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Biomedical subjects

A Bertrand

Publications and source records attributed to A Bertrand.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Effects of hemodilution on the ventricular function of the coronary patient].

Ten patients (9 males and 1 female: mean age: 64.8 +/- 7 yr) were studied. They were all stabilized coronary heart disease patients free of cardiac failure who where to undergo normovolaemic haemodilution as medical treatment of lower limb arteritis. Ventricular function was assessed by a radioisotope method: myocardial perfusion (thallium-201 and dipyridamole scintillation scan) and left ventricular contraction by technetium-99m angiography. Blood volume was measured by iodine-131 marked albumin. The following parameters were also measured: plasma viscosity, blood viscosity at seven different speeds, red blood cell aggregation index and filtration index. These were all measured before and 24 h after normovolaemic haemodilution which was carried out with à 5% albumin solution. This haemodilution was well tolerated: 1,062 +/- 335 ml of blood were sampled, the same volume of albumin being transfused, thus reducing the mean haematocrit from 0.42 +/- 0.05 to 0.32 +/- 0.02 (p less than 0.01). Normovolaemia was respected. Blood viscosity was reduced, especially at low speeds and the red blood cell aggregation index was also reduced. Ventricular contraction did not vary. Moreover, the basal myocardial state as assessed by the thallium scintillation count was not modified by the haemodilution, even being improved in three cases. The dipyridamole perfusion (the equivalent of an effort test) gave no changes in seven patients, resolved the ischaemic signs in two patients and slightly increased ischaemia in one case.

Aged↗
PubMed1985

[Therapeutic importance and tolerance of coated 50 mg Vectarion tablets (almitrine bismesylate) at a dosage of 100 mg/day. Study of blood gas, clinical and biological results after a year of long-term treatment].

The objectives of this study, in which Almitrine bismesylate was administered for one year in chronic bronchitics with obstructive hypoxia, were to assess its clinical and gasometric efficacy and its clinical, laboratory, spirometric and electrocardiac acceptability. The blood gas results show a significant rise in PaO2 (p less than 0.001) rising by 5.5 mmHg after 6 months (T6) and by 6.0 mmHg after 12 months (T12) in comparison with the value at the study's onset. The PaCO2 fell by 3.3 mmHg at T6 and 2.7 mmHg at T12 (p less than 0.001). The dyspnoea of the patient, scored by the doctor on a scale of severity from 0 to 5 was situated on a mean of 3.3 points at the beginning of the study. It was significantly reduced by 0.8 points at T6 and by 0.9 points at T12 (p less than 0.001). The percentage of patients hospitalised during the course of the study fell significantly in comparison with the previous year, from 68% to 49% (p less than 0.001). The improvement in clinical status and in blood gases bore no relation to changes in respiratory function. The clinical acceptability of the product was good; few side effects were observed and the respiratory, digestive and neurological problems were often pre-existing. They only led to cessation of treatment in three cases. The electrocardiogram was unchanged. The laboratory investigations was unchanged, with the exception of a fall in red blood cells in relation to the correction of the hypoxaemia in polycythaemic patients.

Almitrine↗
PubMed1985

[Exertion isotope tests in coronary insufficiency. Comparison with isotopic ventriculography and myocardial scintigraphy].

Very few studies have been described comparing the value of exercise myocardial scintigraphy and left ventricular angioscintigraphy. The authors designed a study comparing these two investigations with conventional exercise stress testing and coronary angiography. The isotopic investigations were carried out within 48 hours of coronary angiography. A total of 143 patients undergoing coronary angiography (35 normal, 108 coronary patients: 36 single vessel, 36 double vessel and 36 triple vessel disease) were included in this study. The lesions were located of the LAD (77 cases), left circumflex (77 cases) and right coronary arteries (62). The sensitivity and specificity of both radionuclide investigations were evaluated to assess their diagnostic value; the best results were obtained with myocardial scintigraphy (sensitivity 86 p. 100; specificity 100 p. 100); angioscintigraphy had a sensitivity of 71 p. 100 and specificity of 97 p. 100, and conventional exercise stress testing of 42 p. 100 and 70 p. 100 respectively. The sensitivity seemed to increase with the degree of stenosis; although the sensitivity of myocardial scintigraphy increased progressively, that of angioscintigraphy doubled in cases of stenosis 90 p. 100 (stenosis less than 90 p. 100, sensitivity = 37 p. 100; stenosis greater than 90 p. 100, sensitivity = 73 p. 100). The sensitivity of myocardial scintigraphy with respect to the severity of the coronary artery disease was best in cases of right coronary artery stenosis (sensitivity in cases of RCA stenosis = 74 p. 100; sensitivity in LAD stenosis = 58 p. 100; sensitivity in left circumflex stenosis = 43 p. 100). The sensitivity of left ventricular angioscintigraphy was best in LAD stenosis (RCA stenosis = 50 p. 100, LAD stenosis = 64 p. 100, left circumflex stenosis = 36 p. 100). The sensitivity of both investigations was poor in left circumflex artery stenosis even when severely diseased. The sensitivity of both investigations was better in diffuse coronary artery disease: myocardial scintigraphy (single vessel disease: 72 p. 100, double vessel disease: 92 p. 100, triple vessel disease: 94 p. 100), left ventricular angioscintigraphy (61 p. 100, 69 p. 100, and 83 p. 100 respectively). Although the association of these two radioisotopic investigations does not improve diagnostic sensitivity, it does provide more information about the localisation and extension of the coronary artery disease especially in LAD and right coronary artery stenosis. These results suggest that these investigations are complementary in the evaluation of patients with coronary artery disease.(ABSTRACT TRUNCATED AT 400 WORDS)

