESULTS: Type III multiple autoimmune disease was diagnosed in all the 11 cases observed. Autoimmune vitiligo was the first autoimmune disorder observed in seven cases and was bilateral, symmetrical and acrofacial in eight cases. Autoimmune thyroid disorder was associated in ten cases. Our data confirms the important association between vitiligo and thyroid autoimmune disorders. CONCLUSION: The predominant female ratio and the acrofacial topography of skin lesions could predict association with others autoimmune disorders in patients with vitiligo.

Adolescent↗
PubMed1998

Threonine and methionine are limiting amino acids for protein synthesis in patients with AIDS.

This study was conducted to identify the most rate-limiting amino acids for whole-body protein synthesis in acquired immunodeficiency syndrome (AIDS) patients. We postulated that an essential amino acid that would be rate limiting in AIDS should have a low basal plasma concentration and should remain at a low level during amino acid infusion. Seven male AIDS patients (median age 37 y, CD4 cell count: 76 mm-3) without any clinically active opportunistic infection during the month before the experiment were infused intravenously with a complete amino acid-glucose mixture for 2.5 h. Eight healthy volunteers were used as controls. Before the infusion, the concentrations of most free essential amino acids (methionine, threonine, histidine, isoleucine, leucine and tryptophan) were significantly lower (P < 0.05) in AIDS patients than in controls. Most plasma free essential amino acids increased significantly during infusion. However, the absolute increase above basal levels for threonine, valine, lysine, (P < 0.05) and methionine (P < 0.073) was smaller in AIDS patients than in control subjects. Thus, threonine and possibly methionine may be rate limiting for whole-body protein synthesis in AIDS patients, suggesting that there are selective amino acid requirements in patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Whole-body protein turnover and hepatic protein synthesis are increased by vaccination in man.

1. The ability of diphtheria-tetanus-poliomyelitis-typhoid vaccination to induce modifications in protein metabolism was investigated in post-absorptive healthy humans. 2. Seven subjects were studied before and 2 days after vaccination. They underwent an intravenous primed constant infusion of L-[1-13C]leucine for 4h. Plasma protein concentrations, whole-body amino acid fluxes and acute-phase protein synthesis were determined. 3. Plasma concentrations of fibrinogen, alpha 1-acid glycoprotein, haptoglobin and alpha 1-antitrypsin were significantly elevated 2 days after vaccination (P < 0.05). Leucine oxidation was unaffected but whole-body protein synthesis and breakdown were both increased (P < 0.05), by 25 and 16% respectively, in subjects who had an elevated body temperature (n = 5). Albumin synthesis was unchanged, but hepatic synthesis of fibrinogen was 56% higher after vaccination. 4. The present investigation indicates that diphtheria-tetanus-poliomyelitis-typhoid vaccination could induce a sustained acute-phase reaction. Moreover, protein metabolism appeared to be extremely sensitive to a mild stress since leucine kinetics and fibrinogen synthesis were affected. Therefore, diphtheria-tetanus-poliomyelitis-typhoid vaccination might represent an attractive model for studying the inflammatory process in humans.

Acute-Phase Proteins↗
PubMed1994

Acute overdose of a new dopamine agonist, CV 205-502.

CV 205-502 is a new dopamine agonist used for hyperprolactinaemia. We report a case of acute overdose (one month treatment, i.e. 2.25 mg) in a 25-year-old male patient. Clinical symptoms were restricted to nausea and mild hypotension. Treatment consisting of ipeca cuanha, charcoal and intravenous fluids allowed a rapid, successful outcome. This case illustrates the particular features of CV 205-502 intoxication when compared to other dopamine agonists, pointing out the tolerance of the drug which can be considered for wider indications and safer prescriptions.

Adult↗
PubMed1994

[Painful chronic thyroiditis. A rare cause of thyroid pain].

