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Biomedical subjects

A Goguel

Publications and source records attributed to A Goguel.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Practical approaches for surgical procedures in congenital factor VII deficiency].

A 33 year old female with a congenital deficit in factor VII underwent four operations, all without any haemorrhage. One of then was carried out using substitutive therapy. She had a non-A non-B hepatitis one month after this treatment. Substitutive therapy depends on the assessment of the risk of haemorrhage, which can be estimated by the concentration of factor VII, the severity of spontaneous haemorrhage, the surgical history, and the planned operation. Since the risk of transmitting viruses with freeze-dried blood products would appear to be virtually nil, since 1985, fresh frozen plasma should be avoided for this type of indication. The doses of concentrated factor VII to be used lie between 20 IU.kg-1 every 4 h and 40 IU.kg-1 every 8 h. Such a dose should be administered in either one or several injections, according to whether the risk of haemorrhage is important or not. Substitutive therapy should be continued as long as the risk persists. Using a test dose of factor VII and, afterwards, measuring its biological activity can help to determine the best time for starting the treatment in order to obtain a level of factor VII greater than the minimum required for surgical haemostasis (10%).

Adult↗
PubMed1987

[Prophylactic and therapeutic use of a low molecular weight heparin fraction, CY 216].

The aim of our work was to study in a population of high risk patients with hemorrhagic and or thrombotic disease, the preventive or therapeutic effect of a low molecular weight heparin fraction, CY 216 (Choay, France), particularly in surgery. CY 216 was given to 9 patients for the treatment of a thrombosis (pulmonary embolism, acute ischemia, deep venous thrombosis) and to 40 patients in prevention of thrombosis. In this second group, 28 had a high thromboembolic risk such as valvular prosthesis, cardiac arrythmia, coronary artery bypass, etc. For all the patients, CY 216 was injected sub-cutaneously twice or three times a day at the mean dose of 1.5 mg/kg/d, equivalent to 300 U anti-Xa Choay/24 h, and always injected 24 hours before surgery. The biological tests used were: blood cells count, platelet count, prothrombin time, activated partial thromboplastin time, heparinemia levels by two technics: anti-factor-Xa activity and anti-factor IIa activity. None thrombotic complication was observed in the 40 patients prophylactically treated and a constant improvement of thrombosis was noted for the 9 patients with thrombo-embolic disease. In 3 patients, bleeding complications were observed: for 2 patients, all the coagulation tests were normal and anti-Xa activities were less than 0.55 U/ml; in one patient, the bleeding time was prolonged (15 minutes Ivy Incision) and returned to normal when the CY 216 was stopped. Concerning the biology, there was no modification except for anti-Xa activity which mean was 0.30 U/ml (01-07). However, this test is unable to predict either thrombotic or hemorrhagic events.

Adolescent↗
PubMed1987

[Extramembranous glomerulopathy in chronic B lymphoid leukemia. 5 years' follow-up].

A nephrotic syndrome due to membranous nephropathy and B chronic lymphocytic leukemia were simultaneously discovered in a 52 year old patient. Proteinuria was significantly reduced with chlorambucil therapy and nephrotic syndrome disappeared. Treatment withdrawal for 5 months resulted in a significant lowering of serum albumin level, while blood lymphocyte count increased. These observations indicate a probable causal relationship between the lymphoproliferative disease and the onset of the glomerulopathy which is supported by the efficacy of the chemotherapy on the evolution of the nephrotic syndrome.

B-Lymphocytes↗
PubMed1983

[Success of treatment with a low-molecular-weight heparin fraction in a case of pulmonary embolism complicated by heparin-induced thrombopenia].

A 40-year-old woman was admitted to Ambroise-Paré Hospital with a mitral stenosis and right ventricular failure. On the admission, heparino-therapy was started (Heparine Calcique Leo 30,000 IU/24 h); 11 days after, a thrombocytopenia (platelet count 60 . 10(9)/l) was observed and a few days later a pulmonary embolus was diagnosed. "In vitro", a heparin dependent plasma platelet aggregating factor was found (with Heparine Leo and all other standard ones tested) leading to the diagnosis of heparin associated thrombocytopenia; on the other this aggregating factor was not found with a low molecular weight (LMW) heparin fraction (Choay laboratory, Paris, batch CY216). We decided to stop standard heparin and to treat this patient with the LMW fraction (7,500 IU every 8 h SC) associated with oral antivitamin K. A rapid clinical improvement was observed and the platelet count rose progressively reaching 300 . 10(9)/l and has subsequently always been greater than 200 . 10(9)/l. The occurrence of heparin induced thrombocytopenia associated with thrombosis leads to heparin cessation; the treatment of the thrombotic episode seems to be improved by the use of LMW heparin associated with vitamin K antagonists.

