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Biomedical subjects

A Larcan

Publications and source records attributed to A Larcan.

At least 145 records · Page 8Linked to original sources
PubMed1977

[Evaluation of a method of study of platelet aggregates using formol fixation].

A new approach for testing platelet aggregates by formol fixation (Wu and Hoak) is presented. The investigations are made either in vitro by the study of aggregation in the presence of ADP, or in vivo after thrombin ADP perfusion in the rabbit. The calculation of an index of aggregability comparing fixed and non fixed platelets permits an evaluation of the presence of aggregates.

Adenosine Diphosphate↗
PubMed1976

[Acute consumption coagulopathies. 120 cases].

Consumption coagulopathy is frequently observed in a resuscitation department. 120 cases of various etiologies are reviewed: complications of pregnancy (61 cases), infections (23 cases) or various stresses: acute hemolysis, shock, severe hepatic failure, intoxications, acidosis, heat-stroke... Consumption coagulopathy is intricated with the general stress which induces it, and with the visceral lesions induced by the stress and which can be aggravated by the consumption coagulopathy. The state of shock is observed in 76% of the cases, the haemorrhagic syndrome in 73%. Acute hemolysis and the clinical signs evocative of disseminated intravascular coagulation (cutaneous signs) are more rare. Following the initial manifestations, visceral complications may develop: renal, hepatic, respiratory, neurological, digestive. The evolution of the biology must be carefully studied. The diagnosis is made on both clinical and biological data. Etiological and pathophysiological treatment should be carried out. In our series, controlled and adapted heparin therapy was given systematically.

Disseminated Intravascular Coagulation↗
PubMed1976

[Consumption coagulopathies and severe postpartum hemorrhage].

15 patients were referred to the Intensive Care Unit immediately after delivery for severe post-partum haemorrhage. In 7 cases complications followed retroplacental haemotoma formation and in the other 8 cases they were due to secondary haemorrhages from the placental site and/or from tears of the cervix or vagina. It is a clinical picture that is associated with a state of shock, with continuing massive bleeding associated with failure of the blood to clot and which persists and becomes worse with the transfusion of stored blood and of the coagulation factors. In all these cases severe coagulation pathology due to consumption defects is revealed. We must point out that tears of the cervix and vagina which have been neglected and failure to compensate for the original blood loss are among the aetiological factors. Treatment with Heparin giving a dose of 1 to 3 mg per kg of body weight per 24 hours and controlled by a strict biological check together with symptomatic resuscitation from the state of shock and from the coagulation factors is successful (9 cases) if it is undertaken early on. A fatal outcome, whether it is due to a persistent state of shock (1 case) or to visceral complications of diffuse intravascular coagulation (C.I.V.D.) (5 cases) can be found where treatment is delayed and when insufficient blood is replaced and when antifibrinolytics are prescribed. A preventive therapeutic plan as well as a curative one can be drawn up for these cases of obstetrical drama.

Adult↗
PubMed1976

[Consumption coagulopathy and acidosis in the diabetic patient (author's transl)].

Four cases of intravascular coagulation associated with a state of acidosis in diabetics were observed in 57 patients with diabetic acidosis and 19 with lactic acidosis, in a series of 112 cases of consumption coagulopathy admitted to a department of medical resuscitation. In three cases the coagulopathy was found only on investigation; in one there were clinical and anatomic signs. The coagulopathy may be found either during the phase of recovery from ketoacidosis, or during the course of severe lactic acidosis, particularly during a recurrence of this form of acidosis. In spite of the unfavorable outcome in 3 of the 4 cases, the abnormal findings of coagulopathy reverted toward normal along with successful metabolic corrections. The factors responsible for consumption coagulopathy are acidosis, collapse, generalised systemic reactions and alterations of platelet function, of coagulation, of the balance between fibrin deposition and lysis and of lipid levels, all characteristic of diabetes. The clinical effects of this coagulopathy seldom become apparent but provide a possible explanation of some of the complications of diabetic ketoacidosis, particularly certain hemorrhagic or thrombotic events, as well as certain visceral complications, especially those affecting renal, pulmonary and cerebral areas.

Adolescent↗
PubMed1976

[Suicidal behavior and meterological conditions].

