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Biomedical subjects

A Grand

Publications and source records attributed to A Grand.

At least 73 records · Page 4Linked to original sources

[Infectious endocarditis caused by Streptococcus bovis and alcoholic cirrhosis complicated by hepatoma].

The case is reported of a 66-year old man who developed Streptococcus bovis endocarditis on a fairly loose aortic stenosis and who also presented with alcoholic cirrhosis complicated by an ultimately lethal hepatoma. On this occasion, comments are made on the following points: -Str. bovis is increasingly responsible for bacterial endocarditis. This micro-organism is now rapidly and reliably identified. -Str. bovis endocarditis has some clinical features of its own. -Patients in whom the usual portals of entry of bacterial infection (i.e. benign or malignant tumours of the colon or rectum) cannot be identified should be investigated systematically for hepatic cirrhosis. -Drug sterilization of the gut is useful to prevent bacteremia of intestinal origin in cirrhotic patients.

Aged↗

[Disabilities, subjective health and mortality after a 3-year follow-up of a rural aged population].

This study examines risk factors for mortality on a three years follow-up, in a sample of 645 subjects 60 years and over, living in a rural area in Haute-Garonne. Basic data were collected by interview in a transversal survey in 1982 and three years later 68 persons had died. The assessment of relative risk factors illustrates the important role of disabilities (RR = 5.3), of self-evaluation of health, and of degree of enthusiasm for life; but there is no statistical relationship between mortality and social support, or number of diseases. A discriminant analysis, indicates that disabilities and subjective assessment of health seem to be independent predictors of mortality. A "mortality risk indicator" including nine components, can identify people who have a high risk of dying within three years, with a sensitivity of 77% and specificity of 78%.

Aged↗

[Eating behavior and life styles: research and action on nutrition in a rural area].

Nutrition education has sometimes been portrayed as a normative discourse, forgetting that nutrition is at the heart of basic lifestyle habits. In fact, eating not only satisfies a basic need, it is a social and communication action that develops an interaction with a person's socio-economic and cultural framework. This article describes an educational programme that involved all 2,200 inhabitants of a small rural town in the south of France. The purpose of the study was to better define what was involved in the development of eating behaviours in order to adapt information for the population. Two hundred families, 28% of the town, were provided with a survey questionnaire. Questions about socio-economic and cultural data of the families, types of food provisions, cooking initiation, perceived knowledge of dietetics, and ways of sociability were included. This research permitted the identification of different profiles of eaters: working class families, the elderly, families without children, etc... The subsequent information campaign attempted to adapt its message to each category identified, taking into consideration economic and psychosocial factors, the attachment of the population to its culinary patrimony, and the pejorative vision of dietetics perceived by part of the population. The entire community collaborated at each stage of the programme. Conceived as a research project, it contributed to motivating the population to take an active role in the management of its health problems.

Feeding Behavior↗

[An overlooked electrocardiographic sign of acute embolic cor pulmonale: elevation of the ST segment in right precordial leads].

Elevation of the ST segment in the right precordial leads may be associated with electrocardiographic signs of acute cor pulmonale. This sign, which we have observed in 77 cases of moderate to severe pulmonary embolism (greater than 1.3 per cent of cases), is a very early but transient sign of usually moderate to severe pulmonary embolism. In the presence of this sign, the diagnosis of pulmonary embolism with acute cor pulmonale should be proposed at the same time as more common aetiologies such as coronary insufficiency and pericardial disease.

Electrocardiography↗

[Aneurysm of the subrenal abdominal aorta spontaneously rupturing into the inferior vena cava].

The authors report a new case of spontaneous rupture of an infrarenal abdominal aortic aneurysm into the inferior vena cava operated with a good haemodynamic result. However, the patient died of multiple postoperative complications and an associated left bronchopulmonary carcinoma. The following features are emphasised: the contribution of complementary investigations to the diagnosis of this condition: abdominal ultrasonography, aortography and above all, especially in future years, of digitised angiography; the clinical importance of ischaemia of the descending colon and acute postoperative renal failure, the prevention of which should improve surgical results.

Acute Kidney Injury↗

[Auriculo-ventricular block and pregnancy].

20 cases of pregnancy in women with complete atrioventricular block (AVB) (12 patients) or with permanent pacemakers (8 patients) were observed in a French cooperative series and compared with I30 previously reported cases. Most patients were asymptomatic but an increase in the number of syncopes during gestation might be observed : 4 out of 12 in our series. Although AVB remains functionally latent during pregnancy, regular cardio-obstetric follow-up is advised. Hospital admission a few days before the expected date of delivery is desirable, and it is essential that the patients are delivered in department specialised in high risk pregnancies. The need for prophylactic temporary pacing during delivery is not universally accepted. On the other hand, dizziness and syncope are clear cut indications for permanent cardiac pacing ; programmable pacers are excellent choices in young women of childbearing age ; nuclear pulse generators (Pu 238) do not seem to expose the mothers or foetus to serious complications. Rejection of pulse generators during pregnancy is rare. Nearly all mothers with AVB, whether paced or not, now have normal pregnancies resulting in normal viable children. This conduction defect is not therefore an indication for therapeutic abortion.

Adolescent↗

[Myocardiopathy of pregnancy in white women].

Over the course of 17 years, 7 women have had heart disease either during the last three months of pregnancy or during the first three months post-partum, which appear to be associated with their pregnancy. Enquiries made throughout the country and relating to the last decade have yielded 11 additional cases so far unpublished. The clinical features of these cases do not differ from those of other non-obstructive cardiomyopathies occurring other than in pregnancy. The prognosis depends essentially on the factor of cardiac volume during the first few months of the disorder: if significant cardiomegaly persists, death will follow in one case out of two. There exists the problem of the criteria for making a diagnosis of myocardial disease of pregnancy. It should be emphasised that only 4 of the 18 cases were different from the usual cases of myocardial disease, in that they progressed to recovery which is unusual in this condition. One case was particularly illustrative of this, as clinical cure was followed by a relapse at subsequent pregnancy. Because the pregnancy itself seems to be the cause in such a tiny number of cases, a new hypothesis seems right; this is that pregnancy does no more than aggravate an associated or already existent myocardial disorder.

Adult↗