Adult↗
PubMed1978

[Evaluation of an automatic clot-sensing instrument : Coag A Pet 200 (author's transl)].

The Coag A Pet 200 is an automatic clot-sensing instrument, with two channels; the variation in the optical density is detected by a photoelectric system. The results are sequentially printed out with the sample number. A critical evaluation of its performance in hospital use over 7 month, is reported. The series of tests thus automated consists of: one stage prothrombin-time, Owren test, activated partial thromboplastin time, analytical determinations of factors II, V, VII + X, VII, IX, XI, XII. The repeatibility is good: CV ranged between 0.5 to 1.5% or 2%, and a high degree of correlation with the standard manual techniques was found: R: 0.93 TO 0.99. This instrument was easy to master, use and maintain.

Autoanalysis↗
PubMed1978

[Data processing in the clinical laboratory (author's transl)].

We will study successively:--the flow of data and biological material into the laboratory and the constitution of the primary message with its attendant areas of possible error generation;--the organization of this data, storage techniques, and methods of information transfer;--common general principles of laboratory organization, constraints to organization inherent in the nature of a given laboratory, and the system of task priority according to the type of laboratory, cases seen and tests required;--perspectives in the development in the handling of results of laboratory tests and diagnostic determinations are briefly discussed.

Computers↗
PubMed1976

[The problem of sterility in men and women after wide area sub-diaphragmatic irradiation (author's transl)].

Sub-diaphragmatic irradiation in an upside down Y pattern for Hodgkin's disease results in sterility in the women. Protection consists of irradiating the lumbar chain only when possible or by displacement of the ovary before irradiation, and laterally for preference. Although subsequent pregnancy is then possible, the genetic risk remains. In the male, Y irradiation results in prolonged virtually complete azoospermia. Associated chemotherapy also causes definitive sterility in the male. Collection for a sperm bank before treatment is advised.

Abdominal Neoplasms↗
PubMed1975

[Bone marrow biopsy in the diagnosis of hematopoietic tuberculosis].

The authors report 6 cases of tuberculosis of the bone marrow, in which the diagnosis was made by biopsy. Three of these cases, included peripheral blood abnormalities, such as pancytopenia, whereas in the three other, nothing special was found on routine blood examination. All the patients, except one who died from intercurrent infection, became cured thanks to anti-tuberculosis treatment. Marrow biopsy thus permits early diagnosis, miliary tuberculosis, even when usual radiological and bacteriological investigations are negative.

Adult↗
PubMed1975

In vitro and in vivo influence of penicillin G on platelet aggregation.

The influence of penicillin G on the in vitro and in vivo ADP-induced platelet aggregation and on the platelet electrophoretic mobility has been studied. The in vitro investigations in presence of penicillin concentrations varying between 1,000 and 10,000 IU/ml of plasma, and doses of adenosine diphosphate (ADP) between 0.3 and 25/muM/ml, have shown that the photometric aggregation, as well as the screen filtration pressure are both decreased, according to the doses of antibiotic and ADP. The electrophoretic mobility is also impaired. The in vivo study of 8 patients submitted to massive penicillin therapy for bacterial endocarditis seems to be in agreement with the in vitro results, and has shown a prolonged bleeding time, an hypoadhesiveness, an impaired photometric aggregation with an early disa-gregation and a decrease of the screen filtration pressure and platelet electrophoretic mobility.

Adenosine Diphosphate↗
PubMed1974

Analysis of an autoimmune antibody (IgM class) in a case of chronic lymphocytic leukaemia.

A case of an acquired circulating anticoagulant occurring in a patient suffering from chronic lymphocytic leukaemia with haemolytic anaemia and autoimmune disorders has been reported. The anticoagulant was found to belong to the IgM class. Coagulation studies show that this anticoagulant inhibits the reaction between human prothrombinase andfactor II.

Anemia, Hemolytic↗