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S Cottin

Publications and source records attributed to S Cottin.

At least 19 recordsLinked to original sources

Evaluation of residual and therapeutic doses of tetracycline in the human-flora-associated (HFA) mice model.

In order to evaluate an in vivo model system for assessing the effect of therapeutic and residue levels of tetracycline on human intestinal microflora, tetracycline was administered via drinking water (1, 10, and 100 mg/liter) to human-flora-associated (HFA) male and female mice. The effects of the antibiotic on fecal aerobic and anaerobic populations, selection of bacteria resistant to tetracycline, metabolic parameters of the microflora, and maintenance of the intestinal barrier against exogenous Salmonella (resistance to colonization) were recorded. In both sexes of mice, tetracycline exposure at 10 and 100 mg/liter induced the selection of several resistant bacterial species (Gram-positive anaerobes, Bacteroides fragilis, enterobacteria, and enterococci). This effect was also observed at the lowest dose (1 mg/liter) in female mice and indicates the potential sensitivity of this endpoint for evaluating the microbiological risk of tetracycline residues. The resistance to colonization was impaired at 100 mg/liter, a concentration corresponding to about half of the therapeutic doses in humans and animals. Metabolic parameters of the microflora were not affected by tetracycline at all levels. In this study, the no-observed-effect level (NOEL) of tetracycline on intestinal flora in this study was less than 1 mg of tetracycline per liter of drinking water. This concentration in the mouse corresponds to 0.125 mg of tetracycline per kilogram of body weight per day. Within the constraints of the experimental design employed here, the HFA mice model proved to be acceptable for studying dose-related effects of tetracycline on human intestinal microflora.

Animals↗

[Iatrogenic drug-induced diseases, requiring hospitalization, in patients over 65 years of age. 1-year retrospective study in an internal medicine department].

Iatrogenic pathology is mainly seen in the elderly. In a one year retrospective study, we showed that drug toxicity was responsible for 87 cases requiring hospitalisation in patients aged 65 years and above (7.7% of hospital admission for patients over 65 years). The major manifestations were: 21 cases of sera electrolyte disturbance, 19 concerning gastro-intestinal tract and liver, 16 cardiological disorders, 13 neurological complications, ten involving the endocrine system, six hematological complications. The most common drugs involved were: antihypertensive agents (36%), of which 20.5% were diuretics, psychotherapeutic drugs (24.8%), anti-inflammatory drugs (17.8%). The average cost per patient was calculated to 20,602 FF per patient. Impossibility for direct return to the original dwelling place was another complication in 29% of hospitalisations related to iatrogenic disorders. The high number of drugs taken daily increases the risk of drug interactions which was responsible for iatrogenic accidents in 12.6% of the patients of this study.

Aged↗

Chronic myelomonocytic leukemia and primary Sjögren's syndrome.

Although associations of Sjögren's syndrome (SS) with malignant affections are well known, an association with chronic myelomonocytic leukemia (CMML) is infrequent. Our report concerns an 80-year-old woman with chronic polyarthrosis, hospitalized for an anemic syndrome, who also complained of buccal dryness. Clinical examination showed simply parotid swelling and discrete splenomegaly. The diagnosis of SS appeared to be primary. The hemogram, myelogram and bone biopsy indicated CMML. During SS, the possibility of occurrence of a lymphoproliferative syndrome is well documented, and other malignant affections are much less likely to be found in the absence of immunosuppressive treatment. The particular case of SS and associated CMML detected at the same time suggests either the favorable role of monocytic proliferation on immunity or a stem clonal anomaly affecting monocytes and B lymphocytes.

Aged↗

The efficacy of selective unilateral temporal artery biopsy versus bilateral biopsies for diagnosis of giant cell arteritis.

Two hundred bilateral temporal artery biopsies performed prospectively in 200 patients suspected of having giant cell arteritis (GCA) were always preceded by Doppler flow study and local clinical examination. If bilateral temporal artery biopsies had been guided by positive local clinical examination, 24 positive biopsies would have been found, and Doppler studies would have improved the diagnostic score to 39; however, the biopsies gave 42 histologically positive results, providing the best diagnostic yield. The possibility of GCA with normal Doppler flow studies was noted as well as the existence of relatively asymptomatic forms of GCA, so that systematic performance of bilateral temporal artery biopsy would seem justified in any case of suspected GCA.

