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Biomedical subjects

A Arnaud

Publications and source records attributed to A Arnaud.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Long-term treatment of pulmonary hypertension in chronic obstructive bronchopneumopathies with nifedipine. Hemodynamic study over 18 months].

The objective of this study was to evaluate the long-term results of an 18 months nifedipine treatment in patients with pulmonary hypertension (PHT) secondary to chronic obstructive broncho-pulmonary disease (COBPD). The possible alterations of the pulmonary vascular reactivity after such chronic treatment were also studied. 20 patients presenting a PHT secondary to a COBPD were randomly distributed in two equal groups: a reference group and a group treated with nifedipine. The haemodynamic work-up and blood gases measurements of patients from both groups as well as the effects of acute sublingual administration of 10 mg of nifedipine were performed at the beginning of the study, under stable conditions. After this initial test, the patients in the treated group, received 30 mg/day of nifedipine per os. The same measurements and pharmacological tests were carried out after 18 months, 24 hours after the treatment was discontinued. All patients completed the study; no adverse reaction was noted, especially no major desaturation. A significant decrease of the cardiac index (p 0.05) was noted in the reference group (-10%). No significant alteration of the pulmonary pressure and resistance, of the blood gases, was noted. The haemodynamic variations during acute testing were similar in both groups before and at the end of the observation period. Chronic administration of nifedipine may prevent the decrease of the cardiac index in patients presenting a PHT secondary to COBPD. The pulmonary vascular reactivity is not affected by this type of treatment.

Female↗
PubMed1988

[Time-related distribution of delayed-action theophylline in the treatment of chronic obstructive bronchopneumopathies].

Three regimens of sustained-release theophylline (Theostat) were administered to 12 male patients with chronic obstructive lung disease in randomized cross over trial. Each 7 days' treatment consisted of: treatment A: 8 mg/kg/day at 07.00 h and 4 mg/kg/day at 19.00 h; treatment B: 6 mg/kg/day at 07.00 h and 6 mg/kg/day at 19.00 h; treatment C: 4 mg/kg/day at 07.00 h and 8 mg/kg/day at 19.00 h. Peak expiratory flow was recorded each day at 07.00, 11.00, 15.00, 19.00 and 23.00 hours, and theophylline plasma levels were determined on the 7th day of each treatment sequence. Cosinor analysis of the data revealed significant circadian rhythms of 24 hr mean Peak expiratory flow for each treatment: the mesor was significantly higher with C and acrophases were located at 14.26 for A, 14.25 for C; a phase shift of the acrophase was detected for B (09.58). These data suggest that an unequal twice daily sustained-release theophylline dosing with higher dose in the evening may be beneficial in the treatment of chronic obstructive lung disease.

Delayed-Action Preparations↗
PubMed1988

Atopy and anaphylactic reactions to suxamethonium.

Muscle relaxants are widely used for general anesthesia and may be responsible for IgE-dependent anaphylactic reactions (AR). A controversial issue in the field of drug allergy is whether ARs are more frequent or severe in atopic subjects. Thus, we performed a case-control study comparing the distribution of various clinical and biologic signs of atopy. The case group included 32 patients with a history of AR to suxamethonium, the most commonly used muscle relaxant. The control group included 128 subjects, matched to the case group according to age, gender, and socioeconomic status. The case group consisted mainly of young and middle-aged women. Distribution of symptoms suggestive of atopy and of skin tests and specific IgE to common aeroallergens was similar in both groups. In contrast, total serum IgE level was much higher in the case group, suggesting the presence of specific IgE against suxamethonium or other drugs. Thus, despite previous studies in the literature, atopy is not a risk factor for the occurrence of anaphylactic reactions to muscle relaxants. As AR to suxamethonium is a pure model of an IgE-dependent drug allergy, our data do not support a relationship between atopy and allergic drug reactions.

Allergens↗
PubMed1988

Enoxacin in the treatment of lower respiratory tract infections.

Twenty patients admitted to hospital with serious lower respiratory tract infections entered an open study of 400 mg enoxacin given orally twice a day for a minimum of seven days. Clinical signs and symptoms were completely cured or improved in six of eight patients with pneumonia, in nine of ten patients with bronchitis, and in two patients with bronchiectasis. Enoxacin was effective in eradicating the initial pathogens in 10 of 12 patients with positive cultures. Enoxacin was well tolerated. Only one treatment-related side-effect was observed during the study. Nine patients received concurrent treatment with theophylline, but no signs of theophylline toxicity were seen. Enoxacin is a safe and effective alternative to parenteral treatment of lower respiratory tract infections.

