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Biomedical subjects

T Bardin

Publications and source records attributed to T Bardin.

At least 19 recordsLinked to original sources
PubMed1992

Antibiotic treatment of venereal disease and Reiter's syndrome in a Greenland population.

OBJECTIVE: To assess the effects of antibiotic treatment of urethritis or cervicitis on the incidence of recurrences of articular symptoms in Reiter's syndrome patients. METHODS: Retrospective evaluation of the medical charts of 109 patients living in Greenland. RESULTS: Thirty-seven percent of the episodes of genitourinary tract inflammation that were not treated or were treated with penicillin were followed by arthritis, compared with 10% of those treated with tetracycline or erythromycin. CONCLUSION: Antibiotics active against Chlamydia trachomatis reduced the risk of postvenereal arthritis in the population studied.

Adult↗
PubMed1992

Renal osteodystrophy, disorders of vitamin D metabolism, and hypophosphatasia.

Recent advances in renal osteodystrophy deal with the pathogenesis of the disease, in particular in early renal failure, with the mechanisms of skeletal resistance to parathyroid hormone, with the potential role of iron, and with increased knowledge of adynamic bone disease. For the control of phosphatemia, aluminum-containing phosphate binders are more and more avoided, whereas calcium acetate or carbonate are more and more prescribed. X-linked hyphophosphatemia continue to cause great interest as well as the various iatrogenic osteomalacias.

Chronic Kidney Disease-Mineral and Bone Disorder↗
PubMed1992

Tumoral calcifications in hemodialysis patients: possible role of aluminum intoxication.

Uremic patients may develop extraskeletal calcifications. Among the latter, periarticular tumoral calcifications (TC) represent massive, multiloculated calcium-phosphate deposits. The aim of this report was to analyze a series of 10 cases of TC in hemodialysis patients who were admitted at the Necker Hospital between 1974 and 1988. They were all male. An increased plasma calcium x phosphorus product was observed in 8 of the 10 patients. Plasma calcium level was increased in only 2 patients. In contrast, hyperphosphatemia was a constant feature in all the patients, as was the absence of an increase in plasma alkaline phosphatase activity. Using the bone histomorphometry technique, osteitis fibrosa of mild degree was observed in 2 patients, of moderate degree in 2 and of severe degree in 2 others. Evidence of aluminum (Al) overload was found in the 8 patients in whom it was searched based on bone histomorphometry, bone histochemistry, bone Al content and increased serum Al levels either in the basal state or after a deferoxamine test. In addition, Al overload was strongly suspected in the 2 remaining patients because of prolonged exposure to Al-contaminated dialysate. Various treatment strategies, including parathyroidectomy (PTx), were undertaken that remained unsuccessful in modifying the course of TC to a significant extent. Remarkably, TC occurred for the first time after PTx in 1 patient and worsened after PTx in 2 others. In conclusion, overt secondary hyperparathyroidism appears not to be an essential prerequisite for TC development in hemodialysis patients, and PTx must not be performed in such patients on the sole basis of the presence of TC.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Destructive arthropathy of the shoulder].

Destructive arthropathy of the shoulder consists of cartilaginous deterioration combined with subchondral osteolysis. The various diseases able to induce joint destruction (infection, neurological disease, chondrocalcinosis, tumour...) are excluded from this description which only concerns the forms with no obvious cause. Since the description of "senile haemorrhagic caries of the shoulder", several authors have reported, under various names, very similar diseases whose common denominator is destruction of the shoulder joint. The pathogenic factors remain unclear, but various theories have been proposed, involving mechanical factors secondary to lesions of the rotator cuff or suggesting the role of apatite microcrystals.

Calcinosis↗
PubMed1992

[Long-term survival and prognostic factors in stage II-III multiple myeloma treated with conventional chemotherapy].

