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Biomedical subjects

A Richard

Publications and source records attributed to A Richard.

At least 127 records · Page 7Linked to original sources
PubMed1984

Heparin-induced thrombocytopenia--association with a platelet aggregating factor and cross-sensitivity to bovine and porcine heparin.

Heparin-induced thrombocytopenia is an infrequently suspected adverse drug reaction since its sequelae often mimic the underlying condition for which the drug is being used. A concomitant decline in platelet count and increase in heparin requirements should alert the clinician to the possible presence of this disorder. A 36-year-old black male developed severe thrombocytopenia with thrombosis while being treated with porcine intestinal mucosal heparin. Platelet counts returned to near-normal levels upon discontinuation of heparin, but quickly dropped again upon resuming treatment with bovine lung heparin. The patient subsequently was treated with warfarin and dipyridamole, with no further complications. Treatment of delayed-onset severe heparin-induced thrombocytopenia consists of stopping the heparin and substituting antiplatelet agents and oral anticoagulants when continued inhibition of coagulation is required.

Adult↗
PubMed1980

[Current aspects of the treatment of deep venous thromboses by heparin (author's transl)].

The use of heparin by continuous infusion from a electric pump gives very good immediate results in the treatment of venous thromboses. In 58 patients, there was a constant improvement in clinical signs and recurrence of the venous thrombosis was exceptional (2%), pulmonary embolism rare (3.5%) and well tolerated. Constant flow and the surveillance of treatment led to the method ensuring stable blood heparin levels. Mid-term results (8 months) in 43 patients appeared to be less favourable, the prevalence of venous sequelae reaching 50% for iliac phlebitis, 28% for sural phlebitis. The respective advantages and disadvantages of heparin and fibrinolytic agents are discussed.

Adult↗
PubMed1980

[Case history of a gassed patient].

Ricardo T., aged 20 years, was a passenger in a Varig air-craft which suffered an accident on July 11th 1973. A fire developed on board whilst the plane was in the air, at about 3 p.m. After emergency landing, rescue workers (firemen and emergency ambulance teams) discovered only two survivors amongst the 122 passengers. One was in his forties and died a few moments later. The other (Ricardo) was rapidly transported to the surgical and traumatological intensive care unit of the Henri Mondor Hospital. At the time of arrival, he was in stage 1 coma with skin burns (3rd degree), burns of the airway and a high carbon monoxide blood level. Treatment consisted of assisted ventilation for 24 hours, with intermittent bronchial lavage used to eliminate ashes and calcinated debris, then for 10 days, spontaneous ventilation without intubation, with a tele-expiratory counter-pressure of 4 milibar in a mini-chamber (globe) enriched in oxygen. Intravenous hyperalimentation was started during the first few hours, continued on the 24th day by enteral alimentation. Initial chest XRays showed heavy flaky appearances, predominantly in the hilar region, and more marked on the right. At about the 15th day, XRay showed fibrous with predominance of signs of the apex. These sequellae were confirmed by respiratory function tests which gave objective evidence of a diffusion disturbance with decrease in membrane permeability coefficient. Repetition of RFT indicated a decrease in mechanical problems. On August 31st (on the 51st day) Ricardo was able to return to Rio in a good general condition, dorso-lumbar burns having healed. There was a dysphonia of mixed origin: scarred infiltrate of the vocal cords, but with normal mobility, and a decrease in vital capacity of --30%. Seen again in September 1978, Ricardo was found to be well with normal activity and slight effort dyspnea. Chest XRays showed signs of residual fibrosis.

Accidents, Aviation↗
PubMed1976

[Vitellogenesis in decapod cephalopods: evolution of oocytes and follicular cells during genital maturation].

The investigation was carried out on two Cephalopods: Sepia officinalis and Loligo vulgaris. During previtellogenesis, the follicle cells (F.C.), originally arranged at the periphery of the oocyte, form strands, through the axis of which runs a blood vessel. The follicle strands then make their way down into the ooplasm. They end up by occuping the greater part of the volume of the oocyte. At this stage, despite their increase in size, the F.C. do not undergo conspicuous cytological transformations. In the ooplasm, excepting a few specialized structures (annulate lamellae), the organites display no notable differentiation. The onset of vitellogenesis is characterized by the appearance in the ooplasm of elements paracrystalline in structure. A zona pellucida appears between the oocyte and the F.C., and it is at the point that yolk of a permanent type begins to accumulate. Concurrently the F.C. undergo characteristic reorganization: hypertrophy of the nucleolar mass, multiplication of granular reticulum cisternae, increase both in the number and the size of the Golgi complexes. The saccules of the Golgi complex process a material rich in carbohydrate protein bearing the same cytochemical characteristics as the yolk. In the basal zone of the F.C., deep invaginations of the wall of blood vessels scallop the cytoplasm. F.C. look like "podocyte cells". Immunofluorescence study suggest there is no immunological identity between blood and yolk proteins. The formation of chorion is accompanied by a fresh transformation of the F.C.: the granular endoplasmic reticulum breaks up into rounded cisternae containing a dense material. Concurrently the morphology of the Golgi complex is modified. The earliest chorion elements accumulate, firstly in the forme of isolated lobules within the zona pellucida. They then fuse to make a continous layer bounding the microvilli of the F.C. These cells eventually enter into a phase of degeneration and disappear, whilst the oocyte is set free by dehiscence into coelomic cavity.

Animals↗
PubMed1976

[Massive facial destruction. Management, resuscitation, anesthesia, surgery (experience at the Henri-Mondor University Hospital Center)].

Anaylsing 67 cases of facial injury treated at the Henri Mondor Hospital in Créteil, the authors consider the various problems raised by these injured patients. -first aid, -methods of protection of the airway, -surgical management, -anaesthetic management and resuscitation, -problems of post-operative supervision, -methods of feeding. Owing to the localisation of these lesions, and the surgical methods, these are high risk injured patients who raise complex problems in the pre, per and post-operative periods, dominated by maintenance of the permeability of the airway. A specialised multidisciplinary team ensures coordination of the various acts.

Adult↗
PubMed1976

[Laryngeo-tracheal contusion caused by a seat belt].

The authors report cases of laryngo-tracheal rupture due to seat belts. They analyse the mechanisms, the clinical and radiological signs of these lesions. Although these lesions are rare, they should be recognised by medical teams when called to treat injured patients. It is, in fact, at this level that emergency treatment must be carried out, although difficult, this alone permits one to save a certain number of injured patients from asphyxia.

Adult↗