Acute Disease↗
PubMed1988

Hemodynamic effects of a single dose of dopamine and L-dopa in pulmonary hypertension secondary to chronic obstructive lung disease.

Dopamine (DA) has rarely been administered at low dosage to stable patients with pulmonary hypertension (PAH) secondary to chronic obstructive lung disease (COLD). Since L-dopa (L-DA) is metabolized into DA, it might be an oral source of DA. After informed consent 10 patients with PAH, secondary to COLD underwent right catheterization to allow measurements of pressures and cardiac output (CO) as well as arterial and mixed venous oxygen levels before and then 30 and 60 min after the beginning of intravenous DA at a rate of 4 micrograms/kg/min. A week later, the same parameters were remeasured in 5 of these patients after a single oral intake of 1.5 g L-DA. At low doses both DA and L-DA increased CO and decreased pulmonary vascular resistances, suggesting a pulmonary vasodilator effect. They also enhanced oxygen delivery and Pvo2 without decreasing Pao2. A correlation was observed between cardiac index and plasma DA level. Thus though they do have some immediate adverse side effects and their long-term effects are unknown, inotropic and vasodilator drugs may have positive effects on pulmonary circulation.

Administration, Oral↗
PubMed1988

One-year clinical study on nifedipine in the treatment of pulmonary hypertension in chronic obstructive lung disease.

The advantages of long-term administration of vasodilators in the treatment of chronic cor pulmonale were investigated after informed consent in 60 patients with obstructive respiratory insufficiency (56 men, 4 women, mean age 63.5 +/- 1.5 years; mean pulmonary pressure 30.4 mm Hg). They were randomly divided into two groups of 30, a control group and a group treated with nifedipine, 10 mg three times a day. The following parameters were recorded every 3 months for a year: dyspnea, degree of right ventricular failure, number of days spent in hospital, survival and arterial blood gas tension. On the first day of study, no significant difference existed between the control and the treated groups. After 1 year 22 patients in the control group were still followed and 8 were dead. In the treated group 19 were followed, 7 were dead and 4 stopped treatment, generally due to ankle edema. At the end of the study, the only significant modification was improvement of the dyspnea in the nifedipine group (p less than 0.01). In conclusion, in spite of an improvement in the dyspnea index, clinical study for 1 year failed to demonstrate any objective benefit of nifedipine treatment.

Aged↗
PubMed1988

[Prevention of infections in chronic bronchitis using vaccination and/or immunomodulation].

Polyvalent antimicrobial vaccines have been widely used in chronic bronchitis for nearly fifty years without their effect or mechanism of action always being well understood. The polysaccharide vaccines, in particular pneumococcal, are better defined chemically and in their mode of action. However, it does not seem that ordinary chronic bronchitis is a good indication for these vaccines. The immunomodulators, extracts of the cell wall of certain bacteria, are aimed at increasing the host's defence capacity in a non-specific manner. The addition of ribosomes may favour specific and non-specific immunomodulation. Certain vaccines have shown their efficacy in reduction of infective episodes in chronic bronchitis. However, other studies ought to be undertaken to obtain purified products which are not toxic and are yet more effective. Finally, it is necessary to have better knowledge of the mode of administration and of the doses administered corresponding to the optimal efficacy of the vaccines.

Adjuvants, Immunologic↗
PubMed1988

[Leiomyosarcoma of the anal canal].