Six hundred and seventy five cases of attempted suicide observed in a resuscitation department were confronted with a certain number of biometeorological factors recorded daily: atmospheric pressure, air temperature, degree of insolation, precipitation, relative humidity, water vapour pressure, wind (speed and direction), hydrometeores, index of solar eruption, density of F2 layer. The confrontation is made for the two days before the intoxication and for the day when suicide is attempted. Parameters are then studied by statistical calculation (calculation of X2 and of the number of degrees of freedom). There does not seem to be any significant relationship, in spite of disconcerting series, between most meteorological factors and the number of attempted suicides observed. However, it is noted that no suicides were recorded during periods of solar eruption, and that there seems to be a marked correlation between suicide and winds, particularly according to their direction. Thus, winds charged with ionised particles seem to coincide with a high rate of self-destruction.

Atmospheric Pressure↗
PubMed1975

[Renal functions and extracorporeal circulation].

During 76 extracorporeal circulations (CEC) carried out for open heart operations using an identical protocol, the authors carried out renal function tests from the time of administration of the anesthetic to the post-operative period. Various periods may be distinguished: pre-operative, anesthesia induction (CEC 1, CEC 2) post induction (CEC 1, post CEC 2) finally, the post-operative period (post-operative 1 to 4). As far as renal hemodynamics are concerned, the authors made the following observations: constant reduction in thiosulphate clearance and endogenous creatinine clearance, which reflect glomerular filtration. Reduction in PAH clearance, which reflects renal perfusion. Taking into consideration changes in the hematocrit, one may consider that there is a reduction in renal blood flow at all stages of anesthesia. Taking into consideration concomitant variations in blood pressure, one may calculate that intrarenal resistances are increased. The diuresis/minute increases in very great proportions during induction of anesthesia. Plasma osmolality also increases, urinary osmolality becomes reduced and osmolar clearance rises. The ratio between osmolar clearance and creatinine clearance rises. The clearance of free water rises from negative values. The serum sodium becomes slightly reduced, and sodium diuresis increases. Serum potassium becomes slightly reduced and urinary potassium rises. The interpretation of these phenomena is difficult and should take into consideration the experimental conditions. Comparison with published results shows that there are definite differences depending on whether pure or diluted blood is used. It is however, possible to seek the role of the anesthetic, the thoracotomy or the extracorporeal circulation itself and its load, quite independent of prior changes due to decompensation or not of the congenital heart disease, whether or not it has been treated. The study of these changes in renal function permits one to understand better the precariousness of renal perfusion during extracorporeal circulation, imperfectly corrected by osmotic diuresis and responsible for transient and reversible renal hypofunction, liable to lead however, in cases of complications and prolonged low blood flow, to organic renal failure.

Adolescent↗
PubMed1975

[Measurement of blood viscosity using a rotatory viscosimeter with coaxial cylinders].

The authors describe a microviscosimeter with coaxial cylinders which requires only a small volume of sample. They draw up formulae permitting to obtain in a simplified way, fluid rheograms, in particular for biological fluids. Furthermore, they consider the use of this viscosimeter for the study of the rheological properties of blood and plasma. Thus, at 30 degrees C, the plasma and serum have a newtonian behaviour, whilst the viscosity of total blood depends mainly on the hematocrit and the rate of shearing. One may thus verify Casson's law (tau 1/2 = tauo 1/2 + S gamma 1/2) which represents approximately the rheological equation of normal blood and permits one to calculate a threshold for viscous outflow.

Blood Viscosity↗
PubMed1975

Cyclical shock with hyperglobulinemia.

Two personal cases are compared with CLARKSON's case, enabling one to describe a syndrome arising in adults without a family history, and characterised by episodes of repeated shock (cyclical shock) with hemoconcentration and hypoproteinemia. The physiopathological mechanism is an acute hyperpermeability. Two cases out of three took a fatal course, with a negative autopsy. In the three cases, the presence of light kappa chain IgG type monoclonal dysglobulinemia was proven. The diagnosis of multiple myeloma can be excluded. Comparison of this syndrome with periodic disease and primary amyloidosis can be envisaged.

Adult↗