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Biomedical subjects

A Marchand

Publications and source records attributed to A Marchand.

At least 37 records · Page 2Linked to original sources
PubMed1990

Central control of the sensory afferent terminals from a leg chordotonal organ in crayfish in vitro preparation.

In an in vitro preparation of the crayfish thoracic locomotor system, intracellular recordings have been performed from terminals of a leg joint coxo-basipodite chordotonal organ (CB). In the terminals, some depolarizing events are observed which display all the characteristics of the primary afferent depolarizations (PADs). PADs reduce the amplitude of orthodromic sensory spikes, and thus correspond to a presynaptic inhibition. PADs are tonic in a tonic preparation, and phasic (phase locked) in a rhythmic preparation. A control of the incoming information from the CB could thus be performed by the central nervous system during fictive locomotion.

Action Potentials↗
PubMed1990

Psychosocial consequences of caesarean childbirth: a four-year follow-up study.

This paper describes the last part of a study on the long-term psychosocial consequences of caesarean delivery. One group of 103 primiparous caesarean delivered women and one control group of 103 women delivered vaginally were followed from delivery to the children's fourth birthday. Previous assessments were made at birth, two months and one year later (Garel, M., Lelong, N. and Kaminski, M. (1987) J. Psychosom. Obstet. Gynecol., 6, 197-209 and (1988) Early Hum. Dev., 16, 271-282). Four years after delivery, 58 mothers of the caesarean group and 50 mothers of the control group returned a completed questionnaire. The questionnaire included questions about subsequent pregnancies and mother's and child's general state of health. The comparisons between respondents and non-respondents showed no significant difference with regard to social and medical factors. As far as possible, factors which might have interfered with the mothers' and children's conditions were controlled in the analysis. There was no association between the method of delivery and the mother's overall state of health. However, after a caesarean section, mothers tended to have fewer children and more difficulty in conceiving. Four years after delivery, mothers in the caesarean group reported fatigue more frequently than control mothers. Five mothers (9%) consulted a psychiatrist, none in the control group (P less than 0.09). Between one and four years, caesarean born children had more hospital admissions but their overall behaviour and development, as reported by the mothers, was not different from those of children in the control group.

Cesarean Section↗
PubMed1990

[Maternal consequences of cesarean delivery. Results of a 4-year follow-up].

This study is of a 4-year follow-up of two groups of mothers, the first having had caesarean operations and the second vaginal deliveries. We have already published studies of the results after delivery, after two months and after one year. The purpose of this 4-year follow-up after delivery is to determine the effects of caesarean operation on the numbers of future pregnancies and their results and to look at the long-term consequences for the physical and psychological health of the mothers. Fifty-eight mothers who had had caesarean operations and fifty mothers as controls replied to a postal questionnaire. The response level was 52%. From the social and the medical point of view there was no significant difference between those who replied and those who did not. The results indicate that mothers who had had a caesarean operation were less likely to have another baby or did so in lower numbers. They further had more difficulty in conceiving another pregnancy than did the control mothers (the differences were not statistically significant). After four years they were often more tired than the others, apart from objective medical and social differences. The use of health services was not linked to the method of delivery, but 9% of women who had had a caesarean consulted a psychiatrist in the last three years but none of the controls did. The replies show that caesarean section contributed to or re-awoke a labile psychological state. The data do not make it possible for us to say that women who had had a caesarean operation had particular psychological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

Cesarean Section↗
PubMed1988

[Trendelenburg's operation using an sternostomy approach for pulmonary embolectomy].

Five cases of extremely serious pulmonary embolism treated by embolectomy without extracorporeal circulation have prompted to recall the Trendelenburg's operation through sternotomy. Rapid, simple and requiring little equipment, this technique is perfectly suited to emergency surgery. Its use should save the lives of several patients who would be condemned to death without surgical operation.

Emergencies↗
PubMed1988

Biocompatibility of carbon-carbon materials: in vivo study of their erosion using 14carbon labelled samples.

