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Biomedical subjects

A Harari

Publications and source records attributed to A Harari.

At least 19 recordsLinked to original sources
PubMed2006

[Specific interferon-gamma assays: a modern tool for tuberculosis diagnosis].

Compared with the tuberculin skin test, the antigen-specific interferon-gamma assays, using a combination of two antigens ESAT-6 and CFP-10, has higher specificity for the diagnosis of latent tuberculosis, better correlation with exposure to M. tuberculosis, no cross-reactivity due to BCG vaccination and less towards nontuberculous mycobacterial infection. Fewer false positive results in uninfected persons avoid the costs of unnecessary therapy and its possible side effects. In low endemic areas, interferon-y assays are useful in addition of diagnostic algorithm for individuals with suspected tuberculosis. Further studies are required to evaluate the utility of the interferon-gamma assays in specialised subgroups of patients (immunocompromised, young children, patients with extrapulmonary disease,...) and as a marker of disease activity.

Humans↗
PubMed1990

Radiation and vibrational properties of submerged stiffened cylindrical shells.

The vibratory response of submerged cylindrical shells is investigated. The shell response is presented in terms of the spatial wave-number spectrum of the normal surface displacement. The power output of the vibrating shell into the fluid and the far-field radiation from the shell are presented as a function of the wave number of the exciting force. The effects of structural damping and stiffeners are also studied.

Acoustics↗
PubMed1984

Respiratory effects of intrathecal morphine after upper abdominal surgery.

The effects of intrathecal (IT) administration of two doses of morphine (Group 1: 2 mg, n = 9; Group 2: 5 mg, n = 10) were studied in 19 patients after upper abdominal surgery. The ventilatory variables and occlusion pressure (P0.1) were recorded during room air breathing and during CO2 rebreathing tests prior to surgery, 24 h after surgery before IT morphine (n = 12), and 3, 5, 7, 11, and 24 h after injection. During room air breathing, minute ventilation (VE) did not change significantly in Group 1 and decreased significantly 3, 5, 7, and 11 h after injection in Group 2. During the rebreathing tests, there was a significant shift to the right of the ventilatory response to CO2 in both groups. The peak of the ventilatory depression was delayed, occurring 7 h and 11 h postinjection in Groups 1 and 2, respectively. Two patients in Group 2 developed clinically significant ventilatory depression. The shallow breathing observed after surgery was not changed after analgesia. In group 2, 5, mg IT morphine was responsible for a significant decrease in f60 (respiratory frequency for a PETCO2 of 60 mmHg). P0.1 increased markedly after surgery during both room air breathing and the rebreathing tests. After IT morphine, compared with the postoperative preanalgesic values, P0.1(60) (P0.1 at a PETCO2 of 60 mmHg) did not change in Group 1 and decreased significantly in Group 2. It is concluded that IT morphine is responsible for a ventilatory depression that is delayed and seems to be dose related and that analgesia does not abolish the shallow breathing observed after upper abdominal surgery.

Abdomen↗
PubMed1982

[Prevention of per-operative myocardial ischemia with continuous nitroglycerin infusion].

The aim of this work is to assess the possible beneficial effects of intra and post operative nitroglycerin infusion in patients with disabling angina pectoris (Class III of the New-York Heart Association). We thus compared the occurrence of myocardial ischemia detected by means of continuous electrocardiographic recording of lead V5 in 31 patients which were divided in two groups. The control group (I) included 16 patients, group II included 15 patients undergoing similar surgical procedures, given a permanent nitroglycerin infusion. Mean dose of nitroglycerin was 0,91 +/- 0,18 micrograms . kg-1 . min-1. An ischemic type S T segment depression occurred in 15 out 16 patients in group I and in only 3 out of 15 patients in group II (p less than 0,001). No S T segment depression occurred following a decrease of more than 25 p. 100 in systolic blood pressure in 8 patients of group II at the time of induction. These hypotensive episodes were easily corrected by decrease of the nitroglycerin infusion rate associated with a rapid blood volume expansion. The very high incidence of intra operative myocardial ischemia in control group demonstrates the severity of the coronary disease in the observed patients. The significantly lower frequency of ischemic S T segment depression observed in the patients given nitroglycerin infusion suggests that this drug is highly effective in preventive myocardial ischemia in patients with severe coronary artery disease. The administration of nitroglycerin in our patients had been easy to control, blood pressure reaching normal value within a few minutes after decrease of the rate of drug infusion when needed.

Aged↗
PubMed1982

Suppression of antidiuretic hormone hypersecretion during surgery by extradural anaesthesia.

The concentrations of antidiuretic hormone in plasma and urine were determined in three groups of patients submitted to the same operative procedure. Seven (group I) underwent general anaesthesia with thiopentone, fentanyl and nitrous oxide and received an infusion of isotonic saline solution 5ml min-l. Seven patients (group II) anaesthetized similarly, received isotonic saline solution 15 ml min-1. In group III (five patients) anaesthesia was produced by extradural blockade. Surgery under general anaesthesia induced a significant increase in plasma and urine ADH concentrations which were not modified by the fluid load. Extradural anaesthesia suppressed almost completely the release of ADH during surgery. This effect of extradural anaesthesia could be related to the interruption of conduction along nociceptive neural pathways.

