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Biomedical subjects

R Lopitaux

Publications and source records attributed to R Lopitaux.

33 records · Page 2Linked to original sources
PubMed1980

[Value of successive chemotherapy in multiple myeloma of bone. Prospective study over 4 years].

In order to study the response of patients with multiple myeloma of the bones (MM) to various anti-cancer drugs (Melphalan M, Cyclophosphamide Cy, Nitrosourea NU, Vincristine V, Adriamycine A and Prednisone P), 70 MM received the following treatment : 1) Induction therapy : a) M and P or b) M and Cy and P ; 2) Levelling with partial or complete response : V Cy P (in case a) or V M Cy P (in case b) ; 3) Relapse : A and NU. The following results were obtained : 1) Only 42.6% of patients respond to induction therapy ; 2) Fewer than 10% of patients showing a response reach a second levelling with Vincristine ; 3) 50% of those not showing a response reach a levelling between --20 and --50 and have prolonged survival ; 4) Only 20% of non responders are improved by Cy P or A and NU. The median actuarial survival is 42 months. Among the responders two poor prognosis factors must be underlined : hypercalcemia and the speed of response.

Aged↗
PubMed1978

[The bactericidal power of antibiotic combinations. Application in the treatment of osteo-articular infections due to Staphylococcus aureus (author's transl)].

Study of the bactericidal power of antibiotic combinations against 18 strains of staphylococcus aureus causing osteoarthritis showed that the combinations most often synergistic or indifferent were: rifampicin + lincomycin or synergistine, rifampicin + fusidic acid, synergistine + fusidic acid or trimethoprim-sulphamethoxazole, cephalosporins + gentamycin, rifampicin or fusidic acid + gentamycin, trimethoprim-sulphamethoxazole + rifampicin or fusidic acid. Study of the antibiotic therapy used here was based upon the inhibitory power of serum and the measurement of antibiotic concentrations in healthy bone. Combinations which are synergistic or indifferent in vitro endow the serum with a high level of bactericidal activity. Certain antagonisms (cephalosporins or penicillin M + rifampicin) found in vitro may be reflected neither clinically nor in study of the inhibitory power of the serum.

Adolescent↗
PubMed1978

[Gastric mucosa and anti-inflammatory agents. A comparative study by fibroscopy].

A comparison was made between the gastroduodenal lesions observed by fibroscopy in a group of 47 patients treated with anti-inflammatory drugs for rheumatic conditions and a group of 50 controls. All patients had clinical symptoms of the stomach or duodenum. A statistical study show that the two groups were similar as regards age, sex and clinical signs. Besides ulcers the gastroduodenal lesions were acute and/or chronic. Among acute gastritis forms distinction is made between superficial, muco-erosive and haemorrhagic gastritis. The study showed the very high frequency of lesions of acute gastritis in rheumatic patients, especially of the antral and muco-erosive types, whereas the incidence of gastroduodenal ulcers was no higher than in the controles. An important finding is that acute gastritis is not favoured by pre-existing chronic gastritis.

Adolescent↗
PubMed1978

[Early diagnosis of staphylococcic infection in epidural space : radiologic contribution (author's transl)].

Infection of the épidural space was demonstrated on clinic (cauda equina compression) and radiology. Three investigations are considered and compared : Dimer X radiculography, lumbar phlebography, duroliopaque myelography. The transfemoral arcending lumbar catheterization of the epidural veins precise the compression by staphylococcic external pachymeningitis. No liquid is introduced in cerebro spinal fluid : there is not risk of infectious arachnoiditis. Myelography with positive contrast (duroliopaque: ethyl monoiodostearate) is much attractive but it is a procedure not easy to perform, even badly tolerated by the patient. For these reasons the lumbar phlebography, easily performed, can be realised in first intention.

Catheterization↗
PubMed1978

[Osteo-articular infections: choice and monitoring of antibiotic therapy. Apropos of 26 observations with an identified organism].

Study of 26 cases of osteo-articular infections with an identified organism collected in a rheumatology department, has confirmed in the first place the increasing importance of gram negative organisms, compared with the staphylococcus which has always mainly predominated in this type of infection. In each case, the authors have made as complete a bacteriological study as possible, including antibiotic sensitivities, the measurement of the minimum inhibitory concentration of the antibiotics on the isolated strains, study of the bactericidal power in vitro of various combinations, and study of the inhibitory power of the serum on the organism. This study of the inhibitory power of the serum approximates most closely to testing the antibiotic activities in vivo, since one cannot make this assessment, in most cases, within the infective focus itself. Rifampicin, with the imperative condition that it is not used alone, is a major antibiotic in the osteo-articular infections, by reason of its very great activity against the staphylococcus, its excelent penetration into bone, and its ease of use. Other recognized anti-staphylococcal antibiotics behave in a more disappointing fashion. When the effectiveness of treatment is checked regularly by the inhibitory power of the serum, together with the other classical criteria of surveillance, cure of the infection as been achieved in every case.

Adolescent↗
PubMed1977

[Discopathies after fractures and destructive vertebral lesions during rheumatismal pelvispondylitis].

In three cases of rheumatic spondylitis, fracture across the disc of an ankylosed spinal segment (C5-C6, D7-D8, and D12-L1 respectively) resulted in rapid development of a discopathy with destruction of the adjacent vertebral bodies. In one of these cases, surgical exposure of the focus permitted anatomical study of the lesion; the changes that had developed after the fracture were inflammatory in appearance, which at first suggested infection by non-specific micro-organisms, an assumption that was rapidly abandoned. This misleading histological appearance largely explains why these destructive discopathies in spondylitis have long been regarded as a consequence of the rheumatic process itself. A review is presented of the arguments which suggest that they have, in fact, a mechanical pathogenesis, often determined by a fracture. From this it may be concluded that the treatment of choice is temporary immobilization in moderate cases and surgery with transplantation in complicated or unstable cases.

Aged↗
PubMedDate not supplied

[Sciatica caused by disk herniation in children. Apropos of 4 cases].

The authors report 4 cases of sciatica from disk herniation occurring in children under 16. It happens rarely in this age range, as is shown in the review of the literature performed for this article. The symptomatology is similar to that in adults. The physical signs are much more prominent than the functional signs. An original traumatism, sometimes severe, is often encountered. The standard X-ray examination is of little use in diagnosis, while contrast studies (opaque myelography, phlebography) clearly show the lesions of compression. Surgical treatment is frequent but not compulsory, following the same rules than in the adults. The post-operative results are usually excellent.

Adolescent↗
PubMedDate not supplied

[Rifampicin diffusion in non-infected human bone (author's transl)].

Rifampicin levels in serum, cortical bone and spongious bone were measured by a biological assay in 13 non-infected patients undergoing total replacement of the hip. Samples were collected after 24-72 hours rifampicin administration (daily oral dose: 600 mg). The mean level was 0.67 +/- 0.48 microgram/g in cortical bone and 3.35 +/- 0.72 microgram/g in spongious bone. Rifampicin diffusion was also assessed in normal bone from crista iliaca needle biopsy specimens in 7 patients treated for osteitis or septic arthritis. Bone and serum levels did not appear linearly correlated but, in any case, bone levels were much higher than MIC for Staphylococcus aureus which is usually involved in bone and joint infections.

Arthritis, Infectious↗