Several uncertainties have to be resolved concerning the in vivo erosion of carbon-carbon composite materials and the outcome of the resulting particles. We studied these phenomena with implants superficially doped with 14carbon, specially prepared using the usual production processes of these materials. The samples implanted in rats presented changes in their measured radioactivity which proved erosion. Autoradiographies of the whole animal as well as pathological studies of peri-implanted tissues with histoautoradiographies of the related sections revealed the presence of carbon at a distance from the implant. However, the majority of the eroded particles were retained in the fibrous capsule surrounding the implant. The methods of electron-diffraction, associated with electron microscopy, seem to be a tool suitable to characterize the nature (fibrous or pyrolytic) of the carbon particles present in the capsule.

Animals↗
PubMed1988

[Comparison of etomidate and thiopental for the anesthesia in cardioversion].

A controlled study was carried out, comparing etomidate and thiopentone used for anaesthesia for cardioversion. Eighty patients presenting with supraventricular tachyarrhythmias were randomly allocated to two groups with stratification for duration of supraventricular tachyarrhythmias and cardiothoracic ratio. After premedication with 10 mg of diazepam, anaesthesia was induced and maintained if necessary with etomidate (0.3 and 0.15 mg.kg-1 respectively) or thiopentone (3 and 1.5 mg.kg-1 respectively). The following observations were made by an independent observer: energy of the electric discharge, systolic and diastolic arterial pressures, heart rate, apnoea with duration, quality of anaesthesia, side-effects if present, and induction, anaesthesia and recovery times. A drawing test and an ambulation test were carried out after recovery. Data were analysed using one-way analysis of variance (continuous variables) and chi-squared test with Yates correction for small numbers (categorical variables) with p less than 0.05 considered significant. The thiopentone (THIO) and etomidate (ETO) groups were similar, except for premedication and number of NYHA class III and IV patients, being more common in ETO (p = 0.04; p = 0.05). Anaesthesia time was 4.6 +/- 2.3 min in THIO and 9.9 +/- 3.5 min in ETO (p less than 10(-9)) with more reinjections in THIO (p = 0.003). Awakening time was shorter in THIO (p less than 10(-6)) and graphic test was carried out better at 15 min in THIO. No difference was found later for graphic test and ambulation. Apnoea was more frequent in THIO (p = 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

A comparative evaluation of the effects of propafenone and lidocaine on early ventricular arrhythmias after acute myocardial infarction.

A double-blind, placebo-controlled trial comparing the antiarrhythmic effects of lidocaine (given intravenously as a bolus injection of 100 mg followed by an infusion of 2 mg min-1) and propafenone (given as a bolus of 105 mg followed by 300 mg orally every 8 h) was conducted in the first 24 h following acute myocardial infarction. Analysis of ventricular arrhythmias was carried out by Holter recordings. The three treatment groups, propafenone (36 patients), lidocaine (28 patients), and placebo (25 patients), did not differ with respect to age, gender, prevalence of previous infarction, delay from the onset of pain to hospitalization, clinical features on entry (the patients with heart failure or malignant arrhythmias were excluded), site of acute myocardial infarction, or CPK peak. A decrease in the number of ventricular premature beats was noted with lidocaine, but was not statistically significant. The analysis of the first 8 h showed trends suggesting that only lidocaine could suppress complex arrhythmias, couplets and ventricular tachycardia. The drugs were well tolerated. Mean plasma concentrations of propafenone and lidocaine were 517 +/- 464 ng ml-1 and 3.84 +/- 1.10 mg l-1, respectively. In conclusion, this study does not favour the use of propafenone as an alternative to lidocaine therapy during the acute phase of myocardial infarction.

Anti-Arrhythmia Agents↗
PubMed1988

[Anticoagulants in the treatment of severe pulmonary embolism. A prospective study].