In this retrospective study, survival and prognostic factors were analysed in 65 patients with stage II-III multiple myeloma with osteolytic lesions. Multiple myeloma was diagnosed from 1976 to 1984, and patients were treated with conventional chemotherapy. The response rate to initial chemotherapy was 46%. The median survival time was 31 months. The 10-year survival rate was 10%. Four variables were individually prognostic: response to initial chemotherapy, bone marrow plasma cell percentage, the Durie and Salmon staging system, a biological staging system derived from Durie and Salmon's biological criteria regardless of bone lesions. In the multivariate analysis, only two prognostic variables were retained, namely the response to chemotherapy and the biological staging system. No prognostic value was observed for the extent of osteolytic lesions. This study suggests that, in conventionally treated multiple myeloma, long-term survival has improved compared with the previous decade. It also indicates that the extent of osteolytic lesions has little value for the definition of high-risk myeloma.

Adult↗
PubMed1992

[Microcrystal deposit arthropathies of the wrist].

Microcrystalline arthropathies of the wrist include three main forms of microcrystalline pathology: gout, chondrocalcinosis and apatite calcifications. Gout of the wrist is now rare and may be missed, particularly in its chronic form, occasionally associated with tophi and large, often asymmetrical erosions on the X-rays. Chondrocalcinosis is frequent and easy to diagnose in the wrist and may be responsible for a very typical arthropathy predominantly involving the radiocarpal joint, while the frequency and specificity of scapho-trapezoid involvement are controversial. Apatite deposits in the wrist involve various tendons and ligaments, especially the tendon of flexor carpi ulnaris, but may also be responsible for intra-articular pathology.

Apatites↗
PubMed1992

[Therapeutic maintenance and tolerance of sulfasalazine in rheumatoid polyarthritis. Retrospective study of 95 patients].

This retrospective study evaluated treatment with sulfasalazine (SAS) in a mean dosage of 2.1 g/day in 95 patients with rheumatoid arthritis (RA) who were followed-up for 3 months to 4 years. Mean disease duration was 7 years; 79 patients had previously received at least one disease-modifying drug. Four per cent of patients were lost to follow-up. Mean duration of treatment was 15 months (3 weeks-50 months). Treatment continuation rates were 57% at one year, 40% at two years, and 26% at three years. Reasons for discontinuation of SAS included adverse effects (n = 24), inefficacy (n = 33), and death unrelated to SAS therapy (n = 2). In four patients, SAS was discontinued within three months of the first dose because of a severe adverse effect (diffuse erythematous rash, diffuse bullous rash, hepatitis with jaundice, agranulocytosis). SAS-induced biologic markers for lupus were seen in one patient. Furthermore, 12% of evaluable patients developed antinuclear antibodies during SAS therapy. The SAS treatment continuation rate was higher (p = 0.05) among patients under 40 years of age (n = 18) than among older patients. This difference was due to a correlation between age and tolerance with less SAS-induced side effects in patients under 40 years of age (p = 0.03). The SAS treatment continuation rate was unrelated to the duration of rheumatoid arthritis or number of previous maintenance treatments. This study suggests that rheumatoid arthritis patients under 40 years of age exhibit better tolerance to SAS therapy.

Adolescent↗
PubMed1992

Decrease of tumor-like calcification in uremia despite aggravation of secondary hyperparathyroidism: a case report.

Extraskeletal pseudotumoral calcifications generally develop in uremic patients with a high calcium x phosphorus (Ca x P) product and severe secondary hyperparathyroidism. In the present case report we describe a chronic hemodialysis patient presenting with a massive calcification of the left shoulder region, severe aluminum (Al) intoxication and moderate hyperparathyroidism. Her initial serum Ca x P product was only slightly elevated: 5.01 mmol2/l2. Under deferoxamine treatment during the subsequent 4 months, Al overload decreased. On the other hand, parathyroid overfunction worsened, as reflected by an increase of the serum immunoreactive parathyroid hormone [1-84] level from initially 690 to 1052 pg/ml (normal, 15-60 pg/ml) and an increase of alkaline phosphatase activity, and plasma calcitriol increased from undetectable to a low-normal value. Predialysis serum total Ca levels decreased rapidly from 2.9 to 2.5 mM but serum P concentrations remained elevated: 1.6-2.5 mM. Unexpectedly, the extent of the periarticular calcification diminished considerably during the same time period. The present observation shows that in a subset of uremic patients with Al overload, pseudotumoral calcifications may regress during Al chelation therapy despite progression of hyperparathyroidism. Since Al may predispose collagen to develop dystrophic or metastatic calcification, it is suggested that this process is reversible by correcting Al intoxication.

