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Biomedical subjects

R Martin-Du Pan

Publications and source records attributed to R Martin-Du Pan.

16 recordsLinked to original sources
PubMed2001

Short- and long-term results of total vs subtotal thyroidectomies in the surgical treatment of Graves' disease.

OBJECTIVE: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. METHODS: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue--mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. RESULTS: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT--with follow-ups averaging two years (0.5-8)--are receiving thyroxin substitution. CONCLUSIONS: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Adolescent↗
PubMed2001

[The benefits of aging. I. Patience and cure: spontaneous beneficial course of certain diseases].

Some chronic diseases have a favourable course and are cured spontaneously. Allergic diseases such as eczema, hay fever and asthma have a good outcome in more than 75% of cases within 7 to 25 years, depending on the kind of allergy. Migraines have also a good evolution in children and after menopause. Many symptoms due to menstruation such as dysmenorrhea, premenstrual syndrome or anemia, disappear after menopause as well as diseases due to estrogens such as uterine leiomyoma, endometriosis and prolactinoma. The risk of epilepsy relapse after a first seizure is about 40% after 2 years. The risk is lower in children. Attention deficit disorder affects 3 to 5% of children but is present in only 30% of them in adult age. The prevalence of depression decreases in women between 30 and 60 years of age. Functional somatic syndromes such as fibromyalgia, irritable bowel syndrome or dyspepsia decrease in 2/3 of cases within 5 to 10 years if there is no history of anxio-depressive symptoms. However, prognosis is reserved when initial symptoms are severe or if they are connected to sexual abuse, domestic violence or depression. Other diseases have a spontaneous favourable course such as myopia, idiopathic infertility, polycystic ovary disease or ventricular arrhythmia. The knowledge of a good prognosis enables to avoid unnecessary treatments and to reassure many patients.

Aged↗
PubMed2001

[The benefits of aging. II. Aging and dying in our time: reasons for optimism?].

The increase of life expectancy is due to the successful treatments of infectious diseases and to the prevention of cardio-vascular (C-V) diseases. People are afraid that an increase of life expectancy would go together with an extension of years of chronic illness and disability. However the compression-of-morbidity hypothesis predicts that persons with better health habits and with a low level of C-V risk factors survive longer without a parallel increase of the period of disability. Depression decreases life quality of elderly people and increases sucidial risk as well as C-V mortality. The prevalence of depression varies between 10 and 20% in different european cities. Emotional well-being and vitality characterized by optimism and sociability seem to protect old people from adverse health outcome. There is a marked increase in epithelial carcinoma in old people. Some cancers (breast, colon) have a reduced aggressiveness in elderly patients. A better access to palliative care and a better control of terminal pain and suffering should restrain patients to ask help for assisted suicide. People who had near death experience recall they felt light and peace. These coping mechanisms seem to ease the passage towards death. Elderly people should be surrounded by a social and affective network in order to help them to cope with illness, dependance and loneliness and to keep their humour and optimism.

Aged↗
PubMed1998

[Statistic pitfalls or how should we interprete numbers in the evaluation of a new treatment].

Are cholesterol lowering drugs useful? Do they increase life expectancy? Do third generation oral contraceptives increase the risk of venous thromboembolism? Is there a worldwide decline in semen quality over the last 50 years? Do vitamin supplements improve your child's IQ? Does homeopathy work better than placebo? These questions illustrate some statistical problems and some bias encountered during clinical studies, which can lead to erroneous results. Type I and II errors, surveillance, prescription or publication bias as well as the healthy user effect are described. Problems of regression to the mean, limits of meta-analysis validity and other statistical problems are discussed.

Bias↗
PubMed1997

[Treatment of amiodarone-induced hyperthyroidism: corticosteroids or potassium perchlorate? What value do interleukin-6 levels have?].

We report 11 cases of amiodarone-induced hyperthyroidism. We tried to classify them into 2 groups, according to Bartelena et al. (JCEM 81: 2930, 1996). The serum level of interleukin-6 (IL-6) was measured in 7 patients by an immunoenzymometric assay. In type I (cases 1-3) the thyroid was abnormal (goiter, Graves' disease) but IL-6 levels were normal. These cases were successfully managed by the combined use of thionamide drugs (carbimazol or propylthioruacil = PTU) and potassium perchlorate. In type II (case 4), the thyroid seemed to be normal but the serum level of IL-6 was increased, possibly due to a destructive thyroiditis. Treatment with prednisone (40 mg/day) and PTU resulted in a prompt normalization of T3. Contrary to Bartalena et al., we observed cases with normal thyroid and normal levels of IL-6 (cases 5-8) (type III). In these cases prednisone (40 mg/day for 2 weeks) was ineffective but the combined use of thionamide drugs and perchlorate was associated with a normalization of thyroid hormones. This combined treatment seems to be effective in most patients (type I, III). In case of failure of this treatment, a high dose of prednisone (1 mg/kg) could be tried or a lower dosage (40 mg/day) could be used in cases with high IL-6 levels (type II).

Adult↗
PubMed1993

[Premature menopause].

This article describes the different etiologies and clinical aspects of precocious menopause as well as the investigations necessary to differentiate between a syndrome of resistant ovaries and pituitary tumors. Therapeutic aspects such as estrogen substitution and oocyte donation are discussed.

Adult↗
PubMed1980

[Clinical implications of present knowledge respecting neuropharmacologic control of antipituitary hormones].

The secretion of the pituitary hormones is controlled by hypothalamic hormones which are synthesized by neurosecreting cells whose activity is modulated by different neurotransmitters such as dopamine, norepinephrine and serotonin. Centrally acting drugs (antiparkinson, antipsychotic, antidepressive and hypotensive agents) interfere with the activity of the neurotransmitters and may thus influence the secretion of hypothalamic and pituitary hormones. The action of different psychotropic drugs on the secretion of hormones of the anterior pituitary gland in man is reviewed, with particular emphasis on: 1. the role of the neurotransmitters on the secretion of the hormones under physiological and pathological conditions (endocrinopathies, neurological and psychiatric diseases); 2. the clinical importance of the secondary endocrinological effects these drugs may elicit; 3. the efficacy of these drugs as therapeutic and diagnostic agents in endocrinopathies.

Antidepressive Agents↗
PubMed1978

[Neuroleptics and sexual dysfunction in man. Neuroendocrine aspects].

Sexual behaviour and fertility of schizophrenic patients are discussed. The various sexual dysfunctions induced by neuroleptics, such as decrease in libido, troubles of ejaculation and impotence, are described and related to their various mechanisms of action. The central antidopaminergic effect of neuroleptics would be responsible for an overall non-specific decrease in libido. Their effect upon the autonomous nervous system would explain ejaculation disturbances. Their endocrine action (increase in prolactine) would produce impotence. The possibility of treatment of these endocrinological troubles by bromocriptine is discussed.

Antipsychotic Agents↗