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Biomedical subjects

A Gerbaux

Publications and source records attributed to A Gerbaux.

At least 19 recordsLinked to original sources
PubMed1989

Hyperamylasemia with papillary serous cystadenocarcinoma of the ovary.

High levels of serum amylase and CA19.9 were noted in a patient with papillary serous cystadenocarcinoma of the ovary. Electrophoresis identified isoamylases of salivary type. Both markers decreased rapidly after removal of the ovarian tumour. These considerations argue in favor of the early detection of amylase isoenzymes in patients in whom history, objective signs, and routine diagnostic studies fail to disclose a pancreatic disease.

Aged↗
PubMed1979

Occlusive coronary thrombosis and oral anticoagulants.

The results of post-mortem examination in 173 patients followed over an average period of five and a half years after their initial myocardial infarction are described. These 173 patients were divided into four groups according to whether or not they had received an oral anticoagulant and if so how adequately. An index of coronary and myocardial lesions was established for each heart. Recent occlusive coronary and myocardial lesions was established for each heart. Recent occlusive coronary thromboses were four times less frequent in the group of patients who had received adequate anticoagulant therapy than in the other three groups of patients (p less than 0,001). There was no significant difference between the inadequately treated groups and the untreated group. The recurrences of myocardial infarction were associated in 90 per cent of the cases with a recent occlusive thrombosis in the corresponding coronary artery and were found four times less frequently in the group subjected to effective long-term anticoagulant therapy (p less than 0,001).

Administration, Oral↗
PubMed1979

[Changes in the exercise electrocardiogram after aortocoronary bypass. Long-term results in 50 patients].

A comparative study of exercise electrocardiogrammes before and after aorto-coronary bypass surgery was carried out in 50 patients over a 2 year period. Coronary arteriography was used to assess the chirurgical results qualitatively ((electrocardiographic appearances) and quantitatively (work capacity and effort tolerance) with respect to the coronary lesions and permeability of the aorto-coronary vein grafts. Exercise electrocardiography has a place in the follow up of patients with aorto-coronary bypass grafts but it only gives information on the permeability of the grafts if all the significant stenosis are bypassed at surgery.

Adult↗
PubMed1979

[Hemodynamic effects of hydralazine in the cardiac insufficiency of non-obstructive myocardiopathy].

The haemodynamic effects of a single dose of between 0.15 and 0.25 mg/kg hydralazine were studied during cardiac catheterisation of 9 patients with primary congestive cardiomyopathy and heart failure. The systemic arterial resistances decreased (--1 370 +/- 400 dynes/s.cm-5/m2, p less than 0.05); the reduction of pulmonary arterial resistances was less marked (--420 +/- 400 dynes/s.cm-5/m2, p less than 0.05). Intraaortic pressure was reduced (--16 +/- 12 mmHg, p less than 0.02) as was average pulmonary arterial (--4.2 +/- 4,2 mmHg, p less than 0.05) and left ventricular end diastolic pressures (--4.2 +/- 3.0 mmHg, p less than 0,02). Systolic index increased in all cases (+13 +/- 5 ml/syst/m2, p less than 0.001). Heart rate was unchanged. This was due to the improvement of left ventricular function by the reduced impedence. These results confirm the place of hydralazine in the treatment of certain forms of heart failure.

Adult↗
PubMed1979

[Effects of intravenous trinitrin infusion on systemic and coronary circulations during atrial electric stimulation].

Intravenous infusion of trinitrin (0.38 +/- 0.25 mg/hour) during rapid atrial pacing reduced pulmonary capillary pressures, cardiac output, coronary blood flow and myocardial oxygen consumption. At these dosages trinitrin allows patients with ischaemic heart disease to undergo atrial pacing in the best conditions by maintaining the pulmonary capillary and systemic arterial pressures and myocardial lactate production within limits close to the basal values. The beneficial effects last during the recovery period after the termination of pacing and of the intravenous infusion.

Adult↗
PubMed1979

[Late thrombosis of mitral valve prosthesis in 27 cases].

Twenty seven cases of late thrombosis of ball and floating or tilting disc prostheses were studied. All patients were on anticoagulant therapy which appeared to be well adapted in 33% patients. Signs suggestive of thrombosis were inconsistant and the diagnosis was made on the association of severl of the following features: -- systemic embolism (44%); -- radiographic signs of left ventricular failure (51%); -- absence of opening click, variable A2 -- opening click intervals, apparition or aggravation of a systolic regurgitant murmur or a distolic murmur suggestive of obstruction on the phonocardiogramme; -- delayed opening of the mobile component or the presence of abnormal echos between the ball and anterior cage echo on the echocardiogramme; -- a gradient of over 12 mmHg across the prosthesis. An isolated episode of systemic embolism when the rest of the work-up is negative may be managed by the addition of a platelet antiaggregant and reinforcement of the anticoagulant therapy; further investigaton is advisable in the face of progressive symptoms. Fibrinolytic treatment and/or surgery is justified when systemic emboli recur or if the work-up is positive.

Adult↗
PubMed1979

[Effects on the systemic and coronary circulation of 2 nitrate derivatives, intravenous trinitrin and sublingual isosorbide dinitrate, administered during atrial pacing].