This prospective study was designed to obtain information on the fate of patients with severe pulmonary embolism who received anticoagulants as first-line treatment, in order to identify those in whom other treatments available might be expected to reduce mortality or sequelae. Thirty-seven patients selected as they showed evidence of acute cor pulmonale entered the study. Seven of them (18.9 p. 100) died in hospital, and these were patients whose age (p = 0.004), degree of pulmonary obstruction (p = 0.008) and serum lactate dehydrogenase level (p = 0.001) were significantly higher than those of the other patients. The mean values of these parameters (64 years, 72 p. 100 and 450 IU/l respectively) made it possible to select patients with a high risk of death. At the end of the follow-up period (25 +/- 12 months) only 2 patients complained of moderate dyspnoea, in contrast with the high incidence (17/18 patients) of paraclinical abnormalities observed 3 months after the initial accident. We conclude that clinical trials comparing other treatments with the one we used would be useful if their objective was to reduce mortality in high risk patients. On the other hand, it seems impossible to demonstrate a functional improvement: we found our treatment satisfactory and its results independent of the abnormalities observed on the 3rd month.

Adolescent↗
PubMed1987

Impact of chickenpox on households of healthy children.

There is little information available regarding the impact of varicella among healthy children. A group of 137 households, identified by the County of Los Angeles Department of Health Services, were interviewed by telephone and yielded 247 cases of varicella. There were no hospitalizations for complications. Rates for physician visits and telephone calls to health care providers were 0.5 and 1.0 per case, respectively. School days lost by cases and work days lost by well adults in the households were 8.7 and 0.5 per case, respectively. Varicella had a measurable impact of economic significance on our survey population. Our observations need to be extended and included in cost-benefit analyses of varicella vaccine.

Absenteeism↗
PubMed1987

Algorithms and protocols for DRG testing.

Clinicians teamed up with the laboratory at this hospital to develop strategies for automatic follow-up testing, including protocols on CK and CK isoenzymes, viral hepatitis, and hemoglobin identification.

Algorithms↗
PubMed1985

Comparison of performance for leukocyte differential counting of the Technicon H6000 system with a manual reference method using the NCCLS standard.

The National Committee for Clinical Laboratory Standards (NCCLS) has published a tentative standard for leukocyte differential counting, by means of which a manual or automated method for leukocyte differential counting can be compared with a manual reference method. The performance of the Technicon H6000 system was evaluated using the standard at Stamford and Overlook Hospitals. A total of 502 patient samples were analyzed: 315 from Overlook and 187 from Stamford. The H6000 system was found to be approximately four times more precise than the 200-cell manual reference method for each cell type. Correlation of the H6000 system with the manual method was good, with correlation coefficients of 0.98 for neutrophils and lymphocytes, 0.96 for eosinophils, 0.72 for monocytes, and 0.5 for basophils. The clinical sensitivity of the H6000 system, measured in terms of false normals and false abnormals, was similar to that of the manual reference method when measured against itself. There were no clinically significant discrepancies in results from the H6000 system, except for possibly one case where a patient was already on antibiotic therapy. The NCCLS standard was found to be a useful but rather complex and involved method for evaluating the performance of the H6000 system, the major problem being the amount of work needed to count manually the number of cells required for the manual reference method.

Diagnostic Errors↗
PubMed1985

Three techniques compared for detecting bacteriuria in symptomatic patients.

We wanted to determine whether the microscopic evaluation of urinary sediment could be replaced by either a biochemical determination (Chemstrip-9) or a colorimetric staining procedure (Bac-T-Screen), and to evaluate the feasibility of omitting from urinalyses attempts to culture urines. Cultures were considered positive when colony counts were greater than or equal to 10(3) for catheterized patients and greater than or equal to 10(4) for noncatheterized patients. The results of three separate studies on symptomatic patients showed a progressive decline in the sensitivity of the Chemstrip-9, which is a test for leukocyte esterase activity, and a difference in the sensitivity of the Bac-T-Screen between two of the studies. Neither test was consistently more sensitive or more predictive of a positive culture than was urine microscopy. By the end of the third study, we were convinced that the three methods are comparably sensitive and specific. Because 13 to 36% of positive cultures would be missed by these techniques, urine from symptomatic patients should routinely be cultured.

Bacteriuria↗
PubMed1985

[Neurinoma of the posterior cerebral fossa and mitral valve prolapse. Possible association and study of possible peri-operative consequences on rhythm].