Coronary Disease↗
PubMed1985

[Pefloxacin: clinical experience].

Pefloxacin was given as the single drug (except in one case) to twenty-seven patients with a variety of infections (bone and/or joint: 8; respiratory tract: 6; urinary tract: 5; bacteremia: 4; meninges: 3; other: 1). The following bacteria were isolated: P. aeruginosa: 11; Enterobacteriaceae: 10; Acinetobacter: 3; Staphylococci: 3 (including 2 methicillin-resistant strains), and Streptococcus faecalis: 2. Pefloxacin was given in a daily dosage of 800 mg in 20 patients and 1 200 to 1 600 mg in 7. All pathogens proved susceptible, in varying degrees. 21 patients recovered. Three incomplete results and three failures were observed. No significant side effects were recorded except for development of three mucosal candidiasis and two transient rashes. The authors put special emphasis on the value of pefloxacin in bone and meningeal infections.

Acinetobacter Infections↗
PubMed1985

[Long-term treatment of chronic respiratory insufficiency using endotracheal ventilation at home in 118 tracheotomy patients].

118 patients suffering from severe chronic respiratory failure were submitted to domiciliary artificial ventilation (V.A.D.T.) by tracheotomy using a fixed rate volumetric respiration. The daily length of V.A.D.T. was 10 to 16 hours. The improvement on the blood gases, their stability, the disappearance of signs of right heart failure and polycythaemia, as well as a large reduction in mean length of hospital stay per subject and per year after V.A.D.T., underlined the efficacy of this method. In the long term (10 years) there was a 50% survival in patients with restrictive respiratory failure and of 33% in subjects with a mixed respiratory failure, which was predominantly restrictive. It was lower with mixed respiratory failure that was predominantly obstructive (20%). No patient with isolated airflow obstruction survived more than six years.

Aged↗
PubMed1985

[Bone angioscintigraphy].

Classical bone scintigraphy can be completed by a dynamic study of the blood supply of a previously defined anatomical region. Our protocol consists of the recording of early images in the histogram mode, centred on the selected pathological region and on the symmetrical region which acts as a control. One film is taken every 3 seconds for 3 minutes following an intravenous injection of 20 mci of Tc99m MDP into a cubital fossa vein. More limited symmetrical zones of interest are visualised on the image obtained by summation of all of the information obtained during the second minute following the arterial passage of the radioactive bolus. The curve reflecting the variation in activity for each zone of interest over these three minutes can therefore be obtained. The first part of the curve, until the first slope change, corresponds to the arterial phase (blood flow), the second part, which includes a brief venous phase, corresponds to the vasculo-tissue phase (blood pool). The value of these bone image, which allow a very detailed analysis of the topography and intensity of the uptake, is above all diagnostic, while the early, vascular images and the resulting curves are essentially of pathophysiological interest. Bone angioscintigraphy is a triple examination and one of its best applications is in reflex sympathetic dystrophy. It is able to distinguish very objectively between "hot" and "cold" forms and it can indicate the most appropriate treatment for each case and follow the effects of treatment. The other indications for bone angioscintigraphy also include Paget's disease, especially the monitoring of treatment, osteomyelitis, sarcomas and osteonecrosis.

Bone Neoplasms↗
PubMed1983

[Evaluation of the clinical activity of cefotiam (SCE 963). Multicentric study in 7 centers].

Cefotiam (SCE 963), a new, broad-spectrum, third generation cephalosporin was used in the treatment of 136 patients suffering from respiratory tract infections, urinary tract infections, septicemia, meningitis, biliary tract infections and osteoarthritis infections. Cefotiam was administered in monotherapy to 98 patients at the mean posology of two grams per day (extreme doses: 1 to 6 g). The following clinical effectiveness was noted: 83 successes and 18 failures on 101 available clinical reports. The general, biological tolerance and renal tolerance was good in all patients.

Adolescent↗
PubMed1983

[Articular manifestations of Yersinia infections. Apropos of 4 personal cases. Review of the literature].