The usual clinical presentation of Hashimoto's chronic lymphocytic thyroiditis is a firm and painless goiter. We report two atypical observations with painful symptoms. Case 1: a 33 year old woman with a two months history of L-thyroxine treated primary hypothyroidism associated with elevated antithyroglobulin and antithyroperoxydase antibodies (respectively 36.000 and 7.000 U/l, normal values < 100 U/l) presents with anterior cervical pain. She is euthyroid, but displays biological inflammatory syndrome. Neck ultrasonography reveals low amplitude echoes of the thyroid gland. Antithyroid antibodies remain at high titers. After failure of NSAI drugs, prednisolone (oral 30 mg/day for 10 days, followed by degression) allows rapid disappearance of both pain inflammatory syndrome. When treatment was stopped pain recurred and required steroids for 3 months. After one year, the patient is painless and only receives L-thyroxine. Case 2: a 36 year old woman is referred for anterior neck pain, fever and hypothyroidism. Biological inflammation is also noted. High levels of antithyroglobulin and antithyroperoxydase antibodies are found. Thyroid uptake was maintained. L-thyroxine and prednisolone (oral 20 mg/day) therapies are associated with rapid pain relief. After two months, steroids are stopped. The patient remains normothyroid under L-thyroxine. Antithyroid antibodies persist at high levels. Other aetiological diagnosis of painful thyroid include acute infectious thyroiditis, cancers, intracystic hemorrhages and mainly subacute De Quervain's thyroiditis. Beyond clinical symptoms (revelation with hypothyroidism), persistent scintiscan uptake and prolonged elevated levels of antithyroglobulin and antithyroperoxydase antibodies remain the strongest arguments in favor of the 33 reported cases of painful Hashimoto's chronic lymphocytic thyroiditis. Eventually, among various therapies used, steroids in conjunction with thyroid hormones, seem the most efficient.

Adrenal Cortex Hormones↗
PubMed1993

[Prevalence of anxiety and depressive symptoms in patients with type 1 and 2 diabetes].

The authors studied data on psychiatric disorders in 34 insulin-dependent and 27 non-insulin dependent diabetic patients by comparison with 25 patients suffering from hypertension. Analysis was performed following clinical diagnosis (according to DSM III-R criteria), Hamilton Anxiety Inventory, Hopkins Symptom Check List 58 and Beck Anxiety Inventory. In all groups the two major psychiatric clinical diagnoses were anxiety disorders (respectively, 53, 59 and 60%, NS) and depressive disorders (respectively 21, 22 and 20%, NS). These disorders were more common in women. The influence of degenerative complications was studied. Insulin-dependent diabetics with objective nephropathy had significantly higher anxiety scores. In non-insulin-dependent diabetic patients, microangiopathy, diabetic foot and poor control (HbA1c > or = 10%) were also associated with depressive disorders. We conclude that diabetics present with high prevalences of anxiety and depressive disorders and we suggest specific therapeutic approaches.

Adolescent↗
PubMed1992

[Mediastinal hemangiopericytoma. Apropos of a case].

The authors report a new case of hemangiopericytoma in an elderly man. An asymptomatic mediastinal mass was found on a routine chest film. C.T. guided fine-needle biopsy was diagnostic. These rare lesions are clinically and radiologically aspecific and require pathologic proof. The value of percutaneous biopsy before therapeutic decision is emphasized.

Aged↗
PubMed1992

[Metabolic adaptation in hyperthyroidism. Implication of insulin].

Hyperthyroidism is associated with intense metabolic disturbances. Thus, an increase of basal metabolism and thermogenesis is noted. Glucose data include increased muscle utilization and hepatic production. Its oxydative catabolism is enhanced, while its use for glycogen synthesis is reduced. Lipid turnover is also increased. In vivo and in vitro improvement of muscle proteolysis in animals induces a reduction of total body protein content; protein synthesis is also paradoxically stimulated. In contrast, this mechanism remains unproved in man. The role of insulin, whose levels usually increase during glucose tolerance tests, is also studied. Glucose tolerance impairment may be related to lower insulin-inhibited glucose production whereas insulin-stimulated glucose peripheral utilization is unmodified. In man, receptor assays demonstrate reduced amount of binding-sites on various cell, while animals studies lead to contradictory results; thus, receptor studies do not demonstrate any clear mechanism for insulin resistance in hyperthyroidism.

Animals↗
PubMed1986

[Neurologic manifestations of basal cell nevomatosis. A case].

The naevoid basal cell syndrome, also called Gorlin's syndrome, is a dysembryoplasia akin to the phakomatoses and which may affect the skin, the bones, the nervous system, the eyes, the endocrine glands and the genitalia. A case with numerous tumours and malformations is presented, together with a review of the literature.

Aged↗