Search PubMed⌕ Search

Biomedical subjects

B Guidet

Publications and source records attributed to B Guidet.

80 records · Page 5Linked to original sources
PubMed1986

[Pulmonary arterial hypertension and chronic obstructive bronchopneumopathy].

Sooner or later, chronic obstructive lung disease becomes complicated with pulmonary arterial hypertension, largely responsible for chronic cor pulmonale. Its principal cause is an increase in pulmonary resistance due to chronic hypoxia. There is no non-invasive method that can be used to measure pulmonary arterial pressure (PAP) with accuracy. In the course of chronic obstructive lung disease PAP increases slowly, by about 0.5 to 0.6 mmHg per year. As mortality factor, it is the second major variable after FEV1. The usefulness of specific vasodilators has not yet been demonstrated.

Animals↗
PubMed1986

[Polycythemia in patients with chronic respiratory insufficiency].

Tissue hypoxia is the main stimulus of erythropoietin production. Erythropoietin stimulates erythropoiesis by acting on medullary stem cells. Unlike healthy subjects adjusting to high altitude, patients with chronic respiratory failure do not always develop polycythaemia. In those who do, the physiopathology of polycythaemia remains unknown. It seems to be due to insufficient action more than to insufficient production of erythropoietin. Most authors agree that polycythaemia is harmful when the haematocrit exceeds 60%. The most commonly used corrective method nowadays is phlebotomy. Blood withdrawal is effective on clinical symptoms and on pulmonary arterial hypertension, but not on blood gases and ventilatory parameters at rest or during exercise.

Adaptation, Physiological↗
PubMed1983

[Percutaneous transluminal angioplasty of the iliac arteries. Immediate and long-term results].

Percutaneous transluminal angioplasty (PTA) was performed 30 times in 28 patients aged from 31 to 77 years (mean: 50.8 years) with stenosis of the iliac arteries. All patients were evaluated before and immediately after PTA by measuring the trans-stenotic pressure gradient and the degree of angiographic stenosis (grade 1 less than or equal to 50%; grade 2 = 50 to less than 75% and grade 3 greater than or equal to 75%). Prior to PTA 27 patients had grade 3 and three patients had grade 2 stenosis. The figures after PTA were 23 grade 1 and seven grade 2 stenosis. The mean trans-stenotic pressure gradient was reduced from 43 +/- 35 to 2.3 +/- 5.9 mmHg, the difference being highly significant (p less than 0.001). Eighteen patients were evaluated clinically and angiographically 8.4 +/- 6.1 months after PTA. Considerable clinical improvement was observed in 15, and 16 had a residual stenosis of less than 50%. PTA therefore appears to be a satisfactory treatment of stenosis of the iliac arteries. The long-term results can be assessed by graded intravenous angiography without any risk of damage to the arteries.

Adult↗
PubMedDate not supplied

Secretory non-pancreatic phopholipase A2 in severe sepsis: relation to endotoxin, cytokines and thromboxane B2.

Circulatory secretory non-pancreatic phospholipase A2 (snp-PLA2) was measured prospectively at the onset (day 0) of severe sepsis in 52 patients as well as on day 1 and 2 in 25 patients, in order to answer two questions: 1) does the snp-PLA2 plasma concentration differ according to the type and severity of infection? 2) what is the relation between snp-PLA2 and other mediators involved in severe sepsis, such as endotoxin, cytokines (TNF alpha, IL-1 beta, IL-6) and thromboxane B2 (the stable metabolite of thromboxane A2)? On day 0, the snp-PLA2 circulatory level was 78 +/- 17 nmol/min/ml in patients with severe sepsis as compared to 3.5 +/- 2 nmol/min/ml in 40 healthy volunteers. There was no statistical difference according to the outcome, the presence of shock, or the type of infection on day 0. However, snp-PLA2 remained elevated or even increased in patients who ultimately died, while it decreased in survivors (p = 0.01 by ANOVA). The cytokine profiles during the 2-day follow-up were similar to that of snp-PLA2, but the differences were not statistically significant between survivors and non-survivors. No correlation was found between snp-PLA2 and other mediators for either initial or peak values.

Adult↗
PubMedDate not supplied

Skin versus hub cultures to predict colonization and infection of central venous catheter in intensive care patients.

Central venous catheters (CVC) are an important source of nosocomial infection in intensive care units. The unnecessary removal of CVC suspected to be infected can probably be minimized. In order to test the accuracy of non-invasive methods for predicting catheter colonization, we prospectively compared the results of 50 consecutive CVC tip cultures, with cultures of the CVC hub and the skin at the insertion site. The CVC were separated into two groups based upon the underlying reason for CVC removal: group I (n = 20), suspicion of infection; group II (n = 30), no suspicion of infection. The skin culture (with a threshold of 15 CFU) was useful in both groups for assessing catheter colonization since it was always positive in cases of catheter colonization and always negative in the absence of catheter colonization. The contribution of the CVC hub cultures alone was minimal since there was no case of catheter colonization with negative skin cultures and positive hub cultures suggesting that the main route of catheter colonization was via the skin. Catheter-related bacteremia was identified in seven patients (six in group I and one in group II). In these patients, the ratio of bacterial colony counts (central/peripheral) was greater than 10:1 in only two cases.

Bacteremia↗
PubMedDate not supplied

[Syndrome of acute colonic pseudo-obstruction (Ogilvie's syndrome). Study of 13 cases].

Acute pseudo-obstruction of the colon involves acute colic distension without mechanical obstruction or stercoroma in a previously healthy colon. Our study is of 13 patients, all of whom presented a pre-existing extradigestive disorder, for which 12 were taking medication. Nine patients were treated by mechanical ventilation, and five of these had previously presented meteorism. Colic dilatation was maximal in the cecum, the diameter of which measured 9 to 14.5 cm. Two patients were treated by decompression colonoscopy, which completely cured meteorism in one case. Two patients treated by digestive aspiration died due to extra-abdominal causes. Operations were carried out on 6 patients: once for peritonitis due to cecal perforation five times for deterioration of meteorism. Five patients died due to postoperative complications. These observations show that the diameter of the cecum should be monitored daily. When it exceeds 9 cm, decompression colonoscopy must be performed. Surgery should only be envisaged when there are setbacks, due to the seriousness of the operation and the possibility of postoperative complications.

Adult↗