Biomedical subjects
C Grange
Publications and source records attributed to C Grange.
[Vascular Ehlers-Danlos syndrome. Diagnosis 17 years after first digestive manifestations].
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[Constrictive bronchiolitis obliterans. Apropos of a case].
INTRODUCTION: Constrictive bronchiolitis obliterans is defined histologically as obliteration of the lumina of bronchioles by inflammatory tissue elements and progressive destruction of bronchioles, eventually replaced by fibrotic tissue. Most of the cases, which are not associated with either solid organ or bone marrow transplantation, occur in the development of rheumatoid arthritis. EXEGESIS: We present the case of a 73-year-old woman who developed severe constrictive bronchiolitis obliterans without readily identifiable cause, rapidly fatal despite corticosteroid therapy. The patient had antinuclear antibodies (titer 1/1024) and antiphospholipid antibodies, but there was no anti-DNA, anti-ENA or anti-beta 2GPI antibodies. Tests for rheumatoid factor were negative. Cryoglobulinemia was present (monoclonal IgM Kappa). CONCLUSION: In this case, constrictive bronchiolitis obliterans was associated with serologic abnormalities and cryoglobulinemia. However, were was no clinical evidence of connective tissue disease.
Anaesthesia for caesarean section in severe pulmonary hypertension.
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Medical implications of employee assistance programmes.
The development of employee assistance programmes (EAPs) has significant implications for doctors, especially general practitioners and psychiatrists. This paper discusses the importance of training counsellors to detect serious psychological disorders among people who use an EAP service and the need for clinicians to accept referrals of those users who are identified as being in need of further medical treatment.
[Association of Biermer's anemia and gastric carcinoid tumors].
BACKGROUND: The occurrence of gastric carcinoid tumors during the cure of pernicious anemia has been reported in the literature. Concerning a new case, we review physiopathological data of this infrequent association. CASE REPORT: We report the case of a 47-year-old women with pernicious anemia in which gastroscopy found two small tumors developed from enterochromaffin-like cells. CONCLUSION: These tumors are usually latent and developed from enterochromaffin-like cells. The pathologic and histologic diagnosis is based on positive chromogranin A immunomarking. The physiopathological mechanism studies are in favour of the predominant part of hypergastrinemia following achlorhydria. Usually, evolution is benign and surgical or endoscopic resection recommended.
[Dementia syndrome of recent appearance...].
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A comparison of midazolam with trimeprazine as an oral premedicant for children.
The effect of oral premedication was investigated in a double-blind, randomised trial in 85 children undergoing tonsillectomy and/or adenoidectomy. Orally administered midazolam 0.5 mg.kg-1 given 30 min pre-operatively was compared with trimeprazine 2 mg.kg-1 given 90 min pre-operatively and a placebo preparation. Compliance, sedation and ease of induction were assessed as were the duration and quality of recovery. Following premedication with midazolam none of the patients was anxious, crying or distressed on leaving the ward, compared with 2/28 in the trimeprazine group and 5/28 in the placebo group (p = 0.0007). More patients were calm and quiet on arrival in the anaesthetic room following midazolam than following trimeprazine, with both premedicant agents comparing favourably with placebo. There was no significant difference between the three groups in the time to recovery or the sedation score on discharge to the ward. Midazolam is a safe and effective oral premedicant for children.
Radicular irritation with 2% lignocaine spinal.
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[Porphyria cutanea tarda and hepatitis B and C virus infection].
Porphyria cutanea tarda is a metabolic disorder caused by reduced hepatic uroporphyrinogen decarboxylase activity characterized by skin lesions and liver damage. The high frequency of liver histological damage in patients with porphyria cutanea tarda led us to study hepatitis B and C viral infection which has a striking prevalence in southern Europe. We attempt here to expose different pathophysiological hypotheses: is viral hepatitis a triggering factor precipiting latent decreased uroporphyrinogen decarboxylase activity or does it directly induce the enzyme deficiency?
Hepatitis C and anaesthetic breathing systems.
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Maximum doses of local anaesthetics.
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Blood lactate levels of decathletes during competition.
There are many detailed physiological profiles of athletes who participate in a wide variety of sporting activities but few data have been obtained on decathletes. This study defines some physiological characteristics of these athletes and measures capillary lactate concentrations [La(b)] during a laboratory test of progressive maximal exhaustion and the different events during competition. The treadmill test is similar to the 100 m, 400 m and 1500 m in terms of [La(b)] accumulation but only similar to the 1500 m in terms of velocity. The 400 m is the most demanding event with the greatest blood lactate accumulation (mean(s.d.) 16.38(2.36) mmol l-1). The [La(b)] at the end of the 110 m hurdles is significantly lower than in any other racing events (mean(s.d.) 6.96(1.32) mmol l-1) compared with mean(s.d.) 12.14(2.87) and mean(s.d.) 11.44(2.16) for the 100 m and 1500 m respectively. The [La(b)] after the long jump, the high jump and the pole vault are not significantly different (mean(s.d.) 5.30(2.23), 4.64(1.39) and 5.36(1.34) mmol l-1) respectively).
Training in paediatric life support.
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[Orthostatic hypotension revealing HIV infection].
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[Internal medicine DES 10 years after creation. Results of the survey realized by the Association of young internists].
The internal medicine young practitioners association (AJI) did set, during 93 spring, a survey among the registered internal medicine interns since 1984, regarding their training and future. 88 did answer, showing a certain homegeneous training but a deep care in their future. Most would wish a dual activity in general hospitals : internal medicine and an other speciality acquired during their training.
Allergy testing after uneventful anaesthesia.
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