The reactive arthritis due to Yersinia enterocolitica (YEC) have been know for a little more than ten years. A great many cases have been reported, especially by Scandinavian authors. In contrast, few cases have been reported in the course of Yersinia pseudotuberculosis infections (YPT). Analysis of 36 cases in the literature shows that although they are rare, the YPT reactive arthritis do exist and are not fundamentally different from those due to YEC. A few minor differences in their clinical signs have been demonstrated: the higher incidence of erythema nodosa and the lower incidence of cardiac involvement in the cases due to YPT. In both forms, there is a characteristic genetic predisposition, marked by the high incidence of the antigen HLB B27 (50 to 80 p. cent), which explains their strict relationship with diseases of the rheumatic pelvispondylitis group.

Adolescent↗
PubMed1983

[Velocimetry and sympathectomy].

In a previous work, the writers have described the influence of vasomotoricity on the shape of the ultrasonic velocimetric curves (Doppler). A vasodilatation induced by an anaesthesia of the sympathetic chain or by a general anaesthesia by penthotal produces a raising of the whole curve above the basic line. The writers have studied in the present work the shape of the velocimetric curves after a lumbar sympathectomy and have compared them with the variations of the cutaneous thermometry and with the clinical results. A correlation has been found in 86.3% of the 124 studied limbs. The study shows that the raising of the curve due to the phenomenon of vasodilatation appears only at the extremity of the limb. The profile of the curve remains unchanged at the root. A velocimetric curve above the basic line may occur apart from any vasomotoric modification. In this case it is the sign of an up-stream obliteration combined with a drop of the index of perfusion (less than the unit).

Arm↗
PubMed1982

[Effects of isosorbide dinitrate injection on acute myocardial infarction. A haemodynamic and gamma-angiographic study (author's transl)].

The haemodynamic and gamma-angiographic effects of isosorbide dinitrate (ISDN) injection were evaluated in 18 patients with recent myocardial infarction by measuring diastolic (DPAP) and systolic (SPAP) pulmonary artery pressures, diastolic (DAP) and systolic (SAP) systemic arterial pressures, cardiac index (CI) and heart rate (HR). Total ejection fraction (EF) was measured by radionuclide angiography. Within the first hour of treatment, there was a significant fall in DPAP (from 25.11 +/- 6.5 to 18.3 +/- 6 mmHg), SPAP (from 47 +/- 11.5 to 36.6 +/- 10 mmHg) and SAP (from 140 +/- 27.8 to 123 +/- 20 mmHg). Changes in DAP, CI and HR were not significant. The drug produced a significant increase in EF (from 32.6 +/- 15 to 35.3 +/- 15 p. cent). On the basis of these results the patients could be divided into three categories: -- Group I patients (n = 5) with EF greater than 45, in whom the haemodynamic effects (fall in DRAP from 20.8 +/- 4.2 to 16.3 +/- 3 mmHg) and the gamma-angiographic effects (increase in EF from 53.8 +/- 6 to 58.6 +/- 3 p. cent) were favourable. -- Group II patients (n = 5) with EF less than 40, in whom the haemodynamic effects (fall in DRAP from 29 +/- 8.5 to 17.8 +/- 6 mmHg) and the gamma-angiographic effects (increase in EF from 23 +/- 9 to 34 +/- 7 p. cent) were still favourable. -- Group III patients (n = 8) with low EF, in whom there were no significant changes in haemodynamic effects (DPAP from 25.3 +/- 3 to 23.4 +/- 5 mmHg) and gamma-angiographic effects (EF from 26 +/- 6 to 25 +/- 5 p. cent). This group corresponds to cases with very extensive necrosis of unfavourable outcome (4 deaths). One may therefore consider that the lack of effectiveness of ISDN in subjects with left ventricular failure and low EF is of poor prognosis and requires more aggressive therapy.

Adult↗
PubMed1982

A one-step determination of serum 5'-nucleotidase using a centrifugal analyzer.

We describe a one-step kinetic method for the determination of 5'-nucleotidase (EC 3.1.3.5). Inosine is formed by the hydrolysis of inosine 5'-monophosphate which is catalyzed by seric 5'-nucleotidase, and then is converted to hypoxanthine by nucleoside phosphorylase. Two moles of hydrogen peroxide are formed for each mole of hypoxanthine oxidized to urate by xanthine oxidase. The rate formation of hydrogen peroxide is monitored at 510 nm using the oxidation of the chromogenic system 3,5-dichloro-2-hydroxybenzenesulfonic acid/4-aminophenazone in the presence of peroxidase. beta-Glycerophosphate inhibits the unspecific cleavage of the substrate by alkaline phosphatases. Inorganic phosphate is added to improve the reagent stability, and ferrocyanide to reduce bilirubin interference. Automation of the technique requiring 20 microliter of serum on a centrifugal analyzer is also described.

5'-Nucleotidase↗