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Biomedical subjects

C Aaron

Publications and source records attributed to C Aaron.

At least 19 recordsLinked to original sources

Fomepizole for the treatment of methanol poisoning.

BACKGROUND: Methanol poisoning may result in metabolic acidosis, blindness, and death. The inhibition of alcohol dehydrogenase is fundamental to the treatment of methanol poisoning. We performed a multicenter study to evaluate fomepizole, an inhibitor of alcohol dehydrogenase, in the treatment of patients with methanol poisoning. METHODS: We administered intravenous fomepizole to 11 consecutive patients who presented with methanol poisoning at a participating center. Serial clinical and laboratory studies, including measurements of plasma formic acid and fomepizole, were performed. The outcomes measured were the preservation of visual acuity, the resolution of metabolic acidosis, the inhibition of formic acid production, the achievment of therapeutic plasma concentrations of fomepizole with the dosing regimen, residual illness or disability, and death. RESULTS: Plasma formic acid concentrations were detectable in eight patients, and these concentrations were closely correlated with the initial arterial pH values (r=0.92, P<0.001). In response to fomepizole, plasma formic acid concentrations fell and metabolic abnormalities resolved in all patients. Nine patients survived. Seven patients initially had visual abnormalities, but at the end of the trial no surviving patient had any detectable visual deficits related to methanol poisoning. Fomepizole had few adverse effects. The two patients who died had anoxic brain injury that was present at the time of enrollment. During treatment, methanol had an elimination half-life of 54 hours. CONCLUSIONS: Fomepizole appears to be safe and effective in the treatment of methanol poisoning.

Acidosis↗

A morphometric study of the lumbar foramen. Influence of flexion-extension movements and of isolated disc collapse.

The authors undertook a morphometric study of the intervertebral foramina in anatomic specimens of spines unaffected by degenerative lesions. They studied the variations in shape and size of 38 intervertebral foramina during flexion-extension movements and following an isolated disc collapse. The cast technique takes into account the bony prominences, the bulge of the disc anteriorly and of the capsulo-ligamentous structures posteriorly. In flexion, all the diameters of the foramina are maximal. In full extension all the diameters decrease significantly: the pedicles come closer together, the disc bulges posteriorly and the ligamentum flavum is pushed forward by the superior articular process of the underlying vertebra. A disc collapse of 4 mm decreases all the diameters, and in this case lumbar extension results in a sufficient decrease of foraminal diameter to threaten the nerve root.

Female↗

Biometry of infrarenal inferior vena cava measured by cavography. Clinical applications.

Placement of a transvenous vena cava filter has became a common way to control recurrent pulmonary embolism. However few studies have been reported on the diameter of the infrarenal inferior vena cava (IIVC) where the device is usually placed. This study based upon 100 cavographies has showed the calculated average diameter of IIVC was 20.9 mm (range 12-27 mm) in its middle part and 21.3 mm (range 10-31 mm) in its terminal end. The calculated average IIVC length was 96 mm (range 80.3-142 mm). There was no statistical correlation between caval size and age, sex, height, weight and corporeal area. There was a statistical difference of left renal vein location between patients presenting with lumbar arthrosis and those without. We discuss different methods to measure IIVC in particular tomodensitometry. CT scans reviewed in our department show that the largest diameter of IIVC is not in a frontal plane and that the width seen on cavography is the projection of the largest diameter on the film. Therefore, the range of the real caval diameters is greater than indicated above.

Adolescent↗

[Morphological variations of the lumbar foramina during flexion-extension and disk collapse].

The authors have studied, on anatomical preparations, the variations in shape and size of 38 intervertebral foramina during flexion-extension movements, on spines which were free of degenerative lesions; they also studied the same variations following an isolated disc collapse. The cast technique takes into account the bony prominences, the bulge of the disc anteriorly, and the capsulo-ligamentous structures posteriorly. In flexion, all the diameters of the foramina are maximum. In extreme extension, all diameters decrease significantly; the pedicles come closer together, the disc bulges posteriorly and the ligamentum flavum pushed by the superior articular process of the underlying vertebra, projects forward. When the height of the disc is preserved, the reduction in size of the foramen does not compress the nerve root. A moderate disc collapse of 4 mm decreases all the diameters and under those circumstances, lumbar extension results in a sufficient decrease of the diameter of the foramen to threaten the nerve root, even in the absence of posterior articular osteophytes.

Adult↗

Surgical approach to the superior mesenteric artery by the Kocher Maneuver: anatomy study and clinical applications.

The Kocher maneuver allows approaching the origin of the superior mesenteric artery. This affords adequate exposure for procedures such as embolectomy or mesenteric arterial reimplantation into the aorta. Because of its simplicity, this technique may be better than the classical interpancreaticoduodenal or splenopancreatic methods. The results of 11 cadaveric dissections and two surgical operations for mesenteric ischemia using this technique are reported.

Aged↗

Therapeutic doses of phenylpropanolamine increase supine systolic blood pressure.

The anorectic agent phenylpropanolamine (PPA) has a low therapeutic index and can cause severe hypertension at doses as low as 85 mg. To determine the effects of a therapeutic dose on blood pressure, PPA 37.5 mg (as a commercially available immediate release formulation) or placebo was administered orally to ten normotensive subjects using a randomized double-blinded crossover design. The mean increase in supine systolic blood pressure (BP) was greater after PPA (18.5 +/- 10.7 mmHg) than after placebo (5.1 +/- 5.4 mmHg, P = 0.005). Increases in systolic BP after PPA ranged from 8 to 43 mmHg. The BP increase due to PPA was postural, and there was no change in sitting or standing BP. Doses of PPA available in over-the-counter formulations can increase supine systolic BP. Recent use of products containing PPA should be considered when evaluating patients with hypertension.

Adolescent↗

[Not Available].

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Diagnosis↗

[The brain of Paul Broca (1824-1880). Correlation of pathological and computed tomography findings (author's transl)].

This historical study briefly recalls the circumstances of Broca's death, and reports some new data concerning his autopsy, and an analysis of macroscopic, microscopic, and computed tomography appearances of his brain following its discovery by Huard. The authenticity of the origin of the brain was established, and the hypothesis the Broca's death was due to rupture of a vascular malformation or a cerebrovascular accident was confirmed.

Brain↗