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Y Lorcy

Publications and source records attributed to Y Lorcy.

At least 19 recordsLinked to original sources

[Synthetic antithyroid drugs and Basedow's disease or the choice of a therapeutic strategy].

We present the conclusions of two prospective studies of patients examined at their first manifestation of Graves' disease and treated with antithyroid drugs (ATD). The purpose of the first study was to investigate the effects of long-term treatment: the patients were given carbimazole in degressive doses without hormone replacement for 18 months, the followed up for 2 to 6 years after drug withdrawal. The second study was designed to determine the effect of treatment duration on the prognosis: the patients were given an ATD according to the same protocol for a duration randomly set at either 6 or 18 months, then seen again 2 years after ATD withdrawal. The results showed that after 18 months of treatment at least 50 percent of the patients could be expected to remain in remission for 6 years. Remissions were less frequent when treatment was shorter (41.7 percent after the 6 month treatment versus 61.8 percent after the 18 month treatment, with a 2 years' follow-up; P less than 0.05). The relapses that occurred came early: 70 percent of them took place within the first post-treatment month. This article also provides evidence of high T3 and/or T4 levels without signs of thyrotoxicosis during the post-treatment clinical course; these exclusively biochemical relapses spontaneously disappeared and may have been expressing epidoses of active thyroiditis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Induction of ovulation by pulsatile gonadoliberin administration. Indications and limits].

With its simplicity, innocuity and efficacy, pulsatile GnRH administration constitutes a considerable advance in ovulation induction techniques. Its purpose is not to replace classic methods like Clomiphene Citrate, gonadotropins or dopaminergic agonists, but to complement them. While the choice of administration route, IV vs SC is still controversial, the efficacy depends mainly on the selection of the patients susceptible of benefiting from this therapy. Low gonadotropic activity hypothalamic amenorrhea remains the best indication for pulsatile GnRH, as substantiated by the results published over the last 10 years. The other anovulation causes, including PCO-S, are more disputable indications, and prospective studies involving homogeneous populations are necessary to assess the true standing of GnRH in such indications.

Amenorrhea

Antithyroid drugs and Graves' disease: a prospective randomized evaluation of the efficacy of treatment duration.

A prospective randomized study was performed in patients with hyperthyroid Graves' disease (GD) in order to compare long (18 months) and short term (6 months) antithyroid drug treatment on the remission rate. A therapeutic protocol was offered to all GD patients who had not been treated for this disease previously. All patients studied who followed the protocol were rechecked 2 yr after treatment was withdrawn, or earlier in the case of relapse. Of the patients having undergone long term treatment, 61.8% still were in remission 2 yr after treatment withdrawal, whereas only 41.7% of the patients treated for 6 months were in remission (P less than 0.05). Such findings clearly establish that treatment duration has a direct beneficial incidence on the remission rate. These results were confirmed by the fact that treatment for 18 months resulted in remission in 7 of 15 patients who had previously relapsed after a 6-month course of therapy. This improvement in relation to treatment duration might be due to the immunosuppressive action of carbimazole. No significant difference was observed between relapse and remission groups, regardless of treatment duration, for HLA ABDr, serum T3 and T4, and T3/T4 ratio determined before treatment. Only the thyroid-stimulating antibody levels determined at the time of diagnosis and at the end of treatment were higher in the relapse group, a difference that was relevant only globally, due to value scattering. Furthermore, thyroid-stimulating antibody levels at the end of treatment may indicate remission or, conversely, continuance of the pathological process.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Paraneoplasic Cushing' syndrome. Neurosecretory granules in a lymph node metastasis in electronic microscopy (author's transl) (proceedings)].

The authors relate a case of paraneoplasic Cushing's syndrome by mediastinal tumor, probably of thymic origin. All the clinical and biological signs recall similar cases previously related. An "ACTH-like" substance has been found by biological method in a lymphoide metastasis. The main interest resides in the anatomo-pathological findings and more especially in electronic microscopy. The abundance of the neurosecretory granules is a characteristic feature of the malignant cells observed. These granules appear to the authors identical to those observed in other secretory thymomas and various tumors.

Adult

[Serum thyroid hormones and TSH response to TRH during treatment of Graves' disease by carbimazole (author's transl)].

Serum concentrations of Thyroxine (T4), triiodothyronine (T3) free thyroxine index (F.T.I.) and TSH response to TRH were evaluated in 55 Graves' diseases treated by Carbimazole. There is a good correlation between serum thyroid hormones and clinical state: 83,7% for T4; 79,5% for T3; on the other hand there is a discrepancy between T3 and T4 in many cases and between delta TSH and T4 (47%) or T3 (46%). The decrease of T4 occurs before that of T3: 46,6% normal at the 4th month and 72,5% at the 9th month for T4 against 41% and 50% for T3. At the end of the treatment 96,4% of patients are clinically normal but 20% of them remain with T3 and T4 values above normal.

Carbimazole