27 patients with an acoustic neurinoma were submitted to a complete cardiological survey oriented towards the detection of mitral valve prolapse (2D echo) and ECG signs of a particular risk of arrhythmia (standard ECG and continuous Holter monitoring). 9 of these 27 patients presented MVP, but none of them presented any serious ventricular arrhythmias. The corrected QT interval was significantly longer in patients without MVP. The frequency of the association of MVP and acoustic neurinoma can not be explained simply by the female predominance of the series and its should be interpreted with reservation in the absence of a control series. The absence of pre-operative arrhythmia does not exclude the potentiating role of MVP in the development of certain cases of unexplained post-operative death.

Adult↗
PubMed1983

The assessment of laboratory tests in the diagnosis of acute appendicitis.

A comparison of laboratory tests was undertaken in 106 patients admitted to the emergency room with the tentative diagnosis of acute appendicitis and who subsequently underwent appendectomy. The tests examined included the total white blood cell count, manual differential count, cytochemical differential count, and C-reactive protein. The sensitivity, specificity, efficiency, and predictive value of these tests in the diagnosis of acute appendicitis were calculated. The cytochemically determined neutrophil count, when greater than the upper limit of the reference interval of either 75% or 7.88 X 10(9)/L, and the total white blood count greater than the upper limit of the reference interval of 10.5 X 10(9)/L were the single best tests for the diagnosis of acute appendicitis with the highest sensitivities of all tests examined (81-84%). The manual differential count and C-reactive protein showed significantly lower sensitivities. Test combinations also were examined. The combinations consisted of two or more tests joined by an "or" rule, i.e., if any one of the individually linked tests of the combination is above the reference interval, the combination is considered as indicating acute appendicitis. When either of the following test combinations were utilized--(1) total white count greater than 10.5 X 10(9)/L or cytochemical neutrophils greater than either 75% or 7.88 X 10(9)/L or CRP greater than 1.2 mg/dL; (2) total white count greater than 10.5 X 10(9)/L or manual bands greater than either 11% or 1.15 X 10(9)/L or CRP greater than 1.2 mg/dL--the sensitivity of the combination in the diagnosis of acute appendicitis approached 100% with a specificity in the range of 50%. We suggest that these test combinations may be useful in deciding which patients need further observation and reexamination prior to surgery. We also suggest the need for further studies to assess the usefulness of these tests in other types of acute inflammation and infection.

Acute Disease↗
PubMed1981

Diagnosis of hemolytic disease by electrophoresis of erythrocyte lactate dehydrogenase isoenzymes on cellulose acetate or Agarose.

We determined the LD-1/LD-2 isoenzyme ratio in hemolysates of erythrocytes by electrophoresis on cellulose acetate and on agarose. A ratio exceeding 1.0 was found with the former but not the latter. Results were similar for in vitro models of hemolytic disorders. Using cellulose acetate electrophoresis, we determined the predictive value of data on total LD activity and of the LD-1/LD-2 ratio in diagnosis of hemolytic disease in 100 patients. The sensitivity of the "flipped" LD-1/LD-2 ratio was only 58%, the specificity was 93%, and the predictive value was 74% for diagnosis of hemolytic disease. A normal total LD activity is highly predictive (92%) for ruling at the presence of hemolytic disease.

Anemia↗
PubMed1980

The predictive value of serum haptoglobin in hemolytic disease.

Using a rapid, highly sensitive immunoprecipitin nephelometric technique, a retrospective study was undertaken to evaluate the clinical usefulness of determining serum haptoglobin in the diagnosis of hemolysis. Haptoglobin assays were performed shortly after admission in 100 patients with a variety of hematologic and nonhematologic conditions and the results correlated with the clinical diagnosis. An ad hoc boolean computer program allowed for the separation of hemolytic from nonhemolytic disorders with a haptoglobin limit of 25 mg/dL or less. The sensitivity and specificity of the test are high (83% and 96%, respectively), providing 87% probability of predicting hemolytic disease when the serum haptoglobin level falls below this limit. These data support the routine use of serum haptoglobin determinations in the diagnosis of hemolytic disease.

Adult↗