Aluminum↗
PubMed1992

Postvenereal Reiter's syndrome in Greenland.

Reiter's syndrome is very frequent in the Inuit of Greenland, because of high frequencies of venereal disease and HLA-B27. The authors report the results of the epidemiologic work and of the study of the effects of antibiotic treatment of venereal infection. In Reiter's syndrome patients, treatment of venereal infections by erythromycin or tetracycline was associated with a significant reduction in the rate of postvenereal arthritic flares.

Anti-Bacterial Agents↗
PubMed1991

[Bone involvement in primary oxalosis. Study of 20 cases].

The authors report 20 cases of primary oxalosis with bone involvement, late revealed in adults in 19 cases. They have studied the clinical, radiological and histological manifestations of this bone oxalosis. 19 cases had an end stage chronic renal failure, either treated by maintenance hemodialysis, or by renal (or liver-renal) graft. 17 patients complained of bone pain after starting hemodialysis; 3 had vertebral crush fractures, and 1 multiple spontaneous fractures. Diffuse bone sclerosis (with a homogeneous pattern on axial skeleton and a patchy appearance on the peripherical skeleton), bone translucency, subperiosteal phalangeal resorption were the main radiological symptoms. Oxalate crystals surrounded by a giant cells granuloma were always observed on bone biopsy (16 cases). Bone resorption was observed in 9 cases, hyperparathyroidism in 14 cases and osteomalacia in 7 cases. Hyperparathyroidism does'nt explain all the clinical and radiological manifestations (especially bone resorption). Bone resorption as other radiological and clinical manifestations can be found without hyperparathyroidism and can increase despite parathyroidectomy; so, bone resorption seems to be partly due to the granulomatous reaction around oxalate crystals rather than hyperparathyroidism.

Adolescent↗
PubMed1991

[Psoriatic rheumatism].

Five to seven per cent of patients with cutaneous psoriasis develop a seronegative inflammatory arthritis which is often erosive and frequently both peripheral and axial. The most common peripheral type of psoriatic arthritis is represented by asymmetrical oligoarthritis, the localisation most suggestive of psoriasis being distal interphalangeal arthritis. Symmetrical polyarthritis may also be observed. Severe and mutilating forms of the disease are fortunately rare. Te axial type of psoriatic arthritis consists of a usually bilateral sacroiliitis and/or spinal lesions which may result in ankylosing spondylitis. Most cases of psoriatic arthritis are treated with non-steroidal anti-inflammatory drugs alone and local treatments. Corticosteroid therapy must be administered with caution and restricted to the severe forms. A fairly large number of maintenance treatments for peripheral arthritis have been used, not always after controlled trials; the most commonly prescribed are gold salts, sulphasalazine and methotrexate.

Arthritis, Psoriatic↗
PubMed1991

[Hereditary chondrocalcinosis in Tunisia. Apropos of 3 families].

Hereditary chondrocalcinosis was reported in three Tunisian families. The clinical manifestations appeared early in life and extensive radiologic involvement was apparent. The mode of inheritance seemed to be autosomal with incomplete penetrance. In one family HLA typing revealed that all affected subjects had the haplotype A1 B12 DR3.

Adolescent↗
PubMed1990

[Objectives to be assigned to the various proposed treatments (NSAID, analgesics, preventive or curative fundamental treatments). Which type of patients for which type of clinical trials].

Short term symptomatic treatment concerns, above all, painful, active osteoarthritis. Long term treatment prevents or slows down the destruction of cartilage and is assessed by radiological measurement of the joint space in the hip and knee. This must also be combined with a clinical criterion based on a functional pain index and the quality of the patient's life. Interphalangeal osteoarthritis, excluding root arthrosis of the thumb, is a good model and the preventive effect of treatment can be assessed from the extension of interphalangeal involvement. In the lower limbs, osteoarthritis of the hip in its idiopathic form (with overall superior or supra-external narrowing) and minor dysplasias were selected. Internal femorotibial osteoarthritis is suitable for evaluating a drug's effect in protecting cartilage. Other varieties are reserved for symptomatic treatments.

Analgesics↗