The changes in the systemic and coronary circulations produced by intravenous trinitrin 0.38 +/- 0.125 mg/hour and sublingual isosorbide dinitrate 5 mg were studied in 24 patients with coronary artery disease. When given during rapid atrial pacing both drugs decreased pulmonary capillary pressures (p less than 0.001), cardiac and coronary output (p less than 0.001 and p less than 0.01) and myocardial oxygen consumption (p less than 0.01). At these dosages, intravenous trinitrin has no significant effect on average systemic blood pressure or left ventricular work index; the coronary arterial resistances increased (p less than 0.005). Isosorbide dinitrate significantly decreased average systemic blood pressure and the left ventricular work index (p less than 0.001); there was no significant difference in the coronary arterial resistances; the decrease in coronary blood flow observed after sublingual isosorbide dinitrate seems partly due to a decreased perfusion pressure. The beneficial effect of these nitrite derivatives seems to be mainly related to a reduced preload.

Administration, Oral↗
PubMed1979

[Risks and long-term results or tricuspid monovalvular replacement, using a ball or disk prosthesis. Apropos of 21 cases].

21 patients (15 with stage IV and 6 with stage III symptoms by the NYHA classification) underwent monovalvular tricuspid replacement with a ball or disc prosthesis for varying tricuspid pathology, bacterial endocarditis in half the cases, between June 1964 and July 1973. Hospital mortality was 29 p. 100 (6 patients), medium-term mortality, nil. There were 23 survivors (62 p. 100) with an average follow up of 7 years (range 5 years to 10 years 4 months), 12 of whom recovered to stage I disability by the NYHA classification after the first postoperative year. 12 patients are on long-term anticoagulant therapy and 3 on diuretic or digitalo-diuretic therapy. The main complications observed were 2 prosthetic thromboses and 3 haemorrhages for 1095 patient-months. The results are to be compared with those bioprostheses, which, not requiring anti-coagulant therapy, may tend to supplant ball and disc prostheses.

Adolescent↗
PubMed1979

[Myocardiopathy from a new anthracyclic derivative (author's transl)].

A 58-year-old man with subcutaneous metastases from a naevocarcinoma was prescribed 1 138 mg/m2 of a new anthracylic derivative, dietoxy-acetoxy-daunorubicine, at doses of 180 mg every three weeks. Irreversible cardiac failure occurred nine months after starting treatment, and was considered to be due to the toxic effects of the compound. He improved for a short period after very high doses of vasodilatators but death occured very shortly afterwards. Histological examination revealed severe subendocardial fibrosis, disseminated interstitial fibrosis, and degenerative and necrotic lesions of the myocytes. The authors discuss the factors involved in the cardiotoxicity of the anthracyclines: total dose, intervals between doses, associated risk, factors (age, radiotherapy). Even at usual doses signs of myocardial dysfunction are found in one third of patients treated, with the presence of histological lesions in all these cases, but clinical cardiac failure is rarely observed.

Cardiomyopathies↗
PubMed1978

[Clinicopathological study of the causes of mortality during the acute phase of myocardial infarction (author's transl)].

Clinical and autopsy study of 100 cases of patients dying during the first 3 weeks of hospitalisation for myocardial infarction revealed the following causes of death: cardiac failure in 59 cases (including 40 of cardiogenic shock), rupture of the heart in 29 cases (24 of rupture of the ventricular wall, 4 of the septum and 1 of a mitral papillary muscle). 4 ventricular arrhythmias and 6 haemorrhagic or embolic complications. In 2 cases, the cause of death could not be accurately determined. In cardiogenic shock, death usually occurred early. It was later in cases of refractory left ventricular failure. Conduction disturbances were much commoner in cases of myocardial infarction complicated by fatal cardiac failure (57.6%) than in the presence of any other complication (17.1%) (p less than 0.001). The responsible infarction was often extensive and recurrent. Rupture of the heart invariably occurred during the first three days of an infarction often initial (p less than 0.001), anterior (apart from septal rupture) and small in size (p less than 0.01). Other complications play only a secondary role in mortality at the present time, in particular arrhythmias, the gravity of which has greatly decreased since the reduction of delays before hospitalisation and improvements in anti-arrhythmic therapy.

Acute Disease↗
PubMed1978

[Study of hemodynamic effects of the methoxamine in 8 cases of obstructive cardiomyopathy with mitral valve insufficiency].

The haemodynamic effects of intravenous Methoxamine were studied in 8 patients with hypertrophic obstructive cardiomyopathy (HOCM) with mitral incompetence (group I) and 8 patients with mitral incompetence due to valvular, subvalvular or other causes (group II). In both groups the left ventricular end-diastolic pressure rose significantly without any great change in the end diastolic surface area: the ventricular distensibility is reduced in both cases. The mean capillary pressure, the V wave/mean capillary pressure ratio, and the degree of regurgitation of the two groups changed in opposite ways : in mitral incompetence due to varying causes (group II) the regurgitation increased, but in mitral incompetence due to HOCM (group I), it decreased. The left ventricular intracavitary gradient in HOCM tended to disappear under the effect of Methoxamine as the systolic aortic pressure approached the basal values recorded in the apical area.

Adult↗
PubMed1978

[Acute renal failure and consumption coagulopathy in the puerperium].

Disseminated intravascular coagulation accompanied 18% of cases of acute renal failure during puerperal disorders. We studied in particular 31 cases of disseminated intravascular coagulation with renal failure due to obstetric disorders : 12 post-abortion infections, 3 retentions of a dead foetus, 5 infections, 6 cases of toxemia, 2 retroplacental hemorrhages, two hemorrhages during the third stage, one uremohemolytic syndrome. For diagnosis one relies on the clinical data (bleeding, purpura, shock, hemolysis, visceral involvement) and laboratory data, (coagulation should be supervised throughout the course). The renal lesions are either cortical necrosis, or interstitial nephritis. The analogies with experimental phenomena suggest a human equivalent of the Schwartzmann-Sanarelli syndrome.

Acute Kidney Injury↗