Leiomyosarcoma originating in the anal canal internal sphincter is an extremely rare malignant tumor of often late diagnosis, since usually asymptomatic, and with malignancy criteria that are sometimes difficult to define. These tumors affect men and women with equal frequency, usually in the 6 th decade. Two cases are reported in patients aged 67 and 65 respectively in whom the tumor was revealed by a painful perianal mass shown on rectoscopy to be due to a submucous tumor projecting into anal canal, Prognosis and treatment of these tumors is discussed, diagnosis being confirmed only after excision biopsy. Tumoral extension was both local and regional by continuity but blood dissemination had occurred with metastases more frequently in liver (1 case) but also in lungs. Glandular extension was exceptional. Limited local exeresis of small tumors appears justified if sufficiently wide, since malignancy of leiomyosarcoma appears to remain circumscribed over long periods. However, this limited procedure runs the risk of local recurrence with the need for abdominoperineal amputation (the case in the 2 patients reported), although long-term results appear to be similar whether excision is or is not extensive, the abdominoperineal amputation failing to avoid the unfavorable course. Complementary radiotherapy or chemotherapy is ineffective, and prognosis is related more to the degree of tumoral differentiation than to the operative treatment itself.

Aged↗
PubMed1987

Hemodynamic and oxygen delivery responses to nifedipine in pulmonary hypertension secondary to chronic obstructive lung disease.

The effects of a single dose of nifedipine (20 mg sublingually) on hemodynamics and tissue oxygenation were evaluated in 24 patients suffering from pulmonary hypertension secondary to severe chronic obstructive lung disease. A significant improvement in pulmonary circulation and right ventricular pump function occurred. An increase in the oxygen delivery to the tissue was also demonstrated. A complementary study in 10 patients showed that the effects observed after a single dose were still apparent after oral intake (30 mg/day) for 15 days. For these reasons nifedipine may contribute in the treatment of cor pulmonale.

Adult↗
PubMed1987

Relationship between inflammation, alpha-1-acid glycoprotein and lidocaine tolerance during fiber-optic bronchoscopy.

The purpose of this study was to determine the relationship between inflammation, increased alpha-1-acid glycoprotein (AAG), and lidocaine tolerance during fiber-optic bronchoscopy. Previous studies indicate that serum lidocaine levels vary widely from one individual to another. One reason for these variations may be the presence of an ongoing inflammatory process, which enhances serum AAG, a major binding protein of lidocaine. To test this hypothesis, we assayed free and bound lidocaine as well as AAG in the blood of 12 patients after administration of 9 mg/kg of lidocaine during fiber-optic bronchoscopy. Some of the subjects had clear evidence of inflammation or infection. A correlation was found between AAG and total and bound lidocaine but not between AAG and free lidocaine (which remained almost constant). Thus, in spite of the high total levels of lidocaine observed in some patients with inflammatory processes, the free fraction (which is the active and toxic fraction) remained low.

Bronchoscopy↗
PubMed1987

Unequal twice-daily, sustained-release theophylline dosing in chronic obstructive pulmonary disease.

Three regimens of sustained-release theophylline (SRT), Theostat were administered to 12 male patients with chronic obstructive pulmonary disease in a randomized cross-over trial. Each 7-day treatment consisted of: treatment A--8 mg/kg at 0700 hr and 4 mg/kg at 1900 hr, treatment B--6 mg/kg at 0700 hr and 6 mg/kg at 1900 hr, treatment C--4 mg/kg at 0700 hr and 8 mg/kg at 1900 hr. Peak expiratory flow (PEF) was recorded each day at 0700, 1100, 1500, 1900 and 2300 hr and theophylline plasma levels were determined on the 7th day of each treatment sequence. Cosinor analysis of the data revealed significant circadian rhythms in PEF for each treatment: the mesor (24-hr average) was significantly higher with C and acrophases (phi, peak time of PEF rhythm) were located at 1426 hr for A and 1425 hr for C; a shift of the acrophase to an earlier timing was detected for B (phi = 0958 hr. These findings suggest that an unequal, twice-daily SRT dosing with the greater amount of drug at night may be beneficial in the treatment of COPD.

Circadian Rhythm↗
PubMed1987

Comparison of the properties of the purified beta-glucosidase from the transformed strain of Saccharomyces cerevisiae TYKF2 with that of the donor strain Kluyveromyces fragilis Y610.

Saccharomyces cerevisiae TYKF2 was obtained by cloning in S. cerevisiae the gene coding for beta-glucosidase in Kluyveromyces fragilis Y610 (ATCC 12424). The beta-glucosidases of both organisms were purified and their biochemical characteristics were determined. The two beta-glucosidases had the same enzymatic properties as those previously described in the literature. The strain S. cerevisiae TYKF2 is able to produce enhanced amounts of enzyme.

Chromatography, Gel↗