Aged↗

[Primary Gougerot-Sjögren syndrome with necrotizing polymyositis: favorable effect of hydroxychloroquine].

A 61-year-old woman was admitted for acute arthralgias and proximal weakness in all four limbs. Clinical examination found xerostomia, xerophthalmia, enlarged parotid glands. The Schirmer test was positive and the salivary gland biopsy showed a mononuclear, lymphoid, sometimes nodular infiltrate. A muscle biopsy showed necrotizing myopathy with perifascicular atrophy. The patient refused steroids and was given hydroxychloroquine (600 mg daily). She improved gradually, and one year later there were no further complications. The favorable course both of Sjögren's syndrome and polymyositis with hydroxychloroquine treatment is unexpected. This led us to suppose that both could have had a common cause.

Female↗

[Clavicle osteolysis in MacDuffie's syndrome].

MacDuffie's syndrome emerges from systemic vasculitis as including recurrent urticaria-like skin lesions, episodic angio-oedemas, articular manifestations and abdominal pains, with a tendency to affect women. Renal involvement may burden the prognosis. Hypocomplementemia is usual by deficiency of the classical pathway. Corticosteroid therapy is habitual. The case reported, fitting to this nosological entity offers two new features: in the first place, the osteolysis of the distal part of the clavicle whereas the joints are not affected by destroying lesions; then the non steroidal anti-inflammatory drugs was effective within a period of one year without complication.

Adult↗

[Pulmonary fibrosis in ankylosing spondylitis. Five new cases (author's transl)].

The most common thoracic finding in ankylosing spondylitis (AS) is ankylosis of the costovertebral joints with severe limitation of chest expansion inducing a restrictive syndrome pleural and pulmonary fibrosis can occur during the course of the disease. One-hundred record of patients with AS were reviewed. Five had pleuro-pulmonary involvement. This always included pachypleuritis, usually apical. Roentgenographic pulmonary changes were infiltrates or fibrobullous lesions. Pulmonary function tests showed restriction in four cases, obstruction in one case, and a decreased diffusing capacity in all five cases.

Adult↗

[Atloido-axoid erosive osteoarthritis. Apropos of 3 cases].

Three cases of unilateral atloido-axis arthropathy are described in women aged 39 to 69 years. The initial diagnosis of arthritis made in view of the severity of the clinical (severe pain and stiffness) and radiological (marked chondrolysis, subchondral erosions), manifestations was contested in the absence of any laboratory abnormality of an inflammatory nature, as well as any bacterial, inflammatory rheumatic or metabolic cause. The final diagnosis made at the time of hospitalisation after 8 to 9 month progression of the disease was osteoarthritis, no subject to any doubt on the basis of the subsequent course. C2-C3 block present in 2 cases was a local factor of joint wear-and-tear. Other severe manifestations of osteoarthritis were seen in 2 patients. By analogy with certain forms of destructive osteoarthritis of the fingers, the term erosive osteoarthritis of the atloido-axis joint is suggested to describe this joint lesion.

Adult↗

[D-penicillamine induced myasthenic syndromes in rheumatoid arthritis. Two cases (author's transl)].

The authors report on 2 personal cases, and review 48 published cases of myasthenia induced by D-penicillamine (D-P) treatment in patients with rheumatoid arthritis. The clinical symptoms were not different from those of myasthenia gravis, and no correlation could be found between the total cumulative dose of D-P and the onset on the myasthenic syndrome. In 71% of the patients the neurological deficiency regressed after D-P was withdrawn, but in some cases anticholinesterase treatment had to be continued and thymectomy was contemplated. The most remarkable biological abnormalities were anti-striational antibodies (found in 58% of the cases) and anti-acetylcholine receptors antibodies (found in 4 out of 7 patients tested). These findings are in favour of a genuine myasthenia and against a myasthenic syndrome due to neuro-muscular blockade. While the mechanisms underlying the emergence of these antibodies remains unknown, their presence throws new light on immunological disorders in rheumatoid arthritis.

Adult↗