Aged↗
PubMed1982

Clinical predictors of intraoperative myocardial ischemia in patients with coronary artery disease undergoing non-cardiac surgery.

In order to detect the incidence of myocardial ischemia during the perioperative period and to determine during which situation it occurred, continuous monitoring of the electrocardiogram by the Holter method was used in 51 patients with coronary artery disease who were undergoing a vascular surgical procedure. Clinical parameters measured preoperatively were evaluated as predictors of the occurrence of myocardial ischemia during the perioperative period. Twenty of 51 patients demonstrated 36 episodes of myocardial ischemia, which started in 11 cases during induction. Fourteen of 16 patients with disabling angina pectoris (Class III and IV) developed myocardial ischemia, whereas only six patients out of 35 with Class II or less or no angina experienced peroperative ischemic episodes (P less than 0.001). All the patients without or with only mild angina who experienced perioperative ischemia showed ST-T abnormalities at the preoperative resting electrocardiogram. Our data suggest that the risk of intraoperative myocardial ischemia can be predicted during the preoperative period by the degree of disability exhibited by patients with coronary artery disease.

Adult↗
PubMed1981

Risk of advanced heart block during extradural anaesthesia in patients with right bundle branch block and left anterior hemiblock.

Electrocardiographic recording by Holter monitoring demonstrated the absence of any modification, however minimal, of the intranodal conduction during surgical procedures under extradural anaesthesia in 20 patients with right bundle branch block (RBBB) and left anterior hemiblock (LAHB) but without symptoms. These data suggest that extradural anaesthesia can be used safely in patients with asymptomatic chronic RBBB and LAHB without prophylactic insertion of pacemakers. However, patients having experienced either syncope or transient Mobitz II second degree AV block are likely to have a trifascicular block and increased risk of advanced heart block during extradural anaesthesia.

Aged↗
PubMed1981

[Blockade of renin secretion by epidural anaesthesia (author's transl)].

In order to determine the rule of neurologic stimuli on the renin-angiotensin system, during surgery, plasma renin activity (PRA) was measured in two groups of patients submitted to either general (group I, N = 7) or epidural (group II, N = 5) anaesthesia during total hip replacement. Salt intakes were normal for all patients before the operation and the perfusion rate, of isotonic saline solution was 5 ml/minute during the surgical procedure. A significant rise in PRA was observed after the skin incision in the first group of patients under general anaesthesia. Epidural anaesthesia suppressed the renin response to surgery. The blockade of conduction along nervous pathways afferent from the surgical area and along renal sympathetic pathways explains the effect of epidural anaesthesia. The lack of increase in PRA despite a significant fall in blood pressure after epidural anaesthesia, also suggests an inhibition of the catecholamines secretion.

Anesthesia, Epidural↗
PubMed1981

[Intervention among patients with right bundle branch block and left anterior hemiblock. Operatory risk (author's transl)].

In order to assess the risk of advanced heart block during anesthesia in patients with right bundle branch block and left anterior hemiblock, 35 consecutive patients were monitored throughout the pre-, intra- and postoperative period. As conventional ECG monitoring may only detect advanced atrioventricular block, patients were monitored according to the Holter method which can easily detect even minor changes of atrioventricular conduction namely slight increased PR interval or dropped P wave. All patients were asymptomatic, in normal sinus rhythm without second degree AV block. Surgical procedures were performed under general anesthesia (n = 15) and epidural anesthesia using lidocaine (n = 20). No episode of second or third degree atrioventricular block occurred. The only modifications observed were rare and transient increase of PR, occurring during surgical procedures in 5 patients, always associated with a sinus bradycardia. They immediately regressed at the termination of the sinus bradycardia either spontaneously or following atropine injection, strongly suggesting the responsability of increased vagal tone. Thus general or epidural anesthesia did not compromise infranodal conduction in any of the observed patients. These data indicate that anesthesia can be safely used without prophylactic preoperative insertion of pacemakers in patients with asymptomatic chronic right bundle branch block and left anterior hemi-block.

Aged↗
PubMed1979

[Severe drug complications: current prevalence amongst patients admitted to adult intensive care units (author's transl)].

A retrospective study involving nine teaching hospital mixed intensive units provided information concerning severe drug complications amongst patients admitted to these departments over the past ten years. Amongst a total of 63717 patients admitted, there were 1132 drug complications (1.8%) without any predominance in terms of sex. Mortality was high (252 patients, i.e. 22.2%), being all the greater in older patients. Details concerning the various drug complications are given, the most common being anaphylactic shock and haemorrhage due to anticoagulants. These statistics are compared withthose already published by hospital departments of internal medicine.

Age Factors↗