PubMed Health⌕ Search

Biomedical subjects

R Maréchaud

Publications and source records attributed to R Maréchaud.

At least 37 records · Page 2Linked to original sources
PubMed1994

Retrospective study of 108 cases of botulism in Poitiers, France.

Botulism, a food-borne toxin-mediated disease caused by Clostridium botulinum is still a common disease, which is most frequent in the rural environment; 108 cases, 66 males and 42 females, average age 32 years, were recorded from 1965 to 1990 in the infectious disease department of the University Hospital of Poitiers (France). In 83% of patients, the food responsible was home-cured ham. Mean incubation time was 3.4 days; digestive symptoms were observed in 93% of cases, ocular symptoms in 92% and urinary tract dysfunction in 22%. A scale of severity was used to classify the patients into those suffering from severe (6), intermediate (50) and mild (52) forms of the disease. Botulinum toxin type B was found in 36 (52%) of 69 blood samples and in 41 (51%) of 81 samples of the suspected food. From 1965 to 1976, 44 patients were treated with both toxoid and heterologous equine serotherapy. Since 1976, 29 patients have been treated with guanidine hydrochloride (35 mg/kg daily) and 35 patients with guanidine hydrochloride plus heterologous serotherapy. All 108 patients recovered without any sequelae.

Adolescent↗
PubMed1993

[Corticotropic macroadenoma: clinical, hormonal, radiological and immunocytochemical study of 6 cases].

We report 6 cases of corticotroph macroadenomas which show heterogeneity of clinical and biological features (from Cushing's syndrome to silent adenoma) and heterogeneity of immunocytochemical staining. One patient reported on had skin hyperpigmentation and ACTH hypersecretion without clear abnormal adrenocortical function; we believe that this patient's plasma contained ACTH with very low bioactivity.

Adenoma↗
PubMed1993

[Transient loss of consciousness in an internal medicine unit. Study of the initial evaluation and medium-term outcome].

The authors report the results of a study concerning 90 patients admitted to an Internal Medicine Unit for transient loss of consciousness. The cause of this event was found in 74 cases (82%), including 73 where the initial evaluation had been simple, consisting of physical examination, electrolytogram, blood glucose level, electrocardiogram and test for postural hypotension. Patients and physicians reported different frequencies of recurrence (17 and 51% respectively) and complications (27 and 96% respectively). Recurrences were usually multiple and appeared soon after the initial event. A 4% mortality rate was recorded over 21 months, but only one death was due to a cardiovascular cause. No death was observed in the group of patients without initial aetiological diagnosis. Apart from cardiac syncopes, the consequences of transient loss of consciousness seem to be psychological rather than physical. A simple initial evaluation is often sufficient.

Adolescent↗
PubMed1991

[Average level and variability of 24 hour blood pressure in the normotensive insulin-dependent diabetic patient].

This prospective study was designed: 1. to determine both the mean level and the intrinsic variability of blood pressure (BP) and heart rate (HR) in normotensive patients with insulin-dependent diabetes mellitus (IDDM), by using a nonambulatory recorder; 2. to look for a relationship between these parameters and the indices of diabetic target-organ damage. The patient group consisted of 21 subjects with IDDM (6 females, 15 males), aged 19 to 70 years, who were normotensive according to WHO criteria. The duration of the diabetics ranged from 1.5 to 32 years. A control group of 17 age and sex-matched normal volunteers was also examined. Each subject underwent a 24 h non ambulatory BP recording, a 2-dimensional echocardiography and a pulsed doppler examination; furthermore, an index of autonomic nervous system dysfunction was established, as well as an index of microangiopathy. Twenty-four hour BP and HR mean levels appeared to be slightly higher in IDDM patients than in control group, but the difference was significant for night SBP and 24 h DBP only. No difference was found with regard to BP and HR absolute variabilities; the relative variability of night DBP was slightly lower in IDDM group (p less than 0.05). A loss of nocturnal decline in BP was noted in 2 control subjects and in 9 IDDM patients: 8 out of these IDDM patients had an autonomic dysfunction. An abnormal HR circadian pattern was seen in 1 control and in 2 IDDM subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Prognosis of treated temporal arteritis. Retrospective study of 87 cases].

Eighty-seven patients (mean age 73 years) with histologically proven Horton's disease were followed up in 5 different specialized hospital units from 1970 to 1984. Except for one patient treated exclusively with antimalarials, all were under corticosteroids. The mean initial dose of prednisone or equivalent was 0.7 mg/kg/day and the mean maintenance dose, 10 mg/day. Steroids could be discontinued in 21 cases after 36 months on average; the other patients could not be weaned, even though 4 of them had been on steroids for more than 10 years. Side-effects were noted in 43 cases. Twenty-four patients died, mostly of cardiovascular diseases. Survival rates were 89 +/- 6.35% at 1 year, 60.2 +/- 8.7% at 5 years and 48 +/- 11.3% at 10 years. In the long run, mortality in our series proved to be exactly the same as in the general population. Nineteen patients had ocular manifestations of giant cell arteritis always from the onset, except for a fall in visual acuity; 26 relapses were observed in 18 patients, either during reduction of steroid dosage (21 cases) or after withdrawal (5 cases). In 2 cases histology showed typical lesions of giant cell arteritis after 41 and 50 months respectively under corticosteroid therapy.

Aged↗
PubMed1986

[Prognosis of generalized scleroderma. A retrospective study of 78 cases].

From 1960 to 1984, 78 new patients with progressive systemic sclerosis were followed up: 60 women and 18 men whose ages ranged from 20 to 83 years, with a mean age of 58 years. Twenty nine are known to be dead and 3 were lost of follow-up. Forty six have been followed up to the present time for a mean period of 5 years. The cumulative survival rates were 88 +/- 7 p. 100 at one year, 62,5 +/- 11,5 p. 100 at five years and 50,5 +/- 15 p. 100 at ten years. These figures are significantly different from those found in a matched group from the French general population. Nine features at the time of diagnosis which might influence prognosis were studied. Seven factors apparently have not affected prognosis: sex, age, time elapsed between initial symptom and definitive diagnosis, location of scleroderma, blood pressure, erythrocyte sedimentation rate and creatinine clearance. On the other hand, survival declined significantly faster in the 28 patients with anemia than in the 50 patients without anemia (P less than 0,001). Similarly, the 47 patients with radiological pulmonary involvement or pulmonary function abnormalities were at significantly higher risk for death than the 31 patients without interstitial pulmonary fibrosis. Anemia and pulmonary involvement are predictors of mortality and important prognostic tools in the management of the different drugs that have been recommended for the treatment of patients with systemic sclerosis.

Adult↗
PubMed1985

[Reversible bone marrow hypoplasia in a case of male anorexia nervosa].

The authors report the case of a 17 year old boy with anorexia nervosa and bone marrow hypoplasia. After a 14 kg weight loss, the patient had pancytopenia, morphological abnormalities of the red cells (acanthocytes, schizocytes), without hemolysis, and hypogonadotropic hypogonadism. Bone marrow biopsy showed a marked reduction of hematopoietic cells with striking diffuse interstitial oedema. Clinical recovery, during the next 6 months, was associated with a return of the haematological changes to normal and to a disappearance of hypogonadism. Anorexia nervosa is a rare entity in boys. In all probability, bone marrow hypoplasia is not a well known feature of this disorder. The haematological changes are reversible with improvement of nutritional status.

Adolescent↗
PubMed1985

[Hyperthyroidism caused by metastatic choriocarcinoma. A new male case].

The authors report a case of hyperthyroidism induced by a metastatic choriocarcinoma (retroperitoneal, lungs, vertebral and epidural localisations) in a 49 year old man. Tachycardia and possibly weight loss were the only clinical signs of thyrotoxicosis. Chemotherapy led to a remission of hyperthyroidism and tumoral syndrome for 4 months. Neoplasia relapsed and circulating levels of thyroid hormones were increased during the final stages. This is the fifth male reported case of choriocarcinoma associated with hyperthyroidism. Many previous studies suggest that hyperthyroidism is induced by HCG thyroid stimulating activity.

Choriocarcinoma↗
PubMed1978

[Acute renal failure in the course of occupational lead intoxication. Chelation therapy responsability (author's transl)].

In a patient with occupational plumbism and a normal kidney function, EDTA therapy (1 g/24 h) resulted in a massive lead excretion (15 000 microgram/24 h) together with acute renal failure. A direct nephrotoxic effect of EDTA was excluded: after renal function returned to normal, EDTA could be subsequently readministered at progressively increasing doses (250 mg to 1 g/24 h) without any renal dysfunction. These findings strongly suggest a close relationship between the burden of lead mobilized by EDTA and the acute renal failure. This case can be classified as acute lead nephropathy of which only a few instances have been reported in the literature. The interest of monitoring lead excretion during chelation therapy is particularly emphasized.

Acute Kidney Injury↗